Infectious disease

Administration of COVID-19 booster doses: Recommendations for winter and spring 2023

  • This document presents the recommendations of the Comité sur l'immunisation du Québec (CIQ) regarding the direction the COVID-19 vaccination program should take in the winter and spring of 2023 to efficiently achieve its objectives.
  • Since the beginning of the vaccination program, the primary objective has been the protection of the most vulnerable persons and the prevention of severe disease and death due to COVID-19.
  • Vaccines against COVID-19 remain an essential tool given their effectiveness in preventing severe infections, primarily those leading to hospitalizations or death.
  • Individuals with hybrid immunity, following a first episode of COVID-19 and the administration of at least 2 doses of mRNA vaccines, have strong protection against hospitalization due to COVID-19.
  • Vaccinated individuals who have never been infected have less protection against hospitalization due to COVID-19 and this protection decreases over time. …
Comité sur l'immunisation du Québec

COVID-19: Infection Prevention and Control Measures for Hemodialysis Units

As there is insufficient data on vaccine’s effects on transmission, we cannot modify the various recommendations:

  • Healthcare workers (and patients, when applicable) must continue to respect all infection prevention and control measures, regardless of their vaccination status (hand hygiene, physical distancing, wearing of personal protective equipment).
  • It is too early to determine the impact of vaccination status on exposure criteria of healthcare workers or patients. The recommendations put forward in this document are therefore still in effect.

This document presents the infection prevention and control (IPC) recommendations to apply during the COVID-19 pandemic for the evaluation and care of dialysis patients, specifically in ambulatory hemodialysis units, regardless of their origin. The evaluation step is crucial as some of the literature appears to demonstrate that dialysis patients may show few symptoms. Hemo…

Comité sur les infections nosocomiales du Québec

COVID-19: Collection, Disinfection and Storage Processes for Single-Use N95 Filtering Facepiece Respirators

Refer to the ministerial directive before applying the recommendations (in French only).

The elements covered are based on the latest information available at the time of writing. Given that the context of the COVID-19 pandemic and the authorizations issued by Health Canada for the new technologies for disinfecting N95 filtering facepiece respirators (FFRs) are evolving, the recommendations in this document are subject to change. Health care facilities must therefore verify that the technologies, at the time of their use, are still authorized by Health Canada under the Interim Order for COVID-19 (Health Canada, 2021a).

This document is intended for managers and clinical personnel involved in medical device reprocessing (MDR).

Its purpose is to describe the guidelines to be followed for the overall proces…

Centre d'expertise en retraitement des dispositifs médicaux

COVID-19: Disinfection of N95 Single-Use Filtering Facepiece Respirators

Refer to the ministerial directive before applying the recommendations (in French only).

The elements of responses presented here are based on the information available at the time of writing this evaluation. Given that the situation and knowledge surrounding the SARS-CoV-2 virus (COVID-19) as well as the authorizations issued by Health Canada for new disinfection technologies for N95 filtering facepiece respirators (FFRs) are evolving, the elements covered and the conclusions and recommendations in this document are subject to change. Health care facilities must therefore verify that the technologies, at the time of their use, are still authorized by Health Canada under the Interim Order for COVID-19 (Health Canada, 2021a). In case of conflicting information between the manufacturer's instructions and the studies cited in thi…

Centre d'expertise en retraitement des dispositifs médicaux

COVID-19: Evaluation of Disinfection Options for N95 Filtering Facepiece Respirators in the Context of the Pandemic

Refer to the ministerial directive before applying the recommendations (in French only).

The elements of responses presented here are based on the information available at the time of writing this evaluation. Given that the situation and knowledge about the SARS-CoV-2 virus (COVID-19), as well as the authorizations issued by Health Canada for new disinfection technologies for N95 filtering facepiece respirators (FFRs), are evolving, the elements covered and the conclusions and recommendations in this document are subject to change. Health care facilities must therefore verify that the technologies, at the time of their use, are still authorized by Health Canada under the Interim Order for COVID-19 (Health Canada, 2021a). In case of conflicting information between the manufacturer's instructions and the studies cited in this document or…

Centre d'expertise en retraitement des dispositifs médicaux

Preliminary Data on Vaccine Effectiveness and Supplementary Opinion on the Strategy for Vaccination Against COVID-19 in Quebec in a Context of Shortage

The Ministère de la Santé et des Services sociaux (MSSS) recently asked the CIQ to issue an opinion on the target interval before administration of the second dose, and important considerations to be taken into account for decision-making. The purpose of this opinion is to answer this question through an analysis of the most recent data on COVID-19 vaccine effectiveness from Quebec and abroad.

