Summary of National Advisory Committee on Immunization (NACI) rapid response: Booster dose of COVID-19 vaccine in long-term care residents and seniors living in other congregate settings

Publication date: September 28, 2021

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Overview

NACI recommends that:

  • A booster dose of an authorized mRNA COVID-19 vaccine (Pfizer-BioNTech Comirnaty or Moderna Spikevax) should be offered to long-term care residents and seniors living in other congregate settings who have already received a primary COVID-19 vaccine series. This dose should be offered at a recommended interval of at least 6 months after the primary series has been completed.
  • A booster dose of an authorized viral vector vaccine (AstraZeneca Vaxzevria, Janssen) should only be considered when an mRNA COVID-19 vaccine is contraindicated or inaccessible.

 To see the full update, please visit NACI rapid response: Booster dose of COVID-19 vaccine in long-term care residents and seniors living in other congregate settings.

What you need to know

Due to the above considerations, NACI recommends that:

To see the full update, please visit NACI rapid response: Booster dose of COVID-19 vaccine in long-term care residents and seniors living in other congregate settings.

Quotes

“Early in the vaccine rollout, residents of long-term care were prioritized for first doses of COVID-19 vaccines as a vulnerable population at risk of severe disease and death.  Now, as we move through a fourth wave of Delta variant, NACI has determined that there is an immediate need to provide a recommendation for a booster dose of COVID-19 vaccine to all long-term care residents and seniors living in other congregate settings, where evidence is emerging that protection might not persist as long as other populations in Canada.  The combined factors of high risk of exposure, high risk of severe outcomes, a relatively long time since receipt of their last dose, a short interval between doses, the impacts of facility outbreaks, and older age create conditions that could exacerbate the effects and consequences of waning vaccine protection against severe outcomes in this group.” 

“While the vaccines initially worked very well to protect this group, we are starting to see signs of outbreaks again in long-term care settings and we are looking to prevent the level of severe outcomes this population experienced early in the pandemic.  Providing a booster dose through a precautionary approach is expected to improve their protection. NACI is closely monitoring how well vaccines are performing in other key populations in order to determine if or when booster doses might be appropriate for other groups.  This advice is specific to residents of long-term care and seniors living in other congregate settings given the unique high risks they experience and does not mean that booster doses are necessary for the general population.”

- Dr. Shelley Deeks, NACI Chair

“We welcome this advice from NACI, which will help us protect individuals in long-term care, who were among the hardest hit during the earlier stages of the pandemic due to their increased risk of infection and severe outcomes from COVID-19. At this time, boosters are not necessary for most of the population, but we want to be sure to address early signs of waning among seniors residing in these settings where shared and close living spaces increase the risk of exposure. Boosting immunity levels in seniors living in long-term care settings will help to maintain their protection against infection and serious illness.”

- Dr. Theresa Tam, Chief Public Health Officer

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