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Why doctors say COVID booster shots aren’t for everyone — yet

Long-term care residents and people with specific immunocompromising conditions eligible in Canada

Many seniors came out to mass vaccination clinics to get their COVID-19 shots earlier this year. Some are wondering why elderly people living in long-term care homes are now eligible for a booster shot, but other seniors aren't. (Evan Mitsui/CBC)

Many seniors came out to mass vaccination clinics to get their COVID-19 shots earlier this year. Some are wondering why elderly people living in long-term care homes are now eligible for a booster shot, but other seniors aren't. (Evan Mitsui/CBC)

Photo:  (Evan Mitsui/CBC)

RCI

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven't subscribed yet, you can do that by clicking here (new window).


Many Canadians are watching as countries like the U.S. and Israel authorize COVID-19 booster shots for more people and wondering why third doses aren't being widely recommended in Canada. 

Israel is moving most aggressively, recommending boosters to everyone (new window) 12 years of age and older. In the U.S., everyone 65 years old and above is eligible for a booster (new window), along with people with certain underlying medical conditions. 

Canada's National Advisory Committee on Immunization (NACI) has so far only recommended third doses for people living in long-term care (new window) and people who have one of a handful of specific conditions that makes them moderately to severely immunocompromised (new window).  

Several people have been contacting CBC News to ask why those with chronic conditions that make them more vulnerable to severe illness if they get COVID-19 — or seniors who don't live in long-term care — aren't on NACI's list. 

CBC News spoke to immunologists, infectious diseases specialists and a geriatrics expert to find out. 

All agreed that everyone will need a booster at some point — but for most people, that time isn't now.  

As of today, we're not seeing any risk that people who are vaccinated, outside of those special populations [identified by NACI] are having any waning immunity, said Dawn Bowdish, Canada Research Chair in aging and immunity and a professor at McMaster University in Hamilton. 

The reason people in long-term care and those who have suppressed immune systems need a third dose, Bowdish said, is that those folks never had a very good immune system to start with. 

Some experts think seniors living outside of long-term care homes should be next to get boosters — particularly if they are frail.

Many elderly people requiring home care probably would be a good candidate for a booster, said Dr. Samir Sinha, director of geriatrics at Mount Sinai and University Health Network hospitals in Toronto. 

With different care providers coming in and out, potentially increasing their risk of exposure to COVID-19, they're literally living in a long-term care home of one, Sinha said.

 But right now I don't necessarily have the public health guidance and backing, or the guidance and backing of NACI, that I could actually successfully advocate for them to get a booster.

Part of the problem, both Sinha and Bowdish said, is that it's difficult to collect data on seniors at home and get the evidence needed to show if their immunity is waning or not. 

Sinha worries that by the time the evidence is available that says boosters are warranted, they'll be competing with an enormous vaccination campaign for children under 12, once Health Canada approves vaccines for them.

Next generation boosters

Right now, health officials are trying to walk the line between making sure people get third doses or boosters before they get sick, but not too much sooner than they need them, McGeer said. 

That's because it's not yet known how long third doses will last, so timing is important to make sure people get the longest immunity protection possible. 

In addition, there are many manufacturers working on the next generation of vaccine boosters, which experts hope will more precisely target variants. 

I'm fully expecting to get my third shot at some point, but I'm holding out and hoping that I'll get one of those variant-specific boosters, said Bowdish. 

Then [we can] use the current vaccines we have to target really vulnerable folks or people outside of Canada who are not getting vaccinated because they just don't have access to the vaccines yet. 

Nicole Ireland (new window) · CBC News

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