A new guidance on COVID-19 boosters issued yesterday by the National Advisory Committee on Immunization 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.

Dr. Theresa Tam, Chief Public Health Officer of Canada (Photo: U.S. Mission to International Organizations in Geneva, Public Domain).

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 Feb. 23, one of which was when are Canadians in high-risk groups going to be allowed to re-up their COVID-19 boosters. 

National Advisory Committee on Immunization Chair Dr. Shelley Deeks (Photo: University of Toronto School of Public Health).

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’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, Ms. 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. 

“Public Health Emergencies Governance Review Panel” Chair Preston Manning (Photo: David J. Climenhaga).

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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  1. I doubt Covid-19 is over. In addition, I’d like to see what Preston Manning says with his report of sorts to see how the UCP looked after the Covid-19 pandemic in Alberta. It’s likely AHS and Dr. Deena Hinshaw bungled things up very badly, the UCP isn’t at fault, and so he ends up $253,000 richer. Reformers can’t be trusted at all.

  2. You can bet the farm that the likes of Preston Manning and the rest of the octogenarian radical conservatives that populate Alberta will secretly (or at least quietly) have that additional covid booster, regardless of what Preston’s fantasy novel eventually says about the pandemic.

    1. Expat: While I can’t speak for Mr. Manning, you are almost certainly right about that as a general statement about the behaviour of that particular group of people. Moreover, I would be willing to bet that a significant number of the people openly advocating for Alberta separatism, possibly an outright majority, have dual citizenship and the use of a U.S. passport. DJC

      1. Good point on the dual-citizens. We need a Public Inquiry into US meddling in Canadian politics, the recent Freedumb blockades being a prime example. Or how about 40 or so years of Alberta’s political culture? The circumstantial evidence is compelling. As soon as Lougheed/Getty started to develop reasonable royalty rates, they were disposed of. Within months of Premier Stelmach announcing the revision of royalty rates, the UCP/Wildrose suddenly had unlimited funds and air time to spread the big lie that Ottawa was taking all our oil revenue. It hardly took more than a few hours for the gullible Ab NDP to appoint an oil industry finance guy to effectively lower royalty rates.

  3. Dave, I think you made a transcription error re: the advisory guidelines, which read: “Adults 65 to 79 years of age, particularly if they do not have a known history of SARS-CoV-2 infection”

  4. Very good synopsis of current trends. As a member of a vulnerable group I was able to secure a fourth booster through my local health unit. Perhaps officials see the advantages of extra immunizations rather than having to provide beds in rooms or hallways.

  5. Thanks for the reminder. We got our 5th shot yesterday and it appears as though the West Edmonton Immunization Clinic will be closing next week and by all accounts that will be the last one, or maybe not. We have a bunch of friends and relatives that got immunized and got COVID and none of those had severe affects or were hospitalized. In spite of what the loonies (D. Smith, et. al.) the vaccine does work, maybe not at preventing Covid but at least making the symptoms less severe.

  6. The NACI, being made up of accomplished experts in their respective fields must be such a foreign concept to Danielle Smith. There are no bagmen, party hacks or useful idiots in the entire group.

  7. The NACI recommendations make perfect sense and seem to be in line with other jurisdictions around the world. By all means get a booster if you’re in the older vulnerable age groups but two thumbs down if you’re in the younger more healthy group where the risks outweigh the benefits.

    Maybe the NACI throw in a hip hip hooray or two for good old vitamin D given recent studies showing high doses of the stuff was probably just as effective of the dreaded vaccines. And in the last few days there were news reports about Vitamin D being effective against dementia. And while we’re at it let’s have a round of applause for ivermectin. Just kidding. (Cue the howls of outrage. He wants to give people horse tranquilizer!).

    1. No freedom of choice for people under 65 who want to make their own informed decision that the vaccine is right for them. No freedom of choice to take Paxlovid, either, for most under-65s.

