Primary Series

Pediatric Pfizer-BioNTech Comirnaty™ 5-11 Years

  • 2 doses of 0.2 mL (10 mcg mRNA) 
  • There are currently no recommendations for a third dose in the primary series for immunocompromised children 5-11 years.
The dose should be chosen according to vaccine recipient’s age at presentation
  • For individuals who received the 12+ vaccine as a first dose and are still 11 when they present for their second dose, complete the series with the Pediatric vaccine formulation (10 mcg mRNA).
  • Children who received the Pediatric vaccine for their first dose and who have turned 12 years old by the time the second dose is due should receive the 30 mcg Pfizer-BioNTech COVID-19 vaccine that is authorized for individuals aged 12 years and older to complete their primary series.
References
Last Updated

23 Nov 2021

  • All Saskatchewan residents ages 5 to 11 years without contraindications to the vaccine.
    • Refer out-of-province individuals or those who do not have valid Saskatchewan health services card to Public Health.
  • The eHR Viewer needs to be checked for all individuals.
        •  
  • Residents who received immunization in a different jurisdiction will be eligible to receive subsequent dose(s) in Saskatchewan. Individuals in this scenario will need to have documentation of their dose(s) from the jurisdiction in which they were received. 
  • See "Interval" below for information about timing of 2nd dose.
Reference
Last Updated

23 Nov 2021

  • The authorized interval is 21 days.
  • The optimal interval is 8 weeks, as recommended by the Ministry of Health and NACI.
    • 8 weeks is recommended, but dose can be provided at a shorter interval (≥ 21 days) if chosen.
  • Based on NACI recommendation, the minimum interval is 19 days between doses (any doses provided at an earlier interval would be considered invalid and need to be repeated).
    • This interval is not a recommended interval and should only be used to determine dose validity.

NOTE: If the interval is longer than recommended, there is no reason to restart the series. Provide the next dose as soon as possible.

References
Last Updated

23 Nov 2021

Pfizer-BioNTech Comirnaty™ ≥12 Years

The dose should be chosen according to vaccine recipient’s age at presentation.

  • For individuals who received the 12+ vaccine as a first dose and are still 11 when they present for their second dose, complete the series with the pediatric vaccine formulation (10 mcg mRNA).
  • Children who received the Pediatric vaccine for their first dose and who have turned 12 years old by the time the second dose is due may received the 30 mcg Pfizer-BioNTech COVID-19 vaccine that is authorized for individuals aged 12 years and older to complete their primary series.
Non-immunocompromised Individuals
  • 2 doses of 0.3 mL (30 mcg mRNA) 
Immunocompromised Individuals
  • 3 doses of 0.3 mL (30 mcg mRNA)
References
Last Updated

23 Nov 2021

General Eligibility
  • All Saskatchewan residents ≥ 12 years of age without contraindications to the vaccine.
    • Refer out-of-province individuals or those who do not have valid Saskatchewan health services card to Public Health.
  • The eHR Viewer needs to be checked for all individuals.
  • Children should receive the same mRNA vaccine brand for their COVID-19 vaccine series. It is important that immunizers double check the immunization records of children presenting for COVID-19 immunization to avoid giving a mixed brand series to children if possible. A mixed vaccine series in persons ≥ 12 years of age is acceptable in Canada but may require a future third dose for travel purposes. 
  • Residents who received immunization in a different jurisdiction will be eligible to receive subsequent dose(s) in Saskatchewan. Individuals in this scenario will need to have documentation of their dose(s) from the jurisdiction in which they were received. 
  • Doses to complete a series in recipients of non-Health Canada authorized vaccines received out of country
    • Residents who received one or two doses of a non-Health Canada authorized COVID-19 vaccine should be offered one additional dose based on the Public Health Agency of Canada’s guidance document.
    • Non-residents who received one or two doses of a non-Health Canada authorized COVID-19 vaccine and are planning to stay in Canada for longer periods of time (i.e. to live, work or study in Canada) should be offered one additional dose based on the Public Health Agency of Canada’s guidance document.
  • See "Interval" below for information about timing of 2nd (and 3rd, when applicable) doses. 
Immunocompromised Individuals for 3rd Dose in Primary Series

