COVID-19 vaccines

High-risk and priority groups

Members of high-risk and priority groups, aged six months and older, should receive the updated COVID-19 vaccine as soon as it is available.  

High-risk individuals are strongly recommended to receive the COVID-19 vaccine. These include individuals who are/have:  

• Adults aged 65+ 
• Residents of long-term care homes and other congregate living settings 
• Pregnant  
• From First Nations, Metis and Inuit communities  
• Members of racialized and other equity-deserving communities 
• Underlying medical conditions that place them at higher risk of severe COVID-19  

In addition, to facilitate coadministration with the influenza vaccine, the following groups should be prioritized to receive the COVID-19 vaccine and the influenza vaccine:  

• Health-care workers 
• First responders 
• Children six months to four years of age 
• Individuals with significant exposure to birds and mammals (such as poultry, livestock, slaughterhouse and processing plant workers, wildlife officers/researchers and veterinarians)  

General population  

Members of the general population are recommended to receive the COVID-19 vaccine starting Oct. 28, 2024. This includes all previously vaccinated and unvaccinated individuals aged six months and older who are not at increased risk of SARS-Co-V-2 infection or severe illness from COVID-19.  

Individuals who have been previously vaccinated are recommended to wait six months from their last dose or recent test-confirmed COVID-19 infection before receiving the COVID-19 vaccine. The shortest interval that may be used is three months.

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.

A reminder that all COVID-19 XBB vaccines have been withdrawn from the Canadian market per the regulator, Health Canada. COVID-19 XBB vaccine doses should no longer be administered. Any remaining supply of XBB vaccine must be quarantined. 

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, Beyfortus^TM. If multiple injections are given at the same visit, separate limbs should be used if possible.

COVID-19 immunization schedules

Primary series

*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 
• Individuals five years and over who started the series with a non-XBB/non-KP.2 vaccine (i.e. original monovalent, BA.1 bivalent or BA. 4/5 bivalent) but did not complete the series

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 dependents 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

The Canadian Medical Protective Association has FAQs on medical-legal considerations related to COVID-19 vaccination.

For other legal inquiries, please contact OMA Legal Affairs.