Why the future of COVID-19 vaccination in Ontario could look very different

All Ontario adults now have the option of rolling up their sleeves for a fourth dose of COVID-19 vaccine, butexactly what vaccination programs will look like in the province in the coming months and years remains murky.

When it comes to the frequency, the exact type of vaccine and even delivery method, experts say severaloptions are on the table as scientists attempt to keep up with the virus and its variants.

Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, told CBC News that given currently available vaccines, Ontario may be looking at one to two boosters a year for people who want them.

"Is that so bad? If that's the price for an open economy, rolling up your arm once or twice a year?" Deonandan said. "It doesn't strike me as a bad deal."

Provincial Medical Officer of Health Dr. Kieran Moore announced this week that as of Thursday, Ontarians between 18 and 59 years old who had a first booster shot at least five months ago will be able to book an appointment to get a second.

The province's top doctor also said healthy people under the age of 60 who have had three doses already may want to wait until the fall for a second booster, when it is anticipated that an Omicron-specific vaccine will be available.

"This [fourth] dose is really for those who are vulnerable," Moore told reporters.

The 'tantalizing possibility' of new options

Several vaccine manufacturers are in the midst of working to develop shots that are tailored to the more infectious Omicron variant. They'rehopingwhat is known as a "bivalent" shot can help blunt a potential surge in casesthat could overwhelm thehealth-care system as flu season sets in.

Current COVID-19 vaccines are known as "monovalent," as they were developed with the original strain of the virus in mind. Bivalent vaccines, meanwhile, would target specific portions of the virus seen in both the original strain and newer strains.

Deonandan called the potential rollout of effective bivalent vaccines in the fall a "tantalizing possibility," but he said it remains to be seen if the province will be able to get them quickly enough or at the volume required or even if they will still be the best option, should yet another a new variant rear its head.

For those reasons and more, he advised that people should get a booster shot now to protect themselves.

Deonandansaid other vaccination options currently being studied include a nasal spray vaccine which could end up targeting Omicron and its subvariants more directly in the body and a "pan-coronavirus vaccine" that would theoretically be effective against all future variants, which is considered the "holy grail" of this arm of research.

"These next generation vaccines may heavily reduce the probability of having frequent boosts," he said.

WATCH | Moore elaborates on who should get a second booster now:

Ontario's top doctor on who should get a 4th COVID-19 dose and why some may want to wait

2 years ago

Duration 0:40

Dr. Kieran Moore, Ontarios chief medical officer, provides advice for Ontarians aged 18+ who may want to book the 4th COVID-19 dose starting July 14.

As it stands, vaccine uptake in Ontario has waned since the initial two shots. In a news release issued Wednesday, the province said that as of July 11, more than 93 per cent of Ontarians over the age of 12 had received at least one dose of vaccine, and over 91 per cent had received a second dose.

But that number drops fairly significantly when it comes to third doses, with just over 57 per cent having received a booster.

"Millions of Ontarians have not received all their recommended vaccinations," Moore said Wednesday, urging people who need them to get their shots.

Millions still without booster

Five million Ontarians have yet to receive their first booster, and over 1.6 million people at the highest risk should they contract the virus haven't gotten their second, Moore said.

JimTiessen, director of the master of health administration community care program at Toronto Metropolitan University, told CBC News that he's "a bit mystified" by the relativelylow uptake after the first two shots some of which he attributes to people not realizing it's now much easier to get a vaccine than when they were initially rolled out and millions of people wereclamouring for them.

"It's easier to get than I think people realize," he said.

Tiessen said he believes that the introduction of new, targeted vaccines will encourage larger numbers of people to get their shots and that's something he encourages.

"I think the government's real job now is to really communicate in the fall, particularly when the new vaccines come out, that people really should get them."