Immunocompromised and clinically extremely vulnerable individuals as listed below - will receive and need to present at immunization a letter from MoH or physician: 

  • Stem cell and organ transplant recipients
  • Recipients of active treatment for malignant, hematologic disorders
  • Recipients of anti-CD20 agents (e.g. rituximab, ocrelizumab, ofatumumab) 
  • Primary or acquired cellular and combined immune deficiency 
  • Poorly controlled HIV/AIDS (CD4 count of <200 cells/microlitre) 
  • Immunosuppressive or immunomodulating therapy at the time of vaccination:
    • individuals who were receiving or had received in the previous 3 months targeted therapy and/or immune modulating therapy for autoimmune disease
    • individuals who were receiving or had received in the previous 6 months immunosuppressive chemotherapy or radiotherapy for any indication
    • individuals with chronic immune mediated inflammatory disease who were receiving or had received immunosuppressive therapy prior to vaccination (e.g. MTX, azathioprine)
    • Individuals who received high dose steroids (>40 mg/day for more than a week) in the month before vaccination 
References
Last Updated

23 Nov 2021

NOTE: If the interval is longer than recommended, there is no reason to restart the series. Provide the next dose as soon as possible.

Non-immunocompromised Individuals
  • Dose 1: Day 0
  • Dose 2: 8 weeks (optimal interval)
    • 8 weeks is recommended, but dose can be provided at a shorter interval† if chosen.
      • † ≥ 21 days if first dose was Comirnaty™
      • † ≥ 28 days if first dose was a different COVID-19 vaccine
    • Based on NACI recommendation, the minimum interval is 19 days between doses (any doses provided at an earlier interval would be considered invalid and need to be repeated).
      • This interval is not a recommended interval and should only be used to determine dose validity.  
Immunocompromised Individuals
  • Dose 1: Day 0
  • Dose 2: ≥ 28 days after 1st dose
  • Dose 3: ≥ 28 days after 2nd dose

NOTE: An interval longer than 28 days (e.g. two to three months) is likely to result in a better immune response; however, delaying the dose leaves the individual vulnerable to infection. When deciding the interval, consider:

  • individual’s risk of COVID-19 infection, including comorbidities and level of immunosuppression
  • individual's level of exposure to COVID-19, including level of SARS-CoV-2 virus circulating in the community
References
Last Updated

23 Nov 2021

Moderna Spikevax™ ≥ 12 Years

Non-immunocompromised Individuals
  • 2 doses of 0.5 mL (100 mcg mRNA) 
Immunocompromised Individuals
  • 3 doses of 0.5 mL (100 mcg mRNA)
Reference
Last Updated

23 Nov 2021

General Eligibility
  • All Saskatchewan residents ≥ 12 years of age and those who were born in 2009 (currently 11 years old and will be 12 by the end of the year) without contraindications to the vaccine.
    • Refer out-of-province individuals or those who do not have valid Saskatchewan health services card to Public Health.
  • The eHR Viewer needs to be checked for all individuals.
  • Children should receive the same mRNA vaccine brand for their COVID-19 vaccine series. It is important that immunizers double check the immunization records of children presenting for COVID-19 immunization to avoid giving a mixed brand series to children if possible. A mixed vaccine series in persons ≥ 12 years of age is acceptable in Canada but may require a future third dose for travel purposes. 
        •  
  • Residents who received immunization in a different jurisdiction will be eligible to receive subsequent dose(s) in Saskatchewan. Individuals in this scenario will need to have documentation of their dose(s) from the jurisdiction in which they were received. 
  • Doses to complete a series in recipients of non-Health Canada authorized vaccines received out of country
    • Residents who received one or two doses of a non-Health Canada authorized COVID-19 vaccine should be offered one additional dose based on the Public Health Agency of Canada’s guidance document.
    • Non-residents who received one or two doses of a non-Health Canada authorized COVID-19 vaccine and are planning to stay in Canada for longer periods of time (i.e. to live, work or study in Canada) should be offered one additional dose based on the Public Health Agency of Canada’s guidance document.
  • See "Interval" below for information about timing of 2nd (and 3rd, when applicable) doses.
Immunocompromised Individuals for 3rd Dose of Primary Series

