Table of updates: Recommendations on the use of COVID-19 vaccines

This table summarizes the updated information provided in each version of the Recommendations on the use of COVID-19 vaccines document page since the publication of the first version on December 12, 2020.

For previous versions of the COVID-19 vaccine statement, visit the archives.

Recommendations on the use of COVID-19 vaccines

Published March 16, 2021

Section Update Date

Introduction

Health Canada authorized two manufacturers to produce the vaccine developed by AstraZeneca and Oxford University: AstraZeneca and Serum Institute of India (SII). NACI has not specifically reviewed evidence for the SII vaccine, but Health Canada has deemed SII and AstraZeneca vaccines to be comparable.

2021-03-16

Vaccines

Table 1. COVID-19 vaccines authorized for use in Canada has been updated to reflect the change in the Pfizer BioNTech COVID-19 product monograph regarding storage requirements. 

2021-03-16

Schedule

Table 2. Recommended immunization schedule, by COVID-19 vaccine has been updated to reflect NACI’s current recommendation for extending the interval for the second dose of COVID-19 vaccines up to four months after the first. The rationale for the intervals included in this table has been included.

2021-03-16

Storage Requirements

Storage requirements for the Pfizer BioNTech COVID-19 vaccine have been updated to reflect changes in the product monograph which allow vials to also be stored at -25°C to -15°C for up to 2 weeks.

2021-03-16

Recommendations

The recommendation on the use of the AstraZeneca COVID-19 vaccine has been updated to include use in those 65 years of age and older. This update is based on results of observational studies of vaccine effectiveness from the United Kingdom released since NACI’s previous recommendations for the use of this vaccine in those 18 to 64 years of age. The rationale for this updated recommendation for the use of AstraZeneca COVID-19 vaccine in those ≥18 years of age has been added.

2021-03-16

Recommendations

The recent recommendation made by NACI on extending the interval for the second dose of COVID-19 vaccines up to four months after the first, summarized in a separate document, is now included. The rationale for this recommendation has been summarized.

2021-03-16

Management options for COVID-19 vaccines authorized for use in Canada

Table 4 has been updated with observational data for AstraZeneca COVID-19 vaccine effectiveness in individuals > 65 years of age.

2021-03-16

Research Priorities

Three additional research priorities have been added under the Efficacy, Effectiveness, Immunogenicity and Safety section.

2021-03-16

Appendix C

A summary and review of evidence on the effectiveness of the AstraZeneca COVID-19 vaccine based on observational studies published as pre-prints has been added to the appendix on the Evidence Summary for AstraZeneca vaccine.

2021-03-16

Recommendations on the use of COVID-19 vaccines (addition of AstraZeneca COVID-19 vaccine) (version now archived)

View the archived version.
Published March 1, 2021

Section Update Date
Vaccines

All sub-sections under Vaccines have been updated to include evidence or information from the product monograph related to the AstraZeneca COVID-19 vaccine. This includes:

  • Table 1. COVID-19 vaccines authorized for use in Canada
  • Dose, Route of administration, and Schedule
  • Efficacy and Immunogenicity
  • Storage requirements
  • Vaccine safety and adverse events following immunization
2021-03-01
Vaccines Table 1. COVID-19 vaccines authorized for use in Canada has been updated to reflect the change in the Pfizer BioNTech COVID-19 product monograph stating one multi-dose vial contains 6 doses. 2021-03-01
Contraindications and Precautions Tromethamine as an ingredient in the Moderna COVID-19 vaccine that has been associated with allergic reactions in other products has been added to Table 3. Clarification on the management of allergies and allergic reactions has been added, in consultation with NACI’s Vaccine Safety Working Group. 2021-03-01
Contraindications and Precautions Potential allergens for AstraZeneca COVID-19 vaccine have been added to Table 3. 2021-03-01
Drug Interactions Guidance on the use of tuberculin skin tests and interferon gamma release assays before or after administration of COVID-19 vaccine has been added. 2021-03-01
Recommendations Recommendations on COVID-19 vaccine now include use of the AstraZeneca COVID-19 vaccine, and the rationales have been updated with evidence from AstraZeneca COVID-19 vaccine clinical trials. 2021-03-01
Recommendations A management options table for the use of different types of COVID-19 vaccines authorized for use in Canada has been added. 2021-03-01
Appendix C Evidence on the efficacy, immunogenicity, and safety of the AstraZeneca COVID-19 vaccine has been added in a new appendix. 2021-03-01
Appendix D Frequency of Solicited Adverse Events Following Immunization for COVID-19 vaccines has been updated to include information on the AstraZeneca COVID-19 vaccine. 2021-03-01

