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Ontario expands 2nd vax dose access as experts, critics call for targeted approach

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TORONTO — Ontario expanded access to second doses of COVID-19 vaccines on Friday while experts called for a more targeted immunization approach to stem the rapid spread of a new, infectious variant that could threaten the province's reopening.

Those aged 70 and older and people who received an mRNA vaccine on or before April 18 can now book second doses at pharmacies or primary care settings. Starting on Monday, they'll be able to book shots through the provincial booking system.

With more vaccine supply expected to arrive in the coming months, the province said it could further accelerate the immunization schedule.

However, the scientific director of the province's COVID-19 Science Advisory Table said the province should instead focus its second dose efforts solely on areas where the more infectious Delta variant is taking off -- especially Peel Region, where the strain makes up between 25 and 30 per cent of cases.

Dr. Peter Juni said such an approach would stop the variant, which is believed to be more transmissible and cause more severe illness, from spreading across the province as COVID-19 trends have been improving and more people are being vaccinated. 

"There needs to be a really clear distinction between a Delta hot spot, that's right now only Peel, parts of Toronto and probably Waterloo, and the rest of the province," Juni said in an interview. 

"It doesn't make sense to pivot to a strategy where you accelerate second doses in the entire province. That's not effective. What is effective is to make sure that especially Peel has as many doses as they can use daily."

He said this move is especially important over the next three to four weeks, when the variant is on track to become dominant in Peel, to prevent it from spreading across the province.

Ontario diverted half of its vaccine supply to virus hot spots for two weeks in May -- a time frame critics considered too short to be truly effective. 

Opposition politicians also called on the province to resume that strategy for second doses in light of the spreading Delta variant.

"Ontario has suffered through a worse third wave, and we need to get folks in hot spots a second dose to avoid a fourth," NDP Leader Andrea Horwath said. 

Green party's Mike Schreiner noted that based on the current schedule, which prioritizes people for second doses based on when they got their first shots, front-line workers who became eligible later in the first dose rollout will be at the back of the line for second doses. 

"The hot spot prioritization plan in early May clearly worked. So why not do the same immediately with second dose," Schreiner said.

The government has said public health units can distribute their share of vaccines to hot spots based on local context.

The health ministry said Friday that the second dose plan "will continue to take into consideration historical as well as current COVID hot-spot regions in Ontario" as more supply arrives. 

Virus trends have been improving in recent weeks since the province enacted strict public health measures in response to a punishing third wave of infections. 

However, the province's top doctor flagged a recent, slight bump in daily infections on Thursday that would need to be monitored going forward. Ontario reported 914 new cases of COVID-19 and 19 more deaths linked to the virus on Friday.

Juni said the slight increase in daily infections would need to be watched further, noting that it might be a blip resulting from gatherings on the May long weekend.

Meanwhile, the province is preparing to slowly reopen its economy by loosening restrictions on businesses and outdoor activities the week of June 14. The government has hinted at possibly moving into the first step of its reopening plan a few days ahead of schedule, though officials have said it will depend on the status of the Delta variant. 

In a Friday letter to their federal counterparts, Health Minister Christine Elliott and Solicitor General Sylvia Jones repeated the province’s concerns about the risks of international travel and "imported variants" that threaten the province's reopening.

They called for a federal requirement that fully vaccinated international travellers present proof of immunization and take a COVID-19 test on arrival, and asked for a stronger quarantine regime for unvaccinated travellers.

Juni said it's more important to discourage travel from Delta hot spots to elsewhere in the province.

"You won't be able to stop that at the border. If we want to stop it, then we probably need to make sure that people do not travel and do not leave (the Greater Toronto Area)," he said.  

One northern health unit that's been struggling with a surge in cases in recent weeks confirmed a case of the Delta variant on Friday. A spokesman for the Porcupine Health Unit said a person in Timmins, Ont., had tested positive for the variant. 

Also on Friday, Ontarians who received a first dose of the Oxford-AstraZeneca vaccine 12 weeks ago had the choice to book a second dose of the same vaccine or an mRNA vaccine like Pfizer-BioNTech or Moderna through a pharmacy.

AstraZeneca recipients can book mRNA second shots through the provincial booking system on Monday.

Residents aged 80 and older were able to start booking accelerated second shots earlier this week.

This report by The Canadian Press was first published June 4, 2021. 

Holly McKenzie-Sutter, The Canadian Press


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