Summary supplemental statement: Addendum to the guidance on the use of COVID-19 vaccines in the fall

On this page

• Overview
• What you need to know
• Quotes

Overview

• On September 12, the Public Health Agency of Canada (PHAC) released an addendum to the July 11, 2023, National Advisory Committee on Immunization (NACI) Guidance on the use of COVID-19 vaccines in the fall of 2023. This advice was developed to support provinces and territories in preparing for a fall vaccination program and anticipated updates to the COVID-19 vaccines.
• On September 12, 2023, Health Canada authorized an XBB.1.5-containing mRNA COVID-19 vaccine for use in individuals 6 months of age and older.
• Following this authorization, NACI is reaffirming the July 11, 2023 recommendation, now specifically referencing the XBB.1.5-containing COVID-19 vaccine, as follows:

Beginning in the fall of 2023 for those previously vaccinated against COVID-19, NACI recommends a dose of the XBB.1.5-containing formulation of COVID-19 vaccine for individuals in the authorized age group if it has been at least 6 months from the previous COVID-19 vaccine dose or known SARS-CoV-2 infection (whichever is later).
Immunization is particularly important for those at increased risk of COVID-19 infection or severe disease, for example:

• Adults 65 years of age or older;
• Residents of long-term care homes and other congregate living settings;
• Individuals with underlying medical conditions that place them at higher risk of severe COVID-19;
• Individuals who are pregnant;
• Individuals in or from First Nations, Métis and Inuit communities;
• Members of racialized and other equity-deserving communities;
• People who provide essential community services

• NACI will continue to monitor the evolving evidence and will update guidance as needed.

For the full addendum, please see Addendum to guidance on the use of COVID-19 vaccines in the fall of 2023.

What you need to know

• Different versions of XBB, a variant of the SARS-CoV-2 virus, are spreading in Canada and around the world. Right now, XBB.1.9.2 is the most common type in Canada, with a subset called EG.5 increasing in Canada and globally.
• Health Canada has authorized the Moderna XBB.1.5-containing COVID-19 vaccine for use in those who have not been previously vaccinated (formerly referred to as the primary series) and those who have been previously vaccinated (formerly referred to as the booster dose). Other XBB.1.5-containing COVID-19 vaccines are currently under review with Health Canada.
• XBB.1.5-containing COVID-19 vaccines are expected to offer better protection against newer variants compared to previous COVID-19 vaccines, similar to the annual updates seen with the influenza vaccine.
• NACI is evaluating COVID-19 vaccine options, schedules, and considerations for vaccinated and unvaccinated individuals based on age or other risk factors, with anticipated guidance in the coming months.
• For now, the updated vaccine can be used to start a vaccination series for those who are previously unvaccinated, or to continue a vaccine series started with a different COVID-19 vaccine.
• An additional dose can be offered 6 or more months from the last COVID-19 dose or a known SARS-CoV-2 infection (whichever is later). Booster vaccination using shorter intervals (i.e. 3 months to < 6 months) following  previous vaccination or infection has not been shown to pose a safety risk, though evidence shows that the antibody response is higher with longer intervals between infection and vaccination and with longer intervals between vaccination doses.

For the full Fall 2023 COVID-19 NACI statement, including supporting evidence and rationale, please see Guidance on the use of COVID-19 vaccines in the fall of 2023.
For further information on NACI's recommendations on the use of COVID-19 vaccines, please refer to NACI: Statements and publications and the COVID-19 vaccine chapter in the Canadian Immunization Guide (CIG).

Quotes

“With the authorization of the first XBB-containing COVID-19 vaccine, NACI is taking this opportunity to reaffirm the planning guidance we released this summer. A dose of XBB-containing COVID-19 vaccine is expected to offer better protection as we head into a respiratory virus season when we expect new SARS-CoV-2 variants to circulate. This will be most important for populations at highest risk of severe disease, including the elderly and individuals who are pregnant.  NACI is now busy considering ways to simplify the COVID-19 vaccine schedule going forward, and will be providing further guidance for those who have not yet been vaccinated.”

“In light of the recent COVID-19 vaccine authorization for individuals 6 months of age and older, I thank NACI for reaffirming their advice to people in Canada, particularly those who are at high risk, to receive a dose of XBB-containing COVID-19 vaccine this fall. This updated vaccine formulation is expected to better protect against the strains  circulating in our communities at this time. We know protection wanes over time; getting vaccinated when you are eligible will help build back your protection against COVID-19 over the fall and winter months. Vaccination layered with personal protective measures continues to be our strongest defense against COVID-19. I encourage people in Canada to take action to stay safe this respiratory virus season.”