General Information

The table below indicates which vaccines are available, according to age. See the Choice of Vaccine section below to help inform the decision of which vaccine(s) may be best or preferred for an individual.

Age Vaccine Comments
Monovalent (Original)
     ≥ 6 Months to <5 Years
Pfizer-BioNTech Comirnaty® 3 mcg/0.2 mL
(maroon cap/maroon border)

Use for primary series. No booster doses have been approved for this age group.

Due to insufficient supply, Moderna Spikevax™ 25 mcg / 0.25 mL will no longer be used in SK to initiate a primary series. It may be used to complete a primary series previously started with this vaccine. After March 8, 2023, Pfizer-BioNTech Comirnaty® will be the only available vaccine for this age group.

These vaccines are not available in SK pharmacies.

Moderna Spikevax™ 25 mcg/0.25 mL
(royal blue cap/purple border)
     5 Years
Pfizer-BioNTech Comirnaty® 10 mcg/0.2 mL
(orange cap/orange border)

Use for primary series.

For booster doses, bivalent is preferred. If monovalent is chosen, use this vaccine.

Moderna Spikevax™ 25 mcg/0.25 mL
(royal blue cap/purple border)

Use for primary series.

Due to insufficient supply, Moderna Spikevax™ 25 mcg / 0.25 mL will no longer be used in SK to initiate a primary series. It may be used to complete a primary series previously started with this vaccine. After March 8, 2023, Pfizer-BioNTech Comirnaty® will be the only available vaccine for this age group.

For booster doses, use Comirnaty® (preferably bivalent).

This vaccine is not available in SK pharmacies.

     ≥ 6 Years to < 12 Years
Pfizer-BioNTech Comirnaty® 10 mcg/0.2 mL
(orange cap/orange border)

Use for primary series. 

For booster doses, bivalent is preferred. If monovalent is chosen, use Comirnaty®.
Moderna Spikevax™ 100 mcg/0.5 mL
(red cap/blue border)
     ≥ 12 Years
Pfizer-BioNTech Comirnaty® 30 mcg/0.3 mL
(grey cap/grey border)

Use for primary series. 

For booster doses, bivalent vaccines are preferred but monovalent (original) may be used.

Moderna Spikevax™ 100 mcg/0.5 mL
(red cap/blue border)
Bivalent 
     ≥ 5 to < 12 Years
Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 10 mcg/0.2 mL (orange cap/orange border)

Use for booster doses.

This vaccine is not available in SK pharmacies.

     ≥ 12 Years
Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 30 mcg/0.3 mL (grey cap/grey border)

Use for booster doses.

This vaccine is not authorized to be used as a primary COVID-19 immunization series. However, the SK Ministry of Health supports permissive administration of the vaccine for this purpose, with informed consent, if an individual requests to start or complete their COVID-19 primary series with bivalent vaccine. Those who have received one or more doses of bivalent vaccine as part of the primary series are not eligible for booster doses at this time.

     ≥ 18 years
Moderna Spikevax™ Bivalent 50 mcg/0.5 mL (royal blue cap/green border)

Use for booster doses.

In SK, this vaccine can be used off-label in adolescents ≥ 12 to <18 years who are moderately to severely immunocompromised.

This vaccine is not authorized to be used as a primary COVID-19 immunization series. However, the SK Ministry of Health supports permissive administration of the vaccine for this purpose, with informed consent, if an individual requests to start or complete their COVID-19 primary series with bivalent vaccine. Those who have received one or more doses of bivalent vaccine as part of the primary series are not eligible for booster doses at this time.

Non-mRNA COVID-19 Vaccines available in SK through Public Health and physicians/nurse practitioners:

  • Janssen Jcovden™ (viral vector, ≥ 18 years)
  • Novavax Nuvaxovid ™ (protein subunit, ≥ 12 years)
References
Last Updated

