Summary of NACI statement of March 3, 2023: Guidance on an additional COVID-19 booster dose in the spring of 2023 for individuals at high risk of severe illness due to COVID-19
Organization: Public Health Agency of Canada
Date published: 2023-03-03
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On March 3, 2023, the Public Health Agency of Canada (PHAC) released guidance from the National Advisory Committee on Immunization (NACI) on an additional COVID-19 booster dose in the spring of 2023 for individuals at high risk of severe illness due to COVID-19. This guidance is based on current evidence, vaccine principles and NACI expert opinion.
NACI now recommends that:
- Starting in the spring of 2023, an additional booster dose may be offered 6 or more months from the last COVID-19 vaccine dose or infection to the following individuals who are at increased risk of severe illness from COVID-19:
(Discretionary NACI recommendation)
- Adults 80 years of age and older
- Adults 65 to 79 years of age, particularly if they do not have a known history of SARS-CoV-2 infection
- Adult residents of long-term care homes and other congregate living settings for seniors or those with complex medical care needs
- Adults 18 years of age and older who are moderately to severely immunocompromised due to an underlying condition or treatment
- Bivalent Omicron-targeting mRNA COVID-19 vaccines continue to be the preferred booster products.
- Individuals who have not received previously recommended doses, including a primary series or fall 2022 booster dose, are recommended to receive them now. For more information, please refer to Guidance on COVID-19 vaccine booster doses: Initial considerations for 2023.
What you need to know
- Spring 2023 COVID-19 booster dose recommendations have a focus on populations who are at increased risk of serious COVID-19 outcomes, including hospitalization and death.
- Age is a very important risk factor for severe disease. The risk of hospitalization and intensive care admission increases with age.
- There may be variability in how each province, territory and community assesses risk and responds to the needs of their respective jurisdictions. For more information on your province or territory's COVID-19 vaccination program, please visit the website of your provincial or territorial health authority.
- There continue to be many uncertainties around the evolution of the COVID-19 pandemic. Additional booster doses may be recommended by NACI for broader population groups in the fall of 2023, depending on the COVID-19 pandemic context.
- NACI continues to closely monitor COVID-19 activity across Canada, as well as emerging evidence on COVID-19 vaccines, and will update recommendations as needed.
For the full statement, including supporting evidence and rationale, please see NACI Statement: Guidance on an additional COVID-19 booster dose in the spring of 2023 for individuals at high risk of severe illness due to COVID-19.
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.
"Bivalent booster dose uptake is still relatively low among the populations at risk of severe disease, and we hope to see this improve. Older adults, particularly those over 80 years, consistently have the highest risk of severe disease, especially if they are unvaccinated. We have historically seen patterns of waning protection against severe disease by 6 months after the last dose, particularly in older adults without prior infection. Because of this, as a precautionary measure, NACI is recommending this spring that an additional bivalent booster dose may be offered after 6 months for those at highest risk of severe disease, including older adults and persons who are moderately to severely immunocompromised. There may be a broader program in fall of 2023, depending on COVID-19 epidemiology."
Dr. Shelley Deeks, NACI Chair
"It remains important to stay up to date with your COVID-19 vaccines, including recommended booster doses, given the continued circulation of SARS-CoV-2 virus variants in Canada and elsewhere. Booster doses help to build back protection against severe disease that wanes over time after COVID-19 vaccination or infections. Given the current COVID-19 epidemiology, including the relatively stable disease activity we have observed in recent months, and generally high levels of antibodies against COVID-19 from vaccines and/or infection among Canadians, NACI is currently not recommending an additional bivalent booster for the general population this spring. However, individuals at highest risk of getting severely ill from COVID-19, including older adults and individuals considered immunocompromised, may be offered a spring bivalent booster dose. Regardless of risk factors, I encourage anyone who has not yet received their primary series or their fall 2022 bivalent booster to get these vaccinations now to reduce their risk of severe outcomes of COVID-19, including hospitalization."
Dr. Theresa Tam, Chief Public Health Officer
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