Administration of COVID-19 booster doses: Recommendations for winter and spring 2023

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This document presents the recommendations of the Comité sur l'immunisation du Québec (CIQ) regarding the direction the COVID-19 vaccination program should take in the winter and spring of 2023 to efficiently achieve its objectives.
Since the beginning of the vaccination program, the primary objective has been the protection of the most vulnerable persons and the prevention of severe disease and death due to COVID-19.
Vaccines against COVID-19 remain an essential tool given their effectiveness in preventing severe infections, primarily those leading to hospitalizations or death.
Individuals with hybrid immunity, following a first episode of COVID-19 and the administration of at least 2 doses of mRNA vaccines, have strong protection against hospitalization due to COVID-19.
Vaccinated individuals who have never been infected have less protection against hospitalization due to COVID-19 and this protection decreases over time.
The greatest gain in terms of preventing hospitalizations and deaths will be achieved by ensuring vaccination of those at high risk of complications who have not yet been infected.
The CIQ recommends a booster dose of a COVID-19 vaccine for high-risk individuals who have not yet been infected and whose last dose was given at least 6 months previously, regardless of the vaccine product previously given.
As previously defined (https://www.inspq.qc.ca/publications/3219-vaccination-influenza-covid-2022), these high-risk individuals are residents of CHSLDs (long-term care facilities ) or RPAs (private seniors’ residences), persons aged 60 or older, persons aged 5 or older who are immunocompromised, on dialysis, or with chronic conditions at high risk of complications due to COVID-19, health care workers, pregnant women, and adults living in remote or isolated areas.