Recommendations on the use of COVID-19 vaccines (version now archived)

View the archived version.
Published January 12, 2021

Section Update Date
Dose, route of administration, and schedule Section on "Delay in receipt of dose 2 in a COVID-19 vaccine series" has been updated to include calculated vaccine efficacy estimates of COVID-19 vaccines after the first dose. 2021-01-12
Recommendations Options for the administration of a complete COVID-19 vaccines series to maximize population health benefits in the context of vaccine delivery, epidemiological, and healthcare system capacity considerations have been added. 2021-01-12
Recommendations Recommendations for immunosuppressed persons, persons with an autoimmune condition, and pregnancy and breastfeeding have been revised for clarity. 2021-01-12
Management Options A section of management options for COVID-19 immunization program roll-out in the context of limited vaccine supply has been added. This section summarizes available evidence and considerations with decision points to guide jurisdictions in the roll-out of an effective, efficient, and equitable COVID-19 immunization program. 2021-01-12
Appendix A Calculated vaccine efficacy estimates of the Pfizer-BioNTech COVID-19 vaccine after the first dose have been added. 2021-01-12
Appendix B Calculated vaccine efficacy estimates of the Moderna COVID-19 vaccine after the first dose have been added. 2021-01-12

Recommendations on the use of COVID-19 vaccines (addition of Moderna COVID-19 vaccine) (version now archived)

View the archived version.

Published December 23, 2020

Section Update Date
Vaccine(s)

All sub-sections under Vaccines have been updated to include evidence or information from the product monograph related to the Moderna COVID-19 vaccine. This includes:

  • Table 1. COVID-19 vaccine(s) authorized for use in Canada
  • Dose, Route of administration, and Schedule
  • Efficacy and Immunogenicity
  • Storage requirements
  • Vaccine safety and adverse events following immunization
2020-12-23
Dose, route of administration, and schedule Additional clarifying information on the schedule for a complete mRNA COVID-19 vaccine series has been added. 2020-12-23
Interchangeability Additional information on the interchangeability of mRNA vaccines and guidance in case of limited supply or unavailability of a particular product has been incorporated under the NACI recommendation on interchangeability. 2020-12-23
Recommendations Recommendations on COVID-19 vaccine now include use of the Moderna COVID-19 vaccine, and the rationales have been updated with evidence from Moderna COVID-19 vaccine clinical trials 2020-12-23
Recommendations The recommendations for immunosuppressed individuals and those with autoimmune conditions have been split into two separate recommendations and further rationale for the recommendations has been provided. 2020-12-23
Recommendations Additional information has been added to the rationale for the recommendation on pregnancy and breastfeeding and now recommends that it would be prudent to delay pregnancy by at least 28 days after the completion of a two-dose series of mRNA COVID-19 vaccines. 2020-12-23
Appendix B Evidence on the efficacy, immunogenicity, and safety of the Moderna COVID-19 vaccine has been added in a new appendix 2020-12-23
Appendix C Application of the EEFA Framework: Ethical analysis of the options for the delivery of a second dose of COVID-19 vaccine in the context of a limited vaccine supply has been added in a new appendix 2020-12-23
Appendix D Frequency of Solicited Adverse Events Following Immunization for COVID-19 vaccine has been added in a new appendix 2020-12-23

Recommendations on the use of COVID-19 vaccine(s) (version now archived)

The first version of the evergreen document was published outlining the recommendations for use of the Pfizer BioNTech COVID-19 vaccine.

Published December 12, 2020

Section Update Date
Contraindications and Precautions

Reinforced existing recommendation that the authorized COVID-19 vaccines are contraindicated in individuals with a history of anaphylaxis after previous administration of the vaccine and included a new table with vaccine components that are potential allergens known to cause type 1 hypersensitivity reactions

  • New Table 3. Potential allergens known to cause type 1 hypersensitivity reactions
2020-12-12
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