Re-thinking COVID-19 boosters: Discussions continue around the number of booster doses needed

While American experts are re-evaluating how many COVID-19 boosters high-risk patients should get, health officials in the Maritimes say they're comfortable with Canadian guidelines, at least for now.

Late last week, a United States advisory panel said there's not enough evidence to recommend more than one shot a year for older people and those with weakened immune systems.

"At this point in time, I would like to continue to follow the advice of our own Canadian researchers and health professionals," said Halifax West MP Lena Metlege Diab outside the newly opened Community Pharmacy Primary Care Clinic in Bedford, N.S.

Inside the clinic, Nick Tobin and Claire Kressner were getting their latest COVID-19 booster shots -- the fifth needle they've had.

"We both had COVID and I really wouldn't want it again," said Kressner, who has been nursing a broken arm, resulting in a number of hospital visits.

The previous shot they received wasn't the bivalent version.

"We had the other one prior, but we feel we would like more protection at this time," said Kressner.

"It's [the vaccine] is the only thing we have right now," added Tobin.

Data from Nova Scotia's COVID-19 dashboard shows 788 people have died since the outbreak began in March of 2020. It also shows the vast majority of the population has had at least one dose of vaccine.

Just slightly more than 18 per cent are considered "primary series incomplete."

"We're trying to step away from dose counting," said Dr. Shelley Deeks, Nova Scotia's deputy chief medical officer of health, adding the province continues to follow advice from the National Advisory Committee on Immunization (NACI).

"Currently, the recommendations are that any adult should have received a booster dose since the fall of 2022. Anyone over five years of age is also eligible to have received a booster dose," said Deeks.

"How NACI separates those are, those that are 'strongly recommended' to receive a booster dose, and those who have a 'discretionary recommendation.'"

Deeks said more vulnerable groups are those who get the stronger recommendation. 

"Anybody who is at high risk, basically, for severe disease from COVID, and elderly people," said Deeks.

The sentiment is similar in New Brunswick.  

“Vaccination continues to be our best tool of defence against COVID-19. Public Health would like to remind all New Brunswickers that the COVID-19 vaccines, which are available for free to all residents, can help reduce their risks for severe outcomes from an infection,” said Sean Hatchard, New Brunswick department of health communications officer, in an email to CTV News.  

“The department of health recommends that you ensure you are fully vaccinated by completing all doses in your primary series and also get one fall/winter booster dose with an mRNA vaccine. An mRNA bivalent vaccine is the preferred product for a fall/winter booster dose. If an individual has received a fall dose (with either a monovalent product or a bivalent product), they are considered up to date and no further boosters are recommended at this time."

“As the pandemic is transitioning, further COVID-19 vaccine recommendations from the National Advisory Committee on Immunizations are expected this year. We will continue to review NACI’s recommendations and communicate COVID-19 vaccine updates as we get more information," wrote Hatchard.

More information on the vaccines available in New Brunswick and who is eligible to receive them can be found on the government's website.

Still, others note guidance is constantly evolving.

"With changing evidence, we have to adapt and work with new guidelines," said pharmacy owner Chintan Prajapati.

"That's been a key part of the COVID immunizations ever since we started, actually. From 21 days between first and second dose, we moved to eight weeks. That was also part of the NACI guidelines that we adapted to. I wouldn't be surprised if there are new guidelines, but that would be definitely supported by evidence, and I think NACI goes by evidence."