Spring is just around the corner. Should you get an updated COVID shot?

As spring approaches, the decision about whether to get an updated COVID-19 dose may be on the minds of Canadians, especially if travel plans are in the works.

In January, the National Advisory Committee on Immunization (NACI) issued guidance for administering an updated dose of COVID-19 vaccines in the spring, specifically for Canadians facing an elevated risk of severe illness from the virus.

“Older adults continue to be at the highest risk of a severe outcome and are less likely to have experienced previous SARS-CoV-2 infection compared to other age groups,” NACI stated.

Since fall 2023, newly revised formulations from Pfizer, Moderna, and Novavax have been accessible to Canadians. The XBB.1.5 COVID-19 vaccines specifically target a more recent lineage of the Omicron variant.

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Starting in the spring, NACI recommends that the following individuals who are at increased risk of severe illness from COVID-19 may receive an additional dose of XBB.1.5 COVID-19 vaccine:

• Adults 65 years of age and older.
• Adult residents of long-term care homes and other congregate living settings for seniors.
• Individuals six months and age and older who are moderately to severely immunocompromised.

“The wording is very important because they are using the word ‘may’ not ‘should’,” explained infectious diseases expert Dr. Isaac Bogoch. “They are talking about who may get a vaccine in the spring of 2024 and it is really the higher risk groups… like people on the older end of the spectrum, people in congregate care settings like retirement homes and nursing homes, people with underlying health conditions that put them at greater risk for severe infection.”

He added that the guidance also clearly indicates that people over the age of 80 are at greatest risk of severe illness from COVID-19, which he believes is “fairly appropriate and well-worded.”

In general, NACI recommends waiting six months from the last COVID-19 vaccine dose before receiving another.

If you are due for a booster but do not fit the NACI guidance, Bogoch stressed it’s still okay to discuss with your health-care provider about receiving a spring COVID-19 vaccine.

“I think it’s important to remember that NACI’s guidance is big-picture public health recommendations,” he said. “They’re not individual nuanced recommendations. Everyone’s going to have a unique situation. And if someone has some issue or some individual concern, it’s just best to speak with a health-care provider regarding the nuances of their situation.”

Overall vaccine uptake has declined with each additional campaign, NACI said, but continues to be highest in older adults (particularly those 80 years of age and older).

Last spring, national vaccination coverage for an updated booster between April 1 and June 18, 2023 was estimated to be approximately 11 per cent in adults 65 years of age and older.

The fall campaign, which kicked off in October 2023, has now seen 14.6 per cent of eligible Canadians receiving the updated XBB.1.5 variant vaccine.

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The dominant COVID-19 variant circulating in Canada is BA.2.86, driven by the JN.1 sub-lineage, according to data from the Public Health Agency of Canada (PHAC).

As of Feb. 24, JN.1 made up 63.9 per cent of all COVID-19 cases in the country.

JN.1 was first detected in Canada on Oct. 9, and since then has rapidly increased taking over as the dominant strain.

In terms of COVID-19 cases, following an increase in mid-November, overall outbreak incidence has remained relatively stable through December and into the beginning of January, PHAC said on its website.

National COVID-19 per cent positivity has been decreasing since mid-December 2023.

Among reporting provinces, trends in COVID-19 patients in hospitals decreased slightly between Feb.20 and Feb. 27, data showed.

Weekly COVID-19 deaths also remain low. The weekly rates of COVID-19 cases hospitalized and admitted to ICU remained highest among the oldest age groups, PHAC said.