18 Jan 2023

mRNA vaccines (monovalent [original] or bivalent) are the recommended COVID-19 vaccine platform for everyone unless contraindicated.
Primary Series
  • Individuals ≥5 Years to <12 Years
    • For the primary series, Pfizer-BioNTech Comirnaty® monovalent (original) is preferred to Moderna Spikevax™ monovalent (original) when both age-appropriate formulations of the vaccines are readily available.
      • It is unknown if a difference in risk of myocarditis and/or pericarditis exists in children < 12 years; however, Comirnaty™ monovalent (original) is the preferred vaccine in this age group as a precaution.
    • For immunocompromised children this age who are receiving their primary COVID-19 vaccine series and both age-appropriate formulations of Spikevax™ monovalent (original) and Comirnaty™ monovalent (original) are readily available, Spikevax™ monovalent (original) may be preferred due to potentially greater immune response (based on adult data).
    • Due to insufficient supply, Moderna Spikevax™ 25 mcg/0.25 mL will no longer be used in SK to initiate a primary series in children who are 5 years of age and younger. It may be used to complete a primary series previously started with this vaccine. After March 8, 2023, Pfizer-BioNTech Comirnaty® will be the only available vaccine for this age group.

  • Individuals ≥12 Years to <29 Years 
    • For the primary series, Pfizer-BioNTech Comirnaty® monovalent (original) is preferred to Moderna Spikevax™ monovalent (original) when both age-appropriate formulations of the vaccines are readily available because of risk of myocarditis/pericarditis.
      • There has been a lower reported rate of myocarditis/pericarditis following Comirnaty™ monovalent (original) compared to Spikevax™ monovalent (original).  
      • Individuals in this age group opting to receive Spikevax™ monovalent should be informed of the increased risk of myocarditis/pericarditis compared to Comirnaty™ monovalent (original).
    • For moderately to severely immunocompromised individuals who are receiving their primary COVID-19 vaccine series and both age-appropriate formulations of Spikevax™ monovalent (original) and Comirnaty™ monovalent (original) are readily available, Spikevax™ monovalent (original) may provide a greater immune response.
    • For those 12 to 29 years who are moderately to severely immunocompromised and both Spikevax™ monovalent (original) and Comirnaty® monovalent (original) are available, consider:
      • patient values
      • risks of myocarditis/pericarditis
        • males
        • 2nd dose, especially at shorter intervals (at least 8 weeks preferred)
      • risks of acquiring COVID-19 infection
        • vaccination status and/or recent COVID-19 infection
        • degree of immune suppression
        • levels of SARS-CoV-2 circulating
        • characteristics of circulating variant(s)
        • level of exposure to SARS-CoV-2 (e.g. level of interaction with the public, personal protection measures taken)
    • Bivalent COVID-19 vaccines are not authorized to be used as a primary COVID-19 immunization series. However, the Ministry of Health supports permissive administration of this bivalent vaccine for this purpose with informed consent if an individual requests to start or complete their COVID-19 primary series with bivalent vaccine. Those who have received one or more doses of bivalent vaccine as part of the primary series are not eligible for booster doses at this time.

  • Individuals ≥ 29 years 
    • Choose from either Pfizer-BioNTech Comirnaty™ monovalent (original) or Moderna Spikevax™ monovalent (original).
    • For moderately to severely immunocompromised individuals who are receiving their primary COVID-19 vaccine series and both age-appropriate formulations of Spikevax™ monovalent (original) and Comirnaty™ monovalent (original) are readily available, Spikevax™ monovalent (original) may provide a greater immune response.
Booster Doses
  • Individuals 5 Years to < 12 Years
    • In Saskatchewan, all individuals ≥ 5 Years to < 12 Years are eligible for ONE fall Omicron-containing bivalent booster dose with Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 10 mcg at least 6 months* following the last dose of the primary series or previous monovalent (original) booster dose
      • If a bivalent Omicron-containing mRNA COVID-19 vaccine is not readily available or desired, Pfizer-BioNTech Comirnaty® monovalent (original) 10 mcg (Orange Cap) may be offered, with informed consent.   

  • Individuals ≥ 12 Years 
    • In Saskatchewan, all individuals 12 years and older are eligible for ONE fall Omicron-containing bivalent booster dose at least 6 months* following the last dose.  
      • If a bivalent Omicron-containing mRNA COVID-19 vaccine is not readily available or desired, a monovalent (original) mRNA COVID-19 vaccine may be offered, with informed consent.
    • The preferred mRNA Omicron-containing bivalent vaccine brand in SK for those 12 years and older who are moderately to severely immunocompromised is Moderna Spikevax™ Bivalent Original/Omicron BA.1.
      • Use of Spikevax™ Bivalent in adolescents < 18 years old is off-label.

See Fall/Winter Booster Dose Eligibility and Summary Table below.

*A minimum interval of 3 months can be used on a case-by-case basis in exceptional circumstances such as individual risk, travel, vaccine availability, and administration efficiency.

