COVID-19 vaccine recommendations for fall 2026 are now available

The National Advisory Committee on Immunization (NACI) has released updated guidance on the use of COVID-19 vaccines, which will take effect in the fall of 2026. The guidance, published as a full document1 and as a summary2 is based on current evidence and NACI expert opinion.Summary of COVID-19 vaccine recommendations:1. NACI continues to strongly recommend COVID-19 immunization programs for individuals at increased risk of SARS-CoV-2 exposure or severe COVID-19 disease.The following groups are considered at increased risk of SARS-CoV-2 exposure or severe COVID-19 disease:All adults ≥ 65 years of ageThose ≥ 6 months of age who are:Residents of long-term care homes and other congregate living settings for seniorsIndividuals with underlying medical conditions that put them at higher risk of severe COVID-19, including children with complex health needsPregnant individualsIndividuals in or from First Nations, Inuit and Métis communitiesHealthcare workers and other care providers in facilities and community settingsMembers of racialized and other equity-denied communities.2. NACI recommends that vaccination programs may also offer immunization to all other individuals ≥ 6 months of age. 3. Most populations are recommended to receive one dose of COVID-19 vaccine per year. However, NACI recommends that some populations continue to receive a second dose per year because protection from COVID-19 vaccines declines over time. Available evidence suggests that protection wanes after about four to six months.NACI strongly recommends that a second dose of COVID-19 vaccine per year be offered to the following groups, at a minimum interval of three months from the previous dose:Adults 80 years of age or olderResidents of long-term care homes, as well as residents of other congregate living settings for seniorsIndividuals ≥ 6 months of age who are moderately to severely immunocompromised (due to an underlying condition or treatment)Adults 65–79 years of age with underlying medical conditions that place them at higher risk of severe COVID-19.NACI recommends that vaccination programs may also offer a second dose of COVID-19 vaccine per year to all other adults 65–79 years of age, at a minimum interval of three months from the previous dose.Other key points:Individuals can receive either an mRNA or protein subunit COVID-19 vaccine, based on age and vaccine availability. COVID-19 vaccines are expected to be updated annually to align with circulating variants; use the most recent COVID-19 vaccine produced by the manufacturer, whenever possible. However, if COVID-19 vaccination is indicated, it should not be delayed while waiting for an updated vaccine.A recent vaccination is expected to provide some cross-protection against strains not targeted by the vaccine.Provinces and territories determine which populations will receive publicly funded COVID-19 vaccines based on several factors (e.g., epidemiology, cost effectiveness, feasibility of delivering the program). For individuals not included in COVID-19 programs funded by provinces and territories, vaccines may be made available for purchase through pharmacies.COVID-19 vaccines may be given concurrently or at any time before or after non-COVID-19 vaccines, including live and non-live vaccines. However, concurrent administration of influenza and COVID-19 vaccines offers the greatest clinical benefit only if the peak circulation periods of seasonal influenza viruses and SARS-COV-2 closely align (which is currently not the case), and if the COVID-19 vaccine provides protection that lasts through the expected peak of SARS-CoV2 activity.Many Canadian jurisdictions continue to offer a combined fall immunization program for seasonal influenza and COVID-19. This approach offers efficiency, but the variable timing of SARS-CoV-2 peak seasonal activity, and the limited duration of vaccine-induced protection against COVID-19 should be considered. In the past three surveillance periods (2022–23 to 2024–25), COVID-19 disease activity started to increase in the late spring or late summer and remained consistently higher from September to January, although it currently circulates year-round. In 2023 and 2024, peak disease incidence between influenza and COVID-19 were different. Data from this limited time period suggest that influenza virus typically peaks later than SARS-CoV-2, indicating a potential mismatch in timing when considering concurrent vaccine administration and vaccine duration of protection. Optimal timing for COVID-19 immunization programs is uncertain.In jurisdictions where vaccines are available throughout the year, individuals may choose to receive their COVID-19 vaccine at a particular time of the year based on anticipated exposure risk, including travel, or anticipated immunocompromised status (e.g., planned immunosuppressive therapy).ReferencesNational Advisory Committee on Immunization (NACI). Guidance on the use of COVID-19 vaccines starting fall 2026. An Advisory Committee Statement (ACS). June 2026. (accessed June 11, 2026).National Advisory Committee on Immunization (NACI). Summary of NACI statement of June 2026: Guidance on the use of COVID-19 vaccines starting fall 2026. June 2026. (accessed June 11, 2026).

COVID-19 vaccine recommendations for fall 2026 are now available

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