 The executive lead of BC's immunization program, Dr Ballum is an outstanding health professional and leader and has done, I think, an extraordinary job in leading our immunization campaign on our immunization program in BC, one of the most successful immunization programs in the world. As part of today's briefing, we'll be providing an update on the next phase of our immunization plan as we prepare for the fall. People in BC have demonstrated a true commitment to protecting themselves, their loved ones, and community throughout the pandemic by observing public health measures and getting vaccinated in record numbers. It's important to recall that 94% of British Columbians, 94%, have received their first dose immunization from COVID-19. And every time, I want to acknowledge and thank every British Columbian who, when they've been invited to get vaccinated, have got vaccinated and protected themselves in their community. These efforts have saved lives. Not a few lives, not 10 lives, but thousands of lives. And of course, around the world, vaccination has saved many, many more than that. Our number one priority is, was, and will be protecting people, especially those at the highest risk of severe illness or death. That is why BC has followed advice from public health since day one and has implemented measures to protect those living in long-term care, elderly populations, and those who are clinically extremely vulnerable, ensured that these groups of people were and are prioritized for vaccination. Equally as important is protecting our healthcare system capacity. This means ensuring our healthcare workers receive priority access to vaccines to protect themselves and those they provide care for and reducing pressure on our healthcare system through a robust vaccination program and appropriate public health measures based on the best available evidence. I am proud that in British Columbia, unlike anywhere else in North America, 100% of our healthcare system workers are vaccinated with a primary series of COVID-19 vaccines. We also want to keep our communities safe and bring people back together safely. Thanks to people getting vaccinated in record numbers, we were able to lift social restrictions earlier this year. We continue our work to reduce the impact of this pandemic, protecting our health and our health system. Now is the time to continue this momentum and prepare for the fall. These are and will continue to be as we continue to live in this pandemic, challenging times, challenging for our healthcare system and challenging for people around BC. We've gone through multiple phases and together implemented different strategies to address COVID-19 while protecting critical social interactions. It's why in BC and we can be proud of this, all of us can be proud of this. We kept schools open when others closed them because the health and social implications for children were so important. And we're going to continue as we deal with the present circumstances of COVID-19 to do the same thing. And with that, it's my honor to invite Dr. Martin Lavoie to provide further details and vaccinations to date and the science guiding our decisions. Thank you, Minister. Good afternoon. So my name is Dr. Martin Lavoie. I'm the Acting Provincial Health Officer in BC. I would also like to acknowledge that we're here gathered here today on the land, the traditional territories of the Musqueam Squamish and the Tsleil-Waututh First Nations people. So I'll repeat that our first priority is and continues to be to protect people and especially those at highest risk of severe illness and death. And as Minister mentioned, continues to protect, we want to protect the healthcare system, its capacity and protect everybody in our communities as well. But we also want to bring people back together safely. So since the beginning of this pandemic, public health, we've been looking, keeping our eyes on a number of key factors. And these factors were actually helping us, guiding us in terms of all the recommendations that were made and also to guide our actions, all the actions that we took to actually manage this pandemic. So these various factors include, among many, a number of things. So we initially, if you remember, we were looking at the interval between the first two doses. We also are looking, continue to be looking at those new variants of concerns that keep popping up and their transmissibility, how infectious they are. We also look at all the different types of vaccines that we have available for COVID-19. We look at outbreaks, we look at cases, infections, breakthrough infections. We also look obviously at what happens in the rest of this country, but also around the world. It's a global pandemic. We look at case rates, the number of cases, how that evolves, and we also look at what happens with hospitalizations. So this work has and continues to be very important, and we will continue to keep our eyes on all these things, and we will continue to adapt as the pandemic is evolving. So as you can see partly here on this graph, the number of deaths and the number of hospitalizations have decreased significantly a number of times and even more recently. And so we can see that here. And they have dropped significantly from those peaks that we see to much lower, much lower levels. Vaccination has made a huge difference to be able to get us there and drop the number of cases, hospitalizations, and deaths. So we need to continue on that trend. We're in a much better position now, and it means that we need to be all up to date with all the doses that are recommended in our particular situations. Unfortunately, we know that there's also about 1.3 million people who have not yet received their booster dose. So being fully immunized with all the doses that are recommended is very important because we know that it makes a huge difference, provides excellent protection, and it makes a big difference in terms of what we see month over month. So over the last few weeks, as you may have heard, we have seen an increase in the number of cases being hospitalized. So we are keeping our eyes on that. The virus continues to circulate, so we want to be clear. The pandemic is not over, unfortunately, and we are seeing the number of cases and number of people ending up in hospital go up and down, and we will continue to see that, and that is expected. We saw, and this graph here is actually showing, so what we saw in the last six months or so is Omicron. Omicron slowly going through COVID-19 are expected to circulate in much higher numbers, and this is when many people get sick, and this is when the risk of getting infected increases. That's why