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Dr. Kieran Moore, Ontario's chief medical officer of health, speaks at a news conference in Toronto, on April 11.Nathan Denette/The Canadian Press

Ontario’s COVID-19 indicators are currently heading in the right direction but the province’s top doctor is preparing for the fall, when trends will likely worsen, with plans including a new round of booster doses.

Chief Medical Officer of Health Dr. Kieran Moore said the preparations include scenarios for various stakeholders in the health system to go through, such as an “aggressive” flu season combined with a COVID-19 resurgence.

Ontario will be purchasing more than six million doses of flu vaccine, he said in an interview, and expects to offer further doses against COVID-19.

“So, another booster dose for the most at-risk of members of our community for COVID, and then potentially opening it up to the general public for another booster dose,” he said.

Third doses are currently available to people 12 and older, and fourth doses are available for people who are 60 and older or First Nation, Inuit and Metis adults as well as their adult household members. Immunocompromised people – such as transplant recipients – aged 60 and older and long-term care residents can get a fifth dose.

Moore anticipates that in the fall a new generation of vaccine will be available that targets both the original COVID strain plus a more up-to-date one that is circulating, such as Omicron.

“We’re looking at distribution models through pharmacy, primary care, and your public health partners,” he said.

“That would be something that could start as early as October. We’ll start with the highest risk, so by age or by occupation, so health-care workers or those over 60, to offer it to them, and then based on the availability and demand expand further.”

If another wave of COVID-19 threatens the health system and its ability to deal with the surgical backlog, Moore said there is a possibility mask mandates may return “if it’s really, absolutely required.”

“Certainly any further public health measures beyond that, I don’t think will ever be necessary, given the benefits of the vaccine that we’ve seen and given the effectiveness of masking at a population level,” he said.

Provincial mask mandates for public transit and health-care settings will expire this weekend – though hospitals say they will keep requiring masks. The mandates remain in place in long-term care and retirement homes, and Moore recommends keeping those until at least the summer of 2023.

The province is also preparing for the eventual approval of vaccines for children under five. An application from Moderna for a COVID-19 vaccine for children aged six months to five years old has been under review by Health Canada since late April.

It took Health Canada almost three months to authorize the Moderna vaccine for adolescents, and almost four months for children ages six to 11. Moore said the youngest children may not be able to be vaccinated until at least late summer.

“We’ve already had plans of how to distribute it through our primary care partners, as well as our pharmacy partners,” he said.

“So we’re ready. It’s now just ensuring that the vaccine is safe, that it’s effective, and that it will indeed, protect children fully. And I don’t mind taking that extra time to ensure the data is correct.”

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