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October 20, 2021

Booster shots should be offered to Canada’s health care workers

COVID-19
vaccination

Booster shots should be offered to Canada’s health care workers: employers must apply a layered approach to protecting workers

The Canadian Federation of Nurses Unions, which represents close to 200,000 nurses and student nurses across Canada, urges the National Advisory Committee on Immunization (NACI) to recommend that provinces/territories offer the Pfizer-BioNTech COVID‑19 booster shot to all frontline direct care health care workers who received their second dose more than six months ago. With health care worker shortages reported in every province and a health system on the brink of collapse in many jurisdictions, Canada cannot afford to lose health care workers to illness.

Nurses and other health care workers are at high risk for exposure to SARS-CoV-2, the virus that causes COVID-19. As of June 15, 2021, over 94,000 health care workers in Canada had been diagnosed with COVID-19. Many of these workers may have suffered, or may now be suffering, “long COVID” symptoms. Data from the Public Health Agency of Canada indicates that 60% of adults had post-COVID syndrome, experiencing at least one symptom over the long term (more than 12 weeks after their initial COVID-19 infection); 10% of adults were unable to return to work over the long term. Notably, “long-haulers” may have experienced asymptomatic, mild, moderate or severe COVID-19.

Health care workers are on the front lines, at the bedside of the very sickest COVID‑19 patients. Because their occupation puts them at high risk of exposure, health care workers need the very highest level of protection to reduce any risk of transmission (to their colleagues, patients and families), of infection, severe illness and the potential long-term complications of COVID-19. It has now been up to 10 months since health care workers in Canada received their initial doses.

New evidence published in The Lancet indicates that the Pfizer-BioNTech vaccine’s effectiveness against all SARS-CoV-2 infections fell from 88% during the first month after receiving two vaccine doses to 47% after six months; its effectiveness against hospitalizations remained high at 90% overall against all variants. The study also recognized that the Delta variant poses a significant and ongoing threat. An analysis released recently in CMAJ shows the Delta variant increases the risk of hospitalization by 108%, ICU admissions by 235% and death by 133% when compared to the original strain.

Following evidence of the efficacy and safety of third doses, the U.S. Centers for Disease Control and Prevention has recommended a third dose of Pfizer-BioNTech vaccine be offered to health care workers. The UK’s National Health Service is also making the booster shot available to workers in its health care system. Finally, earlier this month, the European Medicines Agency concluded that booster doses “may be considered at least 6 months after the second dose for people aged 18 years and older”.

The Canadian Federation of Nurses Unions continues to advocate for a universal vaccination strategy, and a global vaccination effort, informed by equity-mindedness and science. Scientific data makes it clear that vaccines are effective at preventing severe illness, hospitalization and death from COVID-19, including the Delta variant. That said, vaccines are not a panacea, and public health measures need to continue for the foreseeable future. Health care employers must apply a layered approach to protecting workers, including vaccines, infection control plans (including appropriate ventilation and dedicated COVID units), and the use of optimal personal protective equipment with respiratory protection (N95 masks or a higher level of protection) against aerosol transmission.

The CFNU appealed to Prime Minister Trudeau to support the call for the National Advisory Committee on Immunization (NACI) to recommend that provinces and territories offer the Pfizer-BioNTech COVID‑19 booster shot to all frontline direct care health care workers who received their second vaccine dose more than six months ago. (Click here to see the letter.)