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British Columbia expects to deliver third doses of COVID-19 vaccines to 500,000 people by the end of the year to boost waning protection for seniors, Indigenous peoples, those with suppressed immune systems and some health care workers.

The majority of British Columbians will be offered a third dose beginning in January, according to the plan released on Tuesday.

Dr. Bonnie Henry, Provincial Health Officer, said data collected in B.C. and Quebec show that most people who have had two doses of vaccine can get through this winter without a booster.

“Most of us have good, strong protection and we don’t need a booster dose right now,” she told a news conference. “But come next spring, it is something that we should consider for longer-term protection … Everyone who wants a booster dose will be eligible to receive it at least six months after their second dose.”

The province has already started offering third doses to seniors in long-term care and people who are deemed clinically extremely vulnerable. Starting this week, the booster program will be expanded to include all Indigenous people over the age of 11, as well as seniors in the community and health care workers who received their first and second shots early in the vaccine program.

Dr. Henry said the data now show that for most people, two doses of vaccine – no matter what combination – offer strong protection for at least eight months. “And the protection that we get, the immunity we get, from these vaccines wanes a little bit over time, but it doesn’t fall off a cliff.”

B.C. began providing COVID-19 vaccines last December, with a limited supply. Those who were first in line for their shots were those who were most vulnerable to the virus – seniors in long-term care, then seniors in the community, and Indigenous populations. Now, those are the same people who are most likely to see waning protection, almost a year later.

The province is also offering early access to third shots to health care workers in those settings where they are exposed to COVID-19 at work. “So in our [intensive care units], the emergency department or COVID wards, where we know that even though we may have good protection, any illness can be very disruptive to our health care system, which is stretched as it is at this time,” Dr. Henry said. However, the vaccine mandate that took effect on Tuesday for workers in the health care system will not require a third shot as a condition of employment.

Invitations for third shots will be issued to those registered in the provincial Get Vaccinated system. Dr. Penny Ballem, who heads the province’s vaccine program, said the province has access to enough supply of Moderna and Pfizer to provide third shots to everyone who wants them between now and next May. She said there is no need for to match the booster shot to previous COVID-19 vaccines.

The priority booster program this fall includes roughly 200 rural and remote Indigenous communities, where many residents received their first and second shots just four weeks apart. Recent data suggest that the vaccines are more effective with a longer interval, and First Nations health officials have raised concerns that these communities are at an increased risk in the fourth wave of the pandemic.

Dr. Ballem said the delivery of this third round of vaccines will look different than the first phase. “We want this campaign to be more relaxed,” she said. “It’s about providing people with that extra kick that hopefully will sustain them for many months.”

By mid-January, when the province plans to open up vaccine registration for the majority of residents who are not in high-risk categories, pharmacies are expected to be offering shots. In the first phase of B.C.’s vaccine rollout, pharmacies could only offer AstraZeneca vaccines, which are no longer being offered in the province. Since then, the deep-freeze requirements for Moderna and Pfizer have eased, so pharmacies can keep supplies refrigerated for up to one month.

In addition, the province expects to have a specially-formulated version of Pfizer to inoculate up to 340,000 five-to-11-year-olds once Health Canada approves vaccines for that age group. Approval is expected in November, but Dr. Ballem said it is not yet clear how B.C. will deliver those shots.

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