COVID-19 vaccines
Learn more about administering COVID-19 vaccines in Ontario for spring 2025
High-risk groups
Members of high-risk groups who have completed their primary series should receive an additional dose of the COVID-19 vaccine in spring 2025.
High-risk individuals include individuals who are/have:
- Adults aged 65+
- Adults 80+ should receive an additional dose
- Adults 65 to 79 may receive an additional dose
- Residents of long-term care homes and other congregate living settings for seniors
- Adults aged 55+ who identify as First Nations, Inuit or Metis and their non-Indigenous household members who are 55+
- Underlying medical conditions that place them at higher risk of severe COVID-19
While no longer listed as a high-risk group, pregnant or breastfeeding individuals should get the COVID-19 vaccine once in the 2024-25 season. This protects both the pregnant individual and the baby.
General population
Members of the general population who have completed their primary series do not need an additional dose of the COVID-19 vaccine in spring 2025. Those who have not completed their primary series should do so.
Available vaccines
Two publicly-funded mRNA vaccines are available this year: Moderna and Pfizer. Both vaccines target the Omicron KP.2 variant. Moderna is the only vaccine that is approved for use in children six months to 11 years of age.
Individuals who cannot receive an mRNA vaccine should be counselled about treatment options, including Paxlovid, in the event of a COVID-19 infection.
Coadministration
COVID-19 vaccines can be given at the same time as other vaccines, including influenza and respiratory syncytial virus (RSV) vaccines and/or the RSV monoclonal antibody, BeyfortusTM. If multiple injections are given at the same visit, separate limbs should be used if possible.
COVID-19 immunization schedules
Primary series
| Age | Recommendations for general population | Recommendations for immunocompromised individuals |
|---|---|---|
| Six months to four years |
Two doses of Moderna with an eight-week interval If Pfizer was given in the past, three doses are recommended with an eight-week interval* |
A third dose of Moderna with a four-to-eight-week interval between each dose If Pfizer was given in the past, four doses are recommended with an eight-week interval* |
| Five years and over | One dose of Moderna** or Pfizer |
A second dose of Moderna** or Pfizer A third dose of Moderna or Pfizer may be offered with a four-to-eight-week interval based on clinical discretion |
*If both Moderna and Pfizer were used in the same schedule, the number of doses should follow the Pfizer schedule.
**Moderna is the only approved vaccine for children under 12 years.
Special populations
For primary series recommendations for the following groups, refer to the ministry’s health care provider fact sheet: COVID-19 vaccine.
- Children who started the series under five years of age and turned five before completing the series
- New hematopoietic stem cell transplantation (HSCT) recipients and chimeric antigen receptor (CAR) T cell therapy
Who is considered immunocompromised?
The following individuals are considered by the National Advisory Committee on Immunization (NACI) to be moderately to severely immunocompromised:
- Solid tumour or hematologic malignancies or treatments for these conditions
- Solid-organ transplant and taking immunosuppressive therapy
- Hematopoietic stem cell transplant (HSCT) (within two years of transplantation or taking immunosuppression therapy)
- Immunocompromise due to chimeric antigen receptor (CAR) T-cell therapy targeting lymphocytes
- Moderate to severe primary immunodeficiency with associated humoral and/or cell-mediated immunodeficiency or immune dysregulation
- HIV with AIDS-defining illness or TB diagnosis in the last 12 months before starting vaccine series, or severe immune compromise with CD4 <200 cells/microlitre or CD4 <15% or without HIV viral suppression
- Recent treatment with the following categories of immunosuppressive therapies: anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids, alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive
- Chronic kidney disease on dialysis
Booking COVID-19 vaccines
Appointments can be booked through the COVID-19 vaccination portal or by calling the Provincial Vaccine Contact Centre at 1-833-943-3900. Eligible individuals can also book an appointment directly through public health units that use their own booking systems, Indigenous-led vaccination clinics, participating health-care providers and participating pharmacies.
Observation period
The National Advisory Committee on Immunization (NACI) recommends a 15-minute observation period following COVID-19 vaccination. If there is concern about a possible vaccine reaction, a 30-minute observation is preferred.
COVax: Ontario's COVID-19 vaccine administration application
COVax is a real-time, web application that supports the planning and administration of COVID-19 vaccines in Ontario. All immunizers must continue to use this program to record doses of COVID-19 vaccine administered. This database can be accessed by authorized users from any device.
The Ministry of Health has a COVax service desk available to support primary care practices administering COVID-19 vaccines.
Vaccine administration errors
In the event of a vaccine administration error, refer to the Ministry of Health’s vaccine guidance, which states that you should notify your local Public Health Unit or Public Health Ontario. If the vaccine administration error results in an adverse event following immunization, complete Ontario’s AEFI reporting form and submit it to your local PHU.
Adverse Events Following Immunizations (AEFI)
All adverse events should be reported using the adverse event following immunization form to understand any effects of the COVID-19 vaccines in practice. This includes both immediate reactions as well as those that may appear days later. Adverse events should be reported upon first presentation, however, multiple reports per patient will be collated. Completed forms should be sent to the local Public Health Unit for investigation. Learn more about the reporting criteria.
Vaccine injury support program
The Public Health Agency’s new pan-Canadian vaccine injury support program is now accepting claims from individuals who experience a serious, permanent injury as a result of receiving a Health Canada-authorized vaccine, and those who are dependants or successions of an individual who has died after vaccination. This program is administered by RCGT Consulting on behalf of the Public Health Agency of Canada.
Medical-legal questions related to COVID-19 vaccination
For other legal inquiries, please contact OMA Legal Affairs.
COVID-19 vaccine allergies
A tool to determine the appropriate management of patients with allergies.
Vaccine hesitancy
The OMA has created resources to address vaccine hesitancy including an overview of vaccine hesitancy and practical approaches for how to have effective conversations with patients.
Ontario eConsult Centre of Excellence
The Ontario eConsult Centre of Excellence has created specialty groups to allow physicians and nurse practitioners to ask specialists COVID-related clinical questions for certain populations. These groups include:
Sign up for eConsult or complete the intake form and someone will assist you.