Original Published 12:39 May 16, 2022

By Moira Wyton, Local Journalism Initiative Reporter

British Columbia health officials are still undecided on whether fourth vaccine doses will be made available to the general population as  immunity to COVID-19 wanes and the possibility of future, more  transmissible variants looms.

The BA2 Omicron subvariant has already fuelled a sixth wave amid B.C.’s relaxed public health measures, and limited data reporting and testing has made its progression difficult to track.

The BC Centre for Disease Control now only provides new statistics weekly,  and COVID-19 PCR testing is severely limited to those in high-risk  settings, with use of at-home rapid tests for the general population  encouraged instead.

In the last week, according to the  province’s most recent May 12 report on the pandemic, 59 more people  have died after testing positive for COVID-19. There are currently 596 people in hospital,  including 54 in ICU. 

And with lower rates of  third shot booster uptake occurring already, experts say a robust fourth  dose campaign will be key to weathering future variants without B.C.  having to reintroduce major protective measures — such as mandatory  masking and the vaccine card program — seen during the first waves of  the pandemic.

The National Advisory  Committee on Immunization recommends fourth shots, or second boosters,  for those over age 70, Indigenous people over 55, people living in  long-term care and assisted living, and those who are deemed clinically extremely vulnerable. All of these people are currently eligible for a fourth dose of the vaccine in B.C.

“There is really good protection from three  doses for most people, up to age 80 but especially up to age 70,” said  B.C. provincial health officer Dr. Bonnie Henry at a COVID-19 update on  May 10. “That’s where we’re targeting this fourth dose.”

Other provinces are moving more quickly  towards a fourth dose, as immunity from booster shots and previous  infection wanes within three to four months. In Quebec, all adults are  now eligible for a fourth shot, and Ontario has lowered the age  requirement to 60 years.

NACI has not yet recommended fourth shots for the general population under age 60.

Henry said Tuesday she was still reviewing  the evidence, but that it was possible adults would be offered a fourth  shot by the fall.

“We do not yet know if all of us will need  another dose of vaccine come the fall or if protection from the three  doses will carry most of us through,” Henry said.

“We need to find that balance of whether you need it and how long the protection will last.”

But whether British Columbians will be  willing to roll up their sleeves a fourth time to significantly bump  community immunity remains to be seen.

Just 61 per cent of eligible residents over  18 have received a first booster shot, compared to more than 88 per  cent of eligible people who got two shots.

And so far, just over 78,000 people have received a fourth shot in B.C., less than 10 per cent of those eligible.

Research has shown that three doses of  vaccine are essential to protection against the Omicron variant and its  subvariants, and getting that first booster shot provides significantly  more protection against hospitalization and serious illness than two  initial doses of vaccine.

According to Dr. Brian Conway, medical  director at the Vancouver Infectious Diseases Centre, low booster uptake  might partly be a result of pandemic fatigue, but it’s also an issue of  communication and credibility.

“We’ve not done a good enough job to make people understand that with Omicron, you need three shots,” said Conway.

At first, it wasn’t known that immunity  from the COVID-19 vaccines would wane over a matter of months. But as  the evidence and understanding changed to support getting at least one  booster, some people may have felt misled by initial assertions it was a  two-dose vaccine.

“We didn’t know the truth at the time,”  Conway said. “And we’ve not done a good enough job of explaining  variants [and] explaining waning efficacy.”

Conway added that while relaxed protective  measures might signal lower risk, vaccination is the foundation of  reducing one’s own risk to themselves and others.

B.C. Health Minister Adrian Dix said public  health is working to increase booster uptake, as well as vaccinations  among school-aged youth, which have stalled at around 55 per cent.  Children are still at risk of suffering severe outcomes and developing  long COVID as a result of infection.

Conway said increasing the rate of third  doses should be the priority while the evidence around fourth doses is  reviewed. Focusing too much on whether or not everyone may need one  could also be harming vaccine uptake, he added.

“I think we’re slow-walking to everyone getting a fourth dose,” said Conway. 

“And if we wind up… with everyone east of  the Alberta-B.C. border getting fourth shots, then we can have the talk  with a little more urgency.”

This item reprinted with permission from The Tyee, Vancouver, British Columbia