Canada’s National Advisory Committee on immunization: Adaptations and challenges during the COVID-19 pandemic.

Publication date: Aug 30, 2023

The COVID-19 pandemic has challenged traditional vaccine guidance infrastructure and frameworks, and added urgency and complexity to the operation of National Immunization Technical Advisory Groups (NITAGs). Canada’s National Advisory Committee on Immunization (NACI) provides immunization guidance to the Public Health Agency of Canada (PHAC) who publicly shares expert and evidence-informed guidance with Canadian provinces and territories. Throughout the pandemic, NACI and PHAC implemented many adaptations to meet urgent needs for pandemic vaccine guidance. In this paper, we describe: structural adaptations in response to the accelerated pace and amount of work required to issue recommendations that were timed around product authorizations and dynamic epidemiology; technical adaptations in response to rapidly evolving evidence of variable quality which required close monitoring, and which promoted reliance on basic vaccine principles due to incomplete direct evidence; the need to provide nimble advice (e. g., off-label recommendations, preferential recommendations); communications adaptations (e. g. identify sustainable spokespeople for the committee, receive stakeholder feedback, and ensure urgent nuanced advice was communicated to a diverse audience); and research adaptations focussing on solutions to constrained supply (e. g. prioritisation, extended intervals, and heterologous schedules). The early pandemic vaccine experience has created a roadmap of lessons and adaptations that should be leveraged in future pandemic vaccine programs, and has highlighted the essential role of NITAGs to complement regulatory structures during pandemics to ensure timely, impactful, and evidence-informed public health vaccine guidance.

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Concepts Keywords
Canada (COVID-19 pandemic)
Covid (NITAG)
Lessons (Vaccine)


Type Source Name
disease VO Canada
disease VO immunization
disease MESH COVID-19 pandemic
disease VO vaccine
disease IDO quality
disease MESH Infectious Diseases
disease MESH Infection
disease VO efficient
disease VO effectiveness
disease VO Equity
drug DRUGBANK Coenzyme M
disease IDO process
drug DRUGBANK Methionine
disease VO frequency
disease VO Optaflu
disease MESH influenza
disease VO monthly
disease VO volume
drug DRUGBANK Etoperidone
disease VO time
disease MESH emergency
disease MESH anaphylaxis
disease MESH myocarditis
disease MESH pericarditis
disease IDO immune response
drug DRUGBANK Spinosad
disease VO vaccine effectiveness
pathway REACTOME Release
drug DRUGBANK Trestolone
disease VO dose
disease VO protocol
disease MESH uncertainty
disease MESH morbidity
disease VO population
disease VO effective
disease VO vaccination
disease VO Human papillomavirus
disease MESH herpes zoster
disease MESH diphtheria
disease MESH tetanus
disease MESH pertussis
pathway KEGG Pertussis
disease VO Respiratory syncytial virus
disease MESH Ebola virus disease
disease MESH Thrombocytopenia
disease IDO country
disease MESH Allergy
disease MESH monkeypox
disease MESH rabies
disease IDO history
disease VO organization
disease VO live attenuated influenza vaccine
drug DRUGBANK Phenindione
disease VO vaccine dose
drug DRUGBANK Delorazepam
drug DRUGBANK L-Tyrosine
drug DRUGBANK Ibuprofen

Original Article

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