Canada should listen to the World Health Organization (WHO) and not offer COVID-19 vaccine booster shots to its population right now, some experts say.
The recommendations come after the WHO made a plea for countries to halt progress on boosters as the Delta variant continues its dominance worldwide; many countries are still trying to ramp up their own vaccination campaigns.
“Since this pandemic has begun, the lack of global coordination, leadership and direction has been appalling,” said Kerry Bowman, a bioethicist at the University of Toronto.
“No one has their eye on the big picture. We’re increasingly tucked away, trying to figure out what’s best for us and losing the plot,” he said, adding, “the plot being the way to deal with this incredible pandemic is to deal with it globally. And again, focusing on boosters is moving us away from that goal.”
On Wednesday, WHO Director-General Tedros Adhanom Ghebreyesus said he wants a moratorium on boosters until at least the end of September so that every country can vaccinate at least 10 per cent of their population.
“I understand the concern of all governments to protect their people from the Delta variant. But we cannot accept countries that have already used most of the global supply of vaccines using even more of it,” he said.
Canada, facing the start of a fourth wave driven by the Delta variant, has procured enough vaccines to inoculate every eligible Canadian. The country has one of the world’s best vaccination rates, which currently sits at 68 per cent fully vaccinated and 81 per cent partially vaccinated.
Yet the world’s rate for fully vaccinated people is 15.08 per cent, Johns Hopkins University reports.
“Canada has so many more vaccines at this point than we need, and the global situation ethically and epidemiologically needs immediate attention,” Bowman said.
Dr. Theresa Tam, chief public health officer of Canada, told reporters on Thursday that Canada still needs more data on boosters before making a decision. She said experts are monitoring high-risk populations, like the immunocompromised and elderly, for a potential boost.
Tam believes though that if, or when, the time does come for Canada to offer a third shot, the country could still continue to share doses with the world.
The government announced Wednesday that it will send 82,000 doses of the Oxford AstraZeneca vaccine to Trinidad and Tobago. It also announced last month that it’s donating 17.7 million AstraZeneca shots to the global COVAX vaccine sharing program.
“Without the rest of the world being vaccinated, it’s very difficult for us to get out of the pandemic. Also, it would have impacts, potentially, on our precautionary but phased border reopening,” she said.
“Canada’s has, in its range of acting options, a lot of capacity. So I think we can definitely do both.”
Dr. Barry Pakes, a professor with the Dalla Lana School of Public Health at the University of Toronto, believes Canada should have conversations around boosters — but not implement a program right away.
“From an ethical perspective, we shouldn’t be doing that, (and) we should be sharing vaccine with the rest of the world right now if possible. … But we should be thinking about it,” he said.
“I think it’s reasonable to think about it in the future, meaning we should be giving vaccines to countries that need it now with some kind of reciprocal agreement to potentially get those back if we in fact need them.”
In light of the WHO’s request, Germany and France said they will go ahead with boosters for vulnerable populations in September. The United States indicated on Wednesday that it would offer booster shots if needed, but provided no firm plan or timeline.
The first country to administer vaccine top-ups is Israel, which is boosting fully vaccinated people over the age of 60 with Pfizer-BioNTech. Israel decided to offer the booster due to Delta’s spread in the country.
Pakes feels that Israel, because it’s a smaller country, has an ethical obligation to boost its over-60 population and share the data with the world to “better inform, not only the decision-making of other countries, but the ethical framing altogether of the global pandemic response in respect to vaccines.”
Israel has “a much better health system and data system than we do, so the things learned there are just critically important for global health decision making around the pandemic,” he said.
Neither the European Union nor the United States has approved boosters, but pharmaceutical companies are studying them.
Moderna said on Thursday it believes booster shots will be needed by the winter and claims its three vaccine candidates “induced robust antibody responses” against variants like Gamma, Beta and Delta.
Last week, Pfizer released a trial update that claimed its third dose generated virus-neutralizing antibodies against the Delta variant more than five times higher in younger people and more than 11 times higher in older people than from two doses.
COVID-19 vaccines still provide strong protection against the variant, but countries like the United States have had to reintroduce policies for further protection against Delta. The CDC recently cited Delta’s surge for its updated advice that fully vaccinated people return to wearing masks indoors in areas with high transmission.
While U.S. officials say most of the cases are among the unvaccinated, recent studies show the virus has infected those who are fully vaccinated — described as breakthrough cases. A recent CDC report suggested Delta could be as contagious as chickenpox.
For Bowman, Canada needs to think about the decisions it makes.
“Look, this story is not over yet and we need to live with this moral legacy as well of the decisions we make and the decisions we make as a nation will define who we are,” he said.
“This is a very critical point we’re at — I think it’s important we get this right ethically as well as scientifically.”
— with files from Global News’ Jamie Mauracher
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