Approximately half of all individuals in Ontario who are being offered a Moderna Spikevax COVID-19 vaccine are now refusing it.
That’s according to Justin Bates, the CEO of the Ontario Pharmacists Association.
Bates said this data is not collected in a “central fashion,” adding that it is “anecdotal.”
“It’s based on my conversations with many of our member pharmacists who have experienced people either walking out when they find out it’s Moderna, or cancelling appointments or just not showing up,” he said.
Bates said it is also “taking a lot longer” to convince people who were expecting a Pfizer-BioNTech vaccine that “Moderna is a very wise choice.”
Asked why so many people are refusing the Moderna shot, Bates said two things are happening “simultaneously.”
“One is what we’ll call consumer perception, brand awareness,” he explained. “There’s just generally more awareness of the company of Pfizer — and I think that leads a lot of people to even unconsciously want to select it.”
Bates said others still feel “uncertain” whether mixing vaccines is safe.
“What we saw early on in the pandemic — back in March 2021 — we had more supply of Pfizer,” he said, noting supply interruptions for Moderna.
The majority of people received a first or second dose of Pfizer, Bates said.
“So if there’s any hesitancy around mixing, people would then prefer to have the third dose the same,” he said.
“But we know that the efficacy of Moderna is much greater, or at least a little bit greater against the Omicron and Delta variants, and it is safe and effective.”
Bates said both Pfizer and Moderna are “extremely good vaccines — the same.”
“It should be one mRNA equals the other,” he said. “And at the end of the day, that’s the messaging we need from public health.”
On Dec. 20, 2021, the provincial government opened booster availability to anyone over the age of 18 in Ontario who received their last dose more than three months prior.
However, due to supply constraints, across the province doses of the Pfizer-BioNTech vaccines are being prioritized for younger segments of the population, since only the Pfizer vaccine has been approved for use in those aged five-11, and it is the recommended mRNA for use in individuals under 29.
Issues with vaccine shopping
Bates said the problem with “vaccine shopping” is that individuals who are opting to wait for a Pfizer vaccine are less protected against COVID-19.
“Their immunity wanes after about six months of the second dose, and they aren’t as protected,” he said. “So the chance, or the probability, increases significantly of contracting COVID.”
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Bates said booster COVID-19 doses help to prevent infection and help to prevent severe illness or symptoms.
Ultimately, Bates said the “best approach is to get the vaccine that’s available so that you maximize your protection and those around you as well.”
What has the provincial government said?
Both the Moderna and Pfizer COVID-19 mRNA vaccines have been cleared for use by the federal and provincial governments.
The shots have been green-lit for use both as primary vaccines and boosters. The mRNA vaccines can be mixed safely, health officials say.
In an email to Global News on Friday, the Ontario Ministry of Health said both the Moderna and Pfizer vaccines “provide strong protection against COVID-19 and variants, and mixing vaccines is safe and effective.”
Speaking at a press conference on Thursday, Ontario’s Chief Medical Officer of Health Dr. Kieran Moore urged all Ontarians eligible for a booster to “get one as soon as possible.”
“Especially pregnant people,” he said. “Recent data shows that countries with higher levels of booster doses have better results against the Omicron variant.”
Moore said the latest data suggests the “protection offered by Moderna is stronger.”
“I myself received Moderna as a booster shot,” he said. “Your immunity is strong and prolonged. Even for people previously infected by COVID, the vaccine offers extra protection that can be administered as soon as the isolation period is over, when all your symptoms are gone.”
What’s more, in a tweet Friday, Christine Elliott, Ontario’s Deputy Premier and Minister of Health, said the “best vaccine for your booster dose is the vaccine that is available first.”
“Both the Moderna and Pfizer vaccines provide strong protection against #COVID19 and the Omicron variant,” she wrote.
The Ministry of Health says the province “currently has ample supply of vaccines as the province continues to ramp up capacity to accelerate its booster rollout to all Ontarians 18 years of age and older.”
