On December 9, 2022, Health Canada authorized the use of the Pfizer-BioNTech Comirnaty BA.4/5 Bivalent (10 mcg) COVID-19 vaccine as a single booster dose in individuals 5 to 11 years of age, following the authorization on October 7, 2022 of the Pfizer-BioNTech BA.4/5 Bivalent (30 mcg) as a booster dose in individuals ≥12 years of age. On August 19, 2022, NACI published Recommendations on the use of a first booster dose of Pfizer-BioNTech Comirnaty COVID-19 vaccine in children 5 to 11 years of age, which provided guidance on the first COVID-19 booster product (original formulation) authorized for use in children 5 to 11 years of age in Canada.
The epidemiology of COVID-19 continues to change and there is still considerable uncertainty with regard to the likelihood, timing, and severity of any potential future COVID19 waves. COVID-19 epidemiological activity in Canada increased in the summer months, and again in the fall. Consistent with other respiratory viruses, it is possible that the incidence of COVID-19 may again increase in the colder months and that new variants of concern (VOCs) may emerge. However, seasonality of SARS-CoV-2 virus is yet to be established.
The Omicron variant has demonstrated partial immune evasion conferred by the original COVID-19 vaccines or by a previous infection with a SARS-CoV-2 variant that emerged prior to Omicron. The immune evasion exhibited by more recent Omicron subvariants (e.g., BA.4 and BA.5, and BQ.1) may be greater than that exhibited by previous Omicron subvariants, although evidence is still emerging.
The proportion of Canadian children 5 to 11 years of age vaccinated with a primary series is roughly 40%; however, only 5% of children in this age group have received at least one booster dose.
NACI continues to recommend a primary series with an original mRNA vaccine in all authorized age groups, and a booster dose with a recommended vaccine product for those who are eligible. Immunization of those who are eligible for vaccination but have not yet received their recommended doses (primary or booster) remains a top priority in Canada. A booster dose is most important for authorized populations considered at increased risk of severe COVID-19 disease. For further information on NACI’s recommendations on the use of COVID-19 vaccines, please refer to NACI’s: Statements and publications and the COVID-19 vaccine chapter in the Canadian Immunization Guide (CIG). NACI continues to monitor the rapidly evolving scientific data while recognizing that the trajectory of the COVID-19 pandemic remains unclear. Updated recommendations will be made as needed.
NACI’s recommendations remain aligned with the goals of the Canadian COVID-19 Pandemic Response that were updated on February 14, 2022:
- To minimize serious illness and death while minimizing societal disruption as a result of the COVID-19 pandemic
- To transition away from the crisis phase towards a more sustainable approach to long term management of COVID-19.
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