"Months" refer to calendar months. For example, if an individual received a dose Sep 5, 2022, using a 6-month interval, the next dose can be given March 5, 2023, or later.

References
Last Updated

31 Jan 2023

This information applies to non-immunocompromised individuals.

  • Individuals who have received 1 dose of a non-Health Canada authorized vaccine should receive 1 mRNA dose to complete the primary series and then a bivalent booster dose 6 months* later.

  • In Saskatchewan, individuals who have received 2 or more doses of a non-Health Canada authorized vaccine do not need further vaccines to complete the primary series.

  • See Fall/Winter Booster Dose Eligibility and Summary Table below for booster dose eligibility following completion of the primary series. 

* A minimum interval of 3 months can be used on a case-by-case basis in exceptional circumstances such as individual risk, travel, vaccine availability, and administration efficiency.

 "Months" refer to calendar months. For example, if an individual received a dose Sep 5, 2022, using a 6-month interval, the next dose can be given March 5, 2023, or later.

Reference
Last Updated

31 Jan 2023

  • Individuals infected with SARS-CO-V-2 should receive COVID-19 vaccination as vaccination provides more reliable and stronger immune protection.
  • See table below for recommended intervals for individuals 5 years and older.
  • For children ≥ 6 months to < 5 years, the recommended interval is at least 8 weeks post-infection before receiving COVID-19 vaccination. Consider an interval of 4 to 8 weeks for moderately to severely immunocompromised children.
  • A longer interval between infection and vaccination ensures a strong immune response is mounted.
  • If requested, vaccination can be provided before the recommended interval, as long as symptoms have resolved.

Table: Recommended Intervals Between Previous SARS-CoV-2 Infection and COVID-19 Vaccination

SARS-CoV-2 Infection Timing Relative to COVID-19 Vaccination

Individuals 5 Years and Older

Suggested Interval between SARS-CoV-2 Infection and Vaccination

Infection prior to initiation or completion of primary vaccination series

(Primary series for individuals moderately to severely immunocompromised is 3 doses)

 

 

No previous history of MIS-C or MIS-A following vaccination

Not moderately to severely immunocompromised

Vaccine dose 3 months* after symptom onset or positive test (if asymptomatic)

No previous history of MIS-C or MIS-A following vaccination

Moderately to severely immunocompromised

Vaccine dose 3 months^ after symptom onset or positive test (if asymptomatic)

Previous history of MIS-C or MIS-A following vaccination

Regardless of immunocompromised status

Vaccine dose when recovered clinically or at least 90 days since onset of MIS-C or MIS-A, whichever is longer

Infection prior to booster dose (either after primary series or previous booster dose)

Individuals 5 years and older currently eligible for a booster dose

6 months since previous infection, though may be as short as 3 months depending on epidemiological risk

*NACI recommends 8 weeks
^NACI recommends 4-8 weeks
MIS-A = multisystem inflammatory syndrome in adults; MIS-C = multisystem inflammatory syndrome in children

References 
Last Updated

31 Jan 2023

Primary Series

Note: Neither Moderna Spikevax Bivalent nor Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 are authorized to be used as a primary COVID-19 immunization series. However, the SK Ministry of Health supports permissive administration of either bivalent vaccine for this purpose in individuals 12 years and older (NOT < 12 years of age) with informed consent if an individual requests to start or complete their COVID-19 primary series with bivalent vaccine. Those who have received one or more doses of bivalent vaccine as part of the primary series are not eligible for booster doses at this time.

Pfizer-BioNTech Comirnaty® ≥ 5 to < 12 Years (Orange Cap)

The dose should be chosen according to vaccine recipient’s age at presentation, which means some children may receive different doses to complete the series.
  • For example, a child who is 11 years old at the first dose and turns 12 years old before the next dose, would receive 10 mcg (Orange cap) and 30 mcg (Grey cap), respectively, of Pfizer-BioNTech Comirnaty®.   
Non-Immunocompromised Individuals
  • 2* doses of 0.2 mL (10 mcg mRNA)
    • See Interval below for information about timing of 2nd dose.
Moderately to Severely Immunocompromised Individuals
  • 3* doses of 0.2 mL (10 mcg mRNA)
    • See Eligibility below for included individuals.
    • See Interval below for information about timing of 2nd and 3rd doses.

