COVID recall confusion: should you get one now or wait for a new formula? – National

With the latest variants of COVID-19 arriving in the country and flu season looming on the horizon, many Canadians may be wondering whether they should receive their booster immediately or wait for the latest formulations to arrive. vaccines.

The updated booster shots are expected to roll out in the fall, but are still pending Health Canada approval. The new vaccines are also suitable for the dominant XBB.1.5 Omicron subvariants currently circulating in the country.

Although bivalent COVID-19 vaccines are currently available in Canada, the National Advisory Committee on Immunization (NACI) had already stated in July that the fall boosters would target newer SARS-CoV-2 variants and immuno-evasive.

Some health experts say it might be best to wait for updated vaccines to become available, while others advise not to wait. This leaves Canadians with a crucial decision: receive their recall immediately or wait.

“It’s well and truly confusing,” said Kerry Bowman, professor of bioethics and global health at the University of Toronto. “I think we face an incredible lack of clarity as to what should happen. I wish we had stricter guidelines from public health. I have the impression that we are alone on this one.

Adding to the confusion, he said, is the fact that some people have said they will receive both shots, one now and the redacted version when it becomes available. However, this approach is discouraged, Bowman said, emphasizing that waiting at least six months between vaccine injections is advisable.

Here’s what health officials are saying about the fall recall.

In its latest July 11 guidelines, “NACI recommends one dose of the new formulation of COVID-19 vaccine to persons in the approved age groups who have previously received a COVID-19 vaccine, if at least 6 months have pa*sed since the last vaccine. COVID-19 vaccine dose or known SARS-CoV-2 infection (whichever is later).

He noted that the new formulations expected this fall should provide a better immune response to the dominant subvariants. He did not say whether Canadians should receive the current wording of the reminder if the updated version is not available by the fall.

“Booster doses in the fall will be updated formulations to target newer, immune-evasive variants of SARS-CoV-2,” NACI said in its updated vaccine recommendations.

“Individuals vaccinated with the updated formulation should experience an improved immune response against these variants compared to current vaccines. »

It was emphasized that it is particularly important for people at increased risk of infection or serious illness from COVID-19, including people 65 years of age and older, residents of long-term care facilities, pregnant people and those with underlying illnesses, get vaccinated.

In an email Monday to PKBNEWS, a spokesperson for Health Canada said it encourages “all Canadians to ensure their COVID-19 vaccinations are up to date.”

“Vaccination is one of the most effective ways to protect against COVID-19. All COVID-19 vaccines approved and used in Canada continue to be highly effective in protecting against serious illness, hospitalizations and death from COVID-19.

The health agency did not specify in its response whether Canadians should wait for the updated formulations to become available.

The Department of Health website follows NACI guidelines, stating that COVID-19 booster doses may be offered at an interval of six months after a previous dose of COVID-19 vaccine (after the end of of the primary series or a previous booster dose) or after SARS. CoV-2 infection, regardless of the product offered.

Bivalent vaccines are the preferred vaccine for booster doses in people in licensed age groups, Health Canada said on its website. In addition to containing mRNA that codes for the spike protein of the original strain, they contain mRNA that codes for the spike protein of the Omicron variant strains of concern.

Updated NACI guidelines have not been added to Health Canada’s website.

The World Health Organization said Thursday it recommends receiving a booster or extra dose within six to 12 months, depending on your risk category.

Those most at risk should receive their booster immediately if they need it, said Dr Maria Van Kerkhove, WHO technical lead for COVID-19 response, during a question and answer session. WHO on social media.

For those who are most at risk, it is “very essential to receive a reminder and not to wait”, she stressed. “The big message I have for you is don’t wait for the next round of vaccines.”

Earlier, on March 28, the WHO said it no longer “routinely recommends” additional boosters of the COVID-19 vaccine for people at medium or low risk.

