National Advisory Committee on Immunization (NACI): Workplan
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Preamble
The following represents potential policy/program topics to be addressed by the National Advisory Committee on Immunization (NACI) for 2026–2028. It is acknowledged that not all of these topics will be completed over these two years and some will be carried forward to subsequent years.
The priority selections below have been informed by consultations with NACI, the NACI Executive Committee, and Provincial and Territorial (P/T) stakeholders. As new products and indications are authorized in Canada, new information becomes available, or in the event of a public health emergency, workplan items may be added for consideration and priorities may change.
The following triggers may create items for the NACI workplan:
- New vaccine or new indication
- Recommendation adopted by other reputable organizations
- P/T programmatic planning needs
- New or emerging safety signal detected
- Vaccine supply issue
- Changes in disease epidemiology
- Canadian immunization Guide (CIG) chapter review
- Publication of key studies/trials
- Internal inconsistency
- Update to product monograph
- Public health emergency
- Federal priorities
| Initiative | Policy / Program issues | Trigger(s) |
|---|---|---|
| Work currently underway | ||
| Meningococcal | Assess quadrivalent meningococcal conjugated (Men-C-ACYW) vaccine recommendations for use in routine and high-risk infant programs in Canada to support product transition from Men-C-C vaccines | Vaccine supply issue |
| Hepatitis B | Consider a universal hepatitis B birth dose or infant vaccination program | Recommendation adoption by reputable organization |
| Influenza | Statement on seasonal influenza for 2027–2028 | P/T programmatic planning needs |
| Novel mRNA-based influenza vaccine products, if authorised | New vaccine | |
| Combination COVID-19 and influenza vaccine | Evaluate new combination vaccines for COVID-19 and seasonal influenza in the context of existing programs, if authorised | New vaccine |
| Rabies | Assess optimal rabies vaccine post-exposure prophylaxis (PEP) regimens, in context of guidance from the World Health Organization (WHO) | Recommendation adoption by reputable organization |
| Indigenous Health Working Group | Develop collaborative guidance on how to incorporate Indigenous knowledge and perspectives into NACI advice for Indigenous communities | Federal priorities |
| Immunocompromised Populations Working Group | Develop a framework to guide NACI Working Groups in making consistent immunization recommendations for immunocompromised populations | Internal inconsistency |
| Canadian Immunization Guide (CIG): Part 1 (Key Immunization information) | Communicating effectively regarding immunization | CIG chapter review |
| CIG: Part 3 (Vaccination of specific populations) | Immunization of immunocompromised persons | CIG chapter review |
| CIG: Part 4 (active vaccines) | Routine chapter updates: BCG vaccine | CIG chapter review |
| Part 4 chapters will be updated to align with forthcoming NACI advice as well as from CATMAT publications based on travel vaccines | ||
| Next projects | ||
| COVID-19 | Evaluate optimal immunization program for COVID-19 vaccination and whether this can be extended beyond a single season | P/T programmatic planning needs |
| Meningococcal | Assess optimal use of products (MenB, Men-C-ACYW) and schedule for routine IMD programs in Canada across age groups | P/T programmatic planning needs |
| Hepatitis A | Consider a universal hepatitis A vaccine schedule, including 1-dose option | Recommendation adoption by reputable organization |
| Lyme | Provide guidance for a new vaccine to prevent Lyme disease in children and adults, if submitted and authorised | New vaccine |
| Measles | Assess the administration of MMR or MMRV vaccine during pregnancy | P/T programmatic planning needs |
| Assess the optimal timing for the second dose of MMRV or MMR+V vaccine(s) | P/T programmatic planning needs | |
| Gonorrhea | Assess the use of 4CMenB vaccine to prevent gonorrhea in populations at increased risk of exposure | Publication of key studies/trials |
| Influenza | Statement on seasonal influenza for 2028–2029 | P/T programmatic planning needs |
| Evaluate universal seasonal influenza program compared to a targeted seasonal program, in context of combination vaccines | P/T programmatic planning needs | |