*To complete a primary series started with Pfizer-BioNTech Comirnaty® 3 mcg (Maroon cap), children require 3 doses (if immune competent) or 4 doses (if immunocompromised). If the child transitions from 4 years old to 5 years old during the vaccine series, they should still receive the number of doses recommended as part of their initial primary series.  This also applies to mixed vaccine series (i.e. if at least one Moderna Spikevax™ 25 mcg dose has been given as a dose in the primary series). 

  • E.g. Immunocompromised child received 2 doses of Pfizer-BioNTech Comirnaty® 3 mcg (Maroon cap) and turns 5 years old before the 3rd dose. Based on the initial schedule when they started the series, and because they are immunocompromised, their primary series would consist of four doses. Therefore, TWO doses of Pfizer-BioNTech Comirnaty® 10 mcg (Orange cap) will be required to complete the primary series. The Contraindications and Precautions Background Document includes more examples.

References
Last Updated

19 Dec 2022

General Eligibility
  • All Saskatchewan residents ages ≥ 5 to < 12 years without contraindications to the vaccine.
    • Individuals ≥12 years old on day of presentation are not eligible for Pfizer-BioNTech Comirnaty® 10 mcg (Orange Cap) and are to receive a vaccine authorized for their age.

  • Refer to General Information for more information on choosing a vaccine product. 
  • 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 to confirm vaccine eligibility and appropriate interval.

  • 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. 
Immunocompromised Individuals for 3rd Dose in Primary Series

Includes moderately to severely immunocompromised individuals with the following conditions:

  • Recipients of active treatment for solid tumour or hematologic malignancies
  • Recipients of solid-organ transplant and taking immunosuppressive therapy
  • Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate to severe primary immunodeficiency with associated humoral and/or cell-mediated immunodeficiency or immune dysregulation
  • HIV with prior AIDS defining illness OR prior CD4 count ≤ 200/mm3 OR prior CD4 fraction ≤ 15% OR perinatally acquired HIV infection
  • Recipients of active treatment with the following categories of immunosuppressive therapies:
    • anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22)
    • high-dose systemic corticosteroids (prednisone equivalent of ≥ 40 mg per day for more than 1 week)
    • alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive 
    • A list of immunosuppressive medications is available here.
  • Individuals on dialysis or with chronic kidney disease (stage 5) 
References
Last Updated

19 Dec 2022

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 (≥ 21 days) if chosen.
      • NACI recommends an interval of 4 to 8 weeks in non-immunocompromised individuals. This longer interval is expected to provide a greater and more durable immune response as well as reduce the risk of myocarditis or pericarditis; severe outcomes from the Omicron variant are expected to remain low in these children during the time between doses.
    • 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.
  • Dose 3 (if primary series started with Pfizer-BioNTech Comirnaty® 3 mcg): 8 weeks after 2nd dose
Moderately to Severely Immunocompromised Individuals

See Eligibility above for included individuals.

  • Dose 1: Day 0
  • Dose 2: 4 to 8 weeks after 1st dose
    • 4 to 8 weeks is recommended, but dose can be provided ≥ 21 days after 1st dose 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.
  • Dose 3: 4 to 8 weeks after 2nd dose
  • Dose 4 (if primary series started with Pfizer-BioNTech Comirnaty® 3 mcg): 4 to 8 weeks after 3rd dose
  • An interval of 8 weeks is expected to provide a greater and more durable immune response compared to shorter intervals; however, the benefits of this longer interval need to be weighed against the immunocompromised child’s risks of exposure and severe outcomes between doses.
References
Last Updated

28 Oct 2022

Pfizer-BioNTech Comirnaty® ≥ 12 Years (Grey Cap)

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

  • For children who received Pfizer-BioNTech Comirnaty® 10 mcg (Orange Cap) for their first dose and who have turned 12 years old by the time the second dose is due, complete the series with Pfizer-BioNTech Comirnaty® 30 mcg (Grey Cap).
Non-Immunocompromised Individuals
  • 2 doses of 0.3 mL (30 mcg mRNA) 
    • See Interval below for information about timing of 2nd dose. 
Moderately to Severely Immunocompromised Individuals
  • 3 doses of 0.3 mL (30 mcg mRNA)
    • See Eligibility below for included individuals.
    • See Interval below for information about timing of 2nd and 3rd doses. 
References
Last Updated

19 Dec 2022

General Eligibility
  • All Saskatchewan residents ≥ 12 years of age without contraindications to the vaccine.

