'A dilemma': Muddled messaging from B.C. health officials compounds booster availability confusion

Days after the province caved to public and political pressure on the availability of fourth doses of the COVID-19 vaccine, British Columbians are increasingly confused and conflicted about what to do next.

On Friday, B.C. health officials grudgingly announced that adults who’d had their most recent dose at least six months ago can now get their fourth dose but strongly encouraged waiting until September.

The move followed in Quebec’s footsteps as stories kept accumulating of British Columbians driving to Washington state for booster doses in order to better protect themselves during a growing wave of Omicron-driven infections.

Adding to the mixed messaging, text alerts have started arriving from the province notifying recipients that booster doses will be available in the fall, ending with the statement: “If you’re 18+ and feel you have unique needs, you can get another booster sooner. This is okay, but not recommended,” which is echoed by the province’s immunization agency. 

Previously only available to those over the age of 70 or with serious health issues who’ve received invitations, Dr. Penny Ballem spent most of her time on Friday speaking as the head of the COVID-19 immunization program trying to convince people to wait for their shot, but also said simply, “If you're very worried, we'll enable that [now].”

This wave of Omicron is already seeing a steep rise in hospitalizations, but fewer deaths with so many people already vaccinated or with some immunity from previous infections helping avert the death rates of previous waves. 

TO WAIT OR NOT TO WAIT?

Waiting is easier said than done at a time a growing number of British Columbians are past the six-month mark from their booster and the BA.5 omicron variant is widely believed to be spreading so quickly because it’s developed in a way that evades immunity, which is already waning for many.

CTV News asked Dr. David Fisman, a physician, former provincial health officer and current professor of epidemiology at the Dalla Lana School of Public Health at the University of Toronto, without ties to B.C.’s healthcare system, for his advice on what he acknowledges is “a dilemma” for many Canadians.

“Do you think that BA.5 is enough of a risk to you now that you want to get that fourth dose now, or do you want to hang on till the fall?” he asked rhetorically.

“Many people, including myself, are looking to the fall and thinking, 'Oh jeez, the fall is when it's going to get real,' because we're anticipating an Australia-like scenario where we also have an early start to a flu season after not seeing flu for a while.”

Stories of patients getting sick with Omicron for a second or third time will undoubtedly influence someone’s decision on the matter, but Fisman points out wearing high-quality masks is something each of us can do, and choosing to socialize outdoors or with the windows open in the summer is much easier; conversely, the risk will be higher in the cold months when we’re indoors and relying more on vaccine-provided protection.

THE PROMISE OF A BETTER VACCINE

Ballem suggested that by waiting until fall, British Columbians have a greater chance of their next vaccine being bivalent, or specifically engineered to include protection from the original COVID-19 virus (which current vaccines are) as well as Omicron-derived variants which may be approved by fall.

"They look very promising," added Dr. Martin Lavoie, B.C.'s acting provincial health officer. "Those new vaccines, and the boosters, will be critical to helping us maintain our trajectory – a very positive trajectory so far in managing this pandemic." 

One thing all experts agree on, but hasn’t been well-articulated by public health agencies in Canada, is that two doses of vaccine is not enough to provide lasting protection against an increasing number of variants. B.C. has struggled to convince 1.3 million people who’ve had two shots to get a third.

“I don't actually regard fourth doses as a second booster, in my mind they're a first booster and it's pretty clear it's a three-dose vaccine series,” explained Fisman, who cautioned that holding out for bivalent vaccines doesn’t guarantee one in the fall.

“My expectation is there’s probably going to be limited supply and prioritization of people with more significant risk, be they more co-morbidity or age-related, so I think that if you're kind of a younger and otherwise healthy person, I doubt you’re going to be at the front of the queue to get that omicron-specific vaccine.”