| Assess optimal use of available vaccines for groups who at high risk of influenza-associated disease (e.g. immunocompromised) | P/T programmatic planning needs | |
Abbreviations
- 4CMenB
- Multicomponent meningococcal serogroup B vaccine
- BCG
- Bacille Calmette-Guérin
- CATMAT
- Committee to Advise on Tropical Medicine and Travel
- CIG
- Canadian Immunization Guide
- Men-C-C
- Monovalent conjugate meningococcal vaccine
- Men-C-ACYW
- Quadrivalent conjugate meningococcal vaccine
- MenB
- Meningococcal serogroup B vaccine
- MMR
- Measles, mumps, and rubella
- MMRV
- Measles, mumps, rubella, and varicella
- MMR+V
- Measles, mumps, rubella, vaccine and varicella vaccine
- NACI
- National Advisory Committee on Immunization
- P/T
- Provincial and territorial
- PEP
- Post-exposure prophylaxis
- WHO
- World Health Organization
Previous workplans
2024-2026
| Initiative | Policy / Program issues | Trigger(s) |
|---|---|---|
| Work currently underway | ||
| COVID-19 | Program planning for annual use vs. emergent use | P/T programmatic planning needs |
| Herpes Zoster | Recombinant Zoster Vaccine (RZV) use in immunocompromised populations, and other risk groups 18-49 years of age as appropriate | New indication |
| Human Papillomavirus (HPV) | Consider 1-dose HPV vaccination schedule, and consider 2-dose/3-dose schedules among persons 15 years and older | Recommendation adoption by reputable organization; P/T programmatic planning needs |
| Influenza | Statement on seasonal influenza for 2024-2025 | P/T programmatic planning needs |
| Statement on seasonal influenza for 2025-2026 | P/T programmatic planning needs | |
| Supplemental statements or addenda for new products and/or NACI advice related to new or existing products | New vaccine | |
| Measles | Review measles post-exposure prophylaxis interventions including immunoglobulin product options (e.g. subcutaneous or intravenous) and use of vaccine | P/T programmatic planning needs |
| Mpox | Ongoing program monitoring, including consideration of a booster dose if needed | P/T programmatic planning needs |
| Pneumococcal | Guidance on new pneumococcal vaccine (PCV21) for older adults | New vaccine |
| Rabies | Updated guidance on rabies vaccine pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in context of new guidance from WHO, including situations for vaccine use | Recommendation adoption by reputable organization |
| Respiratory Syncytial Virus (RSV) | Guidance for products to prevent RSV in older adults | New vaccine and new indications |
| Vaccine Safety | Review emerging topics in vaccine safety including use of vaccines for those with allergies or contraindications, concurrent administration of new vaccines, and review of adjuvants | Publication of key studies/trials |
| (Canadian Immunization Guide (CIG): Part 1 (Key Immunization Information)) | Blood products, human immunoglobulin and timing of immunization | CIG chapter review |
| Communicating effectively regarding immunization | CIG chapter review | |
| Basic Immunology & Vaccinology | CIG chapter review | |
| Benefits of immunization | CIG chapter review | |
| CIG: Part 4 (Active Vaccines) | Part 4 chapters requiring updates are those with planned NACI statements and CATMAT statements | CIG chapter review |
| Next projects | ||
| Hepatitis A | Consider a universal hepatitis A vaccine schedule, including 1-dose option | Recommendation adoption by reputable organization |
| Hepatitis B | Consider a universal Hepatitis B birth dose or infant vaccination program | Recommendation adoption by reputable organization |
| Recommendations on use of new 3-antigen Hepatitis B Vaccine | New vaccine | |
| Influenza | Novel mRNA-based influenza vaccine products, if submitted and authorised | New vaccine |
| Review product choices for immunocompromised groups | P/T programmatic planning needs | |
| Evaluate universal seasonal influenza program compared to a targeted seasonal program, in context of combination vaccines | P/T programmatic planning needs | |
| Evaluate quadrivalent compared to trivalent vaccines | Changes in disease epidemiology | |
| Meningococcal | Recommendations on use of new Meningococcal (Groups A, C, Y, W) Polysaccharide Tetanus Toxoid Conjugate Vaccine | New vaccine |
| Recommendations on the use of Meningococcal B vaccine in infants and children aged <2 years | Recommendation adoption by reputable organization | |
| Review booster schedule for adult Meningococcal B vaccine recipients | Recommendation adoption by reputable organization | |
