You’re in a key spot to promote the XBB.1.5 COVID-19 vaccine for patients previously unvaccinated or those needing a spring dose.
Only about 15% of Canadians have received an XBB.1.5 vaccine.
Explain that patients who receive an XBB.1.5 COVID-19 vaccine are expected to have a better immune response against current circulating variants, including subvariants JN.1 and HV.1.
But vaccine effectiveness wanes over time. And older patients remain vulnerable to severe illness due to COVID-19.
Continue to ask patients about their COVID-19 vaccine history...and point out that vaccine schedules are now simpler.
Recommend ONE dose of an XBB.1.5 mRNA vaccine for UNvaccinated patients over 5 years old...and a SECOND dose 4 to 8 weeks later for those moderately to severely immunocompromised (cancer, etc).
For UNvaccinated children 6 months to under 5 years, especially those at high risk of severe illness (Down syndrome, etc), recommend TWO doses of Spikevax XBB.1.5 or THREE doses of Comirnaty Omicron XBB.1.5...given 8 weeks apart.
Give an additional dose 4 to 8 weeks later if the child is moderately to severely immunocompromised.
Use this table to help keep doses straight.
For patients who started a series with an earlier formulation (original monovalent, bivalent, etc), complete the series with an XBB.1.5 vaccine based on the earlier dosing schedule.
For example, give a total of 2 doses in a primary series for patients over age 5 years who are not immunocompromised...and 3 doses if they’re moderately to severely immunocompromised.
It’s now okay to give Comirnaty or Spikevax to patients 12 to 29 yrs. The risk of myocarditis is expected to be lower...due to the 1-dose schedule and possibly the reduced dosage of the Spikevax XBB.1.5 vaccine.
Starting this spring, recommend an additional XBB.1.5 vaccine dose to certain patients at increased risk for severe illness...adults over age 65, residents of long-term care, and those over 6 months old who are moderately to severely immunocompromised.
Give the additional XBB.1.5 dose about 6 months after the last COVID-19 vaccine dose or COVID-19 illness for most patients.
See our resources, COVID-19 Vaccines, to compare options...and Communicating About COVID-19 Vaccination, to address concerns.
- Health Canada. Guidance on an additional dose of COVID-19 vaccines in the spring of 2024 for individuals at high risk of severe illness due to COVID-19. January 12, 2024. https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/vaccines-immunization/national-advisory-committee-immunization-guidance-additional-dose-covid-19-vaccines-spring-2024-individuals-high-risk-severe-illness-due-covid-19/naci-statement-2024-01-12.pdf (Accessed March 1, 2024).
- Health Canada. Updated guidance on the use of COVID-19 vaccines in individuals who have not previously been vaccinated against COVID-19. https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/vaccines-immunization/national-advisory-committee-immunization-updated-guidance-covid-19-vaccines-individuals-not-previously-vaccinated/naci-statement-2023-10-27.pdf (Accessed March 1, 2024).