Interim guidance on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada

• On June 29, 2022, the Public Health Agency of Canada (PHAC) released interim guidance from the National Advisory Committee on Immunization (NACI) on planning considerations for a fall 2022 COVID-19 vaccine booster program in Canada. This guidance is based on current evidence and NACI's expert opinion.
• The likelihood, timing, and severity of a future wave of COVID-19 is uncertain. There may be an increase in COVID-19 activity in the later fall and winter seasons as people spend more time together indoors.
• NACI's interim guidance is based on the need for, and benefit of, COVID-19 vaccine booster doses in the fall of 2022 in the Canadian context. This guidance will help provinces and territories plan fall booster dose programs in their jurisdictions to help increase protection against COVID-19 in advance of a possible future wave.
• NACI continues to strongly recommend a primary series with an authorized mRNA COVID-19 vaccine in all authorized age groups to protect against severe COVID-19 illness and hospitalization. NACI also continues to recommend a first and second booster dose in some populations. For more information on these recommendations, please refer to the COVID-19 vaccine chapter in the Canadian Immunization Guide, as well as additional statements on the NACI web page.
• NACI recommends that

1. Individuals who are at increased risk of severe illness from COVID-19 should be offered a fall COVID-19 vaccine booster dose* regardless of the number of booster doses previously received, including:

• Older adults (≥65 years of age)
• Residents of long-term care facilities or congregate living settings for seniors
• Individuals 12 years of age and older with an underlying medical condition that places them at high risk of severe COVID-19
• Adults in or from First Nations, Métis, or Inuit communities, where infection can have disproportionate consequences
• Adults in racialized communities and marginalized communities (e.g., people living with disabilities) disproportionately affected by COVID-19
• Residents of other congregate living settings (e.g., quarters for migrant workers, shelters, correctional facilities, group homes) who are 12 years of age and older

2. All other individuals 12 to 64 years of age maybe offered a COVID-19 booster dose* in the fall of 2022, regardless of the number of booster doses they have previously received. (Discretionary NACI Recommendation)

3. COVID-19 booster doses may be offered at an interval of 6 months since a previous COVID-19 vaccine dose or SARS-CoV-2 infection. A shorter interval of at least 3 months may be warranted in the context of heightened epidemiologic risk, as well as operational considerations for the efficient deployment of vaccine programs. (Discretionary NACI Recommendation)