| Review optimal products for high-risk children < 2 years old, considering new lower age indication for Men-C-ACYW-TT | New indication | |
| Respiratory Syncytial Virus (RSV) | New monoclonal antibody for prevention of RSV in infants, if submitted and authorised | New product |
Abbreviations
- NACI
- National Advisory Committee on Immunization
- CATMAT
- Committee to Advise on Tropical Medicine and Travel
- CIG
- Canadian Immunization Guide
- CPS
- Canadian Paediatric Society
- HPV
- Human Papillomavirus
- P/Ts
- Provinces and territories
- PCV21
- 21-valent pneumococcal conjugate vaccine
- PEP
- Post-exposure prophylaxis
- PrEP
- Pre-exposure prophylaxis
- RSV
- Respiratory Syncytial Virus
- RZV
- Recombinant Zoster Vaccine
- SOGC
- Society of Obstetricians and Gynaecologists of Canada
- WHO
- World Health Organization
2022-2024
| Initiative | Policy / Program issues | Trigger(s) |
|---|---|---|
| Work currently underway | ||
| (COVID-19) | Updated guidance on priority immunization strategies and associated target populations based on current evidence and authorized COVID-19 vaccines. | Public health emergency |
| Updated recommendations on the use of authorized COVID-19 vaccines as they are approved for use in Canada, and as evidence on these vaccines and COVID-19 evolves | New vaccines | |
| CIG COVID-19 Chapter reviews | CIG chapter reviews; new Statement content |
|
| High-Consequence Infectious Diseases (HCID) | Update smallpox vaccine guidance for lab workers and outbreak situations, including consideration of other orthopox viruses (e.g. monkeypox) | Recommendation adoption by reputable organization Public health emergency |
| Pneumococcal | Recommendations for new adult pneumococcal vaccines (PCV15 and PCV20) relative to existing options, dependent on regulatory decisions | New vaccine |
| (Seasonal influenza) | Repeated seasonal influenza vaccination | P/T programmatic concerns |
| Optimal timing of seasonal influenza programs (including intra-season waning) | P/T programmatic concerns | |
| Guidance on seasonal influenza vaccination in the context of COVID-19 | Public health emergency | |
| 2023-2024 Seasonal Influenza Statement | P/T programmatic concerns | |
| Review of safety and effectiveness of influenza vaccine in pregnancy | P/T programmatic concerns | |
| Review of product choice for 65+ | P/T programmatic concerns | |
| 2024-2025 Seasonal Influenza Statement | P/T programmatic concerns | |
| Supplemental statements or Addenda for new products and/or NACI opinions related to new or existing products | New vaccine | |
| Canadian Immunization Guide (CIG): Part 1 (Key Immunization Information) |
Blood products, human immunoglobulin and timing of immunization - completion of revision | CIG chapter review |
| Communicating effectively about immunization - due for revision | CIG chapter review | |
| Updates to various chapters related to COVID-19 vaccine content | CIG chapter review | |
| CIG: Part 3 (Special Populations) |
The following chapters will be due for revision: 1) Immunization of Adults; 2) Immunization of persons with inadequate immunization records; 3) Immunization of infants born prematurely; 4) Immunization of patients in healthcare institutions; 5) Immunization of persons new to Canada; 6) Immunization of workers | CIG chapter review |
| CIG: Part 4 (Active Vaccines) |
Part 4 chapters requiring updates are those withnplanned NACI statements | CIG chapter review |
| Next projects | ||
| Human Papillomavirus (HPV) | Consider 1-dose HPV vaccination schedule, and consider 2-dose/3-dose schedules among persons 15+ | Recommendation adoption by reputable organization |
| Pneumococcal | Recommendations for new pediatric pneumococcal vaccines (PCV15 and PCV20) relative to existing options, dependent on regulatory submission and decisions | New indication |
| Future projects, depending on trajectory of COVID-19 pandemic and associated vaccines (in order of prioritization) | ||
| Respiratory Syncytial Virus (RSV) | New active RSV vaccines or prophylactic monoclonal antibodies, dependent on regulatory submission and decisions | New vaccine |
| Rabies | Updated guidance on rabies vaccine pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in context of new guidance from WHO | Recommendation adoption by reputable organization Work already in progress that was interrupted by the COVID-19 pandemic work |
| Hepatitis A | Consider a universal hepatitis A vaccine schedule, including 1-dose option | Recommendation adoption by reputable organization |
