Ontario expanding eligibility for second booster to adults 60 and over, First Nations from Thursday

Ontario is expanding eligibility for fourth doses of the COVID-19 vaccine to individuals aged 60 and over as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 from Thursday, April 7. 

“As we continue to live with COVID-19, we are using every tool available to manage this virus and reduce its impact on our hospitals and health system, including by expanding the use of booster doses,” said Health Minister Christine Elliott. “Vaccines are our best defence against COVID-19 and its variants. I encourage everyone who’s eligible to get boosted as soon as you’re able.”

Eligible individuals will be able to book their fourth dose appointment through the COVID-19 vaccination portal or by calling the Provincial Vaccine Contact Centre at 1-833-943-3900, directly through public health units that use their own booking systems, through Indigenous-led vaccination clinics, participating pharmacies, and participating primary care settings.

Locations and timing for additional boosters may vary by public health unit based on local planning and considerations.

The Public Health Agency of Canada (PHAC) released initial guidance on the use of second COVID-19 booster doses from the National Advisory Committee on Immunization (NACI) this Monday. 

NACI has recommended that fourth doses be prioritized for adults 80 years of age and older living in the community and residents of long-term care or other congregate living settings for seniors because they are at higher risk of experiencing severe outcomes from COVID-19.

Jurisdictions may also consider offering a second COVID-19 booster dose to adults 70-79 years of age living in the community, the advisory body said.

“A second booster dose should be provided 6 months after the receipt of the previous booster dose,” advised NACI, “but the 6 month interval may need to be balanced with local and current epidemiology.” 

NACI’s recommendations on the use of second COVID-19 booster doses are based on evidence on the need for (e.g., decrease of vaccine effectiveness over time), and benefit of (safety and effectiveness) a second booster dose in the Canadian context. 

There is limited evidence on how long protection from a first booster dose persists, with studies suggesting some decrease over time.

In Ontario fourth doses of the COVID-19 vaccine were offered to vulnerable populations including residents of long-term care homes, retirement homes, First Nation elder care lodges and older adults in other congregate care settings that provide assisted-living and health services from December 2021. As of Monday, over 72 per cent of long-term care residents have received their fourth dose.

At this time, recommendations for second COVID-19 vaccine booster doses are offlabel, as fourth doses are not currently authorized for use by Health Canada. 

Preliminary data suggest the safety of a second booster dose of an mRNA COVID-19 vaccine is similar to the previous dose, according to NACI. Canadian and international safety data suggest a second booster dose is well tolerated with no additional safety signals.

As of April 5, 2022, Ontario has administered more than 32 million doses of the COVID-19 vaccine, with more than 92 per cent of Ontarians aged 12 and over having received at least one dose, more than 91 per cent having received a second dose and more than 55 per cent having received a booster.

NACI is currently reviewing existing recommendations concerning first COVID-19 vaccine booster doses for younger adults (under 50 years of age) and adolescents 12 to 17 years of age, and will release a statement with updated advice in the coming weeks.

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