Ask the Pharmacist

Q: Now that we are well into the fall season, can you give me some details on the new COVID-19 vaccine?

A: As you likely know very well by now, all viruses change (mutate) over time and the SARS-CoV-2 virus, otherwise known as COVID-19, is no exception. We have been made aware of many mutations (variants) of the original COVID-19 virus that have evolved over the past couple of years. The latest COVID-19 variants wreaking havoc in the past several months stem from the Omicron variant.

This fall, both Pfizer-BioNTech (Pfizer) and Moderna have manufactured a new monovalent vaccine that is designed to provide protection against XBB.1.5, a subvariant of Omicron. It has also been shown to provide some protection against the more recent virus strains that have evolved, such as EG.5 and BA.2.86.

If you recall, last year’s updated vaccine was a bi-valent version and was, in fact, a booster to the original vaccine. Before you could have the “booster” bi-valent dose, you had to have been vaccinated with the original vaccine. This is not the case with the new vaccine, and anyone may choose to get this, regardless of your prior vaccination status.

That means that if you chose to not get any of the prior COVID-19 vaccines, you may still receive this new monovalent XBB.1.5 vaccine. This is very similar to the annual influenza vaccine that is updated annually to reflect the current circulating variants.

The new XBB.1.5 vaccine is available to anybody, six months of age and older, providing six months has elapsed since your last COVID-19 vaccine or COVID-19 infection.

Are wondering why you should wait six months after being sick with the virus? After your body is exposed to the COVID-19 virus, it creates its own antibodies to provide protection as though you had the vaccine. These days, more than likely you would have had the XBB.1.5 virus or the more recent variants and you will not be needing this latest vaccine. If you haven’t had a COVID-19 vaccine or the virus in the past six months, your protection from COVID-19 would likely have waned as it naturally does and would not be effective against these new variants.

You also might be wondering what the reasoning is behind waiting six months since your last COVID-19 vaccine before getting another dose. According to the National Advisory Committee on Immunization (NACI), longer intervals help provide a more robust immune response which makes the vaccine more effective, and the protection is also expected to last longer. Longer intervals may also be associated with a lower risk of myocarditis and/or pericarditis AND may also result in a better response after the next dose.

Though anyone, six months of age and older, may receive the new XBB.1.5 vaccine (whether or not you have had prior COVID-19 vaccines), the dosing is dependent upon your age and for those under age five, your COVID-19 vaccination status.
 

• For anyone age 12 and older:
  • previously unvaccinated or six months post vaccine/infection may receive one dose of XBB.1.5 vaccine (Moderna 50ug, Pfizer 30ug)
• For anyone age five to 11:
  • previously unvaccinated or six months post vaccine/infection may receive one dose of XBB.1.5 vaccine (Moderna 25ug, Pfizer 10ug)
• for anyone age six months to four years:
  • with a full vaccine series completed (two doses of Moderna OR three doses of Pfizer) may receive one dose of XBB vaccine (Moderna 25 ug, Pfizer 3ug)
  • with an incomplete vaccine series, it is necessary to complete the series using XBB vaccine:
    • zero COVID-19 doses: give two doses of Moderna XBB (25ug) OR three doses of Pfizer XBB (3ug) following manufacturer interval guidelines
    • one dose of Moderna: give one dose of Moderna XBB (25ug)
    • one dose of Pfizer: give two doses of Pfizer XBB (3ug)
    • two doses of Pfizer: give one dose of Pfizer XBB (3ug)
• Whenever possible, try to stay with the same vaccine product (Pfizer or Moderna). While this may be the most ideal, it may not be possible due to vaccine availability in your area. In these cases, NACI approves of the combination of vaccines. For those under five years of age, if combining Moderna and Pfizer products, it is recommended to adhere to the three-dose schedule. This means the child may have one Pfizer and two Moderna, as an example.

If you have never received a vaccination for COVID-19 and plan to get one now but you recently did have a COVID-19 infection, here are some guidelines for when you may get a XBB.1.5 vaccine. Note, these guidelines differ from the suggested six months for vaccinated individuals.
 

• If you are NOT immuno-compromised and no history of multi-system inflammatory syndrome, wait two months (56 days) after your COVID-19 illness to get vaccinated.
• If you ARE immuno-compromised and no history of multi-system inflammatory syndrome, wait one to two months (28-56 days) after your COVID-19 illness to get vaccinated.
• If you HAVE a history of multi-system inflammatory syndrome, wait until clinical recovery has occurred or up to 90 days since onset, whichever is longer to get vaccinated.

Since the timing of your next COVID-19 XBB vaccine dose is dependent not only on your last vaccine but also your last COVID-19 illness, it is still wise to ensure you test yourself when you are ill to confirm if you, indeed, have COVID-19. If the rapid tests you have at home have been collecting dust and you are concerned they might be expired, Health Canada just extended the shelf life to 24 months (two years) beyond the manufacturing date.

With so much talk of variants over the past couple of years, you might wish to get a better picture of where the XBB variants have originated. Below is a photo showing the earlier variants you may recall, such as Beta, Delta, Omicron, BA.1, BA.4, BA.5. The BA variants are descendants of Omicron and were the variants we were contending with last fall. According to this depiction, XBB is a combination of two different BA.2 variants.



For those of you who wish to receive a COVID-19 vaccine but do not want to have Moderna or Pfizer that use mRNA technology, there is a vaccine by Novovax which is a protein-based vaccine, using older, more traditional technology. Though this vaccine will not be as readily available, if you are interested in this vaccine, you should contact Public Health directly to discuss.

For ease of convenience, it is acceptable to get both the COVID-19 XBB vaccine and the influenza vaccine at the same time. They should, ideally, be administered in separate arms.

Tune in next week for an update on the latest information on this year’s influenza vaccines available.

To get yourself booked for an appointment for either the COVID-19 or the flu shot, register on-line today at BookMyShot.com. Just select the service you are looking for (COVID-19 vaccine or flu vaccine) and enter the first three digits of your postal code, then choose the pharmacy of your choice and register how many people. It is that simple. If you are having difficulties, don’t hesitate to give us a call and we will help you get registered.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/