| Herpes Zoster | Recombinant Zoster Vaccine (RZV) use in immunocompromised populations (new indication for those under 50 years old at high risk of disease) | New indication |
| Meningococcal | Recommendations on use of new Meningococcal (Groups A, C, Y, W) Polysaccharide Tetanus Toxoid Conjugate Vaccine | New vaccine |
| Hepatitis B | Recommendations on use of 3-antigen Hepatitis B Vaccine Candidate | New vaccine |
Abbreviations
- NACI
- National Advisory Committee on Immunization
- CATMAT
- Committee to Advise on Tropical Medicine and Travel
- CIC
- Canadian Immunization Committee
- CIG
- Canadian Immunization Guide
- CPS
- Canadian Paediatric Society
- HPV
- Human Papillomavirus
- P/Ts
- Provinces and territories
- PEP
- Post-exposure prophylaxis
- PrEP
- Pre-exposure prophylaxis
- RSV
- Respiratory Syncytial Virus
- RZV
- Recombinant Zoster Vaccine
- SOGC
- Society of Obstetricians and Surgeons of Canada
- WHO
- World Health Organization
2020-2021
| Initiative | Issue(s) | Triggers | Expected date of completion* |
| COVID-19 | Updated guidance on priority immunization strategies and associated key populations based on current evidence and authorized COVID-19 vaccines. | Public health emergency | Q3 2020-2021 |
| Updated recommendations on the use of authorized COVID-19 vaccines as they are approved for use in Canada, and as evidence on these vaccines and COVID-19 evolves. | New vaccine | 2021 for final guidance, pending clinical trial progression | |
| Hepatitis A | Consider a universal hepatitis A vaccine schedule, including 1-dose option. | Recommendation adoption by reputable organization | On hold for COVID-19 |
| Measles, Mumps, Rubella (MMR) | Additional dose of mumps-containing vaccine in outbreaks | Changes in disease epidemiology | 2021 |
| Full CIG Chapter Update for Measles, Mumps and Rubella due | CIG Chapter reviews due | 2021 | |
| Pertussis | Optimal timing of adult and adolescent Tdap boosters, inlcuding Td intervals | New indication | On hold for COVID-19 |
| Pneumococcal | Consider recommendations for PCV10 in light of new indications and practice | New indication | On hold for COVID-19 |
| Rabies | Updated guidance on rabies vaccine PrEP and PEP in context of new guidance from WHO | Recommendation adoption by reputable organization | 2021 |
| Full CIG chapter review due | CIG Chapter review due | 2021 | |
| Smallpox | Update smallpox vaccine guidance for lab workers and outbreak situations, including monkeypox | New vaccine | On hold for COVID-19 |
| Seasonal Influenza | Seasonal Influenza statement | New vaccine | 2020-21 |
| Consider dose-sparing strategies, including intradermal administration | Prevention of vaccine supply issues | Q2 2020-2021 | |
| Minimum observation time following influenza vaccination, in context of COVID-19 | Recommendation adoption by reputable organization | Q2 2020-2021 | |
| Optimal timing of seasonal influenza vaccine programs (including intra-season waning) | P/T programmatic concerns | 2022 | |
| Analysis of product choices for adults 65+ | P/T programmatic concerns | 2021 | |
| Repeated Vaccination | P/T programmatic concerns | 2020 | |
| Review of safety and effectiveness of influenza vaccine in pregnancy | Publication of key studies | 2021 | |
| CIG: Part 1 (Key immunization information) | Routine chapter updates (5): Benefits of Immunization, National Guidelines for Immunization Practices, Communicating Effectively about Immunization, Principles of Vaccine Interchangeability, Blood Products, Human Immune Globulin and Timing of Immunization | CIG Chapter reviews due | 2021 |
| CIG : Part 2 ( Vaccine Safety) | Routine Chapter updates (3) | CIG Chapter reviews overdue | 2019-20 |
| CIG: Part 4: Active Vaccines | Routine chapter updates (13): BCG, Diphtheria, Hep A, Hib, MMR, Polio, Pneumococcal, Rotavirus, Rabies, Smallpox, Tetanus, Varicella, Yellow Fever | CIG Chapter reviews due and some overdue | On hold for COVID-19 |
| Evidence-based methods | Transition to GRADE methodology | Recommendation adoption by reputable organization | On hold for COVID-19 |
| NACI economics framework | Incorporation into NACI process: economics framework | Recommendation adoption by reputable organization | 2021 |
| Economic guidelines | Incorporation into NACI process: economic guidelines | Recommendation adoption by reputable organization | 2022 |
*Please note that this workplan is evergreen. As new products and indications are authorized or new information becomes available, workplan items may be added for consideration and priorities may change.