Immunocompromised and clinically extremely vulnerable individuals as listed below - will receive and need to present at immunization a letter from MoH or physician: 

  • Stem cell and organ transplant recipients
  • Recipients of active treatment for malignant, hematologic disorders
  • Recipients of anti-CD20 agents (e.g. rituximab, ocrelizumab, ofatumumab) 
  • Primary or acquired cellular and combined immune deficiency 
  • Poorly controlled HIV/AIDS (CD4 count of <200 cells/microlitre) 
  • Immunosuppressive or immunomodulating therapy at the time of vaccination:
    • individuals who were receiving or had received in the previous 3 months targeted therapy and/or immune modulating therapy for autoimmune disease
    • individuals who were receiving or had received in the previous 6 months immunosuppressive chemotherapy or radiotherapy for any indication
    • individuals with chronic immune mediated inflammatory disease who were receiving or had received immunosuppressive therapy prior to vaccination (e.g. MTX, azathioprine)
    • Individuals who received high dose steroids (>40 mg/day for more than a week) in the month before vaccination 
References
Last Updated

23 Nov 2021

NOTE: If the interval is longer than recommended, there is no reason to restart the series. Provide the next dose as soon as possible.

Non-immunocompromised Individuals
  • Dose 1: Day 0
  • Dose 2: 8 weeks (optimal interval)
    • 8 weeks is recommended, but dose can be provided at a shorter interval (≥ 28 days) if chosen.
    • Based on NACI recommendation, the minimum interval is 21 days between doses (any doses provided at an earlier interval would be considered invalid and need to be repeated).
      • This interval is not a recommended interval and should only be used to determine dose validity.  
Immunocompromised Individuals
  • Dose 1: Day 0
  • Dose 2: ≥ 28 days after 1st dose
  • Dose 3: ≥ 28 days after 2nd dose

NOTE: An interval longer than 28 days (e.g. two to three months) is likely to result in a better immune response; however, delaying the dose leaves the individual vulnerable to infection. When deciding the interval, consider:

  • individual’s risk of COVID-19 infection, including comorbidities and level of immunosuppression
  • individual's level of exposure to COVID-19, including level of SARS-CoV-2 virus circulating in the community
References
Last Updated

23 Nov 2021

Additional/Booster Doses

There are currently no additional/booster doses authorized for children 5-11 years.

Dose

Booster Doses
  • 0.3 mL (30 mcg mRNA)  
Additional Doses

Recipients of Janssen (Johnson & Johnson); Travel Purposes

  • 0.3 mL (30 mcg mRNA)  
References
Last Updated

23 Nov 2021

Booster Doses
  • 0.5 mL (100 mcg mRNA)  
Additional Doses

Recipients of Janssen (Johnson & Johnson); Travel Purposes

  • 0.5 mL (100 mcg mRNA)  
Reference
Last Updated

23 Nov 2021

Eligibility and Interval

  • Residents of LTC, special care and personal care homes - homes will be contacted by SHA
  • See information under Primary Series for eligibility and intervals for immunocompromised individuals eligible for 3 doses in a primary series.