right now it's very important to have received all the doses that are recommended and also to take measures to stay safe and to protect people around you as well. So right now our layers of protection are similar, slightly different, we're in a better place. We were able to lift the restrictions we had put in place before, which is good. We're coming back together safely, but we need to continue. And so I want to emphasize, and this is very important, that individually we all continue to play a role. I see people here wearing masks, keeping your distances when you're in crowds, not going out when you're sick. These kinds of things are extremely important, washing your hands as well, very important. And so these things are measures, actions that people can continue to take, and people do, and we encourage that. We should continue to respect everyone's personal space. Some people have various medical conditions that put them at higher risk. It's important to respect that. Consider their particular situation before interacting with them. And I mentioned, clean your hands and staying home when you're sick. That is very important. When you know you're sick, you don't want to bring the virus to others. Most importantly, of course, and it's critical, is to get vaccinated. And we have made many recommendations for the primary series, the booster, for some people a second booster, and now we're going to be talking about the fall booster. Vaccines and vaccination offer excellent protection against severe disease, and that's the path we're on. And we continue. We're taking the next step in the fall. So the National Advisory Committee on Immunization, NACI, is strongly, very strongly recommending that vulnerable people, so those 65 years and over and people with medical conditions, receive a fall booster. NACI also recommends that all others, between 12 and 64, receive a fall booster as well. So NACI is a group of experts from various backgrounds and expertise, working together, keeping a very close eye on the situation, on this pandemic, the epidemiology of the pandemic, on the vaccines that are available, keeping an eye on research and on an ongoing basis, keeping track of all that to make sure that they can make the best recommendations to guide us, particularly with the vaccines, on how to manage this pandemic in the best way possible. So we have in BC follow very closely NACI's advice and we continue to do so. And so this is no different at this time and this is what their latest recommendations are about for the fall booster. So I want to talk a little bit more about also new vaccines that are more than likely coming to us. I think this is very important to know at this time. Understanding what's coming for us in the fall. So after over a year and a half, maybe a little bit more than that even, we have now direct experience with COVID-19 vaccines around the world. So we've learned a lot. And so now we have a much deeper understanding also on how to create, to make those vaccines to protect us against current strains, current viruses that are circulating. So what's important to know now is that the manufacturers have developed vaccines that will be better adapted to Omicron, which is great news. And this is what we're going to see more than likely. Things seems to go very well right now in terms of their assessment. They seem to be very promising. And the virus has evolved as you know over time. We have the original virus that started a while ago now. And then we had the Alpha, the Beta, the Delta and many others. And it has evolved and our vaccines need to evolve as well so that as the virus goes further out away from the vaccine that we have now, we need to have a vaccine that actually is closer related to what circulates to be more effective. So these bivalent vaccines, and bivalent means two, it's going to contain the same as the ones we have now, the original virus and the Omicron as well. It'll be able to be effective again against those two strains. And they look very promising, like I said, but they still need approval by Health Canada. And so this is underway right now. So we have to wait for that. Like I said, it looks promising, but it's not done until we have confirmation. And NACI is also at the same time reviewing and they will be making more specific recommendation as they said in their latest statement about the types of vaccines that would include the bivalent vaccines. The two brands that we are expecting for those vaccines are Pfizer and Moderna. Brands that people know very well. So they're going to be mRNA vaccines as well. So we know that COVID-19 vaccinations are highly, very, highly effective and booster doses are extremely important. So we have extended boosters now for quite a while. It helps boost, bring your capacity to fight the virus back up again, but also extend so that it lasts longer. And so with boosters now we can actually be assured that we are very well protected for a much longer period of time. And so the boosters have actually helped us move transition away from the crisis phase where we were a year, year and a half ago when we started using those vaccines and things were happening very fast to a more stable, more long-term management of this pandemic. So those new vaccines and the boosters will be critical to help us maintain our trajectory, very positive trajectory so far in terms of managing this pandemic. Thank you. So now I would like to pass it on to Dr. Penny Ballum. She's the executive lead of the immunization program to talk about how to operationalize all these approaches that I've just mentioned. Penny. Thank you so much, Dr. Lavois and Minister Dix. And welcome to everyone. It's a privilege to be here. And just to talk to you about the new, you know, evolving phases of our vaccine program. I thought what I would do first of all is just give you an update of where we are with the results of our overall vaccine program. I think you know that we have, for our primary series, got really extraordinary results in our province with 93.8% of our eligible public, 12 and older, having received their first dose. And 91.2% have received their second dose of vaccine. This means that 91.2% of those who are eligible are actually fully vaccinated. And this is something as Dr. Lavois has referenced is, you know, really a remarkable level of protection when we look at jurisdictions across the world. We started our first booster program. You'll remember back in October. We started out with the most vulnerable first. If you look at all the people eligible for vaccination, 59.5% of those have received their first booster. And if you look at the people that actually were fully