Should you get another COVID booster? Guidelines are changing

Click to play video: 'Update on COVID-19 boosters'
Update on COVID-19 boosters
WATCH: Update on COVID-19 booster shots – Mar 29, 2023

The World Health Organization (WHO) on Tuesday said it no longer “routinely recommends” additional COVID-19 vaccine boosters for medium or low-risk people, but one Canadian doctor is warning the “advice isn’t probably the best.”

The updated roadmap from WHO outlines three priority-use groups for COVID-19 vaccination: high, medium and low, and is designed to prioritize vaccines for those at greater risk of the disease.

The WHO recommended additional booster doses for high-priority groups such as older people, immunocompromised people of all ages, front-line health workers and pregnant people. But for those who fall under the low and medium-risk group, WHO did not recommend additional COVID-19 boosters, citing “low public health returns.”

The WHO’s updated guidance comes just weeks after Canada’s National Advisory Committee on Immunization (NACI) last updated its guidelines on boosters.

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“Society is caught between wanting this whole thing to be over and still reconciling that it’s still a threatening problem out there,” Dr. Kashif Pirzada, a Toronto emergency room doctor, told Global News.

“We see plenty of people with just two vaccines who get a fairly brutal illness…the most severe your illness, the more chances you’ll have long-term lingering symptoms. So I think they didn’t really factor that in is that it’s still out there,” he said.

Despite the persistent presence of the highly contagious Omicron variant in Canada, COVID-19 is not expected to surge in the coming months as hospitalizations and deaths remain stable, federal health officials said earlier this month.

Click to play video: 'COVID-19 apathy: vaccination rates slowing three years into pandemic'
COVID-19 apathy: vaccination rates slowing three years into pandemic

On March 10, Canada’s chief public health officer, Dr. Theresa Tam, said that COVID-19 activity has reached a “relatively steady state,” in the country and “we may not see any major waves in the coming months as we prepare for a potential fall and winter surge.”

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Because the country is seeing a decrease in deaths relating to COVID-19 infection, Dr. Susy Hota, medical director of infection prevention and control at the University Health Network, said she agrees with WHO’s recommendations.

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“I think from a global perspective it makes a lot of sense and probably also makes sense from a Canadian perspective,” she said.

“We know that especially in Canada, younger people have a higher level of hybrid immunity. So having had vaccine doses, but then also prior infections…may offer better protection overall,” she said.

Canada — and the rest of the world — seems to be shifting into a new way of dealing with the disease, she added, which is transitioning into something “more sustainable” for the long term, such as focusing on high-risk individuals.

In terms of where Canada stands on vaccine boosters, Pirzada said there has been little messaging out there, other than a spring shot for high-risk individuals.

Canada's current COVID vaccine recommendations

NACI’s latest guidance on COVID-19 vaccines on March 3 recommended that people facing a high risk of serious illness should get another COVID-19 booster in the spring.

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The committee advises all Canadians five years old and up should get immunized against COVID-19 with a full primary series of vaccines. For most people, a primary series is two doses of a COVID-19 vaccine, at a recommended interval of eight weeks apart.

NACI states that “children 6 months to under 5 years of age may be immunized with a primary series of an authorized mRNA vaccine.”

NACI further recommends a booster dose six months after the last dose of a primary course for everyone aged five years old and up.

'Make a case' to get booster

Because the most recent NACI guideline is only for high-risk individuals, Pirzada worries, like the WHO, NACI is not taking into account long-term COVID-19 symptoms, which can happen in healthy young people too.

“And the farther out you are from your boosters or from your vaccines, the more chances of having a much more severe course of illness,” he said.

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His advice for Canadians is to get a booster if you are six to 12 months out of your vaccine, especially if you’re going to travel or be around large crowds.

If you don’t fall under the high-risk category and want to get boosted, Pirzada said “to make a case” to a physician or pharmacist saying, you’re worried about COVID-19 infection and want a booster.

“Boosters will protect you for three months from infection. That’s pretty good…protection for three months. If you are at high-risk settings in that time where you want to really have fun, that’s not a bad idea,” he added.

Hota believes that low-risk individuals, mainly those who feel nervous about travelling without a booster, should modify their behaviour “if they are concerned.”

The goal of vaccines, she said, is to reduce the risk of severe illness, and if an individual has a very low risk of getting severely sick from COVID-19 (because of hybrid immunity), “it’s probably not going to be offering you that much more protection.”

Click to play video: 'Health Matters: Bivalent vaccines and pregnancy'
Health Matters: Bivalent vaccines and pregnancy

She stressed that vaccines will have the greatest impact on those at the highest risk.

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According to Health Canada, a booster dose of a BA.4/5 bivalent mRNA COVID-19 vaccine “provides increased protection against both symptomatic disease and hospitalization, compared to those who did not receive a bivalent booster dose but received at least two previous doses of original monovalent vaccines in the past.”

— with files from Reuters

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