NOTE: 

  • An interval longer than 28 days (e.g. two to three months) is likely to result in a better immune response; however, delaying the dose leaves the individual vulnerable to infection. When deciding the interval, consider:
    • individual’s risk of COVID-19 infection, including comorbidities and level of immunosuppression
    • individual's level of exposure to COVID-19, including level of SARS-CoV-2 virus circulating in the community
References
Last Updated

23 Nov 2021

  • Residents 65 years and older 
  • Individuals in Far North and those living on First Nation communities 50 years and older 
  • Healthcare Workers - must present SHA ID, copy of professional license, or pay stub 
  • Individuals born in 2009 or earlier with underlying health conditions that are clinically extremely vulnerable as listed below – must present letter received from MD or NP 
    • People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD) 
    • People with rare diseases that significantly increase the risk of infections, such as homozygous sickle cell disease 
    • People who had their spleen removed 
    • Adults with very significant developmental disabilities that increase risk, such as Down Syndrome 
    • Adults on dialysis or with chronic kidney disease (stage 5) 
    • Significant neuromuscular conditions requiring respiratory support 

6 months refers to calendar 6 months. For example, if an individual is eligible for a booster dose and the 2nd dose was received April 30, 2021, the booster dose can be received October 30, 2021 or later. 

Reference
Last updated

23 Nov 2021

  • Janssen single dose vaccine recipients will be eligible for a booster dose two months following their vaccination.

  • An mRNA COVID-19 vaccine (Pfizer-BioNTech Comirnaty™ or Moderna Spikevax™) will be used for the booster dose.

Reference
Last Updated

17 Nov 2021

  • ≥ 28 days from most recent COVID-19 vaccine dose
Reference
Last updated

25 Sep 2021

Supplementary Information

Additional/Booster Doses to Increase Immunity

  • These doses are being offered in a phased approach at specified intervals similar to the rollout of initial COVID-19 vaccine:
    • Residents of LTC, special care and personal care homes
      • at least 28 days after the 2nd dose
    • Moderately to severely immunocompromised individuals as per specific eligibility criteria
      • at least 28 days after the 2nd dose
    • Clinically vulnerable individuals and other populations as per specific eligibility criteria
      • at least 6 calendar months after the 2nd dose

  • Individuals who have already received a third dose for travel do not require a fourth dose. The third dose provides the necessary increased protection and no further doses are needed at this time.

  • Note that the approach in Saskatchewan differs somewhat from NACI recommendations. NACI's recommendations for additional doses:
    • An additional dose is recommended as part of the primary vaccine series for moderately to severely immunocompromised individuals.
      • In other words, in immunocompetent individuals, NACI recommends two doses of mRNA vaccine; in moderately to severely immunocompromised individuals, NACI recommends three doses of mRNA vaccine, with the 3rd dose administered at least 28 days after the 2nd.
        • An interval longer than 28 days between the 2nd and 3rd doses (e.g. two to three months) is likely to result in a better immune response; however, delaying the dose leaves the individual vulnerable to infection. When deciding the interval, consider:
          • individual’s risk of COVID-19 infection, including comorbidities and level of immunosuppression
          • individual's level of exposure to COVID-19, including level of SARS-CoV-2 virus circulating in the community
    • A booster dose is recommended at least 6 months following completion of the primary series to increase immunity in select vulnerable populations. 
      • NACI strongly recommends the following populations should be offered a booster dose:
        • Adults living in long-term care homes for seniors or other congregate living settings that provide care for seniors
        • Adults 80 years and older
      • NACI recommends the following populations may be offered a booster dose based on local epidemiology, any evidence of waning protection, and impacts on health system capacity, and with consideration of individual risks and potential benefits:
        • Adults 70 to 79 years of age
        • Adults who received two doses of AstraZeneca Vaxzevria™ or one dose of Janssen (Johnson & Johnson)
        • Adults in or from First Nations, Inuit and Métis communities
        • Adults who are frontline healthcare workers (having direct close physical contact with patients) and who were vaccinated with a very short minimum interval (< 28 days) between the first and second doses of an mRNA COVID-19 primary vaccine series
      • NACI continues to monitor the evidence and will update the recommendations when required.
  • Effectiveness
    • Current evidence shows that, compared to the general population, specific immunocompromised individuals may require an additional dose for optimal immune response after a two-dose COVID-19 vaccine series and that the administration of an additional COVID-19 mRNA dose elicits antibody levels that significantly exceed antibodies seen after any two-dose primary COVID-19 vaccine series in specific populations at higher risk. Currently there are no data regarding the efficacy/effectiveness of these doses (i.e. if or by how much the additional dose reduces symptomatic disease, symptom severity, hospitalizations and death).
    • Limited data available for older adults suggests mRNA booster doses boosted immune responses and increased short-term vaccine effectiveness in the overall study populations.

