Quebec renews COVID-19 vaccination recommendations for fall amid uptick in cases

With COVID-19 cases on the rise, Quebec's immunization committee has released its recommendations on administering vaccines this fall.

In a report published Monday, the committee recommends that the same groups as it did last year get a booster dose. They include: 

• People aged 60 and over.

• People living in long-term care homes.

• People who are immunocompromised, undergo dialysis or live with a chronic illness.

• Pregnant people.

• Health-care workers.

• Adults living in isolated areas.

Quebec had 790 positive COVID-19 cases in the week of July 14, according to the latest data from the Institut national de santé publique du Québec (INSPQ). About 820 patients were hospitalized due to COVID-19 that same week, nearly twice as many since the end of April. 

The positivity rate for COVID-19 tests jumped to 16.3 per cent in July from 2.3 per cent in April.

People who have never had COVID-19 are more likely to develop complications following their first infection with SARS-CoV-2  despite good vaccination coverage, the immunization committee report says. That's because the effectiveness of the vaccine tends to wane after several months, especially when new variants emerge.

The committee says the likelihood of experiencing severe COVID-19 symptoms leading to hospitalization is much higher for elderly people, and that risk is compounded when a person has a chronic illness. 

Preliminary analyses conducted on people who were 60 years old and older during the 2023 vaccination campaign show that they were 43 per cent more protected than people who only received a booster dose in 2022. 

Young adults in good health may get another dose, but the committee says a booster dose for that group would have few benefits given the group's low risk of developing COVID-19 complications. 

"The vaccine is very effective to prevent severe hospitalization. It's not as effective to prevent transmission," said Dr. Nicholas Brousseau, a public health physician at the INSPQ. "That's why our recommendations target at-risk people."

New variants

The committee is also recommending that the government wait for the availability of vaccines which are better adapted to new strains circulating before launching the next vaccination campaign. 

It is calling on the government to withdraw its preference for mRNA vaccines over Nuvaxovid (Novavax) so that Quebec may recommend the vaccine that "offers protection against variants that are closest to those circulating" and look into offering booster doses along with the flu shot.  

The virus SARS-CoV-2 continues to produce new variants since it was first detected in 2019, with the JN.1 strain being the most prominent in Quebec and Canada as of March 13, 2024. 

The last provincial vaccination campaign targeted the XBB.1.5 variant. 

"By fall 2024, it is expected that new versions of COVID-19 vaccines, targeting one or more strains closer to those currently in circulation, will be developed and authorized," the report says.