vaccinated, it's actually of all those because you can't get a booster until you've had dose two. It's up to about 66%. So 66% of the people that got their primary series have actually taken the opportunity of their first booster back through November, December, January, February, and they're still coming. But I just want to draw your attention. There's still 1.3 million people who haven't yet had that preliminary booster. That's very, very important because that means that if they've only had dose one and dose two, yes, they've got a good level of protection, but they're starting to get too far away from their first booster. And we're ready for them at any time. And I just want to mention that some of them have wanted to try some of the newer vaccines, the Novavax, some are interested in and we are working hard to make those vaccines available. Novavax has been in the province now for a couple of months and we are matching people up with our pharmacists around the province if they want Novavax we're trying to enable people to get what they want in order to get them that booster. So to the 1.3 million out there today, if you haven't had that first booster that we started back last fall, please go and get it from your local pharmacy or from one of your health authority clinics. And as Dr. Lavois mentioned, we started what was called the spring booster program that was, as NACI advised us, focused on more vulnerable groups and people over the age of 70 and at this point of the people that were eligible for that 64% have taken it up. And that's a reflection of we know the older people and the people with conditions that immunosuppressed them, they're keen. They really know they need protection. We know that the risk of COVID and poor outcomes is related to age primarily and other conditions where your immune system is not active. So it's not surprising that we've had that level of uptake so soon but again there are still over 200,000 people who have received an invitation for this spring booster who haven't yet taken up that opportunity and we really encourage those people because they're the group that our advisors at the national level and NACI has said you need this protection. Before I go on to the next slide, I really just want to do a shout out for the pharmacy sector in the province and the health authorities who have worked together to support this campaign for the spring booster and will be working together as we move into the fall booster. They've done a remarkable job. We have anywhere between 600 and 700 pharmacies every day offering vaccines everywhere in this province. And then for the health authorities, they're covering off the small children where people are not able to reach a pharmacy to some of our more rural and isolated areas working with the First Nations Health Authority to make sure our indigenous communities are having access to the full range of immunization. So just a big thank you to them. I've been at that for a long time and it's really great to see the results. So just a little bit more detail on the second booster campaign, our spring booster. As you remember, there were vulnerable groups that were identified and this is just some data to show you that across those groups there has been good uptake and I think we're very happy on the long-term care and assisted living residents who are actually taking up on their spring booster and that has made a big difference in that sector for just the number of cases of Omicron that we've seen. So as you can see as our vaccine campaign has evolved it gets more and more complicated and by age, by vaccine we now have gone from originally two vaccines that we were working with for the first year of the campaign we now have seven vaccines. We've got Moderna, Pfizer, we've got Pediatric Pfizer, we've got Janssen we've got Novavax and we had AstraZeneca and CovaShield so this campaign has become more complex and you know as you know the different age groups, we've had different vaccines developed for them. So if you look at people 12 and over in our province, they've been eligible for one dose two. If they were clinically extremely vulnerable and immunosuppressed the CEV one in two groups, they were eligible for a third dose to get them fully vaccinated in their primary series and then we have the two booster campaigns the first booster campaign that covered everyone except for the five to eleven year olds and the spring booster number two that actually covered the vulnerable groups we've just talked about. For children five to eleven, remember we started our campaign in very beginning of November there was a lot of excitement that those children were going to have access so again they are now eligible for dose one, dose two and for those younger children who also have compromising medical conditions that immunosuppressed them, children with cancer children with different kinds of autoimmune disease and immunodeficiency they were eligible again for a third booster, a third dose to complete their primary series and now Health Canada and subsequently NASA will be looking at whether we advise that these children five to eleven will receive a booster dose. So that is still under consideration at this point children five to eleven are not eligible for any booster dose. And I think you know we're anticipating approval of a vaccine or a formulation of a vaccine for children the really small ones, six months to four years and so that will essentially mean from six months on up everybody in this province will be eligible for at least a primary series. So we're hoping that by the end of July we will have the approval by Health Canada and NASA to commence that campaign. The health authorities will be delivering that campaign for small children with their five to eleven clinics and making provision for small children with different conditions that make vaccination not a great experience. So we're very conscious of making these clinics child friendly for the whole range of small and larger children that we're actually taking care of. But we hope that by the beginning of August we'll have approval. We know the vaccine is here in the country and so it's just the regulatory approval and then the review by NASA that will be happening you know in the very near future. So just turning now to you know the fall and you know at this point some minor adjustments that we're going to make to this spring booster campaign. As you know I've reviewed this that right now for people 12 and over we're continuing to give them dose one and two and it's always interesting I look at these reports every day to see well who's coming in for a first and second dose or their first