  • Safety
    • There is preliminary information on the safety of additional COVID-19 doses in immunocompromised individuals. It is expected that individuals may experience mild to moderate symptoms (e.g., fever, chills, aches and pain at the injection site) after additional COVID-19 vaccine doses.
    • Limited data available for older adults suggests mRNA booster doses show a safety profile comparable to that of the second dose of the primary series.
References
Last Updated

31 Oct 2021

  •  See table below for recommended vaccine to use for additional dose depending on first two doses.
    • If the individual received a mixed mRNA schedule for first and second doses, either mRNA product may be used for the additional dose.
    • If the individual received an AstraZeneca Vaxzevria™ dose followed by an mRNA dose, the same mRNA vaccine should be used for the additional dose.
    • Any mRNA vaccine can be used after a two-dose AstraZeneca Vaxzevria™ series.
      • If there are contraindications to mRNA vaccines, AstraZeneca Vaxzevria™ may be used for the additional dose. AstraZeneca Vaxzevria™ is only available at public health clinics.
    • Although no research data exists, clinical experts have advised that at this time Janssen/Johnson & Johnson vaccine recipients can receive additional doses as they become eligible.
      • Saskatchewan will offer one mRNA dose as an additional dose for eligible individuals who have received a Janssen (Johnson & Johnson) one dose vaccination.
    • Although no research data exists, clinical experts have advised that at this time non-Health Canada approved vaccine recipients can receive additional doses as they become eligible.
      • Individuals who received a non-Health Canada approved COVID-19 vaccine and have received one additional dose of an mRNA COVID-19 vaccine (based on Public Health Agency of Canada guidelines) would be considered fully immunized (i.e. equivalent to receiving a two-dose Health Canada approved COVID-19 vaccine series).   
      • Saskatchewan will offer an additional, second mRNA dose as an additional dose as they become eligible.
      Recommended COVID-19 Vaccines for Additional Doses to Increase Immunity
Dose 1 Dose 2 Dose 3
COVISHIELD COVISHIELD Pfizer-BioNTech Comirnaty™
COVISHIELD COVISHIELD Moderna Spikevax™
COVISHIELD AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™
COVISHIELD AstraZeneca Vaxzevria™ Moderna Spikevax™
COVISHIELD Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
COVISHIELD Moderna Spikevax™ Moderna Spikevax™
AstraZeneca Vaxzevria™ AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™
AstraZeneca Vaxzevria™ AstraZeneca Vaxzevria™ Moderna Spikevax™
AstraZeneca Vaxzevria™ COVISHIELD Pfizer-BioNTech Comirnaty™
AstraZeneca Vaxzevria™ COVISHIELD Moderna Spikevax™
AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
AstraZeneca Vaxzevria™ Moderna Spikevax™ Moderna Spikevax™
Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
Pfizer-BioNTech Comirnaty™ Moderna Spikevax™ Moderna Spikevax™
Pfizer-BioNTech Comirnaty™ Moderna Spikevax™ Pfizer-BioNTech Comirnaty™
Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™ Moderna Spikevax™
Pfizer-BioNTech Comirnaty™ AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™
Pfizer-BioNTech Comirnaty™ COVISHIELD Pfizer-BioNTech Comirnaty™
Moderna Spikevax™ Moderna Spikevax™ Moderna Spikevax™
Moderna Spikevax™ Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
Moderna Spikevax™ Pfizer-BioNTech Comirnaty™ Moderna Spikevax™
Moderna Spikevax™ Moderna Spikevax™ Pfizer-BioNTech Comirnaty™
Moderna Spikevax™ AstraZeneca Vaxzevria™ Moderna Spikevax™
Moderna Spikevax™ COVISHIELD Moderna Spikevax™
Janssen (Johnson & Johnson) Pfizer-BioNTech Comirnaty™ -
Janssen (Johnson & Johnson) Moderna Spikevax™ -

