Preliminary guidance on key populations for early COVID-19 immunization

The National Advisory Committee on Immunization (NACI) is an External Advisory Body that provides the Public Health Agency of Canada (PHAC) with independent medical, scientific and public health advice. Earlier this month, the NACI released a report with Preliminary Guidance on Key Populations for early COVID-19 immunization. The statement provides advice and recommendations on how to plan efficiently, effectively, and equitably for the allocation of the COVID-19 vaccine once it is authorized for use and distribution in Canada. The goal of these suggestions is to reduce the number of people with a serious illness from the virus and the number deaths from COVID-19. 

Due to the expected staggered arrival of the vaccine, NACI has recommended that key populations should be prioritized first for the immunization. The populations and prioritization will be based on the following: 

  • A population-based risk-benefit analysis taking into consideration risk of exposure, risk of transmission to others, risk of severe illness and death, and the safety and effectiveness of vaccine(s) in key populations 
  • Vaccine supply (number of available vaccine types, number and timing of available does, number of doses required) 
  • COVID-19 epidemic conditions when the vaccine(s) become(s) available 

Key Populations include: 

  • Those at high risk of severe illness and death from COVID-19   

    • Advanced age, other high-risk conditions 

  • Those most likely to transmit COVID-19 to those at high risk of severe illness and death from COVID-19 and workers essential to maintaining the COVID-19 response 

    • Healthcare workers, personal care workers and caregivers in long-term care facilities

    • Other workers essential for managing COVID-19 response or providing frontline care

    • Household contacts of those at high-risk 

  • Those contributing to the maintenance of other essential services for the functioning of society  

    • Those who cannot work virtually and have differential exposure to COVID-19 such as police, firefighters, grocery store staff. 

  • Those whose living or working conditions put them at elevated risk of infection and where infection could have disproportionate consequences, including Indigenous communities 

    • Such as places where physical distancing is challenging, access to healthcare infrastructure is reduced, and infection could have disproportionate consequences 

  • Other considerations include increasing access to immunization services to reduce health inequities, monitoring the safety, effectiveness and coverage of the vaccine in the key populations, and improving the knowledge about vaccines, specifically the COVID-19 vaccine, by addressing misinformation about immunization. 

We would like to congratulate fellow hospital pharmacist Dr. Natalie Dayneka for being a member of the National Advisory Committee on Immunization (NACI) and for her contributions to this great work.