booster and it ranges across all the ages but we know that if you go down the ages it's still the 70 the 80 year olds and above 60 year olds as we go to the older age groups they are taking up the D3 and the dose one and two if they haven't already had it at higher rates and it's the younger people that we really need to encourage and particularly to try and get them to come in for that first booster we want them to come in because they need that protection as we move into the fall but the groups that we have been vaccinating in the spring booster campaign are the very vulnerable long-term care assisted living seniors 70 and over our indigenous peoples 55 and over clinically extremely vulnerable who are immunosuppressed and we've had you know particularly from people in their late 60s we get a number of calls every day letters to doctor Henry's office saying you know I feel that I'm vulnerable I'm now quite away six months from my last dose and I'd like to have a spring booster and so what we're going to do is you know allow people who feel they meet sort of have unique circumstances if they really want to have a spring booster we will enable that but the big message is the recommendation is really the best thing to do is wait for the fall that is what Nassi has recommended the reasons Dr. Lavois has gone over this is where we're most exposed to respiratory illness we're moving indoors through the fall and the winter the risk is highest and you want to get your booster when your risk is highest and the group that were approved for the spring booster were much more vulnerable so what we will do is allow people we will be sending an update around to everyone 12 and over and give them an update on Nassi guidelines we'll be doing this through the get vaccinated system and what we will tell people is it's all about the fall we want you to wait for the next booster in the fall if you haven't had your first booster go get it now but if for your next booster it's get it in the fall but if you really feel that you've got special circumstances you can give the call center a call and we'll arrange for you to have a booster now there are disadvantages to that Dr. Lavois has talked about the new vaccines that are coming for your fall booster will be six months so if you have a booster early then the fall then you will have to wait for your full six months to get access to the new vaccines or to a fall booster when we're providing it for the whole population so best to wait and follow the advice of public health but if you really feel you have special circumstances we will enable that for the rest of the population we will be commencing a campaign and for us the fall will start at the beginning of September and we have to be nimble if things change and take direction from public health but right now our planning is focused on starting our fall campaign in September it will be a campaign that will as always the priorities will be articulated by our public health leadership and then our job in the vaccination program is to organize that so that we send out the invitations through the get vaccinated system according to those priorities and we will be doing that as we have for all the other phases of this campaign starting in early September and for the children they will continue to get offered dose one and dose two and if there is a change in the recommendation for a booster from Health Canada in the coming weeks or months then we will be opening that opportunity up to them at a six month interval and for children six months to four years we hope to be opening up their primary series for them hopefully by early August so you know generally in summary Nassie has strongly recommended that the fall is the best time to get your next shot and that's to give us the best protection against respiratory season the illnesses that move around it's a time when our health care system is always challenged in the winter traditionally with influenza and other respiratory viruses and now with COVID is added to that list so that's when the risk is highest and that's the strong recommendation of when we want you to get your fall booster and you know at this point in time you know everyone will get invited come the fall they'll get that invitation as they have for other things through the get vaccinated system and you know all our campaigns as the minister has said will be done in order of priority so those who you know as I mentioned are going to want to get it early we will be sending out invitations not invitations but there are updates will go out to everyone but they will go in the order as we always do it those at the oldest at the longest intervals will get their updates first and those updates go out at about 40,000 a day sending an update telling everyone about the nasi guidelines get your booster in the fall but if you feel extremely susceptible at this point in time and you're not in the vulnerable group then we will enable you to get an early booster through the call center so finally you know Dr. Lavoie has talked about this boosters benefit us in many ways essentially it provides us longer protection it stimulates an immune system that's already been set up by your early shots it protects people who have a higher risk of illness and who have immune systems that where the protection wanes more quickly and that's mostly our elderly people or if you have a condition where you're immunosuppressed and generally as we've seen it's kept our community safe near normal it's not completely normal and it's allowed our hospitals to carry on dealing with things that are also very important and so just a reminder on the golden rules get all your recommended doses my 1.3 million that are out there that haven't had their first booster come on in we're waiting for you follow the health guidelines stay home if you're sick wash your hands all the time respect people's personal space we know that outdoors is safer and that's why the summer is such a great time and we usually do better in terms of respiratory illness because we're outdoors enjoying the outdoors take into consideration other people's situation elderly people in your circle of family and friends and if you're going traveling check before you travel and make sure that you're up to date on the guidelines that comes in from the federal government for travelers who are going out around the world so thank you so much minister and Dr. Levoix and I'll turn it over to you minister thank you very much Dr. Levoix and Dr. Ballum I just want to say finally again strong and emphatic thank you to everyone in BC for this effort in our province to all the healthcare workers and healthcare