National Advisory Committee on Immunization (NACI): Workplan
Preamble
The following represents the National Advisory Committee on Immunization's planned work for the 2020-2021 fiscal year (April 2020 to March 2021). These projects will not necessarily be completed within the fiscal year. This workplan may be reassessed based on emerging public health needs. Triggers for the activation of Working Groups (WGs) and the development of new NACI guidance documents, or the adoption of new priorities may include the following:
- new vaccine or new indication
- new recommendation by an authoritative Canadian body (government or professional organization)
- provincial or territorial (P/T) programmatic concerns
- recommendation adopted by reputable international organizations
- new safety signal detected
- vaccine supply issues
- anticipated public health emergency
- changes in disease epidemiology
- Canadian Immunization Guide (CIG) chapter review
- publication of key trials
- internal inconsistency
- update to product monograph
- Public health emergency
Workplan
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 |
| 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 |
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