The ministry said it is working with its “health system partners” to ensure there is “sufficient supply” of the Pfizer vaccine for those aged 12 to 29.
“We have requested an additional four million Pfizer doses from the federal government in January, of which approximately 2.7 million have been confirmed,” the email reads. “We continue to wait on the confirmation of the timing of deliveries.”
For now, the ministry said the federal government has provided a “sufficient supply of Moderna,” which will be supplied to “all distribution channels.”
According to the email, the province has “received assurances” from the federal government that there will be enough vaccines for all Ontarians.
In September, Ontario’s Chief Medical Officer of Health recommended the Pfizer-BioNTech COVID-19 vaccine be used for individuals aged 18 to 24 years old. The Pfizer vaccine is also being used for children 12 to 17.
On Dec. 16, 2021, the province released updated guidance for booster shots, which advised the Pfizer-BioNTech vaccines should be used for individuals 18 to 29 years old.
The ministry said there were lower reported rates of myocarditis — heart inflammation — following vaccination with a 30 microgram dose of the Pfizer-BioNTech vaccine, compared to a 100 microgram Moderna shot, based on second-dose data.
Those in that age group can still receive a Moderna vaccine, but they must provide informed consent.
Asked whether people between 18 and 29 should wait for a Pfizer booster vaccine, Bates said he would recommend people “do get Moderna.”
Bates said the risk of myocarditis after receiving the Moderna vaccine is “very, very low.”
“I think given the risk profile, everyone will have to do their own assessment, but it’s still better to get the vaccine whether that’s Moderna at 18-plus or not,” he said.
The latest data released by the provincial government on Friday said that 82 per cent of all eligible Ontarians are fully vaccinated. Six per cent are considered partially vaccinated, while 12 per cent remain unvaccinated.
As of Friday, 4,406,948 people in Ontario had received their third dose of a COVID-19 vaccine.
What has Toronto Public Health said?
In an email to Global News on Friday, Toronto Public Health (TPH) said the availability and distribution of COVID-19 vaccines in the city “depends on the vaccine supply of the Province of Ontario.”
TPH said that the City of Toronto COVID-19 vaccination clinics offer mRNA vaccines — either Pfizer or Moderna.
“The Moderna and Pfizer vaccines are incredibly similar with near identical efficacy rates,” the email reads. “Clinic clients can chose not to proceed with vaccination depending on what is available at the clinic when they arrive.”
TPH said the city “does not track data” on people who have declined vaccination appointments due to the type of vaccine brand available.
Overall, though, TPH said, “both vaccines have similar side effects and are safe, effective and interchangeable.”
The public health agency said it “follows provincial guidance on recommended COVID-19 vaccine administration, including by age group.”
A City of Toronto news release issued Monday said while clinics and health-care partners across Ontario wait for shipments of Pfizer COVID-19 vaccines later this month, as of Jan. 6, all City of Toronto-run clinics will administer the Moderna COVID-19 vaccine to residents aged 18 and up.
Similarly, in Durham, beginning on Dec. 29, those aged 30 and older would be given the Moderna Spikevax vaccine, so the Pfizer doses could be prioritized for younger sections of the population.
Moderna says booster effective against Omicron
Last month, Moderna Inc. said a booster dose of its COVID-19 vaccine appeared to be protective against the Omicron variant in a laboratory test.
The company said that its current version of the shot would continue to be Moderna’s “first line of defence against Omicron.”
Moderna’s Chief Medical Officer, Dr. Paul Burton, told Reuters the vaccine available now is “highly effective, and it’s extremely safe.”
Burton told the media outlet the vaccine would protect people “through these winter months, when we’re going to see the most severe pressure of Omicron.”
According to Moderna, a two-dose course of its vaccine generated low neutralizing antibodies against the Omicron variant, but a 50 microgram booster increased neutralizing antibodies by 37-fold.
What’s more, the company said a 100 microgram booster raised antibody levels to more than 80 times pre-boost levels.
— With files from Reuters
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