professionals who have on the ground delivered our vaccination program to Dr. Ballum and her team her incredible team of both staff and volunteers who supported this program people who worked in the through the past year in the service industry and who came out and made the customer service of our vaccination campaign so outstanding and I have to say I have never seen in terms of our service of people who received the vaccines so much public support for the delivery of those vaccines I mean getting a shot I take a few every day because I have type 1 diabetes but getting a shot is not a fun thing but it is an important thing and people have different reactions and different circumstances and it is a fantastic job I want to speak just to the people who have followed our guidance and got the vaccines when they have been invited the 2.8 million people who have got their first booster their third dose and that 2.8 million people are obviously strong supporters of the vaccination campaign and we are very appreciative to them today except for those who are 70 and above and those who are in clinically vulnerable 1 and 2 categories who have immune issues is that a fall booster campaign is coming and that's the best time to get it but we also respect you and your judgment and so we will be contacting you and if you feel like you need to get a booster now one will be made available to everyone in that group, thank you so that 1.3 million people who have got their 2 doses are eligible for their third dose and haven't got it yet, it's time this is a really good time as we see circumstance here and around the world an important time and as Dr Ballum says we are here and ready for you and thank you for getting the 2 doses we also haven't got their first dose yet of a COVID-19 vaccine it's 6% of the population in BC it's about 1 in 16 or 1 in 17 people there is never a better day than today to get vaccinated for the first time and I want to say that we will welcome you and every day it's not because we've been doing this for some time a large number but every day some people come in we appreciate our appreciation and our support to all of them and thank you in advance for getting those doses we are working hard to ensure that this outstanding vaccination program that serve people in every community in BC from indigenous communities and our partnership with the First Nations Health Authority to communities in every health authority that we are going to continue and it's a major challenge in the fall but we are going to continue to honor and celebrate everyone in BC and to do what we've done from the beginning of this pandemic which is to work together all of us to ensure that to reduce the impact of COVID-19 on ourselves on our neighbors and our friends in our communities it's very important to protect our health care system and allow us to do in the midst of a pandemic all the things that we hope and dream and aspire to do so thank you very much and we'll be happy to take your questions Dr. Ballum, Dr. Levoix and myself Thank you to all our speakers a reminder for media on the phone please press star one to enter the queue that's star one to ask a question please also remember to take your phone off mute you will not be audible until your name is called for media in the room please line up at the microphone provided and wait to be called please make sure to provide your full name and outlet media will be limited to one question and one follow up for our first question today we'll be starting in the room please go ahead Hi Cole Schisler, Black Press Media Hi Cole Hello So with BA5 being the dominant strain right now what is the risk of infection to people and reinfection and what's the immune escape of that variant So you'll understand that I'm going to turn that question over to Dr. Levoix Hi, good question Ready with Omicron the first one BA1 and BA2 we will see infections the risk of reinfection with Omicron is higher than it used to be before Omicron but usually typically what we would see is a less severe infection so it is not impossible to potentially even have two Omicron infections but it's more something that we would see with before Omicron and now getting infected with Omicron so what we are seeing right now is it's Omicron overall since the winter and we went from one of the siblings I call them siblings they're related Omicron BA1 replaced by BA2 now being replaced by BA5 it's not quite the majority BA5 at the moment but we are seeing the replacement so BA2 is going down and BA5 is going up so we expect to continue to see that same pattern and which will as I said we expect to see fluctuations in the number of cases number of people having to go to hospital because of it and we will probably see some of that but right now with the vaccine that people have if they have received all the recommended doses people are very well protected and what is driving severe cases mostly is really people unfortunately advanced age 80 plus to some extent also 70 to 79 as we have mentioned a few times people with immune system issues so to be protected you need to have an immune system that works well and there is only so much we can do when the immune system is significantly affected did you have a follow up yeah so we are seeing cases go up right now today the BC COVID-19 modeling group says we are on the cusp of a third Omicron wave in August but we are not getting the fourth shots until September what proactive protective measures could the province take today to stave off this incoming Omicron wave well if we remember we just went through BA2 which was quote on quote a wave so a second period of Omicron different sibling and we did quite well I mean like I said earlier it's not perfect we do see cases and where we are now and people having received all the recommended doses is the best thing that we have we are in a much better place now than we were many months ago so we are already in a good place we continue to recommend receiving all the doses that you should be receiving for your situation and we know that people who have done that are well protected now for the next number of months and that's why Nassi has looked at that very carefully and that's why the recommendation for the fall booster is in the fall and we'll stay in the room please go ahead Dr Ballum you were talking about the disadvantages to boosting early in preparation for a risky fall considering that we are in the middle of a wave or the start of a third wave of Omicron are there risks to not boosting now to protect those people and should is there a tipping point where that spring booster becomes a more widespread phenomenon that's a good question