A new guidance on COVID-19 boosters issued Friday by the National Advisory Committee on Immunization (NACI) recommends that an additional booster dose be offered to people at increased risk of severe illness from the disease six months from their last vaccine dose or infection.
The March 3 advisory – Guidance on an additional COVID-19 booster dose in the spring of 2023 for individuals at high risk of severe illness due to COVID-19 – was published by the Public Health Agency of Canada and lists four categories of individuals at risk who should qualify for the additional booster:
– Adults 80 years of age and older
– Adults 65 to 79 years of age, particularly if they do not have a known history of SARS-CoV-2 infection
– Adult residents of long-term care homes and other congregate living settings for seniors or those with complex medical care needs
– Adults 18 years of age and older who are moderately to severely immunocompromised due to an underlying condition or treatment
The federal immunization advisory body says in the guidance that “bivalent Omicron-targeting mRNA COVID-19 vaccines continue to be the preferred booster products.”
NACI explained that the risk of hospitalization and intensive care admission increases with age and noted that additional booster doses may be recommended this fall for broader population groups, depending on “the COVID-19 pandemic context” – in other words, how fast and far the disease is spreading by autumn.
In the meantime, this casts a little light on the questions asked in this space on February 23, one of which was when are Canadians in high-risk groups going to be allowed to re-up their COVID-19 boosters.
At the time, all provinces were awaiting a guidance from NACI before proceeding with another round of COVID-19 boosters for eligible citizens.
Since NACI has now advised boosters for vulnerable populations, the question becomes how long will it take Alberta Health (as the provincial health department is known) to instruct Alberta Health Services to proceed with a booster program.
The guidance presents an interesting conundrum for Premier Danielle Smith’s government, with the United Conservative Party (UCP)’s organization if not its Legislative Caucus now dominated by the anti-vaccination militants of the Take Back Alberta group.
With a provincial election looming, Smith and the UCP will presumably be under public pressure both to proceed with vaccine boosters and not to allow them.
Meanwhile, the UCP-appointed “Public Health Emergencies Governance Review Panel” led by former Reform Party leader Preston Manning, author of a “fictional” screed fantasizing about an imaginary future federal government holding public health officials criminally responsible for their response to the pandemic, must make Alberta health officials nervous about the wisdom of following NACI’s advice.
In the Guidance, NACI Chair Dr. Shelley Deeks observed that “we have historically seen patterns of waning protection against severe disease by six months after the last dose, particularly in older adults without prior infection.”
“Because of this, as a precautionary measure, NACI is recommending this spring that an additional bivalent booster dose may be offered after six months for those at highest risk of severe disease, including older adults and persons who are moderately to severely immunocompromised,” she said.
Dr. Theresa Tam, the Chief Public Health Officer of Canada, was quoted in the same document. “It remains important to stay up to date with your COVID-19 vaccines, including recommended booster doses, given the continued circulation of SARS-CoV-2 virus variants in Canada and elsewhere,” she said.
“Given the current COVID-19 epidemiology, including the relatively stable disease activity we have observed in recent months, and generally high levels of antibodies against COVID-19 from vaccines and/or infection among Canadians, NACI is currently not recommending an additional bivalent booster for the general population this spring,” she also said. “However, individuals at highest risk of getting severely ill from COVID-19, including older adults and individuals considered immunocompromised, may be offered a spring bivalent booster dose.”
As of Wednesday, 554 Albertans were in hospital with COVID-19, 15 of them in intensive care.
NACI is made up of 14 voting members, an executive secretary, about a dozen industry liaison representatives and a similar number of professional representatives from Health Canada. According to the Wikipedia, NACI’s voting members are drawn from the fields of immunization, public health, vaccine preventable diseases, pediatric or adult infectious diseases, allergy/immunology, other related areas of expertise.
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