Fourth COVID vaccine shots are open to Ontario adults. Do I need one?


With Ontario in the grips of a new COVID wave, this time driven by the new, ultra-contagious BA.5 variant, the province has announced that everyone 18 and older in Ontario is eligible for a second booster, or fourth dose, of a COVID-19 vaccine, starting Thursday.

But Ontario’s chief medical officer of health, Dr. Kieran Moore, took a different tone than with previous vaccination campaigns, saying he’s most concerned about high-risk people and the five million Ontarians who haven’t gotten a third shot.

You might have a few questions about what that means for you.

The Star breaks down what you need to know:

Is this the same vaccine as the original one, and how is it going to protect me against new variants?

It is the same vaccine. These vaccines were developed for original 2020 COVID and are less effective at preventing transmission because of the way the virus has mutated. However, they still do a good job at preventing the worst outcomes, if you do get the disease, such as serious complications requiring hospitalization, and death.

Moderna and Pfizer are working on bivalent vaccines, which would protect against Omicron variants. Moderna recently announced its version also protects against the BA.5 variant, which is good at getting around immunity from both vaccines and prior infection.

These vaccines are not ready yet. Moore, said at a Wednesday news conference announcing the expansion of fourth-dose eligibility that the province “absolutely” anticipates having a bivalent vaccine in the fall. But it’s not clear which version and when these vaccines could be available. Maybe by November or December.

Data is still emerging about second booster shots, but the protection period offered by the fourth dose might not last longer than a few weeks — still, that protection could be crucial for someone who is at higher risk for severe outcomes, said Dr. Sumon Chakrabarti, an infectious disease physician at Trillium Health Partners in Mississauga.

“If you’re an elderly person … even a mild viral infection that causes fever … in that population, five weeks of protection would be worth it,” he said.

Chakrabarti said the populations that will benefit most from a fourth dose of the current vaccine are those who are older, or those who have health conditions. The health-care system needs to focus on getting those third doses out to everyone and ensuring that those at the highest risk get their fourth shots, he explained.

However, Dr. Gerald Evans, chair of the infectious disease department at Queen’s University School of Medicine, said a fourth dose offers important protection, even against current variants, and welcomes shots being offered to all adults.

“This is probably a good decision — too bad it wasn’t made three or four weeks ago,” as the population won’t receive protection from the shots until closer to the end of July, well into the current wave, he said. For booster shots, it also only take a week for the immunity to kick in, he said.

“The good news in all of this is now that we’re going to get this going into the summer, it’s going to put us in a good position in the fall … to get people these bivalent vaccines,” said Evans.

If I get this fourth dose now, will I have to wait six months to get an Omicron-specific vaccine, if one becomes available soon?

Moore said it should not “interfere (with) or slow down” the timing of an eventual Omicron vaccine. “I don’t want anyone thinking this will block their ability to get the bivalent vaccine in the fall,” he told reporters at Queen’s Park.

Evans said those getting a fourth dose this month should have no issue getting the Omicron-specific vaccine in the fall, as long as the government maintains that eligibility.

“If you get a fourth dose in July, you will almost certainly be able to get another shot somewhere around October of a bivalent vaccine,” he said.

He also hopes ramping up the vaccination infrastructure in the province through the summer will allow the system to be more prepared to efficiently roll out the Omicron vaccines in the fall, as vaccine clinics have been scaled back.

How long after my third dose do I need to wait?

You can get the fourth shot five months after your previous COVID vaccine.

What if I recently had COVID, should I wait?

Moore said you should wait until three months after a COVID infection.

Do I need a fourth dose if I am low-risk, young and healthy?

Moore said he recommends the fourth shot for people 18 to 59 who have underlying medical conditions that could put them at risk for more severe cases of COVID, for example people who have diabetes, or people who smoke. If you’re a young and otherwise healthy person you can get the fourth shot but he stopped short of saying you should and said it would be “fine to wait” for the bivalent vaccine in the fall.

But a fourth shot does decrease your ability to transmit the virus, so you would want to get one, for example, if you have a parent going through chemotherapy, he said.

If you are unsure, Moore recommended speaking to your family doctor or nurse practitioner to figure out what’s right for you and your family.

Healthy people who received a third shot of the vaccine six months ago or less are still receiving strong protection, said Evans.

“If you just got your third shot a month ago, you’re in great shape. I would not be pushing for a fourth dose,” he said. “It has to do a lot with when was the time you had your most recent shot.”

For people under 60 who have received three shots, and have been recently infected with COVID-19, chances are they are well protected, said Chakrabarti.

For younger people, he said it’s not as urgent of a decision to get a fourth dose, compared to the need for the first three doses. Vulnerable populations who have still not received a third dose need one as soon as possible, he added.

Where/how do I get a fourth dose?

They will be available at the same places that the other doses were, pharmacies, some doctors’ offices and clinics. More information on how to book is available on the province’s website. https://covid-19.ontario.ca/getting-covid-19-vaccine

Vaccine Hunters Canada, the grassroots volunteer group that helped Canadians find their shots last year, has helpful online tools on where to find vaccines, and how to calculate exactly when you can get your next dose.

https://vaccinehunters.ca/

Can my teen get a fourth dose?

No, the fourth doses are only open to adults 18 and older. But young people ages 12-17 are eligible for a third dose, at least six months after their second.

I’m immunosuppressed and I was already eligible for a fourth dose, can I get a fifth one?

If you are in this situation, you can get a fifth dose three months after the fourth dose, Moore said.

Have other provinces opened up fourth doses?

Quebec allows people 18 and up to get a fourth dose. It’s also widely available in P.E.I., and New Brunswick recently expanded access to anyone over 18.

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