FALL 2024 VACCINE UPDATES

Influenza vaccine

The National Advisory Committee on Immunization (NACI) recommends the annual in:luenza vaccine for everyone aged 6 months and older, provided there are no contraindications. Influenza vaccination is particularly important for: 

Adults 65 years and older
Pregnant individuals
Indigenous Peoples
Individuals with chronic health conditions, including heart
or lung diseases, diabetes, immunocompromising conditions, kidney disease, or anemia.
Seasonal influenza vaccines are now available at community pharmacies and our office-if you wish to receive the flu vaccine from us please call to schedule a time. Influenza vaccinations are also recommended for those who may
transmit the flu to high-risk individuals, including household members as well as caregivers in health and childcare settings. 

COVID-19 vaccine

Updated Pfizer Comirnaty and Moderna Spikevax vaccines targeting the KP.2 and JN1 strains respectively, have been approved by Health Canada and are currently available from participating community pharmacies or vaccination clinics. We do not administer COVID-19 vaccinations in our clinic.

Who should be vaccinated?

Beginning in Fall 2024, COVID-19 vaccination, using the most recently updated vaccine, is recommended for both previously vaccinated and unvaccinated individuals at increased risk of COVID-19 infection or severe COVID-19 disease as follows:

All adults 65 years of age or older
Those 6 months of age and older who are:

Residents of long-term care homes and other congregate living settings
Individuals with underlying medical conditions that place them at higher risk of    severe COVID-19, including children with complex health needs

Individuals who are pregnant
Individuals in or from First Nations, Métis and Inuit communities
Members of racialized and other equity-deserving communities
People who provide essential community services
All other individuals aged 6 months of age and older who are not at increased risk may also receive the most recently updated vaccine.

Which vaccine should I get?

For those 6 months to 11 years of age, Moderna Spikevax is recommended for both the primary series (not previously vaccinated) and for those who have been previously vaccinated. The primary series may consist of one more more doses depending on age and whether an individual is immunocompromised. Only one dose is required once the primary series has been completed.

For those aged 12 years or older, either Pfizer Comirnaty or Moderna Spikevax COVID-19 vaccines can be used for the primary series as well as subsequent doses provided there are no contraindications.

How long should I wait since my last dose or last COVID-19 infection?

For previously vaccinated individuals, the recommended interval is 6 months from the last dose, with a minimum interval of 3 months. This ensures that those who received a Spring 2024 dose, especially those at high risk, will be eligible for an updated Fall 2024 dose. Individuals who have previously completed their primary series can get an updated COVID-19 vaccine dose 6 months after their last COVID-19 infection.

Can I get other vaccines at the same time?

COVID-19 vaccines may be administered concurrently (i.e., on the same day), or at any time before or after non-COVID-19 vaccines, including live and non-live vaccines.

RSV vaccines and immunizing agents

RSV is a major cause of lower respiratory tract illness, particularly in infants, young children and older adults, typically occurring in outbreaks from Fall to early Spring.

Who should be vaccinated?

Infants: RSV immunization is recommended for infants entering or
born during their 1st RSV season and for those at ongoing increased risk during their 2nd RSV season.

Pregnant individuals: Vaccination may be considered to prevent RSV disease in infants. (Please note that if you are delivering your baby at Mount Sinai Hospital this respiratory season we will offer to give your newborn RSV protection

Older adults 50+:

RSV immunization is recommended for those 75 years of age and older, particularly if they are at increased risk of severe disease

It is also recommended for adults 60 years of age and older who are residents of nursing homes and other chronic care facilities.
It may be considered for other adults aged 60 to 74 years in consultation with your health care provider.
Additional doses: There is currently no recommendation regarding this. If an individual received a dose of RSV vaccine during the 2023-2024 season, they do not need to receive another dose this season.

