Archived 41: Summary of NACI statement of June 29, 2022: Interim guidance on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada

Publication date: June 29, 2022

Notice to reader

• NACI statements and publications
• COVID-19 vaccine: Canadian Immunization Guide

On this page

• Overview
• What you need to know
• Quotes

Overview

• On June 29, 2022, the Public Health Agency of Canada (PHAC) released interim guidance from the National Advisory Committee on Immunization (NACI) on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada. This guidance is based on current evidence and NACI's expert opinion.
• The likelihood, timing, and severity of a future wave of COVID-19 is uncertain. There may be an increase in COVID-19 activity in the later fall and winter seasons as people spend more time together indoors.
• NACI's interim guidance is based on the need for, and benefit of, COVID-19 vaccine booster doses in the fall of 2022 in the Canadian context. This guidance will help provinces and territories plan fall booster dose programs in their jurisdictions to help increase protection against COVID-19 in advance of a possible future wave.
• NACI continues to strongly recommend a primary series with an authorized mRNA COVID-19 vaccine in all authorized age groups to protect against severe COVID-19 illness and hospitalization. NACI also continues to recommend a first and second booster dose in some populations. For more information on these recommendations, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide, as well as additional statements on the NACI web page.
• NACI recommends that:
  1. Individuals who are at increased risk of severe illness from COVID-19 should be offered a fall COVID-19 vaccine booster dose^{Footnote *} regardless of the number of booster doses previously received, including:
     • Older adults (≥65 years of age)
     • Residents of long-term care facilities or congregate living settings for seniors
     • Individuals 12 years of age and older with an underlying medical condition that places them at high risk of severe COVID-19
     • Adults in or from First Nations, Métis, or Inuit communities, where infection can have disproportionate consequences
     • Adults in racialized communities and marginalized communities (e.g., people living with disabilities) disproportionately affected by COVID-19
     • Residents of other congregate living settings (e.g., quarters for migrant workers, shelters, correctional facilities, group homes) who are 12 years of age and older

       (Strong NACI Recommendation)

  2. All other individuals 12 to 64 years of age may be offered a COVID-19 booster dose^{Footnote *} in the fall of 2022, regardless of the number of booster doses they have previously received. (Discretionary NACI Recommendation)
  3. COVID-19 booster doses may be offered at an interval of 6 months since a previous COVID-19 vaccine dose or SARS-CoV-2 infection. A shorter interval of at least 3 months may be warranted in the context of heightened epidemiologic risk, as well as operational considerations for the efficient deployment of vaccine programs. (Discretionary NACI Recommendation)

For the full statement, including supporting evidence and rationale, please see NACI Statement: Interim guidance on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada.

For more information on NACI’s recommendations on the use of COVID-19 vaccines, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide (CIG), as well as additional statements on the NACI web page.

What you need to know

• NACI continues to strongly recommend a primary series with an authorized mRNA COVID-19 vaccine in all authorized age groups to protect against severe COVID-19 illness and hospitalization. NACI also continues to recommend a first and second booster dose in some populations. For more information on these recommendations, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide, as well as additional statements on the NACI web page.
• In the later fall and winter months, Canada could experience an increase in COVID-19 activity as people spend more time together inside. The emergence of new variants in the fall and winter seasons is also possible.
• NACI has developed interim guidance to help provinces and territories plan COVID-19 booster dose programs in advance of a possible fall wave. When developing this guidance, NACI reviewed data on the current epidemiology of COVID-19 in Canada; the duration of protection offered by COVID-19 vaccines and SARS-CoV-2 infection; and considered new vaccine formulations, including multivalent vaccines.
• NACI recommendations on the use of booster doses in the fall have a focus on populations who are at increased risk of severe illness and death from COVID-19. Preliminary evidence suggests that protection against infection and symptomatic disease from COVID-19 vaccines decreases over time, although protection against severe disease appears to last longer. Booster doses can help increase protection against both infection and severe disease, which is especially important for people who are at high risk of severe outcomes.
• Preliminary data suggest that the safety of additional booster doses of mRNA COVID-19 vaccines is comparable to previous doses. Canadian and international safety data show that booster doses of mRNA COVID-19 vaccines are well tolerated and no new safety signals have been identified.
• Vaccine manufacturers are working on new COVID-19 vaccines, including multivalent vaccines and vaccines that target specific variants of concern. Multivalent vaccines are designed to provide protection against two or more strains of the COVID-19 virus (e.g., original strain and Omicron strain). Details on the safety and efficacy of these vaccines continue to emerge.
• NACI will provide recommendations on the type of COVID-19 vaccines for booster doses offered in the fall as evidence on new COVID-19 vaccine formulations, including multivalent COVID-19 vaccines, becomes available.
• NACI will continue to monitor the evolving evidence, including COVID-19 activity and COVID-19 vaccine options in Canada, and will update guidance as needed.
• Provinces and territories continue to closely monitor COVID-19 activity in their jurisdictions and will determine when to offer fall booster doses based on their unique circumstances.

For the full statement, including supporting evidence and rationale, please see NACI Statement: Interim guidance on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada.

For more information on NACI’s recommendations on the use of COVID-19 vaccines, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide (CIG), as well as additional statements on the NACI web page.

Quotes

“We know that respiratory infections often increase in the later fall and winter when people gather together indoors. While we are not yet certain whether the SARS-CoV-2 virus will fall into a regular seasonal pattern, it is prudent to prepare for a fall COVID-19 vaccine booster program to prevent a resurgence in the later fall and winter, when the health system is historically strained from other diseases.

As with previous COVID-19 booster programs, a fall booster dose will be most important for older adults and other populations at increased risk of severe COVID-19 disease. A fall or winter booster could be your first, second, or third COVID-19 booster dose.

As we have seen with previous boosters, we expect these boosters to provide good protection at first, but we expect protection against symptomatic disease to wane over time with protection against severe disease to be better maintained. NACI encourages you to listen to your provincial and territorial public health authority to understand when is the right time for you to receive a fall booster dose, as we know these are most impactful when used close to a disease wave before waning occurs.”

“As the COVID-19 virus continues to circulate worldwide and emergence of new variants is ongoing, we must remain prepared for resurgence in the months ahead. As such, keeping up-to-date with booster doses continues to be very important for reducing the risk of hospitalisation and death due to COVID-19. Data from early April through early May, when Omicron variant activity was very high, indicate that people vaccinated with a complete primary series plus an additional dose of COVID-19 vaccines had approximately five times lower hospitalisation rate and seven times lower mortality rate compared to unvaccinated people. To this end, NACI's guidance on planning considerations for a fall COVID-19 vaccine booster program, which continue to focus on populations at increased risk of severe illness and death from COVID-19, will help provinces and territories plan booster programs in advance of a possible fall or winter COVID-19 wave. As we can expect local epidemiology to vary, it is important to follow your provincial or territorial health authority recommendations for staying up-to-date with COVID-19 vaccines, including booster doses, to protect against serious illness. Once again, I would like to thank NACI for continuing to provide timely, expert advice on the use of COVID-19 vaccines to provide Canadians with the best possible protection against the SARS-CoV-2 virus.”