Moore-Razak, different views on the fourth dose

TORONTO – Despite the favorable Covid indicators in Ontario and the relaxation of the obligation to wear masks, we must not be taken by easy enthusiasm. 

The province’s Chief Medical Officer of Health Kieran Moore warns residents to prepare for a turnaround in the fall and the possibility of a new cycle of vaccine booster doses.

Ontario will purchase more than six million doses of flu vaccine, he said in an interview, and plans to offer additional doses against Covid-19. “So, another booster for the most Covid-at-risk members of our community and potentially for the general public as well,” he said.

The third dose is currently available for people 12 years of age and older, and the fourth dose is available for people aged 60 years and older or for adults in the First Nations, Inuit and Metis, as well as their adult family members. Immunocompromised people, such as transplant recipients, aged 60 and older and long-term care residents could receive a fifth dose.

Moore predicts that a new generation of vaccine will be available in the fall that targets both the original Covid strain and a newer one that is circulating, such as Omicron. “We are looking at methods for distribution through pharmacies and public health partners – said the health officer of the province – we could start as early as October. We will start from those with the highest risk, therefore by age or occupation, offering it to health workers or over sixty years old and then expand the administration according to availability and demand”.

But while Moore seems to have no doubts about the next steps in the fight against Covid, once again Dr. Fahad Razak, the new director of the Ontario Science Table, is not on the same wavelength. Last week he said he was unconvinced about Moore’s elimination of the mask requirement and now believes that “more evidence is needed on the benefits of fourth doses for the entire population.”

“The usefulness of the third dose is very clear – said Razak – the fourth dose is beneficial for high-risk groups … but for the general public, healthy 20- or 30-year-olds who have no risk factors, there is still no clear evidence to recommend the fourth dose to them. And in fact some jurisdictions are allowing it while others are not, and this reflects the lack of clear evidence at this time.”

Razak said that while the indicators are positive right now, Ontario is still in the sixth wave. “A combination of high vaccination rates and recent infections has given Ontario a strong ‘wall of immunity’ but in the fall immunity will be declining and other respiratory viruses will arrive that have been kept at bay for two years due to public health measures for Covid-19,” he said.

And, it cannot be excluded, the potential arrival of a new variant. “What we’ve seen in previous waves… it is essentially a new wave, a new variant develops and somehow it spreads in the population approximately every six months – said the director of the Scientific Technical Table – no one knows if this trend will continue, but if it will be so after a good summer we will go towards an autumn season with some risk”.

The hope is that the worst has passed but we must not believe that Covid has magically disappeared: the danger of a new surge in cases must be kept in mind. It is forbidden to lower your guard.