AstraZeneca Vaxzevria™ is available through Public Health and may be given to individuals who have contraindications to mRNA vaccines.

References
Last Updated

12 Oct 2021

Additional Doses for Travel Purposes

  • Recipients of these doses must sign this form.
  • The Saskatchewan Ministry of Health has authorized additional doses for those who wish to complete a schedule acceptable for international travel in situations where their current completed immunization series is not approved by the country/agency/venue they intend to visit.
    • These doses are not mandatory and are not considered booster doses.
    • Consider necessity to travel and COVID-19 vaccine requirements at destination(s) –jurisdictions may recognize the individual’s current COVID-19 vaccination history.
      • A document with considerations regarding destination requirements and some resources for finding them is available here.
    • Doses should be separated by at least 28 days from the most recent COVID-19 immunization.

  • Currently, NACI has no recommendations for additional COVID-19 vaccine doses for the sole purpose of travel.  

  • There are preliminary data on the safety of third COVID-19 doses, mainly in the context of giving additional doses to immunocompromised patients. Results from a larger Pfizer-BioNTech Comirnaty™ study of an additional dose in healthy adults are still forthcoming. It is expected that individuals may experience mild to moderate symptoms (e.g., fever, chills, aches and pains at the injection site) after additional COVID-19 vaccine doses.
References
Last Updated

25 Sep 2021

                                COVID-19 Vaccines for Travel Purposes
Dose 1 Dose 2 Dose 3 Dose 4
COVISHIELD COVISHIELD Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
COVISHIELD COVISHIELD Moderna Spikevax™  Moderna Spikevax™ 
COVISHIELD AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
COVISHIELD AstraZeneca Vaxzevria™ Moderna Spikevax™  Moderna Spikevax™ 
COVISHIELD Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™ -
COVISHIELD Moderna Spikevax™  Moderna Spikevax™  -
AstraZeneca Vaxzevria™ AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
AstraZeneca Vaxzevria™ AstraZeneca Vaxzevria™ Moderna Spikevax™  Moderna Spikevax™ 
AstraZeneca Vaxzevria™ COVISHIELD Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™
AstraZeneca Vaxzevria™ COVISHIELD Moderna Spikevax™  Moderna Spikevax™ 
AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™ -
AstraZeneca Vaxzevria™ Moderna Spikevax™  Moderna Spikevax™  -
Pfizer-BioNTech Comirnaty™ Moderna Spikevax™  Moderna Spikevax™  -
Pfizer-BioNTech Comirnaty™ Moderna Spikevax™  Pfizer-BioNTech Comirnaty™ -
Pfizer-BioNTech Comirnaty™ AstraZeneca Vaxzevria™ Pfizer-BioNTech Comirnaty™ -
Pfizer-BioNTech Comirnaty™ COVISHIELD Pfizer-BioNTech Comirnaty™ -
Moderna Spikevax™  Pfizer-BioNTech Comirnaty™ Pfizer-BioNTech Comirnaty™ -
Moderna Spikevax™  Pfizer-BioNTech Comirnaty™ Moderna Spikevax™  -
Moderna Spikevax™  AstraZeneca Vaxzevria™ Moderna Spikevax™  -
Moderna Spikevax™  COVISHIELD Moderna Spikevax™  -
References
Ministry of Health
Last Updated

25 Sep 2021