  • Refer to General Information for more information on choosing a vaccine product.

  • 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 to confirm vaccine eligibility and appropriate interval.

  • 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. 
Eligibility for Immunocompromised Individuals to Receive 3rd Dose of Primary Series

Includes moderately to severely immunocompromised individuals with the following conditions:

  • Recipients of active treatment for solid tumour or hematologic malignancies
  • Recipients of solid-organ transplant and taking immunosuppressive therapy
  • Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate to severe primary immunodeficiency with associated humoral and/or cell-mediated immunodeficiency or immune dysregulation
  • HIV with prior AIDS defining illness OR prior CD4 count ≤ 200/mm3 OR prior CD4 fraction ≤ 15% OR perinatally acquired HIV infection
  • Recipients of active treatment with the following categories of immunosuppressive therapies:
    • anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22)
    • high-dose systemic corticosteroids (prednisone equivalent of ≥ 40 mg per day for more than 1 week)
    • alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive 
    • A list of immunosuppressive medications is available here.
  • Individuals on dialysis or with chronic kidney disease (stage 5)
References
Last Updated

19 Dec 2022

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.  
Moderately to Severely Immunocompromised Individuals

See Eligibility above for included individuals.

  • Dose 1: Day 0
  • Dose 2: 4 to 8 weeks after 1st dose
    • 4 to 8 weeks Is recommended, but dose can be provided ≥ 21 days after 1st dose if chosen.
    • Based on NACI recommendation, the minimum intervalis 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.
  • Dose 3: 4 to 8 weeks after 2nd dose
    • 4 to 8 weeks Is recommended, but dose can be provided ≥ 21 days after 2nd dose if chosen.
  • Moderately to severely immunocompromised individuals who have previously received two doses should be offered a third dose 4 to 8 weeks after the second dose.
  • An interval of 8 weeks is expected to provide a greater and more durable immune response compared to shorter intervals; however, the benefits of this longer interval need to be weighed against the immunocompromised child’s risks of exposure and severe outcomes between doses.
References
Last Updated

23 Nov 2021

Moderna Spikevax™ ≥ 6 Years (Red Cap)

Non-Immunocompromised Individuals
≥ 12 years
  • 2 doses of 0.5 mL (100 mcg mRNA) 

≥ 6 to < 12 years

  • 2 doses of 0.25 mL (50 mcg mRNA)

See Interval below for information about timing of 2nd dose. 

Moderately to Severely Immunocompromised Individuals

≥ 12 years

  • 3 doses of 0.5 mL (100 mcg mRNA) 

≥ 6 to < 12 years

  • 3 doses of 0.25 mL (50 mcg mRNA)

See Eligibility below for included individuals.
See Interval below for information about timing of 2nd and 3rd doses.

References
Last Updated

18 Mar 2022

General Eligibility
  • All Saskatchewan residents ≥ 6 years of age without contraindications to the vaccine.

  • Refer to General Information for more information on choosing a vaccine product.
  • 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 to confirm vaccine eligibility and appropriate interval. 
      •  
  • 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. 
Eligibility for Immunocompromised Individuals to Receive 3rd Dose of Primary Series

Includes moderately to severely immunocompromised individuals with the following conditions:

  • Recipients of active treatment for solid tumour or hematologic malignancies
  • Recipients of solid-organ transplant and taking immunosuppressive therapy
  • Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate to severe primary immunodeficiency with associated humoral and/or cell-mediated immunodeficiency or immune dysregulation
  • HIV with prior AIDS defining illness OR prior CD4 count ≤ 200/mm3 OR prior CD4 fraction ≤ 15% OR perinatally acquired HIV infection
  • Recipients of active treatment with the following categories of immunosuppressive therapies:
    • anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22)
    • high-dose systemic corticosteroids (prednisone equivalent of ≥ 40 mg per day for more than 1 week)
    • alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive 
  • Individuals on dialysis or with chronic kidney disease (stage 5) 
References
Last Updated

19 Dec 2022

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.  
Moderately to Severely Immunocompromised Individuals

See Eligibility above for included individuals.

