Summary of NACI statement of January 12, 2024: Guidance on an additional dose of COVID-19 vaccines in the spring of 2024 for individuals at high risk of severe illness due to COVID-19

On this page

• Overview
• What you need to know
• Quotes

Overview

On January 12, 2024, the Public Health Agency of Canada (PHAC) released the National Advisory Committee on Immunization's (NACI) Guidance on an additional dose of COVID-19 vaccines in the spring of 2024 for individuals at high risk of severe illness due to COVID-19. This guidance is based on current evidence and NACI expert opinion.

NACI recommends that:

• Starting in the spring of 2024, the following individuals who are at increased risk of severe illness from COVID-19 may receive an additional dose of XBB.1.5 COVID-19 vaccine:
• Adults 65 years of age and older
• Adult residents of long-term care homes and other congregate living settings for seniors
• Individuals 6 months of age and older who are moderately to severely immunocompromised (due to underlying conditions or treatment)
• This is a very similar approach to spring programs that have been recommended in Canada for the last two years. NACI is providing this guidance to help provinces and territories begin planning spring 2024 COVID-19 vaccine programs.
• The XBB.1.5 COVID-19 vaccines continue to be the recommended products for unvaccinated and previously vaccinated individuals.
• Receiving a COVID-19 vaccine in the spring of 2024 is particularly important for individuals at increased risk of severe illness due to COVID-19, if they did not receive a recommended dose of an XBB.1.5 COVID-19 vaccine during the fall/winter 2023 to 2024 program.
• The recommended interval is 6 months from the last COVID-19 vaccine dose. However, a shorter interval of at least 3 months (i.e., a minimum interval of 3 months) has not been shown to pose a safety risk and may be used to support program implementation (including timing of the spring campaign relative to previous and future fall campaigns).

For the full statement, including supporting evidence and rationale, please see NACI's Guidance on an additional dose of COVID-19 vaccines in the spring of 2024 for individuals at high risk of severe illness due to COVID-19.

What you need to know

• Consistent with previous years, NACI has made COVID-19 vaccination recommendations for the fall/winter and spring periods. These recommendations are based on what is known about vaccine effectiveness over time and the levels of immunity in the population from past SARS-CoV-2 infections and COVID-19 vaccinations. They also take into consideration individuals most at risk for severe COVID-19 illness.
• As a result, the potential COVID-19 spring immunization program will be smaller and more focused than the fall program, targeting individuals at a higher risk of severe illness due to SARS-CoV-2 infection.
• As provinces and territories have resumed various public health programs and activities, NACI is offering guidance well ahead of time to help with planning for a potential COVID-19 spring immunization program. There may be variability in how each province, territory, and community assesses risk and responds to the needs of their respective jurisdictions.
• The seasonality of SARS-CoV-2 is not yet established, and the need for an annual COVID-19 vaccination program is still unclear. However, we know that protection against infection and severe illness can decrease within 6 months of COVID-19 vaccination. A dose of an XBB.1.5 vaccine is expected to increase protection that has decreased over time in the most vulnerable populations.
• Older adults, including those living in congregate living settings, and individuals with underlying health conditions continue to be at increased risk of severe outcomes from COVID-19.
• Health Canada has recently authorized the use of the Novavax Nuvaxovid COVID-19 vaccine targeting the Omicron XBB.1.5 subvariant for individuals 12 year of age and older. The authorization of this vaccine provides an additional option for jurisdictions to consider as they begin planning spring 2024 COVID-19 vaccine programs.

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.

For more information on your province or territory's COVID-19 vaccination program, please visit the website of your provincial or territorial health authority.

Quotes

"Our experience in previous seasons has shown that protection against severe disease can wane about six months after the last vaccine dose for those at highest risk, a trend more evident among older adults who haven't had a prior infection. It is expected that most people will continue to be well protected by their fall XBB.1.5 vaccine dose this spring, but NACI advises that an additional dose of an XBB.1.5 vaccine may be provided to individuals at highest risk of severe illness from COVID-19, such as older adults and immunocompromised people. This focused approach is aimed at enhancing protection for the most vulnerable who are more likely to experience severe outcomes from SARS-CoV-2 infection."

"I would like to thank NACI for providing this guidance to help Provinces and Territories plan for COVID-19 vaccine programs next spring. Our understanding of COVID-19 continues to grow, and while there are still many unknowns we now have several years of experience with this virus. We know protection against severe illness due to COVID-19 can wane in those who are most at risk, and that an additional dose of COVID-19 vaccine can increase that protection again. As we move through the winter months into spring, the Public Health Agency of Canada and NACI will continue to monitor COVID-19 activity and the effectiveness of the updated vaccines."