Quick reference guide on use of COVID-19 vaccines for youth and adults (12 years and over): Vaccines available in Canada

Table 1 summarizes some of the key features of COVID-19 vaccines available in Canada for youth (12 to 18 years) and adults.

Table 1. Quick reference table on COVID-19 vaccines available in Canada for youth and adults
Product brand name	Pfizer-BioNTech Comirnaty COVID-19 vaccine	Moderna Spikevax COVID-19 vaccine	AstraZeneca Vaxzevria COVID-19 vaccine	Janssen COVID-19 vaccine
Type of vaccine	mRNA	mRNA	Viral vector	Viral vector
Date of authorization in Canada	December 9, 2020 (16 years and older) May 5, 2021 (12 years and older) November 9, 2021 (booster)	December 23, 2020 (18 years and older) August 9, 2021 (12 years and older) November 12, 2021 (booster)	February 26, 2021	March 5, 2021
Authorized ages for use	12 years and older^{Table 1 Footnote g} 18 years and older for booster^{Table 1 Footnote g}	12 years and older^{Table 1 Footnote g} 18 years and older for booster^{Table 1 Footnote g}	18 years and older	18 years and older
Authorized dose	0.3 mL (30 mcg of mRNA)^{Table 1 Footnote a}	0.5 mL (100 mcg of mRNA) for primary series 0.25 ml (50 mcg of mRNA) for booster^{Table 1 Footnote b}	0.5 mL (5 x 1010 viral particles)	0.5 mL (5 x 1010 viral particles)
Authorized schedule^{Table 1 Footnote b}	2 doses, 3 weeks apart booster at least 6 months after primary series completed	2 doses, 4 weeks apart booster at least 6 months after primary series completed	2 doses, 4 to 12 weeks apart	1 dose
Route of administration	Intramuscular (IM)	Intramuscular (IM)	Intramuscular (IM)	Intramuscular (IM)
Nature of the antigen	Transmembrane prefusion spike protein	Transmembrane prefusion spike protein	Transmembrane spike protein	Transmembrane prefusion spike protein
Adjuvant (if present)	None	None	None	None
Primary storage requirements pre-puncture^{Table 1 Footnote c}	-90°C to -60°C	-25°C to -15°C^{Table 1 Footnote d}	+2°C to +8°C	+2°C to +8°C
Additional storage options pre-puncturec	1 month at +2°C to +8°C and 2 hours up to +25°C -25°C to -15°C for up to 2 weeks^{Table 1 Footnote e}	30 days at +2°C to +8°C and/or 24 hours at +8° to +25°C (the 24 hours is combined with any post-puncture time at this temperature)	-	-
Diluent	Yes - 0.9% sodium chloride diluent provided by the manufacturer 1.8 ml added to the vial	No	No	No
Usage limit post-puncture	6 hours at +2°C to +25°C^{Table 1 Footnote f}	24 hours at +2°C to +25°C (any post-puncture time at +8° to +25°C is combined with any pre-puncture time at this temperature to not exceed 24 hours)	6 hours at room temperature (+8 to +30°C) or 48 hours at +2°C to +8°C	3 hours at room temperature (up to +25°C) or 6 hours at +2°C to +8°C
Formats available	Multi-dose vial (6 doses)^{Table 1 Footnote a}, preservative-free	Multi-dose vial - may vary depending on use for primary series or booster doses (maximum 20 doses), preservative-free	Multi-dose vial (8- and 10-dose presentations), preservative-free	Multi-dose vial (5 doses), preservative-free
Abbreviations: mRNA: Messenger ribonucleic acid
Table 1 Footnote a Refer to the Pfizer-BioNTech Comirnaty COVID-19 Vaccine product monograph for appropriate diluent, dilution instructions and type of needles/syringes that can be used to extract 6 doses from a single vial. Table 1 Return to footnote a referrer Table 1 Footnote b Authorized schedule per the product monograph. The National Advisory Committee on Immunization (NACI) recommendations may differ for interval between the first and second dose, and for the Moderna dosage for the booster dose. See appropriate sections under "Recommendations for Use". Table 1 Return to footnote b referrer Table 1 Footnote c Protected from light during storage Table 1 Return to footnote c referrer Table 1 Footnote d Do not store on dry ice or below -40°C Table 1 Return to footnote d referrer Table 1 Footnote e Vials stored at -25°C to -15°C for up to 2 weeks may be returned one time to the recommended storage condition of -80°C to -60°C. Total cumulative time the vials are stored at -25°C to -15°C should be tracked and should not exceed 2 weeks Return to footnote e referrer Footnote f After dilution, vaccine must be used within 6 hours Table 1 Return to footnote f referrer Table 1 Footnote g NACI has indicated that, to minimize the risk of myocarditis/pericarditis, the Pfizer-BioNTech Comirnaty product is the preferred vaccine for the primary series in those 12 to 29 years of age. It may also be the preferred product for the booster dose in those 18 to 29 years of age. NACI notes that moderately and severely immunocompromised individuals may benefit from the slightly higher antibody levels generated and slightly higher vaccine effectiveness provided by the Moderna 100 mcg vaccine compared to the Pfizer-BioNTech 30mcg vaccine. Moderna Spikevax may be considered for those who are moderately or severely immunocompromised based on clinical judgment. Table 1 Return to footnote g referrer

Note: NACI preferentially recommends mRNA vaccines because of the following:

they have a higher efficacy and effectiveness than the viral vector vaccines, including against variants of concern
they have not been linked with vaccine-induced immune thrombotic thrombocytopenia (VITT) and other adverse events, which have been associated with viral vector vaccines