Statement from the Council of Chief Medical Officers of Health (CCMOH) on vaccination programs for Fall 2022


September 7, 2022 | Ottawa, ON

As we reflect upon the last two and a half years of the COVID-19 pandemic, Canada's Chief Medical Officers of Health celebrate the strong collaboration that has occurred across federal, provincial and territorial jurisdictions and in partnership with First Nations, Inuit and M├ętis leadership. These collective efforts include the timely advice and guidance from our public health experts and advisory tables; and the tireless efforts of our health professionals and other staff supporting Canada's largest vaccination campaign and providing care despite the considerable strains on our health systems. Moreover, the efforts made by communities and individuals in Canada have allowed us to achieve high vaccine coverage, reduced the harms of COVID-19 and increased the number of saved lives. We have come a long way since the first dose of a COVID-19 vaccine was administered in Canada, with vaccines now available for anyone 6 months of age or older. Over 80% of the total population in Canada are vaccinated with the primary series, and almost 60% of adults have had at least one additional dose. Moving forward, our continued work together will play an integral role in our emergence from this pandemic.

Communities across Canada recently experienced a rise in transmission driven primarily by the Omicron BA.4 and BA.5 variants. The impact of this summer wave was reduced by the high level of vaccination and immunity in Canada, however, it underscores the reality that COVID-19 still poses a risk for individuals and communities, and increases pressure on our health systems. As Fall approaches and we return to spending more time indoors, we expect to see an increase in cases again. There are several other factors of concern as we head into the respiratory illness season. These include ongoing evolution of the SARS-CoV2 virus, waning immunity from previous doses of COVID-19 vaccine or infection (more than 6 months ago), and the increased circulation of other respiratory diseases like influenza, which puts more pressure on our strained health systems.

Studies show that booster doses of mRNA COVID-19 vaccines are effective at bolstering waned immunity from previous doses or infection, which increases protection against severe disease including reducing hospitalization and death. The National Advisory Committee on Immunization (NACI) strongly recommends that individuals who are at an increased risk of severe illness from COVID-19 (including at-risk children 5 to 11 years of age) should be offered a Fall COVID-19 vaccine booster, six months after the last dose or infection regardless of the number of booster doses previously received. NACI also recommends that all other individuals 5 to 64 years of age may be offered a fall COVID-19 booster dose six months since the last dose or infection, regardless of the number of booster doses previously received.

With the authorization of the bivalent Omicron-containing mRNA COVID-19 vaccine on September 1, 2022, NACI strongly recommends that individuals 18+ should be offered this vaccine as a booster dose. For adolescents 12 to 17 years of age with moderately to severely immunocompromising conditions and/or who have biological or social risk factors that place them at high risk of severe outcomes from COVID-19, NACI also recommends that the bivalent vaccine may be offered to this population based on expert opinion and data in adults. However, individuals eligible for a Fall booster dose, particularly those in groups at a higher risk of severe outcomes from COVID-19, should not delay their planned vaccination if the bivalent vaccine is not readily available. The original mRNA COVID-19 vaccines continue to provide effective protection as a booster against severe COVID-19 outcomes. Individuals choosing to delay a booster dose in anticipation of a new vaccine formulation should carefully assess their individual risks.

As children head back to school, a key focus is to support parents and children 5 to 11 years of age to receive their primary series of COVID-19 vaccine, since vaccine uptake in Canada stands at only 50% for this age group. For children 6 months to 5 years of age who have a higher risk of COVID-19 related hospitalizations than older children, vaccination programs recently began with a primary series of two doses of the Moderna Spikevax (25 mcg) vaccine. We will work with health providers including pediatricians and trusted community leaders to provide reliable information and lower barriers to access vaccines in the youngest age groups prior to respiratory virus season.

Staying up-to-date with our vaccines is essential to maintaining protection against COVID-19 and other vaccine preventable diseases, allowing us to continue enjoying the essential connections in our lives and the activities we love most. While different Federal-Provincial-Territorial jurisdictions and Indigenous communities may adjust their programs based on epidemiology and programmatic considerations, in general, staying up-to-date with COVID-19 vaccinations means getting a Fall booster for those who have not had a vaccine or infection in the preceding six months. We also urge eligible individuals to get their flu vaccinations as these become available. As the school year approaches, it is a good time to think about catching up on other vaccinations (e.g., measles, polio), as the COVID-19 pandemic may have disrupted access to routine immunizations. We encourage people to seek information from their health provider or local public health authorities if they have questions about the vaccines that are best for them or the children in their care. We would also like to recognize and acknowledge Indigenous and other racialized populations' ongoing efforts to administer COVID-19 vaccines.

As individuals, we can further contribute to reducing the impact of not only COVID-19, but also influenza and other respiratory illnesses, by continuing to layer personal protective measures alongside vaccinations. This includes staying home when sick, especially if you have a fever and cough, wearing a well-fitting respirator or mask in public indoor settings for additional protection, improving indoor ventilation, and washing hands regularly. These combined efforts will continue to help us in our collective transition away from the crisis phase towards a more sustainable approach to long-term management of COVID-19.

The Council of Chief Medical Officers of Health includes the Chief Medical Officer of Health from each provincial and territorial jurisdiction, Canada's Chief Public Health Officer, the Chief Medical Advisor of Health Canada, the Chief Medical Officer of Public Health of Indigenous Services Canada, the Chief Medical Officer from the First Nations Health Authority, and ex-officio members from other federal government departments. Learn more about federal, provincial and territorial collaboration on public health in Canada by visiting the Pan-Canadian Public Health Network website.

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