In November 2020, the National Advisory Committee on Immunization (NACI) released comprehensive and evidence-informed preliminary guidance on key populations for early COVID-19 immunization to inform planning for the efficient, effective, and equitable allocation of COVID-19 vaccine(s) once authorized for use in Canada when limited initial vaccine supply will necessitate the prioritization of immunization in some populations earlier than others.
The key populations identified by NACI for early COVID-19 immunization include: those at high risk for severe illness and death, those most likely to transmit to those at high-risk and workers essential to COVID-19 response, essential services for the functioning of society, and those in living or working conditions with elevated risk for infection or disproportionate consequences, including Indigenous communities, according to a statement on the federal government website.
Stage 1
NACI recommends that initial doses of authorized COVID-19 vaccine(s) should be offered to individuals without contraindications (a symptom or condition that makes a treatment risky) in the following populations:
- Residents and staff of congregate living settings that provide care for seniors
- Adults 70 years of age and older, beginning with adults 80 years of age and older, then decreasing the age limit by 5-year increments to age 70 years as supply becomes available
- Health care workers (including all those who work in health care settings and personal support workers whose work involves direct contact with patients)
- Adults in Indigenous communities where infection can have disproportionate consequences
Stage 2
NACI recommends that as additional COVID-19 vaccine supplies become available with sufficient supply to vaccinate the above populations, authorized COVID-19 vaccine(s) should be offered to individuals without contraindications in the following populations:
- Health care workers not included in the initial rollout
- Residents and staff of all other congregate settings (e.g., quarters for migrant workers, correctional facilities, homeless shelters)
- Essential workers – (e.g., police, firefighters, food production)
NACI also notes that due to restrictive storage and handling requirements, there is a risk of dose wastage if excess doses remain after complete immunization in a particular setting. If doses of COVID-19 vaccine(s) have been delivered to an immunization setting and have been used for a group recommended in Stage 1 but cannot be re-located to another setting for other groups recommended in Stage 1, remaining doses on-site may be provided to individuals in the groups recommended in Stage 2 in order to minimize the risk of vaccine wastage and maximize the benefits of vaccination, it adds.
