Booster uptake stalling as experts debate fourth COVID shots.

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Authors: Diana Duong and Lauren Vogel
Date: Apr. 11, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 14)
Publisher: CMA Impact Inc.
Document Type: Article
Length: 1,163 words
Lexile Measure: 1470L

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As Canadian provinces lift mask mandates and proof of vaccination policies, experts are worried that only 56% of adults, and far fewer children, have received three doses of a SARS-COV-2 vaccine. Meanwhile, vaccine manufacturers are warning that fourth doses may be necessary to maintain immunity.

Canada has enough vaccine supply to offer third doses to everyone who is eligible, but uptake has slowed dramatically in recent weeks. As of mid-March, Newfoundland and Labrador had the highest booster coverage at 66%, while Saskatchewan had the lowest at 45%.

Why is booster uptake slowing?

"We're basically in a situation where people either don't have the appetite for third doses anymore," or they've been infected and have to wait three months before getting a booster, said Peter Juni, formerly of Ontario's COVID-19 science advisory table. Based on wastewater analysis, some 3.5 to 4.5 million people in Ontario alone may have been infected with SARS-CoV-2 since December 1.

Jeff Kwong of ICES in Toronto attributes slowing booster uptake to a combination of "complacency, hesitancy, and access" issues.

"A lot of people think, 'I've already had my two doses. This Omicron is not that bad. I don't need another dose.' or maybe they've already had an infection, so they feel they don't need it," Kwong says.

Meanwhile, it's possible that the booster campaign hasn't benefited from "the same push" as the first two doses, he says.

Calling the third dose a booster may also be a "double-edged sword," and mis lead people to think it's not necessary, according to Catherine Hankins of the COVID-19 Immunity Task Force.

With immunity waning over time and more infectious variants circulating, "we do need to have that third dose," Hankins says. Effectively, "it is a three-dose series."

A third...

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