Available vaccines & immunizing agents:

Pregnant individuals: Abrysvo vaccine to protect infant through passive transfer of maternal antibodies

Infants:
Nirsevimab (Beyfortus): Preferred; can be administered at our offices but will be offered to all newborns born in hospital this respiratory season

Palivizumab (Synagis): Alternative; generally offered in hospital
settings and requires referral

Older adults 50+:
Arexvy vaccine: approved for ages 50-59 years at increased risk of RSV disease as well as ages 60 years and up (publicly funded supply not currently available but is available for purchase)
Abrysvo vaccine (approved by Health Canada for pregnant individuals and older adults aged 60+)
The following older adults are eligible for available publicly funded RSV vaccine (Abrysvo only):
Patients in hospital receiving alternate level of care (including similar settings, such as complex continuing care, hospital transitional programs)
Patients receiving hemodialysis or peritoneal dialysis
Recipients of solid organ or hematopoietic stem cell transplants
Individuals experiencing homelessness
Individuals who are First Nations, Inuit, or Metis
mResvia is Moderna’s mRNA based RSV vaccine for adults 60+. It has been approved by Health Canada and is expected to be available in early 2025

Pneumococcal Vaccines

The bacterium Streptococcus pneumoniae causes invasive pneumococcal disease (IPD) and is a common cause of respiratory infections, including community-acquired pneumonia (CAP) and acute otitis media (AOM).Older Adults: Prevnar-20 is now publicly funded for individuals 65 years of age and older, replacing Pneumovax-23.
Those previously vaccinated with Pneumovax-23 (with or without Prevnar-13) should receive a subsequent dose of Prevnar-20, typically given either at 1 year (for high-risk individuals) or 5 years (for low-risk individuals) from the last pneumococcal vaccine.

Those at low risk for IPD are not currently eligible for public funding for a 2nd pneumococcal vaccine dose. However, there is funding for individuals meeting high risk criteria.

Infants and children: Prevnar-15 has replaced Prevnar-13 for routine vaccination at 6 weeks to 4 years of age. Prevnar-20 should be used to immunize high-risk children.

Pertussis (Whooping Cough)-containing Vaccines

Pertussis is often an unrecognized cause of persistent cough in adolescents and adults. It is particularly concerning for infants, who are at the highest risk of severe disease. The age group most commonly affected is 10-to-14-year-olds (approximately 41% of cases). As of August 26, 2024, there were 99 con:irmed cases in Toronto, more than double the 5-year pre-pandemic average over the same period. Symptoms start with a runny nose and sneezing, progressing to prolonged coughing episodes that can end in vomiting or gagging lasting for 1-2 months. Individuals with pertussis should avoid contact with infants, young children, and pregnant individuals in their 3rd trimester until after completion of 5 days of antibiotic therapy or 21 days of coughing.

Who should be vaccinated?

Ensure that children and teens receive their scheduled vaccinations, which include pertussis protection:

Infants: 2, 4, 6, and 18 months
Children: 4 to 6 years
Teens: 14 to 16 years

Adulthood: a single dose in adulthood, ideally at age 24-26 but may be given as a catch-up at any age. All adults are encouraged to ensure the have one dose
Pregnant individuals: should receive a publicly funded vaccine during each pregnancy, ideally between 27 and 32 weeks of gestation.
Meningococcal Vaccines
The bacteria Neisseria meningitides can cause severe infections such as meningitis or blood infections and can lead to death. Meningitis vaccine was introduced as part of the Ontario Immunization program in 2004
and 2005 for infants at 12 months of age and Grade 7 students respectively, however many Ontarians remain unvaccinated. Toronto Public Health (TPH) continues to see an increase in the number of reported cases of invasive meningococcal disease (IMD) in Toronto residents. TPH has documented 14 cases so far in 2024, an increase from an average of 6 cases per year.

Who should be vaccinated?

