Off-Label use of vaccines may save lives and money: lessons from the province of Quebec, Canada
Bibliographic record
Abstract
INTRODUCTION: In Canada, vaccines are authorized by Health Canada but publicly funded programs are of provincial/territorial jurisdiction. Off-label (OL) use of vaccines has been frequently implemented in Quebec over the last 30 years. AREAS COVERED: The first part of this manuscript describes 11 recommendations from the Quebec Immunization Committee on meningococcal, pneumococcal, hepatitis A and B, HPV, rotavirus, and COVID-19 vaccines that were clearly OL. In the second part, challenges associated with OL use are discussed, including (i) the justifications of OL recommendations, (ii) the level of supporting scientific evidence, (iii) effectiveness and safety considerations, (iv) vaccine confidence and acceptability, (v) liability risks and informed consent. EXPERT OPINION: With one exception, OL vaccine use in Quebec was successful. Reducing the number of doses or recommending the use of two different vaccines in a single immunization regimen (one vaccine having a much lower purchase cost than the other) allowed for more cost-effective immunization programs. Another OL's justification was to increase protection, by extending the age limit or interval between doses, or allowing an interchangeability of available vaccines. OL vaccine use should always be considered when properly justified by scientific evidence and vaccinology principles, and carefully evaluated when implemented.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".