  • Dose 1: Day 0
  • Dose 2: ≥ 28 days* after 1st dose  
    • Based on NACI recommendation, the minimum interval is 21 days between doses 1 & 2 (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.
  • Dose 3: ≥ 28 days* after 2nd dose  

*NACI recommends an optimal interval of 4 to 8 weeks: a longer interval is expected to provide a greater and more durable immune response compared to shorter intervals; however, the benefits of this longer interval need to be weighed against the immunocompromised individual’s risks of exposure and severe outcomes between doses

References
Last Updated

31 Jan 2023

Booster Doses

Dose

  • For individuals ≥ 5 to < 12 years, Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 10 mcg is the recommended vaccine for booster doses.
    • Pfizer-BioNTech Comirnaty® 10 mcg monovalent (original) may be used if requested or if bivalent vaccine is not available. 
  • See primary series for first 3 doses in moderately to severely immunocompromised individuals.
Booster Dose
  • 0.2 mL (10 mcg mRNA)
References
Last Updated 

09 Jan 2023

  • For individuals 12 years and older, Omicron-containing bivalent COVID-19 vaccines are recommended for booster doses, however Pfizer-BioNTech Comirnaty® monovalent (original) may be used if requested or if bivalent vaccine is not available.
  • See primary series for first 3 doses in moderately to severely immunocompromised individuals.
Booster Doses
  • 0.3 mL (30 mcg mRNA)   
References
Last Updated

02 Nov 2022

  • For individuals 12 years and older, Omicron-containing bivalent COVID-19 vaccines are recommended for booster doses, however Moderna Spikevax™ monovalent (original) may be used if requested or if bivalent vaccine is not available.
  • Moderna Spikevax™ (Red Cap) can be used for individuals ≥ 6 years for primary series doses and for individuals ≥ 12 years for booster doses.  
  • See primary series for first 3 doses in moderately to severely immunocompromised individuals.
 Booster Doses
  • The following individuals are to receive a dose of 0.5 mL (100 mcg mRNA):
    • Residents of Long-Term Care (Special Care Homes), Personal Care Homes and Seniors' Assisted Living residents, regardless of age
    • Individuals 70 years and older
    • Moderately to severely immunocompromised individuals (those who received a 3-dose primary series)

  • All other individuals eligible for a booster are to receive a dose of 0.25 mL (50 mcg mRNA)^.

^Regardless of type of vaccine used for the primary series.

References
Last Updated

02 Nov 2022

  • Moderna Spikevax™ Bivalent is:
    • indicated for individuals ≥ 18 years as a booster dose for those previously immunized with a COVID-19 vaccine series.  
    • not authorized to be used as a primary COVID-19 immunization series. However, the Ministry of Health supports permissive administration of this bivalent vaccine for this purpose with informed consent if an individual requests to start or complete their COVID-19 primary series with bivalent vaccine. Those who have received one or more doses of bivalent vaccine as part of the primary series are not eligible for booster doses at this time.
Booster Dose
  • 0.5 mL (50 mcg mRNA) containing 25 mcg original and 25 mcg Omicron BA.1 variant
References
Last Updated

18 Jan 2023

  • Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 has been authorized by Health Canada for individuals ≥ 12 years as a booster dose for those previously immunized with a COVID-19 vaccine primary series.
  • This bivalent vaccine is not authorized to be used as a primary COVID-19 immunization series. However, the Ministry of Health supports permissive administration of this bivalent vaccine for this purpose with informed consent if an individual requests to start or complete their COVID-19 primary series with bivalent vaccine. Those who have received one or more doses of bivalent vaccine as part of the primary series are not eligible for booster doses at this time.
Booster Dose
  • 0.3 mL (30 mcg mRNA) containing 15 mcg original and 15 mcg Omicron BA.4/BA.5 variant
References
Last Updated

18 Jan 2023

Eligibility and Interval

Eligibility Quicksheet

winter-booster-eligibility.png

  • Individuals in SK who are 5 years and older are eligible for one age-appropriate booster dose as part of the Fall/Winter 2022 booster program. Omicron-containing bivalent vaccines are preferred; however, monovalent vaccines can be provided with informed consent.

  • Refer to General Information for more information on choosing a vaccine product.

  • Eligible individuals should receive booster doses at least 6 months* following their last COVID-19 vaccination:
    • regardless of the number of COVID-19 doses previously received, as long as their primary series is complete, and
    • regardless of the previous monovalent (original) COVID-19 vaccine brand(s) received

  • Anyone who has received a bivalent vaccine dose at any time (including as part of a completed primary series) is considered up to date.  