so there are many factors that we need to consider so one we need to be reassured that with people having received all the recommended doses we're in a good place and so when we're talking we just have to remind ourselves that it's very specific groups that are actually suffering more severe illness and we have actually recommended a second booster for these groups in particular but even with that it's not perfect because they only have so much immune system to go with and so there is a limit to what we can do so it's if we were to immunize everybody else that wouldn't make any difference to these people in terms of their capacity to prevent a severe disease follow up Minister you were talking about vaccinations and rates of vaccination and the first dose but there's clearly 1.3 million people who haven't gotten the third dose there's clearly a segment of the population that won't be vaccinated and if vaccines as you say are so important to this with such a large group that won't go down that road should the province, can the province reinstate some of the measures that were in place during the more severe portions of COVID masks for example and what would it take to go back down those roads I think that we've seen multiple steps taken at different times in the pandemic and it's important to remember that at different times in the pandemic for example in long-term care we've taken very different approaches to visitation our focus on visitation now understanding its importance right its importance of visitation to the lives of people in long-term care is to as much as we possibly can enable it in other words you have to be vaccinated you have to have done a rapid test and go through that to keep people maximum protected that doesn't eliminate all risk but eliminates some so our strategy has changed and will consistently change over time and so we can't predict of course what's going to happen in the fall but I am more optimistic than you the 1.3 million people we're talking about who haven't received their booster dose or their third dose who are eligible because they've received their first two or primary series dose clearly that's a group of people that supports vaccination how do we know that we know because they've got two doses and so I think the message to them in terms of keeping themselves and the community safer is to get vaccinated and every day that category slowly but significantly in the thousands moves up right equally for people who need a fourth dose who are eligible for a fourth dose because that number well relatively high there's still a significant number of people in the hundreds of thousands who are eligible for a fourth dose who haven't received it yet so to encourage them to get that and to enable that today we said that people received a third dose who are at 182 days will if they want to be able to get a fourth dose but I would say that we're still in a pandemic and that means we still have to be cautious because there is an impact every day and there is no day when I heard of someone who has had severe health outcomes from COVID-19 including death that we don't grieve for them and so as a community we've adapted and we've adapted and we've adapted and we're going to have to continue to adapt to the circumstances in front of us and right now the focus of this effort should be on those who have been invited to get a dose of a COVID-19 vaccine makes us all protected and we're going to continue to consider all of the measures that need to be taken at all times to keep people safe understanding that those have an impact one of the things that people in BC should be proud of is that we kept schools open it wasn't easy and it reflects I think exceptional work by people in the education system people in public health it wasn't easy but we did it and people had months of school in person that people living in every other problems in Canada or most other problems in Canada didn't have and that has public health and community benefits that are incalculable if you have children you know this, we know this that when you cancel school it has health impacts and impacts on them and their lives so we have to balance these things all the time and in BC we've made the decision that we should be able to keep people safe and we're going to continue to do that and I think that's the leadership of people such as Dr. Henry such as Dr. Levoix, such as Dr. Gustafson such as Dr. Ballum to lead our campaign and provide us with that guidance and I am very proud to speak all the time in solidarity with them and they are on this every single day and the action has consequences for people for people's health and for the society and we're going to continue to act based on all the evidence and follow the direction with respect to COVID-19 of public health. For our next question we're actually going to go to the phones we'll come back to the room in a moment our first question on the phones is for Rob Monroe info news please go ahead. Hi Rob. I think you need to know about the lower than 5% lower in all categories than the provincial average. I'm just wondering what you're doing about that and also all of these are severe cases I think I heard the question, it was a little muffled rub, but I'm going to give it a go. In general, the rates of vaccination BC in areas with apples apples are higher than other jurisdictions can, although they're all good. Everyone has done a good job. So the 94% of dose one is high, higher than the Canadian average and high in general. And for second doses as well. And depending on availability, the fourth dose is a little different than that, but we've done pretty well. And that reflects I think the excellent campaign we have, the really customer friendly campaign we've had, if I may say, and the outstanding work of our healthcare professionals and healthcare workers. So our task is to continue to communicate the need for vaccination and the need when you're invited to be vaccinated based on the best advice of public health to get vaccinated. And for us to do everything we can to make that easy. And that's what we're going to continue to do as there are other jurisdictions in Canada. We work together and meet on this regularly. And look, there are going to be new challenges ahead and we're going to meet those challenges. I mean, we're going to have, as Dr. Levois and Dr. Balama have said, potentially new vaccines approved by Health Canada soon, or at least a new vaccine that will provide better response against Omicron variants of concern. And that will require another huge effort on our part. And a fall vaccination campaign involving millions of people will require a huge effort