      It’s funny how the people who cry “freedom” loudly don’t actually want freedom. They only want to limit the choices of others. Freedom is what they say it is, and anyone who disagrees can get stuffed. Case in point, a certain anti-vaxx representative in Calgary shifted his attention to bashing transgender people in public places, and uttering slurs at children and their parents in a library. He sells anti-vaxx T-shirts as a side gig, or maybe his only gig. He won. Story time is finushed. Freedom of choice is being stomped out by the very people who profess to be all about freedom. Freedom = erosion of democracy = no freedom. George Orwell would not be surprised.

      1. When anti-vaxxers say “my body my choice” I ask them how they feel about someone else choosing to get gender reassignment surgery on their body, or someone else getting an abortion, or someone else using illegal drugs. All of those behaviours can also be justified by the slogan “my body my choice.”

    2. Sir: forgive me if your reference to Vitamin D was sarcastic, in the same vein as that for ivermectin, but if it wasn’t, let me suggest that the benefits of Vitamin D supplementation have been oversold both in the popular consciousness and amongst health care professionals. Aside from preventing vitamin D deficiency disease — aka rickets — and bone loss in older adults, clinical trial after clinical trial has failed to demonstrate any health benefits to additional Vitamin D supplementation beyond the generally accepted recommendations from Health Canada for adults 50 years of age and older for 400 units daily, due to our high latitudes and resulting reduced exposure to sunlight.

      It’s a persistent and pervasive example of medical mythology unsupported by any evidence, just as are other recommendations for vitamin supplementation in the absence of a deficiency or other disease state.




      1. What first piqued my interest in Vitamin D was a Nature of Things program a few years ago hosted by Dr David Suzuki. He speculated a whole range of diseases and conditions was caused by vitamin D deficiency which was widespread in northern climates.

  8. This leaves gaps, one of which is whether or not provinces will go along with the plan. What will happen if some provinces opt out? Will Canadians (i.e. Albertans) be able to get the vaccine in a province that does?

    Then there’s the question of people under 65 who provide care to people over 65, some of whom share a household. Gone are the days when we kept elders safe by getting the vaccine. Remembering that it is virtually impossible to get the Covid antiviral Paxlovid for most of the population, thanks to Alberta’s (the UCP’s) decision to restrict its use to the point that it will expire unused on pharmacy shelves.

    Danielle Smith’s government is on the anti-vaxxer side of the spectrum, “the most discriminated against group that I’ve ever witnessed in my lifetime.” This means that if the UCP win the May 2023 election, hopes and prayers might be all we have to deal with the worst pandemic in a century. Good luck with that.

  9. Of course, this guidance will be considered federal over reach, so whatever.

    Everyone is comfortable, or fatalistic, that COVID has, either, run its course, or the next variant outbreak is just around the corner, so who cares anymore?

    COVID ennui is a thing now. Public health orders with be released with hesistance, or not at all, because no one wants to offend the crazies anymore. I have been long of the belief that COVID was humanity’s best chance to wipe out the unreasonable and the loonies once and for all. Natural Selection would take its course and clean up society of its dumbest monkeys. But that’s was not to be and the dumb monkeys were allowed to run amok and pretty much guide the public discourse. This is what FreeDUMB of Speech will get you, so you’ve been warned.

  10. Smith’s response to NACI’s recommendations will show us whether she is a true libertarian, or an anti-science nut. A libertarian will make the vaccines available to those who want them; an anti-science nut will claim they are not necessary, cuz she’s smarter than the people on NACI.

  11. EXCERPT: ‘mRNA vaccine (bivalent) 2-month (60-day) interval “‘
    This the USA dosing schedules which only require a 2-month (60-day) interval from the previous vaccine shots for both boosters the Pfizer and Moderna bivalents at the links below:



    Specific intervals for all age groups and different risk groups are at the links.

    It would be interesting if some Canadian health reporters asked Canada’s officials why we’re using 6 months, and not the US standard minimum of 2 month intervals.

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