Q. So many people now seem to be able to get an early second dose of the covid vaccine. When might I be eligible and what may I get?
A. It is true that many people are able to get a second dose sooner than the original 16 weeks option that we were given only a few months ago. That is great news since the Delta variant is continuing to rear its ugly head. The sooner the majority of the population gets doubly vaccinated, the better off we will all be and hopefully continue our quest towards normalcy.
England is ahead of us in both their vaccinations and in their re-opening. Many might be envious of this fact but Canada can observe and learn from how they do as they also seem to be ahead of us when it comes to the appearance of new variants. At first glance, this Delta variant might pose a threat and alter England’s’ next stage of re-opening which is scheduled to occur on June 21st (as a last minute edit, a news release just appeared on my computer indicating this has now officially been pushed back to July 19th). According to their Prime Minister, Boris Johnson, a jump in new coronavirus cases was expected after their initial stage of re-opening last month but their new modelling shows that this increase might be far more dramatic than they had expected. It appears that this Delta variant is 60% more transmissible and now accounts for 90% of the new active cases in England.
Many are concerned with this variant since the vaccines do not seem to be quite as effective against it. That being said, now is not the time to raise your hands or throw in the towel and give up. Now, more than ever, is the time to continue this race against the variants.
For starters, the unvaccinated are more at risk from this Delta variant (as well as the other variants) and are therefore more likely to be hospitalized and/or succumb to it. Once again, we can use England as an example. Of the 223 people that were hospitalized with the Delta variant there, most were unvaccinated or had only 1 dose of the vaccine. Only 20 of those people were fully vaccinated. Of the 42 deaths due to Delta, 30 of them were unvaccinated or had only 1 dose while 12 of them were fully vaccinated. So, though we hoped that being fully vaccinated would be more effective, it is better than choosing to be unvaccinated or only having 1 dose.
New information such as this has spurred our government’s decision to begin offering second doses of the various vaccines sooner. Our hope is that the government will continue to broaden access for eligibility of earlier second doses. It is confusing to discern whom is eligible to get a second dose early. We hope this article will make it clearer and more concise while keeping in mind that, even as this column is written, the information will probably continue to change.
This is the information as it stands on June 14, 2021 but do try to also keep abreast of the situation as it evolves on news stations, social media or, of course, your local pharmacy.
· For anyone who had the AstraZeneca (AZ) vaccine as their first dose, the interval has been shortened from the original 16 weeks to 8 weeks. These individuals may choose to stay with AZ or opt for either of the mRNA vaccines for the second dose. According to Ontario’s MOH, those that opt for a second dose AZ series and receive them 12 weeks apart will have about 82% efficacy as opposed to 69% when doses are given between 9 to 12 weeks apart. However, as stated above, the Delta variant is a concern and thus, people have been given the option to proceed with an earlier second dose. For the people that opt for mixing the vaccine doses, early data shows you may experience more temporary side effects such as headache, fatigue and other flu-like symptoms but perhaps will benefit with a more robust immunity. The data has yet to be published to confirm this finding.
· Anyone who had an AstraZeneca (AZ) vaccine as their first dose AND has a letter from their health care provider documenting they have a health condition that makes them eligible for an earlier dose of their choice may receive their second dose as early as 4 weeks. The following are some examples of such health conditions;
- Live in a long-term care home, retirement home or assisted living facility
- Organ transplant recipients
- Treatments which compromise the immune system (chemotherapy)
- Neurological diseases which may compromise breathing
- Receive dialysis
- Kidney disease (eGFR<30)
- Obesity (BMI>40)
- First Nations, Inuit and Métis persons
- Primary care-giver to an individual with the eligible health condition
· People who received an mRNA vaccine, either Pfizer or Moderna, as their first dose may receive their second dose at 16 weeks. There are a number of exceptions that can reduce the interval to 21 days for Pfizer and 28 days for Moderna such as;
- High risk health care workers
- Live in a long-term care home or retirement home or assisted living facility
- Individuals with a letter from their health care provider documenting they have a health condition that makes them eligible for an earlier dose (see above for examples of such)
- First Nations, Inuit and Métis persons
- Anyone 70 years of age or older
- Anyone who received their first dose on or before April 18/21
- Anyone who received their first dose on or before May 9/21 AND live in a Delta variant hotspot (Halton, Peel, Porcupine, Toronto, Waterloo, Wellington-Dufferin-Guelph or York Public Health Units)
According to the Ontario Ministry of Health website the following will soon be eligible for an early second dose;
- Beginning July 19/21, anyone who received their first dose on or before May 9/21 regardless of where they live
- Beginning August 2/21, anyone who received their first dose on or before May 30/21
- Beginning August 9/21, anyone who received their first dose May 31/21 or later
So, to recap;
· If you received an AZ as your first dose, you may choose to have either AZ, Pfizer or Moderna as your second dose 8 weeks after your first (see above for exceptions).
· If you received an mRNA vaccine (Pfizer or Moderna) as your first, you are to wait 16 weeks for your second dose unless you are 70 years old or older or had your first dose on or before April 18th. See above for the other exceptions.
It is suggested that you receive the same mRNA vaccine for your second dose, however if you are not able to secure an appointment for the same vaccine or you are unsure of which dose was given initially, then you may opt for the other type of mRNA vaccine.
As for those individuals who have not received their first dose, at the time of vaccination;
· anyone 12 years and older may have Pfizer
· anyone 18 years and older may have Moderna or Pfizer
For more information on this or any other topic, contact your pharmacist.