on our part. It's based on the best evidence that we're going that route, based on what we've been told by the NACI. We're going to do our best to continue to communicate with people, including children, 5 to 11, for example, and others who may soon become eligible for younger children who may soon become eligible for a COVID-19 vaccine. Rob, did you have a follow-up? Yes, I don't think you quite did hear me. What I'm asking is how many of the people that are getting spirited are unvaccinated and what impact does that have on the interior health region, which has a lower vaccination rate? That caused even greater spread here, greater risk. Basically, the risk of hospitalization is five times lower if you're vaccinated. The risk of mortality is eight times lower. That's the evidence. So in interior health, it does have an impact for a number of reasons. It has an impact in the following ways. That overall areas where the rate of transmission of COVID-19 is higher and at the moment that's interior health, Vancouver Island health and northern health. Also, by definition, will have the highest rates of health care workers absent due to illness because when you're sick, you don't go to work. So that has an impact on the delivery of services, especially in some small communities. So if you only have three people working in shift in a small community and two get sick, will that affect your ability to deliver the service. So it has an impact there. And so the argument simply is to encourage people in interior health and northern health, for example, is to get vaccinated. And they have in their overwhelming majority. So the differences between some of these regions, well, maybe higher in Vancouver, in the Metro Vancouver health authorities, it's only a few percentage points higher. But we need to encourage and continue to encourage people to stay safe. We need to do this again and to ensure people are safe safe during a safe as possible during respiratory illness season. For our next question, we're going to Moira Winton, the tie. Please go ahead. Good afternoon. Thank you for taking my question. For Dr. Levois, you mentioned the limits of vaccinations, particularly more Moira, I think if you're on speaker, if you come off that because we're having you're quite low and it may be a problem at our end. If you can speak directly in the phone, I appreciate that so I can hear you clearly. Is that better? That's better. Thank you. Okay, thank you. I'm on our landline because myself about Dr. Levois, you mentioned the limits of vaccination, particularly for the most elderly and vulnerable. So what could be done today to reduce circulation and transmission of the virus itself in order to prevent death and permanent damage like long COVID? Yes. Thank you for your question. So the idea is to try to kind of maximize all the things that we can do. And so that includes the vaccines, obviously. So for those who have received all the recommended doses, in essence, we're pretty much maxed out in terms of what we can accomplish there. The zones, the areas where we could actually increase our protection and not receive all those doses. So we've mentioned that. We know also that, and I've mentioned that earlier, but individually, we all play a role. We did, of course, as Minister mentioned, if we need to reinstate measures, we will need to look at that. We keep our eyes on that. We're not there yet. But individually, we can make also a big difference and there's so many things that people can do every day to reduce the risk of transmission. So it's a number of different things. And what's coming, because we also want to have a vaccine that's adapted to Omicron, because right now the vaccine we have is not adapted. It does make a difference, but it's going to be better to have that vaccine. And so that's coming. And so we have all these things that we're trying to balance. And if you think back just a number of weeks ago, we were going through Omicron BA2. And so people are taking some measures. And we continue to immunize people and give them vaccine doses that are recommended. And Penny mentioned that. And so that's what we continue to do. Moira, did you have a follow-up? Yes, I do. Thank you. I know we're following the NACI recommendations quite closely. And NACI does say that a second booster may be offered to anyone over 12, 6 months after their last dose. So what is the risk analysis being done that says that the vaccine that's being for a more tailored vaccine or a bivalent vaccine is going to have a bigger effect than giving the non-tailored vaccine now, given that we are seeing already an increase in BA5 and hospitalization? Yeah. So when NACI look at things and come up with recommendations that say it's kind of looking at, depending on the situation, you may consider offering this. Well, the situation is right now is that we have Omicron and the vaccine that we have is not adapted to that. And so it's based on the risk, but also the difference we can make with the tools that we have. And so using the same vaccine with people who are already well protected, and that's something else we keep our eyes on, is how well are people protected with all the recommended doses? For most people, it's primary series and their booster. And they are still very well protected. And so that's in that sense that NACI is making those recommendations because what we don't know and what NACI knows that can happen is we can have another completely different variant of concern that shows up, or maybe one that we have seen already that comes back potentially. And so it just depends on the situation. And we need to look at that, what happens in Canada, in BC, and then use the tools and all the measures we have at our disposal in the best way possible. So that's what we have done up to this point. For our next question, we're going to Joujou Globe and Mail. Please go ahead. According to federal government data, BC's uptake of the second booster shot is currently lower than most provinces across the country. Could you please explain why other jurisdictions are ahead of us? So, very straightforwardly, within the categories that are recommended strongly by the NACI, as people over 70 and people with immune issues, so that 100,000 people or 96,000 people in the CEDV one and two categories, that's not the case, the take-up has been higher, higher. We have had a less broad offer of the second booster dose so far, so other jurisdictions have offered it with some of the same advice that we're giving today, with the same advice, but offered to a broader group of people in the third shot population. That's the reason why on the fourth booster, they'd be