Recommendations on the use of Moderna Spikevax COVID-19 vaccine in children 6 months to 5 years of age

Abstract

On July 14, 2022, the Public Health Agency of Canada (PHAC) released recommendations from the National Advisory Committee on Immunization (NACI) regarding the use of Moderna Spikevax COVID-19 vaccine in children 6 months to 5 years of age. This guidance is based on current evidence and NACI's expert opinion.
On July 14, 2022, Health Canada authorized Moderna Spikevax (25 mcg) mRNA COVID-19 vaccine for use as a two dose primary series in children 6 months to 5 years of age. This is the first COVID-19 vaccine authorized in Canada for use in children under the age of 5.
NACI reviewed clinical trial data on the safety, efficacy and immune response generated by Moderna Spikevax (25 mcg) COVID-19 vaccine in children 6 months to 5 years of age, as well as the spread and severity of COVID-19 in children under 5.
For children 6 months to 5 years of age, NACI recommends that:

A primary series of two doses of Moderna Spikevax (25 mcg) COVID-19 vaccine may be offered to children 6 months to 5 years of age who do not have contraindications to the vaccine, with a dosing interval of at least 8 weeks between the first and second dose. (Discretionary NACI recommendation)
A primary series of three doses of Moderna Spikevax (25 mcg) COVID-19 vaccine may be offered to children 6 months to 5 years of age who are moderately to severely immunocompromised, with an interval of 4 to 8 weeks between each dose. (Discretionary NACI recommendation)
At this time, Moderna Spikevax (25 mcg) COVID-19 vaccine should not routinely be given concurrently (i.e., same day) with other vaccines. (Strong NACI recommendation)

As this is a newly authorized COVID-19 vaccine in this age group, NACI recommends that Moderna Spikevax (25 mcg) COVID-19 vaccine should be given 14 days before or after a different vaccine. This will help to determine if a potential side effect is due to Moderna Spikevax (25 mcg) COVID-19 vaccine or a different vaccine. A shorter interval between the administration of Moderna Spikevax (25 mcg) vaccine and a different vaccine may be warranted in some circumstances at the discretion of a health care provider.