Quebec should plan mass COVID second-booster program for the fall: vaccine committee

Quebec's immunization committee is suggesting the government start preparing a mass COVID-19 vaccine fourth-dose campaign for the general population that would be launched in the fall.

Quebecers most vulnerable to serious consequences from the disease -- seniors over 80, immunocompromised people and residents of long-term care homes -- can start receiving a fourth dose of vaccine next week, health officials said Wednesday. The same day, the immunization committee said the government should start planning to give second boosters out to everyone in a few months.

In a written opinion released Thursday, the Comite sur l'immunisation du Quebec recommended the government implement "a new vaccine strategy aimed at periodically boosting immunity against COVID-19 while also allowing for the ability to react to a possible emergence of a new variant of concern."

A mass second-booster campaign, the committee suggested, could take place in September or October and target "either all persons authorized to receive vaccines against COVID-19, or those usually targeted by the seasonal influenza vaccination program."

Currently, only 52 per cent of the population aged five and older have received a third dose of vaccine, according to provincial health data.

The committee released an analysis of hospitalizations and deaths that occurred between January and mid-March indicating that people 80 and older were almost 200 times more likely to die of COVID-19 than those under 60, and 16 times more likely to be hospitalized. Some 95 per cent of those who died in hospital were 60 and older, the study said.

Among all age groups, people with chronic illnesses were seven times more likely to be hospitalized than those without them, and 95 per cent of those who died had at least one chronic condition.

However, the report found that age, rather than chronic illness, was the biggest risk factor in both hospitalizations and deaths.

The analysis found that rates of hospitalizations and deaths were much higher in those who were unvaccinated or only partially vaccinated compared to those who were fully vaccinated -- people with two doses or who had been infected and had one dose. For those who received a booster, it found "protection against hospitalization was more than 90 per cent in all age groups and it was maintained for 16 weeks after the last dose."

The report included an analysis of both the pros and cons of offering second boosters, concluding fourth doses should be offered to higher-risk groups.

"Even if the protection after a first booster dose of vaccine against COVID-19 is high and durable, a second booster is immunogenic, increases protection and appears to be safe for vulnerable people," the committee wrote.

The negatives cited in the report include the concern that the protection a fourth dose offers against infection by Omicron is likely to be "relatively short-lived." It also cited the fact that the latest variants of the novel coronavirus appear to cause less severe illness than earlier mutations, and it said the best protection against COVID-19 appears to be two or three vaccine doses followed by an infection.

The document shows that the committee was also concerned that the rollout of a second booster could "undermine confidence in the usefulness of vaccines," citing surveys that show an increase in the percentage of Quebecers who question their effectiveness.

"This trend could be amplified in the event of the offer of a second booster being wrongly interpreted as an admission of ineffectiveness and have harmful consequences on all provincial vaccination programs," the committee wrote.

The report concluded it would not be beneficial to begin giving second boosters to younger age groups immediately, but it recommended that Quebecers who ask for boosters be allowed to receive them.

Meanwhile, Quebec reported 14 more deaths linked to the novel coronavirus on Wednesday and a 28-patient increase in the number of people hospitalized with the disease. Health officials said there were 1,062 people in hospital after 127 patients were admitted in the past 24 hours and 99 were discharged. The number of people in intensive care with COVID-19 rose by seven, to 57.

Interim public health director Dr. Luc Boileau said Wednesday that officials are expecting a rise in cases due to the easing of restrictions and the growing presence of the BA.2 subvariant, but he said it was too early to tell if the province is experiencing a sixth wave.

-- This report by The Canadian Press was first published March 24, 2022.