Summary of NACI statement of April 12, 2022: Updated guidance on a first booster dose of COVID-19 vaccines in Canada

Publication: April 12, 2022

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Organization: Public Health Agency of Canada

Published: 2022-04-12

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Overview

  • NACI has strengthened the following recommendations from 'may' to 'should,' so that now all adults 18 years of age and over are strongly recommended to receive a booster dose:
    • A first booster dose of an mRNA COVID-19 vaccine should be offered at least 6 months after the completion of a primary series to all adults 18 to 49 years of age and over.
    • A first booster dose of an mRNA COVID-19 vaccine should be offered at least 6 months after the completion of a primary series to adolescents 12 to 17 years of age who:
      • have an underlying medical condition that puts them at high risk of severe outcomes from COVID-19, including adolescents who are immunocompromised and have already received an additional vaccine dose;
      • are residents of congregate living settings;
      • belong to racialized and/or marginalized communities disproportionately affected by COVID-19.
  • NACI has added a new recommendation, and now recommends that for all other adolescents 12 to 17 years of age:
    • A first booster dose of an mRNA COVID-19 vaccine may be offered at least 6 months after the completion of the primary series in the context of increased COVID-19 activity.

For the full statement, including supporting evidence and rationale, please see NACI Statement: Updated guidance on a first booster dose of COVID-19 vaccines 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

For the full statement, including supporting evidence and rationale, please see NACI Statement: Updated guidance on a first booster dose of COVID-19 vaccines 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

"Evidence continues to grow stronger about the value of a COVID-19 booster dose for all adults, and even for adolescents, especially with variants of concern. Accordingly, NACI is strengthening recommendations for first booster doses in all adults and for adolescents at the highest risk of severe disease; while also expanding booster options for all adolescents.

The question of booster timing is complex. The protection from infection that is gained from a booster dose is highest in the period following vaccination, and can fade over time. Protection against severe disease is longer lasting. It is possible that, consistent with other respiratory viruses, cases of COVID-19 may increase in the fall season.

It will be important for those who have not yet been boosted to listen to public health officials in order to understand when risk is increasing, and when is the right time to get a booster dose. For those who were recently infected with SARS-CoV-2, NACI continues to suggest that the booster dose may be deferred up to 3 months after infection."

Dr. Robyn Harrison, NACI Vice-chair

"NACI's updated review of the evidence is reassuring, showing that a first booster dose following a primary series of mRNA COVID-19 vaccines provides better protection against Omicron infection and severe outcomes than a primary series alone. Considered together with the latest evidence on safety and effectiveness of a first booster dose in adults and adolescents and the changing epidemiology of COVID-19 in Canada, NACI has strengthened their recommendations. NACI now strongly recommends that a first booster dose of an mRNA COVID-19 vaccine should be offered to adults 18 years of age or older, at least 6 months after the completion of a primary series. NACI likewise strongly recommends the same for certain adolescent populations, aged 12 to 17 years of age, who are at higher risk of severe outcomes or are disproportionately affected by COVID-19. Finally, NACI has made a new recommendation that a first booster dose of an mRNA COVID-19 vaccine may be considered for all adolescents, in the context of heightened epidemiological risk. Given the ongoing evolution of the SARS-CoV-2 virus, including continued spread of the more transmissible BA.2 sub-lineage of Omicron in Canada, these strengthened NACI recommendations can help guide provinces and territories in adjusting their vaccination programs toward achieving better protection across additional age groups."

Dr. Theresa Tam, Chief Public Health Officer

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