Adults 18 to 38 years of age and certain high-risk individuals who missed their dose or are uncertain about their history of meningococcal vaccination are eligible for publicly funded vaccine; this can be administered at Taddle Creek or through Toronto Public Health vaccination clinics.
Other adults who are considering vaccination are encouraged to speak with their PCP to discuss whether meningococcal vaccination is recommended for them. 

Shingles Vaccine
Shingles, also known as herpes zoster, is caused by the reactivation of the varicella virus, the same virus that causes chickenpox. An estimated one in three people will get shingles in their lifetime. Shingles often affects older adults and those with weakened immune systems. Symptoms include headache, fever and a painful rash that usually occurs on one side of the body (typically the face, neck or chest). The rash forms blisters that crust over and usually clear up within 2 to 4 weeks. About 1 in 5 people who get shingles may experience severe pain lasting months to years after the rash clears, a condition known as post-herpetic neuralgia.
Who should be vaccinated?
NACI recommends Shingrix vaccination for individuals aged 50 years and older. It is publicly funded for older adults 65 to 70 (as well as those born between 1949 and 1953 until Dec 31, 2024). Adults 18 years and older with a weakened immune system may also be recommended to receive Shingrix.

Grade 7 Vaccines

Typically, Grade 7 students in Ontario receive publicly funded Hepatitis B vaccine (2 doses if aged 11-15, 3 doses if older) to prevent liver disease and cancer, Human Papilloma Virus (HPV) vaccine (2 doses if aged 9-14, 3 doses if older) to prevent several types of cancers, and Meningococcal vaccine (1 dose) to prevent meningitis. However, due to the COVID-19 pandemic, many individuals have missed these vital immunizations. Please consult us if you or your child may have missed these vaccinations.

References:

Statement on seasonal influenza vaccine for 2024-2025. Accessed Sept 3 from: https://www.canada.ca/en/public-health/services/publications/vaccines- immunization/national-advisory-committee-immunization-statement-seasonal-in:luenza-vaccine-2024-2025.html
Guidance on the use of COVID-19 vaccines during the fall of 2024. NACI. Accessed Sept 3 from: https://www.canada.ca/en/public-health/services/ publications/vaccines-immunization/national-advisory-committee-immunization-guidance-covid-19-vaccines-fall-2024.html#a12
COVID-19 Vaccine Eligibility & Doses. Accessed Sept 3 from: https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/ respiratory-viruses/covid-19/covid-19-vaccines/covid-19-vaccine-eligibility-doses/
Respiratory Syncytial Virus (RSV) Vaccines: Canadian Immunization Guide. Accessed Sept 3 from: https://www.canada.ca/en/public-health/services/ publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/respiratory-syncytial-virus.html#a2.2
Toronto Public Health. Changes to Ministry of Health’s Pneumococcal Vaccine Program. Accessed Sept 3 from: https://tph.upaknee.com/editor_images2/ image_2cd62a69/:iles/2024-07-17_FINAL_Pneu_Vax_Transition.pdf
Public Health Ontario. Public Health Management Considerations for Pertussis. 2nd revision: December 2022. Accessed Sept 3 from: https:// www.publichealthontario.ca/-/media/Documents/P/2020/pertussis-case-contact-management.pdf ? rev=5cc57421eab74dd5802411e916eb8e1b&sc_lang=en
Toronto Public Health. Meningococcal Vaccines (Men C & Men ACYW-135). Accessed Sept 25 from: https://www.toronto.ca/community-people/health- wellness-care/diseases-medications-vaccines/meningococcal-type-c-vaccine/
Toronto Public Health. Shingles (Herpes Zoster) Vaccine. Accessed Sept 3 from: https://www.toronto.ca/community-people/health-wellness-care/diseases- medications-vaccines/shingles-herpes-zoster-vaccine/
Publicly Funded Immunization Schedules for Ontario. June 2022. Accessed Sept 3 from: https://www.ontario.ca/:iles/2024-01/moh-publicly-funded- immunization-schedule-en-2024-01-23.pdf