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Quebec offers extra dose to travellers whose vaccination status isn’t recognized

MONTREAL — Quebec is offering an extra dose of mRNA vaccine to people who want to travel to countries that don't recognize their vaccination status.

A third dose is being made available because some countries don't consider people fully vaccinated if they have received a mix of COVID-19 vaccines, the Health Department said Monday.

"The administration of an additional dose of vaccine remains an exceptional measure for people who have an essential trip planned outside the country, in the short term, and that must meet vaccination requirements," the department said in a statement.

But health officials are warning it's up to the recipient to seek advice and weigh the risks before getting an extra dose of the Pfizer-BioNTech or Moderna vaccines.

A spokesman for the Health Department said earlier on Monday an additional dose doesn't necessarily provide more protection compared with two doses, adding the safety of receiving three doses is unclear. 

"The person should be properly counselled to be informed of the potential risks associated with this added dose compared to the benefits of the planned trip," Robert Maranda said in an email. "It is up to everyone to weigh the balance of risks and benefits."

Quebec considers people who have recovered from COVID-19 and who have had a single dose of a two-dose vaccine to be adequately vaccinated. But health officials in mid-July said they would offer that group a second dose if they wanted to travel.

One expert preached patience, noting that the rules are evolving as more data becomes available. "I think we need to be patient, we shouldn’t give people vaccines they don’t need," said Dr. André Veillette, an immunologist at the Montreal Clinical Research Institute, a research centre affiliated with Université de Montréal.

Veillette said there are certain segments of the population that could benefit from a third dose, such as those who are immunocompromised or who have had an organ transplant. Another group that might be considered for a third dose are residents of seniors homes, many of whom will be six months removed from their second doses by October.

But third doses shouldn't be needlessly doled out, Veillette said in an interview Monday. “We should not waste vaccines simply because people want to go to the Caribbean,” he said, adding that it would be embarrassing given some countries haven't yet begun to vaccinate their own population. 

"It’s not a good image," he said.

The Health Department says there is no international consensus on what constitutes a fully vaccinated person, adding that the federal government is working to have mixed vaccinations or shots of AstraZeneca or Covishield more widely recognized internationally.

"In the meantime, certain exceptional measures are possible in Quebec to accommodate people who have an essential trip planned in the short term," the department said.

In Quebec and the rest of the country, mixing doses is accepted. Dr. Matthew Oughton, an infectious disease specialist at Montreal's Jewish General Hospital, said there is accumulating evidence that certain combinations of mixed vaccine schedules are equivalent or superior to two doses of the same vaccine.

“It’s kind of a conflict between the bureaucratic and the scientific,” Oughton said. “Until such time, people in that situation are stuck between the bureaucratic and the scientific where if they want to travel, they may have to go get a second dose of an approved two-dose vaccine to be fully immunized."

Quebec reported 75 new cases of COVID-19 Monday along with 223 new infections from Friday and Saturday. The province has 814 active reported cases. Health officials reported one death attributed to the novel coronavirus since Friday's report, and they said the number of patients in hospital with COVID-19 was 67 — stable since Friday.

Meanwhile, Premier François Legault announced on Monday his government is relaxing more rules for bars, nightclubs, festivals and entertainment venues. 

Legault said on Twitter that beginning Sunday, bars and nightclubs can serve alcohol for an extra hour, until 1 a.m., and they must close by 2 a.m. Festivals will be able to host a maximum of 15,000 people outside — up from 5,000. Indoor venues will be permitted to welcome a maximum of 7,500 people seated indoors, up from 3,500. Dancing, however, remains prohibited.

Quebec's public health institute says 83.5 per cent of residents aged 12 and up have received at least one dose of COVID-19 vaccine and 62.5 per cent are considered adequately vaccinated. 

This report by The Canadian Press was first published July 26, 2021.

Sidhartha Banerjee, The Canadian Press

Note to readers: This is a corrected story. A previous version stated that Quebec was offering the extra dose only to recipients of AstraZeneca vaccine.