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NACI's new guidance: Get fully vaccinated, even if previously infected with COVID-19

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With hundreds of thousands of Canadians infected with the Omicron variant over the last two months, the National Advisory Committee on Immunization (NACI) issued new guidance on Friday that emphasized the importance of still being up-to-date on the COVID-19 vaccination, even with a previous infection.

Individuals who were infected before starting or completing their first two doses should get their next dose eight weeks after symptoms began, or after testing positive if they were asymptomatic, NACI says. Those who were infected after receiving their first two doses can get a booster shot three months after the onset of symptoms or after testing positive, the committee recommended, as long as it is at least six months after having received their second shot.

“Given the very large number of Canadians with a confirmed or apparent infection during the Omicron surge in particular, it is also important to highlight that previously infected people benefit from starting or completing their COVID-19 vaccination,” said Dr. Theresa Tam, Canada’s Chief Public Health Officer, during the federal COVID-19 update.

“Hence, for the best possible protection against severe illness now and going forward, health authorities continue to strongly recommend up-to-date COVID-19 vaccination for all eligible people, including for those who have had a COVID-19 infection.”

Tam stressed that getting either a Pfizer or Moderna mRNA booster dose helps keep more people out of hospital or prevent more deaths, with data showing that protection against hospitalizations is more than 90 per cent – a 15 to 40 per cent higher effectiveness over two doses. Wearing masks and taking other protective measures remained important, however, given no vaccine is 100 per cent effective, she added.

The new guidance comes as infections appear to be decreasing across the country, but hospitalizations and intensive care cases remain very high.

Though cases have been declining, an average of more than 10,000 people with COVID-19 are being treated in hospitals daily, including more than 1,100 in intensive care, Tam said, adding that in excess of 140 deaths have been reported daily.

Health officials said, as of Jan. 30, 50 per cent of all eligible Canadians have received a booster dose, an increase of five per cent from the week before. Nearly 55 per cent of eligible children have received at least one shot, up two per cent.

Following the rush for rapid antigen tests over the holidays amid the surge in Omicron cases, Health Minister Jean-Yves Duclos said on Friday that the government secured 140 million rapid tests that arrived by the end of January. The majority of the tests have been delivered to provinces and territories, he said, but more would be arriving to different regions in the coming days.

MANDATES AND RESTRICTIONS

With hospitalizations remaining at elevated levels, public health officials said it would not be prudent to lift public health rules too quickly. Some provinces have already begun signalling that they would be loosening restrictions soon, but the issue has been especially at the forefront this week in Ottawa, where a key demand by protesters with the “Freedom Convoy” has been to end all COVID-19 mandates and restrictions.

“The key objective of the vaccine mandate…is to protect individuals, protect people, through vaccination,” said Duclos.

“Vaccine mandates are not there to punish people.”

Duclos added that the mandates do work, noting that 99 per cent of public servants for the federal government are now vaccinated.

Officials said changes to mandates and restrictions were “an ongoing conversation” but that it was also important to evaluate what was happening not only in Canada in terms of cases and the health-care system’s ability to cope, but also what was happening globally, particularly with respect to travel mandates.

“[With] hospitalizations still going up in many areas, it is quite difficult to reduce those measures when that's a situation of the ability to cope with any kind of additional introduction [of infections],” said Tam.

“At the same time, we need to begin to plan forward for when this particular wave recedes and be ready…We do need to get back to some normalcy and that includes our border measures and policies.” 

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