No less than 31% of Quebec caregivers have still not received their third dose of the vaccine against COVID-19, while nearly 11,000 illness-related absences continue to plague the health system. The immunity to infection given to staff doubly vaccinated in the fall has all but disappeared, experts say.
Many healthcare workers said they were “present” in 2021 to receive their first two doses. This vaccination coverage, then considered adequate, reached 90% at the end of September – nearly seven months ago – when the government pretended to impose compulsory vaccination.
However, this enthusiasm has waned, according to the latest data on vaccination from the National Institute of Public Health of Quebec (INSPQ). In mid-April, only 69% of health network employees had obtained the third dose, which would allow them to maintain conclusive protection against symptomatic infection and the risk of developing serious illness.
“What is clear with Omicron is that four to six months after the second dose, the immunity against infection with BA.1 or BA.2 is only around 10%. Two doses only provide 65% protection against severe disease, which is lower than those who received three doses (80%),” says Alain Lamarre, professor and researcher in virology and immunology at the Institut national de la scientific research, citing in particular a Qatari study which, however, has not yet been peer reviewed. INSPQ data prior to the arrival of the BA.2 sub-variant already reported in January of immunity with two reduced doses compared to Omicron.
Mass absences
The dizzying number of infected healthcare workers is not without consequence, notes Professor Lamarre. Absences due to the virus passed the 10,000 per day mark in the network in early April, and reached 13,000 on April 8. Some 10,833 employees were missing on Thursday.
“These massive absences can cause service disruptions. As for transmission, it is not clear whether infected employees are the source of outbreaks in healthcare settings. It can also come from visitors and caregivers. In the presence of a variant as contagious as BA.2, if only to reduce absenteeism, employees should receive the third dose. »
On Thursday, some 1,840 active cases of infection were counted in CHSLDs – or 11% of residents –, as well as around a hundred deaths linked to ongoing outbreaks. In seniors’ residences, more than 5,139 residents were affected. However, the vaccination coverage of employees in these living environments is no longer disseminated by the INSPQ.
One thing is certain, the lack of personnel linked to COVID continues to put pressure on the hospital network, indicated in a press briefing on Thursday the DD Lucie Opatrny, Assistant Deputy Minister in the Academic, Medical, Nursing and Pharmaceutical Affairs Branch. The Estrie region has reached level 4 load shedding, the highest. The congestion of several emergency rooms in Montreal, she added, also stems from the lack of personnel.
“It is linked to the availability of beds, which are linked to the level of absence of human resources. Absenteeism does indeed cause there to be significant pressure,” she explained.
According to Alain Lamarre, the situation warrants that we “update public health messages” on the importance of the third dose. “Even though vaccines aren’t perfect, they help curb outbreaks. »
In a press briefing on Thursday, the acting national director of public health for Quebec, Dr.r Luc Boileau, moreover, answered on this subject that he could reconsider the term “adequately vaccinated” chosen to describe the vaccination status conferred by two doses. In English, he added that people “were not scared off by BA.2” and that those who felt protected by two doses or a recent infection should go get that third dose.
Declining immunity
Other immunology researchers also question the lack of effort made by Quebec to increase adherence to the third dose among health care workers, but also in the general population.
“A little less than half of the population has only received two doses – most for more than six months –; it’s as if all these people had never had a vaccine protecting them against infection, ”underlines the Dr Donald Vinh, professor and researcher in microbiology and immunology at the McGill University Health Center.
“Communication on this subject is sub-optimal. If nothing is done, our hospitals are likely to remain busy for a long time, he continues. With two doses, many people with comorbid factors who do not consider themselves at risk are. They think two doses are enough, but that’s not the case anymore. »
Promoting the third dose earlier might have helped to mitigate the magnitude of the current wave, believes Alain Lamarre. “Why do people who are doubly vaccinated not go get that third dose? There is no longer the same sense of urgency. Yet the health system is also overburdened. »
The famous six-month interval between the first and second doses, which had allowed Quebec to extend the immunity conferred by the first vaccines, no longer holds water with the third dose and Omicron, adds the researcher. “There is no benefit in waiting for the third dose or waiting after a recent infection. »
Vaccines effective against multiple variants — being developed now — will likely be available in the fall, agree the two immunology experts. But even if Quebecers risk being called upon again to roll up their sleeves in the fall, according to them, they gain nothing by postponing obtaining a third or fourth dose.
“There is no reason to wait three months after an infection, relaunches the Dr Vinh. People who had BA.1 can have BA.2, and the duration of immunity is known to decrease with this variant. Collectively, we need this third dose. »