Opinion: Is a third COVID-19 shot the charm?

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With the COVID-19 pandemic unfolding, we will all eventually need a third dose of the vaccine.

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But there’s no reason we should rush to get everyone the so-called “booster” shot at this time. (More on the language in a minute.)

In fact, there is every indication that the longer we can stay, the better.

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For now, we need to target our efforts, focusing on high-risk groups, especially the elderly in institutional care and some people who are immunized, such as transplant and cancer patients, as indicated by the National Institute on Immunization Advisory Committee (NACI). wisely recommended.

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Being vulnerable, older people need another shot not because the vaccine worked, but because they had a weakened immune response in the first place.

Nearly all of the hospitalizations and deaths we’re hearing about people who are “fully” vaccinated are in the over 65 demographic. The main reason for this is that they are not actually fully vaccinated. He needs a third shot.

Many scientists do not like the common vernacular “booster”. Rather, they want the public to consider three shots as a common COVID-19 vaccination regimen.

Multiple doses to provide protection are not uncommon, as with HPV vaccination. Boosters are something else – used to strengthen immunity when weak; For example, we should get a tetanus booster every 10 years.

The good news is that immunity to SARS-CoV-2, the virus that causes COVID-19, doesn’t seem to wane too badly in the general population. A study by the Institute for Clinical Evaluative Studies (ICES) found that, in Ontario, the vaccination had an 81-percent protection even eight months after the second shot, and was even safer than the dangerous delta variant.

Those figures don’t suggest that we need a massive third shot campaign.

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However, it should be noted that we still have a lot to learn about immunity, and how to measure it. For example, there is much debate about whether getting infected and being cured provides as much protection against infection as vaccination.

So far, only two countries are aggressively promoting the third shot, the US and Israel.

Israel is recommending that everyone over the age of 12 get three shots. It is also modifying its green passes so that access to public places is restricted to those with three shots. There are preliminary reports that the third shot has dramatically improved protection, but it is not clear whether this benefit will last in the long run.

The US, for its part, is asking anyone over 65 and with chronic health conditions to get a third COVID-19 shot. (The third dose is actually half the dose.) In its system, which prioritizes personal preference, many young people are also getting a “booster.”

Barring these external factors, most countries are finding it difficult, both scientifically and ethically, to justify a universal third shot campaign.

The situation in Canada is quite unusual. Because of the initial shortage, the interval between the first and second shots for Canadians was up to 16 weeks. It was controversial, but proved to be really good for strengthening immunity.

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Similarly, due to contracts with multiple suppliers, Canada did a lot of mixing-and-matching of vaccines. That too seems to provide better immunity.

This is a rare instance where running away politically can actually prove beneficial to our collective health.

In the coming weeks, vaccines for COVID-19 will almost certainly be approved for children between the ages of five and 11. Clearly, we should be prioritizing young people getting the first shot rather than the third shot for the general population. (Elderly in community settings is another matter; they should get dibs, and they already are in many provinces.)

Let’s also not forget that out of the 7.7 billion people on Earth, only 2.8 billion have been fully vaccinated (meaning two doses) – just over a third. (In Canada, it is 73 percent, one of the highest rates in the world.)

Mike Ryan, executive director of the Health Emergencies Program at the World Health Organization, said universal third-shot campaigns are unethical in a world where many people have not received a single vaccine dose. “We are planning to give additional life jackets to those who already have life jackets, while we are leaving others to drown without a single life jacket,” he said.

Of course, immunization of the world and improvements in vaccine coverage of our domestic population are not mutually exclusive. We both can and should.

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We don’t need to promote inequality, especially given that, for now, the incremental benefits of a wider embrace of the third dose are not worth it.

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