Canada’s National Advisory Committee on Immunization (NACI) is recommending COVID-19 booster shots for all adults 80 years of age and older, and is also opening the door for certain other groups who may be at increased risk of lowered protection over time since their initial vaccinations.
“Populations at highest risk of waning protection following their primary series and at highest risk of severe COVID-19 illness should be offered a booster dose of an mRNA COVID-19 vaccine at least six months after completing their primary series,” NACI’s new guidance released Friday said, noting that seniors 80 years and older “should” be offered a booster shot.
NACI also said other people “may” be offered a booster shot, because they “may be at increased risk of lower protection over time since vaccination, increased risk of severe illness or who are essential for maintaining health system capacity.”
Those groups include:
- Adults between the ages of 70 and 79.
- People who received two doses of the AstraZeneca/COVISHIELD vaccine or one dose of the Janssen vaccine.
- Adults in or from First Nations, Inuit and Métis communities.
- Adults who are front-line health-care workers who have direct in-person contact with patients and who were vaccinated with a very short interval between their first and second doses (three or four weeks).
Booster shots should be given at least six months after the second dose of vaccine, NACI said. The boosters should also be one of the mRNA vaccines — Pfizer-BioNTech or Moderna, it said.
Although NACI makes recommendations, it’s up to the provinces and territories to decide who they will offer booster shots to.
In Alberta, Indigenous people age 65 and older and other seniors who are 75 and older can already get booster shots.
On Thursday, the Northwest Territories announced anyone 18 years of age or older will now be eligible for a booster shot.
Last week, British Columbia said that seniors age 70 and older, all Indigenous people 12 and older and health-care workers who only had three or four weeks between their two doses will all be able to get a booster shot by the end of the year. By next May, everyone in B.C. will be eligible for one.
WATCH | B.C. to offer COVID-19 booster shots to everyone by May:
![](https://thumbnails.cbc.ca/maven_legacy/thumbnails/877/311/covid-bc-boosters-strachan-261021.jpg?crop=1.777xh:h;*,*&downsize=510px:*%20510w")
B.C. is the first province to announce a plan for COVID-19 booster shots, with all residents being eligible in May, or six to eight months after their first dose. 1:53
After NACI’s guidance was released on Friday, the Ontario government said it would release its plan for COVID-19 boosters next week.
NACI has already recommended third doses for people living in long-term care homes or other congregate settings, as well as people with specific immunocompromising conditions.
In its guidance on Friday, the advisory group said it continues to “strongly recommend” that people who are moderately to severely immunocompromised should get a third dose of vaccine. People in that category include:
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Active treatment for solid tumour or blood cancers.
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Organ transplant recipients taking immunosuppressive therapy.
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People getting chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within two years of transplantation or taking immunosuppression therapy).
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Moderate to severe primary immunodeficiency (e.g. DiGeorge syndrome, Wiskott-Aldrich syndrome).
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Stage 3 or advanced untreated HIV infection and those with AIDS.
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Active treatment with certain immunosuppressive therapies.
What’s the difference between a booster shot and a 3rd dose?
The three approved COVID-19 vaccines in Canada (Pfizer-BioNTech, Moderna and AstraZeneca) are all two-dose regimens. A third dose is for people who may not have mounted a strong enough immune response to fight off COVID-19 after two doses.
NACI has identified two populations that require third doses: elderly people living in long-term care and those who have specific health conditions that make them immunocompromised (including organ transplant recipients). For these people, a third dose is an extension of their primary series of vaccinations.
A booster shot is for people who likely had a fulsome immune response to the regular two-dose vaccine regimen, but “with time, the immunity and clinical protection has fallen below a rate deemed sufficient in that population,” according to the World Health Organization (WHO).
It’s comparable to the tetanus vaccine, which requires a booster shot every 10 years. Most experts agree that everyone will likely need a COVID-19 booster shot at some point within the next year, but the big question is when.
