COVID-19 vaccines

(a) Individuals at increased risk of COVID-19 disease should receive COVID-19 vaccine dose(s) as soon as they become available in the fall and should also receive an additional dose in spring 2027. This group includes:

• Individuals aged 80+  
• Residents of long-term care homes aged 18+
• Residents of congregate living settings aged 65+
• Individuals aged 65-79 with certain underlying medical conditions that place them at higher risk of severe COVID-19
• Individuals aged six months and older who are moderately to severely immunocompromised due to an underlying condition or treatment
• Adults aged 55+ who identify as First Nations, Inuit or Métis and their non-Indigenous household members aged 55+

(b) Adults aged 65-79 who are not included in the list above should receive COVID-19 vaccine dose(s) as soon as they become available in the fall and may receive an additional dose in spring 2027.

Individuals at increased risk of SARS-CoV-2 exposure or severe COVID-19 disease should receive COVID-19 vaccine dose(s) as soon as they become available in the fall:

• Residents of long-term care homes aged 17 years and younger
• Residents of congregate living settings aged 64 years and younger
• Pregnant individuals
• Individuals aged 54 years and younger who identify as First Nations, Inuit, or Métis and their non-Indigenous household members aged 6 months to 54 years
• Individuals aged 64 years and younger with certain underlying medical conditions that place them at higher risk of severe COVID-19
• Children aged 17 and younger with complex health needs, specifically:
  • children who are medically fragile/have medical complexities
  • children with more than one comorbidity
  • children with neurological disorders
  • children with chronic lung disease
  • children with Down syndrome (Trisomy 21)
  • children with other immunocompromising conditions
• Health care workers (HCWs) – any person, paid or unpaid, who provides services, works, volunteers, or trains in a hospital, clinic, or other healthcare facility – including:
  • care providers
  • emergency response workers (i.e. first responders including fire, police, and ambulance)
  • those who work in continuing care or long-term care facilities or residences
  • those who provide home care for people at high-risk
  • students/trainees of related healthcare services
• Members of underserved communities

Individuals with the following underlying medical conditions are eligible for fall vaccination within the high-risk populations (group 1 for ages 65+ and group 2 for ages 64 and under):

• Cancer
• Cerebrovascular disease
• Chronic kidney disease
• Chronic liver diseases (limited to cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease, and autoimmune hepatitis)
• Chronic lung diseases (limited to bronchiectasis, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary hypertension, pulmonary embolism)
• Cystic fibrosis
• Diabetes mellitus, types 1 and 2
• Disabilities (e.g. Down syndrome, learning, intellectual, or developmental disabilities; ADHD; cerebral palsy; congenital disabilities; spinal cord injuries)
• Heart conditions (e.g. cardiomyopathies, coronary artery disease, heart failure, etc.)
• HIV infection
• Mental health disorders (limited to mood disorders, including depression and schizophrenia spectrum disorders)
• Obesity
• Pregnancy and recent pregnancy
• Primary immunodeficiency diseases
• Smoking, current or former
• Solid organ or blood stem cell transplant
• Tuberculosis
• Use of corticosteroids or other immunosuppressive medication

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)  
• Immunocompromised 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
  • tumor-necrosis factor (TNF) inhibitors
  • other biologic agents that are significantly immunosuppressive
• Chronic kidney disease on dialysis

Two doses per year: Individuals belonging to Group 1 of the high-risk populations should receive two COVID-19 vaccine doses per year (one in fall and one in spring) if they have completed their primary series. If the dose (or the primary series for those who have not yet completed it) is not given in the fall, then it should be given in the spring.

One dose per year:

• Individuals belonging to Group 2 of the high-risk populations should receive one annual dose in fall if they have completed their primary series
• Individuals belonging to priority populations and/or the general population may receive one COVID-19 vaccine dose in fall if they have completed their primary series

For more information on dosing and intervals, please refer to the ministry’s health care provider fact sheet: COVID-19 vaccine program. 

COVID-19 vaccines may be given at the same time, before or after other vaccines, including influenza and respiratory syncytial virus (RSV) vaccines and/or the RSV monoclonal antibody, Beyfortus^®. If multiple injections are given at the same visit, separate limbs should be used where possible. If administered into the same muscle, injections should be separated by at least 2.5 cm (1 inch).

The Canadian Immunization Guide recommends a 15-minute observation period following COVID-19 vaccination. If there is concern about a possible vaccine allergy, a 30-minute observation is a preferred interval.

Reporting COVID-19 vaccine administration remains a legislated requirement for all vaccinators under the COVID-19 Vaccination Reporting Act.

COVaxON was decommissioned March 13, 2026. As of Sept. 14, 2026, Ontario has moved to using the Panorama Guided Workflow (PGW) to document COVID-19 vaccine inventory and administration information.

If you applied for Panorama-Guided-Workflow (PGW) access, you can receive COVID-19 vaccine supply from your local public health unit while your onboarding steps are in process. While awaiting PGW access, you should count the COVID-19 vaccine inventory you receive, confirm it against the packing slip and continue documenting every dose administered. Once access is granted, enter all doses administered since fall 2026 into PGW. The system will automatically deduct these doses from your organization’s inventory, so no manual adjustment is needed.

For any questions about the PGW and onboarding, contact PanoramaGuidedWorkflow@ontario.ca.

Refer to Public Health Ontario’s PGW Resources webpage for more information about the PGW, including training materials.

In the event of a vaccine administration error or deviation, refer to the Government of Canada’s Planning guidance for immunization clinics for COVID-19 vaccines: Managing vaccine administration errors or deviations. For errors and deviations not addressed in this guidance or that have additional complexity, contact your local public health unit or Public Health Ontario for further advice.

The local PHU should be notified in these circumstances. Any vaccine administration errors and deviations should be handled and reported in accordance with the policies and procedures from the site, the local PHU and any relevant regulatory college.

If the vaccine administration error or deviation results in an adverse event following immunization, complete Ontario’s AEFI reporting form and submit it to your local PHU.

Under the Health Protection and Promotion Act, it is mandatory to report all adverse events related to receiving a COVID-19 vaccine within seven days after recognizing its presence. Adverse events must be reported through local PHUs using the adverse event following immunization form.

Any event that may be related to receipt of a vaccine, as outlined in Public Health Ontario’s AEFI reporting fact sheet, should be reported. This includes both immediate and delayed reactions, particularly if they require medical consultation or are unusual and unexpected. Submitting a report does not mean that the vaccine caused the event. Some common or mild events that do not require reporting include:

• Fever that is not accompanied by any other symptoms
• Injection site reactions that last less than four days and do not extend past the nearest joint
• Vasovagal syncope (without injury)
• Events that are clearly attributed to other causes

Refer to COVID-19 vaccines: Canadian Immunization guide for more information about vaccine safety and adverse events. 

The Public Health Agency’s pan-Canadian Vaccine Impact Assistance Program (VIAP) provides support to individuals who have been assessed as having been seriously and permanently injured as a result of receiving a Health Canada-authorized vaccine.

The Program was first announced in 2020 and began accepting applications in 2021 under its former name, the Vaccine Injury Support Program. As of April 1, 2026, the Government of Canada administers the Vaccine Impact Assistance Program.