Should vaccine passports require 3 doses instead of 2? Experts weigh in
Governments need to decide now whether they'll switch to requiring three doses for a valid proof of vaccination against COVID-19 instead of the current two, according to an Ontario medical expert.
Dr. Peter Juni's comments come amid growing conversations about limiting certain public health restrictions — defined by some as "living with" COVID-19 — and as Canada's biggest and most deadly wave of cases begins to wind down.
"If we would want to change our definitions for a vaccine certificate from two to three doses, it would need to be done very swiftly," said Juni, science adviser of the Ontario COVID-19 Science Advisory Table.
"It wouldn't make sense if we start to implement something like that only [in the] second half of March. That's too late."
Juni said three vaccine doses provide strong protection against COVID-19, particularly from developing severe disease. Requiring three doses to enter establishments like restaurants would also help prevent spread, he added.
Nearly 80 per cent of Canadians are fully vaccinated, but only about 40 per cent have received a third dose, based on data from the Public Health Agency of Canada (PHAC).
However, recent data suggests two doses, while still helping to prevent severe illness, are less effective at preventing transmission of Omicron, making the current system ineffective against reducing spread, according to Juni.
Some provinces have signalled their desire to reconsider using vaccine passports.
Dr. Kieran Moore, Ontario's chief medical officer of health, said Thursday it was time to "reassess the value" of passports. Saskatchewan Premier Scott Moe said proof of vaccination has "run its course."
Dr. Theresa Tam, the country's chief public health officer, said Friday that Canada needs to adopt a "more sustainable" approach to the pandemic. Speaking to reporters, Tam said public health measures, including vaccine passports, should be assessed in the coming weeks.
"What we need to do going forward, as we emerge out of this Omicron wave, is recognize this virus is not going to disappear. We need to be able to address the ongoing presence of the SARS-CoV-2 virus in a more sustainable way."
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As Canada begins moving away from COVID-19 restrictions, Dr. Zain Chagla, an associate professor of medicine at McMaster University in Hamilton, said requiring three doses for vaccine passports is the wrong move at this stage of the pandemic.
Not only has the rollout of third doses been "inequitable," but the number of Canadians who have been infected with Omicron is high and contributes to significant natural immunity, said Chagla, an infectious disease physician, .
In Ontario alone, since Dec. 1, it's estimated at least 1.5 million people — both vaccinated and unvaccinated — were infected with Omicron.
WATCH | Dr. Theresa Tam on the importance of booster doses:
Vaccine passport has 'run its course'
Proof of vaccination was never intended to be permanent.
Chagla said that during earlier waves of the pandemic that set in early in 2020, their value was more pronounced.
"When Delta [variant] was around, the data behind two doses of vaccine preventing infection even 26 weeks out was still pretty good," he said.
Given how the more contagious Omicron variant has changed the pandemic's trajectory, Dr. Sumon Chakrabarti said, he wants passports — and all restrictions — gone sooner rather than later.
Chakrabarti said restrictive measures like lockdowns and proof of vaccination requirements have an adverse effect on the most marginalized in Canada — those who work in factories and other essential businesses — while protecting office workers he refers to as the "Zoom class."
Lifting restrictions in Ontario could come as soon as the end of February, given the current number of cases in the province, he added.
"I think that the vaccine passport has run its course at this point in time. I understand the initial justification for it, but I think that with the evidence on the ground, that we can't really justify it any longer," said Chakrabarti.
"We can't keep unvaccinated people out of public space just because you don't like their choice."
Chagla, too, said he expects conversations about eliminating proof of vaccination within the next one to two months.
WATCH | Sask. Premier Scott Moe says province will scrap vaccine requirement program:
Lean on personal risk assessments
With fewer restrictions, both Chagla and Chakrabarti said, participating in society will require more personal risk assessment.
Efforts to help people understand personal risk have been lacking thus far, Chagla said, but the experience with Omicron highlights a few takeaways.
Younger people with three doses, and those with two doses who have recovered from COVID, are at low risk of becoming seriously ill should they contract the coronavirus, Chagla said.
Others, like older individuals who are not fully vaccinated or have yet to receive a booster, may still want to consider avoiding large gatherings, he added.
Chagla said those who are vulnerable should still consider a vaccine booster.
"Unfortunately, people have to recognize there is going to be a risk in high-risk environments," he said.
"And unfortunately, vaccine passports may reduce that risk slightly, but not by a significant degree."