Abbreviations
- NACI
- National Advisory Committee on Immunization
- BCG
- Bacillus Calmette-Guérin
- CATMAT
- Committee to Advise on Tropical Medicine and Travel
- CCDR
- Canada Communicable Disease Report
- CIC
- Canadian Immunization Committee
- CIG
- Canadian Immunization Guide
- CPS
- Canadian Paediatric Society
- EEFA
- Ethics, Equity, Feasibility, Acceptability
- FY
- Fiscal year (April 1 - March 31)
- JE
- Japanese encephalitis
- NoC
- Notice of compliance
- P/Ts
- Provinces and territories
- QIV
- Quadrivalent influenza vaccine
- SOGC
- Society of Obstetricians and Surgeons of Canada
- TIV
- Trivalent influenza vaccine
- TOR
- Terms of reference
- WG
- Working group
- WHO
- World Health Organization
- YF
- Yellow fever
2019-2020
| Initiative | Issue(s) | Triggers | Expected date of completion* |
|---|---|---|---|
| Ebola Virus Disease | Interim pre-market guidance on domestic use of stockpiled investigational vaccine for ring vaccination strategy in event of imported cases, post-market guidance to follow in later years | New vaccine | Q2 2019 for interim guidance |
| Hepatitis A | Consider a universal hepatitis A vaccine schedule, including 1-dose option | Recommendation adoption by reputable organization | 2021 |
| Measles, Mumps, Rubella (MMR) | Consider additional dose of mumps-containing vaccine in outbreaks | Changes in disease epidemiology | 2019-20 |
| Full CIG chapter update for Measles, Mumps and Rubella due | CIG chapter reviews due | 2019-20 | |
| Pertussis | Optimal timing of adult and adolescent Tdap boosters, including Td intervals | P/T programmatic concerns | 2020 |
| Pneumococcal | Evaluation of preferential PCV13 recommendation for routine infant programs | Recommendation adoption by reputable organization | 2020 |
| Rabies | Updated guidance on rabies vaccine PrEP and PEP in context of new guidance from WHO | Recommendation adoption by reputable organization | 2020 |
| Full CIG chapter review due | CIG chapter review due | 2020 | |
| Respiratory Syncytial Virus (RSV) | Review/update NACI guidance on Palivizumab | Recommendation adoption by reputable organization | 2019-20 |
| CIG - chapter creation | 2019-20 | ||
| Seasonal Influenza | Seasonal influenza | New vaccine | 2020-21 |
| New Products: quadrivalent influenza vaccines | New vaccine | 2020-21 (dependant on NOC) | |
| Repeated vaccination | P/T programmatic concerns | 2020 | |
| CIG: Part 1 (Key immunization information) | Routine chapter updates (6): Immunization in Canada. Benefits of Immunization, National Guidelines for Immunization Practices, Communicating Effectively about Immunization, Principles of Vaccine Interchangeability, Blood Products, Human Immune Globulin and Timing of Immunization | CIG chapter reviews due | 2019-20 |
| CIG : Part 2: Vaccine Safety |
Routine chapter updates (3) | CIG chapter reviews overdue | 2019-20 |
| CIG: Part 3: Special Populations | Routine chapter updates (6): Immunization of Adults, Immunization of Persons with Inadequate Immunization Records, Immunization of Infants Born Prematurely, Immunization of Patients in Healthcare Institutions, Immunization of Persons New to Canada, Immunization of Workers | CIG chapter reviews overdue | 2019-20 |
| CIG: Part 4: Active Vaccines | Routine chapter updates (12): BCG, Diphtheria, Hib, MMR, Polio, Rabies, Smallpox, Tetanus, YF, JE | CIG chapter reviews due and some overdue | 2019-20 |
| Ethics, Equity, Feasibility, Acceptability (EEFA) | Incorporation into NACI process: EEFA | Recommendation adoption by reputable organization | 2019 |
| NACI economics framework | Incorporation into NACI process: economics framework | Recommendation adoption by reputable organization | 2020 |
| Economic guidelines | Incorporation into NACI process: economic guidelines | Recommendation adoption by reputable organization | 2021 |
*Please note that this workplan is evergreen. As new products and indications are authorized or new information becomes available, workplan items may be added for consideration and priorities may change.
Abbreviations
- NACI
- National Advisory Committee on Immunization
- BCG
- Bacillus Calmette-Guérin
- CATMAT
- Committee to Advise on Tropical Medicine and Travel
- CCDR
- Canada Communicable Disease Report
- CIC
- Canadian Immunization Committee
- CIG
- Canadian Immunization Guide
- CPS
- Canadian Paediatric Society
- EEFA
- Ethics, Equity, Feasibility, Acceptability
- FY
- Fiscal year (April 1 - March 31)
- Hib
- Haemophilus influenzae type b
- JE
- Japanese encephalitis
- NoC
- Notice of compliance
- PCV13
- Pneumococcal conjugate vaccine
- PEP
- Post-exposure prophylaxis
- PrEP
- Pre-exposure prophylaxis
- P/Ts
- Provinces and territories
- QIV
- Quadrivalent influenza vaccine
- SOGC
- Society of Obstetricians and Surgeons of Canada
- Td
- Tetanus and diphtheria vaccine
- Tdap
- Tetanus, diphtheria and pertussis vaccine
- TIV
- Trivalent influenza vaccine
- TOR
- Terms of reference
- WG
- Working group
- WHO
- World Health Organization
- YF
- Yellow fever