New Guidance on COVID-19 Boosters for Adolescents, Third Doses for Children, Vaccine for People who Test Positive
The Province is recommending a booster dose of COVID-19 vaccine for Nova Scotians ages 12 to 17 at higher risk of severe illness.
The age of booster eligibility has lowered following a recent recommendation by the National Advisory Committee on Immunization (NACI) for young people 12 to17 years old who:
- have an underlying medical condition that may put them at high risk of severe illness due to COVID-19, including those who are immunocompromised and who have already received a three-dose primary series (for adolescents who are immunocompromised, a booster dose would be their fourth dose)
- are residents of congregate living settings, including shelters, group homes, quarters for migrant workers and correctional facilities
- belong to racialized or marginalized communities disproportionately affected by COVID-19.
“The majority of adolescents 12 to 17 in Nova Scotia do not need a booster dose as they are at low risk of severe COVID-19 outcomes if they are fully vaccinated,” said Dr. Robert Strang, Nova Scotia’s Chief Medical Officer of Health. “However, for some, the benefit of receiving a booster dose ahead of further approvals outweighs the risk of getting COVID-19.”
Booster doses in this age group are currently considered off-label because Health Canada, the federal regulator, has not yet approved the vaccine for this use in this age group. However, NACI says preliminary findings from booster doses in adolescents in other parts of the world show no different safety concerns than those from the primary series of vaccine. NACI also says the Pfizer booster dose is preferred for this age group.
Families with children 12 to 17 who do not fall into the groups above are also eligible for a booster with informed consent. They will need to review the information provided during the booking process about booster doses in this age group, including the rare risk of myocarditis and pericarditis following a dose of COVID-19 mRNA vaccine. Evidence shows adolescents remain well protected against severe COVID-19 and hospitalization with two doses of vaccine.
NACI recently also issued a strong recommendation on third doses for children ages 5 to 11 who are moderately to severely immunocompromised at the time of their first or second dose of COVID-19 vaccine. They are now eligible for a third dose of vaccine to complete their primary series. A third dose can be booked 56 days after the second dose.
And, NACI has new advice on vaccine timing for people who have tested positive for COVID-19:
- people who tested positive and have not been fully vaccinated are advised to wait at least two months to get a first or second dose of vaccine
- people who have tested positive for COVID-19 and have been fully vaccinated are advised to wait at least three months to get a booster dose, provided they have been fully vaccinated for at least 168 days and are eligible for a booster.
The Province supports NACI’s most recent guidance.
My IWK infectious disease experts and I support the NS Public Health and National Advisory Committee on Immunizations recommendation to prioritize COVID booster vaccinations for our 12 to 17-year-olds with risk factors. When compared to older adults, adolescents tend to have milder COVID disease. However, when compared to their peers, adolescents with risk factors for more serious COVID infections include those with obesity, moderate to severe asthma, cancer, cystic fibrosis, diabetes, serious heart and lung conditions, some blood disorders, Down Syndrome, epilepsy and weakened immune systems. Please discuss any concerns you may have with your family physician or pediatric specialist.
Dr. Andrew Lynk, Chief, Pediatrics, IWK Health Centre; Chair, Pediatrics, Dalhousie University
- booster doses are administered 168 days after a two-dose primary series
- the primary series for people who are moderately to severely immunocompromised is three doses; a booster would be their fourth dose
- about 98 per cent of people 12 to 17 years old have received two doses of COVID-19 vaccine or have a second dose appointment scheduled
COVID-19 booster doses: https://novascotia.ca/coronavirus/vaccine/#additional-doses
NACI guidance on the use of booster COVID-19 vaccine doses in adolescents 12-17 years of age: https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/guidance-use-booster-covid-19-vaccines-adolescents-12-17-years-age.pdf
NACI updated recommendations on the use of COVID-19 vaccines in children 5 to 11 years of age: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/updated-recommendations-use-covid-19-vaccines-children-5-11-years-age.html#a5
National Advisory Committee on Immunization (NACI) Rapid response: Updated guidance on COVID-19 vaccination timing for individuals previously infected with SARS-CoV-2: https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/naci-rapid-response-updated-guidance-covid-19-vaccination-timing-individuals-previously-infected-sars-cov-2.pdf