COVID-19 cases are ticking up in Toronto. Should you rush to get vaccinated?

New COVID-19 boosters are expected to roll out in Toronto — and across Canada — this fall.  

Those new vaccines come as early signals forecast Canada is potentially entering a fall COVID-19 wave, with positive COVID-19 tests and hospitalizations on the rise across the country, according to new data from the Public Health Agency of Canada.

In Toronto, health officials are also tracking a small peak in some COVID-19 activity. The latest data from the city shows the seven-day average of new cases and the number outbreaks in institutions have been slowly climbing over the past 30 days. 

Despite that slight uptick, research shows that a majority of Canada's population has developed some level of immunity against the virus thanks to high rates of vaccination. However, health experts warn there is still the potential for lasting health impacts from first or repeat infections such as long COVID, and new subvariants could still pose risks. 

Here's what you need to know about the population's level of protection, and whether or not you should get the jab. 

Is this uptick in COVID-19 cases cause for concern? 

Health officials say small waves of the virus are expected this time of year, especially as people start spending more time indoors as temperatures drop. 

"We've seen this year after year after year now, that we are going to see a rise in cases predictably as we move from the summer into the fall," said Dr. Isaac Bogoch, an infectious disease specialist at University Health Network.

For now, Toronto Public Health (TPH) says community levels of transmission in Toronto remain relatively low, adding that current trends for the virus are currently no cause for concern.

"Every fall we see an increase in COVID activity...We're monitoring the data and preparing if there might be an early start," said Irene Armstrong, an associate medical office of health with the city's public health agency.

Dr. Fahad Razak, an internal medicine physician at St. Michael's Hospital, said subvariants play a role in the spread of the virus.

"We shouldn't be surprised. The virus mutates in order to survive," Razak said. 

One subvariant in particular — a lineage named BA.2.86 — has caught the attention of the medical community. In a tweet, the U.S. Centers for Disease Control said it is monitoring the subvariant, which was first detected in the United States, Denmark and Israel.

"It is heavily, heavily mutated. This version of the virus has more than 30 mutations," Razak said.

Though it's unclear if the strain will cause more severe illness, Razak said it's one to "very carefully watch" over the coming weeks. 

What is hybrid immunity and will it protect me?

Hybrid immunity is developed through a combination of both prior vaccination and infection, allowing peoples' immune systems to better detect and fight the virus.  

A new study shows that three-quarters of the country had detectable antibodies from prior infections by March 2023.

Even with hybrid immunity, people can still catch COVID-19, Bogoch said. But their chances of developing a severe illness due to the virus are reduced.

It's important to note that antibodies developed through prior infections can wane and become tougher for a person's body to detect over time, health officials say.  

Should I get the updated booster? 

Booster shots could shore up Canadians' immunity this fall, particularly as drug makers have adapted their vaccines to better match currently circulating strains. Canada's national vaccine advisors have already recommended getting an updated dose once fresh vaccines do arrive. 

Razak said the latest booster is expected to protect against all major subvariants of the virus, with the possible exception of the BA.2.86 strain. 

If you're considered at high-risk, TPH recommends you get the updated shot when it's available. High-risk individuals include seniors aged 65 and up, people living in long-term care homes, pregnant individuals, anyone with underlying medical conditions, people who are pregnant, and First Nations, Métis and Inuit people.

For adults not at high risk, officials still recommend you get the jab. But health experts say it's up to individuals to decide whether they want an extra layer of protection.

"There's a myriad of health-care providers that are available that can really help walk through some the intricacies and nuances of individual clinical decisions," Bogoch said.  

What if I'm behind on the last booster?

If you're not up to date on your boosters, the National Advisory Committee on Immunization (NACI) and Ontario's Ministry of Health are recommending people who aren't high-risk to hold off on getting vaccinated until the fall boosters are rolled out. 

The next round of vaccines will likely be monovalent — meaning they will specifically target the Omicron family of sub-lineages, NACI said in July. 

Because they can better target the strains that are circulating, Armstrong said the updated vaccine "should provide better coverage" than the current vaccines. 

When are the boosters rolling out? 

That next wave of booster shots isn't yet approved in either Canada or the U.S.

Experts warn those vaccines could still be weeks away from approval but are expected to be released at some point this fall.