Summary

The data available on the efficacy of mRNA vaccines against COVID-19 in Phase 3 studies (clinical studies) and their effectiveness in studies monitoring the rollout (public health programs) remain limited at present time. It is, however, possible to identify certain preliminary trends:

  • The VE of a single dose of mRNA vaccines against COVID-19 appears high in the short term. It is likely that field effectiveness would be lower than the efficacy demonstrated in Phase 3 studies (92 %), one reason being that clinical trial participants are younger…
Comité sur l'immunisation du Québec

Aerosol-Generating Medical Interventions on Suspected and Confirmed Cases of COVID-19

These recommendations apply to aerosol-generating medical procedures (AGMPs) carried out on suspected or confirmed COVID-19 cases. In contexts of sustained community transmission, a risk assessment must be carried out to determine whether these recommendations shall also apply during AGMPs on individuals who are asymptomatic or have unknown COVID-19 status.

(See Section 4: AGMP management for patients determined to be at no risk of having COVID-19 [ “cold patients”])

A table summarizating the recommendations is available in the appendix.

In the context of the SARS-CoV-2 pandemic, a number of interventions and procedures are now considered AGMPs by medical societies while they previously were not. Many of these procedures are not backed by conclusive data that classify them as such, but are often associated with coughing produced during the procedure and by implication, the presumed production of small aerosols.

The Analysis section allows for a good u…

Comité sur les infections nosocomiales du Québec

Requested supplement to the notice Strategy for Vaccination Against COVID-19: Postponement of the Second Dose in a Context of Shortage

Recently, various strategies have been recommended in a number of jurisdictions regarding the time interval between the two doses of COVID-19 vaccines. The Ministère de la Santé et des Services sociaux (MSSS) has asked the Comité sur l'immunisation du Québec (CIQ) to explain the basis of these different intervals. The MSSS also inquired whether the CIQ has maintained the recommendations that it put forward in a recent scientific notice (1), in particular, the recommendation to offer an initial dose of the vaccine to the greatest number of individuals belonging to the first six priority groups1 before administering the second dose.

Response

Data on certain approved vaccines

The Phase 3 trials on COVID-19 vaccines were carried out in a context where the objective was to very quickly obtain protection that meets the authorization criteria of the Food and Drug Administration and the World Health Organization (…

Comité sur l'immunisation du Québec

Strategy for Vaccination Against COVID-19: Postponement of the Second Dose in a Context of Shortage

Context

The number of cases, hospitalizations, and deaths due to COVID-19 have been increasing in Quebec since August 2020. In addition to the suffering of those infected and their friends and family, caring for patients and their contacts creates a significant burden for healthcare workers, who are frequently infected, threatening the integrity of our healthcare system. The way the pandemic develops in the coming months will depend on the population’s compliance with the recommendations to minimize contacts, maintain physical distancing, wear a mask, and wash hands. It will also depend on the general measures enacted by the government. Unless there is dramatic improvement in the population’s compliance or there are much stricter measures implemented, we cannot expect a swift decline in the weekly number of new hospitalizations and deaths without vaccination. In the short term, the impact of vaccination will depend on the targeted groups, the vaccination coverage within th…

Comité sur l'immunisation du Québec

Training Ambassadors in the Prevention and Surveillance of Lyme Disease in Québec

The Institut national de santé publique du Québec (INSPQ) conducted a training project with the Nature Conservancy of Canada (NCC) from January to December 2019 in the regions where Lyme disease (LD) is a growing public health issue. The objective was to train Lyme disease prevention ambassadors through a cascade training approach (training trainers).

Once trained, the members of this new regional network had to lead activities to raise LD awareness among their colleagues and clients and independently carry out tick sampling activities in their respective communities. In total, 18 ambassadors were trained and 28 awareness-raising activities were organized, directly reaching at least 1,860 people in seven different public health units. During this period, 28 sampling activities were completed, and 36 ticks were collected (through active and passive surveillance). The participants’ evaluation of the project was very positive. The project very clearly fulfil…