WHO has recommended additional booster doses for high priority groups such as the elderly, immunocompromised people of all ages, frontline health workers and pregnant people. But for those in the low and medium risk group, the WHO did not recommend additional COVID-19 boosters, citing “weak public health feedback”.

A strong majority of Canadians have hybrid immunity to the virus through natural infection and vaccines.

For that reason, Bowman said some of the confusion surrounding the COVID-19 fall recall is “understandable.”

“This is a very different pandemic profile than we’ve faced in the past, and whether you get a reminder now or later could depend on the risks you face,” he said. explain. “So the short answer is: if you have risk factors, go ahead and get it now. »

But there are a lot of gray areas.

For example, he said if a healthy 25-year-old lives with someone who has advanced cancer and is undergoing chemotherapy, that creates uncertainty.

“We are seeing an incredible lack of clarity as to what should happen,” he said, adding that due to the circulation of new variants, the level of risk and appropriate precautions have become even more difficult to determine. determine.

With so much uncertainty, Bowman argued that now was not the time for public health to be silent, but rather a time for more advice.

“I think most of us understand that there’s no one-size-fits-all solution anymore, but we still need a lot more help than what we’re getting,” he said.

Dawn Bowdish, an immunologist at McMaster University in Hamilton, told The Canadian Press that the virus mutation puts vulnerable populations, including the elderly, at the highest risk of infection.

However, only about 21 percent of Canadians aged 80 and older have received boosters or completed a primary vaccination in the past six months, she said.

Anyone starting chemotherapy or having major surgery can consider getting a booster before the reformulated vaccines become available, but otherwise it’s best to wait, Bowden pointed out.

Dr Gerald Evans, an infectious disease specialist at Queen’s University in Kingston, Ont., said it would be ideal if XBB vaccines were available now before the start of flu season.

“It would be great to have it as soon as possible,” he said. “Once Health Canada says ‘yes, we approve’, it’s the manufacturer who creates some delay. I hope this delay will be extremely short-lived as many people are now due to receive boosters, including young and healthy people, for whom we say to receive them once a year.

He added that if “we manage to get them out and into people’s arms in September,” that could potentially help curb the current surge in COVID-19 cases.

Health Canada is currently reviewing three new vaccines containing the XBB.1.5 Omicron subvariant, for people six months and older. It reviews submissions from Pfizer-BioNtech, Moderna and Novavax.

While no specific rollout date has been set, the Pfizer and Moderna vaccines are expected to likely be approved in the fall, followed by the Novavax vaccine at a later date, Health Canada said in an email Monday.

“The authorization and availability of new vaccines will depend on many factors, including the date of submission, timelines for review, acceptability of information submitted and supply of the vaccine from the manufacturer. If authorized, Canada will have a sufficient supply of the new formulation of mRNA vaccines available in the fall of 2023,” the spokesperson said.

Canada will also have access to an mRNA-free vaccine (Novavax) for those unwilling or unable to receive an mRNA injection, Health Canada said.

“We expect it to be available later this year, pending Health Canada submission and clearance.”

Public Services and Procurement Canada told PKBNEWS in an email Monday that it has reached agreements to purchase the latest COVID-19 vaccines, ensuring Canada has the right amount of doses it needs for 2023. to 2024.

“This includes agreements with Pfizer, Moderna and Novavax, currently authorizing up to 33 million doses to be manufactured from their respective offshore facilities and delivered in fall/winter 2023, pending regulatory approvals from Health Canada.” , said the spokesperson.

As in Canada, the rollout of the COVID-19 booster shots in the United States is expected in the fall, according to the United States Food and Drug Administration (FDA).

The updated recall is expected to be cleared by the FDA before a Centers for Disease Control and Prevention (CDC) Vaccine Advisory Committee, which is due to meet Sept. 12 to vote on whether to recommend the updated vaccines, reported NBC News.

In England, health officials said on Wednesday that vaccines would be available from September 11 (rather than the original October release date) as a precautionary measure to protect the most vulnerable as the months of death approach. ‘winter.

— with files from The Canadian Press