  • Individuals who received a monovalent (original) vaccine when bivalent was requested should be directed to the Medical Health Officer (Public Health) for recommendations on a case-by-case basis. Pharmacists: if monovalent (original) vaccine is administered in error (bivalent intended), contact dpebimmunizations@health.gov.sk.ca who will coordinate with the appropriate agencies.

  • New COVID-19 immunization programming and recommendations will be based on future epidemiology, data on waning immunity, new emerging variants, and new vaccines.

* A minimum interval of 3 months can be used on a case-by-case basis in exceptional circumstances such as individual risk, travel, vaccine availability, and administration efficiency.

 "Months" refer to calendar months. For example, if an individual received a dose Sep 5, 2022, using a 6-month interval, the next dose can be given March 5, 2023, or later.

Eligibility Summary Table

eligibility-table-part1.png

  1. See Individuals Who Are Moderately to Severely Immunocompromised tab for definition of moderately to severely immune compromised.
  2. mRNA vaccines are preferred as booster doses, but alternatives (e.g. Novavax Nuvaxovid™, Janssen Jcovden™) are available through Public Health.
  3. At time of authorization, only preclinical data (antibody response) and indirect clinical data of Pfizer-BioNTech Comirnaty® bivalent vaccine were available. Clinical data of this vaccine are now available and support its safety and efficacy.
  4. There are limited adult data indicating potentially greater immune response from Moderna Spikevax™ monovalent (original) compared to Pfizer-BioNTech Comirnaty® monovalent (original). This recommendation is based on expert opinion.
  5. The following individuals are to receive a dose of 0.5 mL (100 mcg mRNA):
    • Residents of Long-Term Care (Special Care Homes), Personal Care Homes and Seniors' Assisted Living residents, regardless of age
    • Individuals 70 years and older
  6. There are limited data on use of Moderna Spikevax™ monovalent (original) in those 12-17 years and no data on Moderna Spikevax™ Bivalent in <18 years of age; recommendation based on expert opinion.
  7. There are no data of bivalent mRNA vaccines in adolescents 12-17 years. Use of Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 in this age group has been authorized based on extensive experience and post-market safety data with the same dose (30 mcg) of Pfizer-BioNTech Comirnaty® monovalent (original).
  8. There are no data of bivalent mRNA vaccines in children 5 -11 years. Use of Pfizer-BioNTech Comirnaty® Original & Omicron BA.4/BA.5 in this age group has been authorized based on experience and post-market safety data with the same dose (10 mcg) of Pfizer-BioNTech Comirnaty® monovalent (original).
  9. Janssen Jcovden™ is only approved for individuals 18 years and older.
  10. For individuals who are moderately to severely immunocompromised who received Janssen Jcovden™, the interval to the 2nd dose (mRNA preferred), is at least 28 days from the Jcovden™ dose. 
References
Last Updated

31 Jan2023

Moderately to severely immunocompromised individuals include those with the following conditions:
  • Recipients of active treatment for solid tumour or hematologic malignancies
  • Recipients of solid-organ transplant and taking immunosuppressive therapy
  • Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate to severe primary immunodeficiency with associated humoral and/or cell-mediated immunodeficiency or immune dysregulation
  • HIV with prior AIDS defining illness OR prior CD4 count ≤ 200/mm3 OR prior CD4 fraction ≤ 15% OR perinatally acquired HIV infection
  • Recipients of active treatment with the following categories of immunosuppressive therapies:
    • anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22)
    • high-dose systemic corticosteroids (prednisone equivalent of ≥ 40 mg per day for more than 1 week)
    • alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive
    • A list of immunosuppressive medications is available here.
  • Individuals on dialysis or with chronic kidney disease (stage 5)

Reminder: primary series is 3 doses of most vaccines; 3rd dose at least 28 days following 2nd dose
Viral vector vaccines are not recommended for immunocompromised individuals. However, if an immunocompromised individual receives Janssen Jcovden™, NACI recommends an mRNA dose be provided at least 28 days following the Jcovden™ dose to complete the primary series. Booster doses would then apply. 

Other Important Information 

  • Individuals not previously immunocompromised but become moderately to severely immunocompromised receive a 3-dose primary series (minimum 28 days between each dose). Booster doses can be received when eligible. 

  • In SK, Moderna Spikevax™ Bivalent is the preferred booster vaccine for those who are moderately to severely immunocompromised (off-label recommendation for ≥12 to <18 years).
References
Last Updated

19 Dec 2022