higher. And did you have a follow-up? Yes, I do. Prior to today's announcement, infectious disease experts said the messaging for people to get booster shots have not been forceful and clear enough in BC, that's including the third shot. So what's your thoughts on that? Then I have been, I would say, and I just say this delicately, of the last 150 times that I've said this, if you've been invited for your first booster, get your first booster today, sign up for the appointment today, it'll make you safer, it'll make your family safer, it'll make your community safer, get it done today. And if you've been invited for a second booster and you're in those categories, get it done today. That's something we have had and we've consistently had capacity to address it. And people are responding to this, I should say. I mean, we've been doing about 50,000 shots a week through, largely through, overwhelmingly through, a community pharmacy in the last number of weeks and we continue to do so. But there was a lot of urgency, you remember, in December and January and February and March and we certainly made the case and there was 2.8 million of them have received their third shot, their first booster. And so I think we got to continue to push that message in every jurisdiction in Canada because in terms of the third shot or the first booster, we might call it that, that was started to be made available in October, November and December. The numbers are pretty consistent across the country so we face some of the same challenges, get the booster. If you've been invited, as you have been now, in most cases for months and months and months and months, get the booster. I just want to give you my personal experience, if we will, just to say what the circumstances are. I got my first COVID-19 vaccine in the middle of April, 2021. I was about the 1.5 millionth person to get it. So it was another front of the line and I was about the 1.5 million people had received it before I did. And then I got my second COVID-19 vaccine at the strong encouragement of Dr. Ballum in the middle of July, right? Consistent with when other people got it. So if I had not in January got my third shot, that was the second shot, the third shot in the middle of January, it would be next week, one year since I've had a COVID-19 vaccine. So I strongly encourage you, every in the strongest possible way, if people have not received their booster dose, their first booster dose, their third dose, if you're in that 1.3 million people to book an appointment today, please do so, or just do so. For our next question, we're coming back to the room. Please go ahead. Bala Mendoza, CBC. Would you consider bringing back some of public health restrictions if the COVID situation worsens in BC and if so, which ones would be implemented first? And could we get an answer in French as well? First of all, I want to say it's a very, very good day for CBC and Radio Canada because Dr. Levois will be here to give the answer in French, which is, I think, having listened to me for some months, the people at Radio Canada will particularly appreciate. You know, we monitor COVID-19 every day. And it's the strong view of public health at the moment. And it's the strong view of public health at the moment. That people need to get up to date with their vaccinations and that's the key priority for us. That we've got to continue to manage in our public health care system and it has implications for us the impact of COVID-19. That people have to be careful in their lives and we talked about the golden rules before. But when I go to indoor public spaces, when I shop at Save On Foods on Marine Way or on Safeway at Kingsway in time, I wear a mask. And people don't need me to tell them to wear a mask to stay safer. And if you're visiting with a large number of people you don't know, you can wear a mask. All of these circumstances are available to people right now and they can do so. One of the things that I'm proud of in BC is that we are the first province to bring in paid sick leave. We have the Minister of Labor, which allows more people to stay home when they're sick and not face financial consequences from that. So if you're sick, stay home. And that's not just true, by the way, of COVID-19. And so I think that we just got to continue to monitor, to stay on top of, to ensure that vaccination takes place and to learn more and more about COVID-19 every day. And one of the things I am most impressed by Dr. Levoix and by Dr. Henry and by Dr. Gustafson and all of our, this is Dr. Daley, all our team around BC and the different health authorities, is their willingness to learn and their willingness to engage with people on the ground. The work that's been done in communities such as the downtown east side, for example, by Coastal Health, and the high vaccination rates in sometimes very challenging circumstances is a tribute to how much people are taking care of people. We're going to continue to do that, continue to learn, and the advice has changed a number of times. People have told me this a number of times that the advice has changed. It will change, of course, again. We'll just, again, adapt to the circumstances. Not for me to speculate what that might be in the future, but you know that we're taking care of that every day. And did you have a follow-up? Yes. Hello. I would like to know exactly what kind of measures we're going to take into account, because, as I said earlier, we're looking at and we're looking at our eyes on many, many, many factors. And we also know that the measures that we put into place in the last year, in particular, have played a role in a certain context. The context has changed a lot. So what I don't want to do is to try to predict what factors, the situation will change in what way we should take into account such or such measures, because that's a bit too much of a prediction. But we look at what's going on at the point of view of the pandemic, in what way it's distributed, the people who are the most affected, and then we're going to put in place the measures that are the most appropriate. So it's sure that there's a mask that's a measure that's easy, but when we take into account very, very strict measures at a large scale, it has negative impacts and we look at that very closely. We try not to take into account restrictive measures if we don't need to do it. We've been with restrictions for a very long time. It's been very painful. It's been very difficult. People have taken part. But we're going to do it if we need to do it. It will depend on the situation. Thank you, everyone. That's all the time we have for today. Thank you, everyone, for joining.