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A spring COVID-19 booster? NACI has released updated guidelines

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Canadians may be in the thick of winter, but the National Advisory Committee on Immunization (NACI) recently unveiled guidelines for an extra dose of the COVID-19 vaccine for the upcoming spring.

On Friday, NACI released updated guidelines on the COVID-19 boosters for spring 2024.

“A sufficient supply of XBB.1.5 vaccine has already been federally purchased and is expected to be available to support a spring 2024 campaign,” NACI said in the release. “However, a spring program would involve additional resources for implementation, compared to a fall program that can take advantage of the infrastructure of the long-established influenza vaccine program.”

Starting in the spring of 2024, NACI recommends that the following Canadians who are at increased risk of severe illness from COVID-19 may receive an additional dose of XBB.1.5 vaccine:

  • adults 65 years of age and older
  • adult residents of long-term care homes and other congregate living settings for seniors
  • individuals six months and older who are moderately to severely immunocompromised (due to an underlying condition or treatment)
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The current COVID-19 subvariants circulating Canada are of Omicron origin, which current updated vaccines target.

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The risk of severe illness from the virus is highest in adults 80 years of age and older, NACI said. However, those who are 65 years of age and older are being included in the recommendation as an “acknowledgment that the risk of severe illness exists along a gradient in older adults.”

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For those who are unvaccinated and are moderately to severely immunocompromised, starting their primary vaccine series with an XBB.1.5 vaccine is recommended. If they are five years of age and older, they should receive two doses, spaced four to eight weeks apart. If aged six months to under five years, three to four doses are advised.

For individuals who are at higher risk for severe COVID-19, an additional dose of COVID-19 vaccine in the spring of 2024 may further improve or boost the immune response, NACI said.

“Receiving a COVID-19 vaccine in the spring is particularly important for individuals at increased risk of severe illness due from COVID-19 who did not receive a dose of XBB.1.5 COVID-19 vaccine during the fall program,” the releases stated.

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The recommended interval between the doses continues to be six months. However, a shorter interval of at least three months may be used, to support implementation and timing of the spring campaign.

NACI said overall vaccine uptake has declined with each additional campaign, but continues to be highest in older adults (particularly those 80 years of age and older).

Last spring, national vaccination coverage between April 1 and June 18, 2023, was estimated to be approximately 11 per cent in adults 65 years of age and older.

The fall campaign, which kicked off in October 2023, has now seen 14.6 per cent of eligible Canadians receiving the updated XBB.1.5 variant vaccine.

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