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Getting a COVID-19 Booster Shot in Canada for Those Previously Infected with COVID

New recommendations regarding the COVID-19 booster shot in Canada were made recently.

Canada’s National Committee on Immunization (NACI) states that any citizen who is fully-vaccinated and eligible for a third dose but gets infected with the coronavirus needs to wait for at least three months before getting a COVID-19 booster shot in Canada.

The three months will be counted from the onset of symptoms or after they obtain a positive result on a COVID-19 test. This regulation is applicable to anyone 12 years of age or older. 

Different guidelines apply to those who get infected with the COVID-19 virus before they start or complete their primary vaccination regimen against the disease. They should wait at least eight weeks before getting their COVID-19 vaccine. This will similarly be counted from the onset of symptoms or after obtaining a positive COVID-19 test result.

The NACI also recommended similar changes in the vaccination timeline for certain populations. 

Citizens aged 5 and up with a moderately to severely immunocompromised immune system and no prior medical history of a multi-system syndrome in children (MISC-C) will be eligible for a COVID-19 vaccine 4-8 weeks after the onset of their symptoms or a positive COVID-19 test.  

Those who have a medical history of MIS-C will need to wait for 90 days after the onset of MISC-C or until they have recovered. If there is a difference between the two intervals, the longer interval will take precedence. This applies to anyone with MIS-C. Having an immunocompromised status does not influence any changes in the guidelines. 

Why Were Recommendations on the COVID-19 Booster Shot in Canada Changed?

This new recommendation was created to adjust to the current COVID-19 situation in the country. The Omicron variant, which is the dominant strain in the country, is more transmissible and has a better ability to evade immunity than previous coronavirus variants. Because of this, millions of Canadians have already been infected with the COVID-19 virus.  

The NACI said that lengthening the period between infection and vaccination “may result in a better immune response as this allows time for this response to mature in breadth and strength, and for circulating antibodies to decrease, thus avoiding immune interference when the vaccine is administered.” 

However, the NACI does admit that there is not enough clinical or real-world evidence to back up this decision on when to get a COVID-19 booster dose in Canada. This does not mean, though, that the decision was made haphazardly. The advisory body still proceeded with as much scientific rigor as possible. They made use of the data currently available to them and the established principles of vaccinology and immunology. 

Some Agree to the Change in Guidelines for the Booster Dose in Canada

Angela Rasmussen says that increasing the interval between infection and vaccination seems “reasonable.” She is a virologist and researcher with the University of Saskatchewan’s Vaccine and Infectious Disease Organization.  

Increasing the interval will lead to the development of a more long-lasting immune response. As such, individuals infected with the COVID-19 virus should be given time for their immune systems to return to baseline levels. Once their immune systems are not heightened anymore, they can be given a booster dose. This will increase the probability of developing a better immune response from the third dose.

Other immunologists echo the same sentiment. Dr. Jamie Scott, a molecular immunologist and professor emeritus at Simon Fraser University in Burnaby, says that “it’ll have a stronger effect again because the memory cells will be much more fully developed and the antibody levels will be down.”

Will I Still Need a Booster Even After Getting Sick with COVID?

Even if you’ve already had the disease, Dr. Lynora Saxinger, an infectious diseases specialist and associate professor at the University of Alberta, still recommends getting a booster shot.

However, don’t get a booster shot when you’re sick. This isn’t just applicable to the COVID-19 vaccine, but to all vaccines in general. Your immune system will be busy fighting off whatever pathogen you have in your body. Because of this, you might not be able to mount an appropriate immune response to the vaccine when you take it while you’re sick.

Antibody levels after getting a COVID-19 booster shot in Canada
A booster shot offers strong protection against COVID because the levels of antibodies remain above the threshold over time

Despite developing antibodies to COVID-19 through natural infection, these will eventually wane. By then, you might not be protected against severe disease as much any more. So, getting a booster dose is still needed so that you can prevent any serious health consequences that the coronavirus may bring. 

There are studies showing that vaccination and a prior infection with COVID provide the best protection. Other studies have also shown that getting three doses of the COVID-19 vaccine and having a history of infection with the omicron variant offers strong protection.

Do I Follow Provincial Guidelines or NACI’s Recommendations When Getting a Booster?

Provincial guidelines may differ from the recommendations made by the NACI. 

Some provinces, such as Quebec, advise their citizens to wait until their COVID-19 symptoms are gone. BC recommends waiting for at least 10 days after symptoms appear, while Ontario recommends waiting for at least 30 days. 

At the same time, access to COVID-19 testing has been difficult for many citizens. Some provinces have limited the use of RT-PCR testing to specific populations, hindering the general public from availing such services. 

This regulation has placed citizens in a tough spot. It will be impossible for them to confirm whether they have actually been infected with the COVID-19 virus or not without undergoing the gold-standard test for it. Without this vital piece of information, citizens may have trouble deciding when to best get a COVID-19 booster shot in Canada.  

An infectious disease specialist, Dr. Zain Chagla, says that individuals with respiratory symptoms should not assume that they’ve been infected with the coronavirus. Getting an RT-PCR test is the only way to confirm infection with the disease. This is because many individuals who seek treatment for COVID-like symptoms end up testing negative for it. Seasonal viruses are also going around, which produce similar symptoms. As such, it may not be safe to quickly assume that you have COVID-19 just because of your symptoms and the epidemiological status of the country.

What if I Already Got a Booster Dose Within a Shorter Interval?

There is no need to worry if you’ve already taken your booster dose at an interval shorter than what is recommended by the NACI. 

A science communicator in Toronto, Samantha Yammine, said that citizens who followed provincial guidelines on booster doses should not regret their decision to do so. It wasn’t wrong to obtain a booster dose less than the 3 months that the NACI recently announced. 

She said that the new recommendations by NACI were done so that individuals could develop an immune response that would last longer. This doesn’t mean that doing otherwise is unsafe and ineffective. The guidelines of the provincial governments are still reasonable and will provide citizens with the necessary protection against the COVID-19 virus.

For individuals with high levels of exposure to the virus or those belonging to vulnerable populations, it would be best to seek medical advice from anyone in the health team if they want to get a COVID-19 booster shot in Canada soon after infection with the virus.

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