As COVID-19 experiences a significant resurgence in Quebec, the Comité sur l’immunisation du Québec (CIQ) is once again recommending that vulnerable people be vaccinated this fall. This directive is similar to the one issued at the same time last year. However, experts are urging the government to wait for the availability of a new vaccine better adapted to the new strains in circulation before launching its vaccination campaign.
In a report published Monday, the CIQ issued its recommendations for COVID-19 vaccination in Quebec for fall 2024.
As in its previous report on the issue, the CIQ recommends offering a dose of vaccine to residents of CHSLDs and RPAs, to people aged 60 and over, as well as to people who are immunosuppressed or living with a chronic illness.
Similarly, pregnant people and health workers are also considered by the CIQ as part of the group of vulnerable people to be vaccinated as a priority.
“For other groups such as healthy young adults, a dose could be offered. However, the CIQ considers that the benefits of such a dose will be minor, given the low risk of complications from COVID-19 in this population,” indicates the group of experts from the Institut national de santé publique du Québec.
The virus is returning
COVID-19 indicators have been on the rise since the beginning of the summer. The test positivity rate has climbed to 16.3%, while it had fallen to 2% in April.
This resurgence of COVID-19 activity is not without consequences for the health network. The number of people hospitalized has been increasing for three months.
There are currently 820 COVID-19 positive patients, twice the low seen in April. However, the infections are currently causing few deaths, averaging three per day.
Please note that, beyond COVID-19, other respiratory viruses that regularly occur in Quebec, such as influenza and respiratory syncytial virus (RSV), are currently circulating very little.
Two new RSV vaccines have just been approved by Health Canada. However, the CIQ recommends that priority be given to vaccinating only CHSLD residents, people aged 75 and over living in RPAs, and people aged 75 and over living in the community with a chronic illness.
More dangerous for some
The CIQ’s recommendations are based in part on the fact that people aged 60 and over are at much higher risk of being hospitalized when they contract the virus. Deaths are also more frequent among the elderly.
Also, it should be noted that “people who have never had COVID-19 are more likely to develop complications following their first infection with SARS-CoV-2,” the experts explain.
Here again, the statistics on the disease tip the balance towards vaccinating vulnerable people, says the CIQ. Indeed, older people are more numerous in having never caught SARS-CoV-2.
In a December 2023 census in British Columbia, more than 80 per cent of the province’s citizens had the antibodies needed to fight the virus, but that figure dropped to 69 per cent among those aged 70 to 79 and 66 per cent among those aged 80 and older, the report said.
In addition, the COVID-19 death rate for people with a chronic illness is three to nine times higher than for people in the same age group, according to a Quebec study cited by CIQ experts, hence their inclusion in the group of vulnerable people.
New variants require new vaccine
SARS-CoV-2 has continued to evolve since it was first detected in late 2019 and will continue to do so this fall. The JN.1 variant was the most prevalent in Quebec as of March 13, 2024, according to the CIQ.
However, the last vaccine administered in Quebec targeted the XBB.1.5 variant, which is no longer in circulation today.
This is why the CIQ recommends that the government wait for the arrival of a new vaccine that is more effective against the new strains before starting vaccination this fall.
“By fall 2024, it is expected that new versions of COVID-19 vaccines, targeting a strain or strains closer to those currently in circulation, will be developed and authorized. It remains impossible to predict the level of effectiveness that these future vaccines will have,” the experts specify.
The CIQ is also asking the government to evaluate the possibility of offering this new vaccine against COVID-19 at the same time as the one protecting against the flu.
In the same vein, experts want the government to withdraw its preference for mRNA vaccines over the recombinant protein Nuvaxovid vaccine in order to “choose the vaccine offering protection against the variants closest to those in circulation.”