COVID-19 vaccines

Program overview

Eligibility criteria for the province’s publicly-funded COVID-19 vaccine program has now been aligned with the universal influenza immunization program and includes individuals six months of age and older who live, work, or go to school in Ontario.

This year’s COVID-19 vaccine program includes two products: Comirnaty (Pfizer-BioNTech) and Spikevax (Moderna), both targeting the LP.8.1 strain. Spikevax (Moderna) is the only vaccine currently approved for use in children six months to four years of age.

Nuvaxovid (Novavax) will not be available this year. Individuals who cannot receive an mRNA vaccine should be counselled about treatment options, including Paxlovid, and ways to lower their risk of infection.

Vaccine supply rolled out to the highest risk settings (hospitals and long-term care homes) starting at the end of September. In October, supply will become available to community settings, who can then begin vaccinations for high risk and priority populations. Vaccinations for the general population will start October 27. 

Target populations

Members of high-risk and priority groups who have completed their primary series should receive a COVID-19 vaccine dose as soon as it becomes available in fall 2025.

High-risk groups

High-risk individuals include individuals who are/haveare divided into two groups with distinct recommendations.

Group 1: Individuals at increased risk of COVID-19 should receive COVID-19 vaccine dose(s) as soon as it is available this fall and should receive an additional dose in spring 2026 (two doses annually unless individuals have not completed their primary series). This group includes:

• Adults aged 80+  
• Adult residents of long-term care homes and other congregate living settings for seniors
• 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 who are 55+ 

Adults aged 65-79 should receive COVID-19 vaccine dose(s) as soon it is available this fall and may receive an additional dose in spring 2026. 

Group 2: Individuals at increased risk of exposure or severe COVID-19 should receive COVID-19 vaccine dose(s) as soon as it is available this fall (one dose annually unless individuals have not completed their primary series). This group includes:

• Health-care workers and other care providers in facilities and community settings
• Residents of long-term care homes and other congregate living settings who are aged 17 years and under
• Pregnant individuals
• Individuals aged 54 and under from First Nations, Inuit or Métis communities
• Members of underserved communities

Priority populations

To optimize co-administration with the influenza vaccine, the following populations may receive COVID-19 vaccine dose(s) as soon as it becomes available this fall (one dose annually, unless they have not completed their primary series):

• Children aged six months to four years
• Individuals with significant exposure to birds or mammals through interactions, such as poultry, livestock, slaughterhouse and processing plant workers; wildlife officers and researchers; and veterinarians

General population  

All individuals six months of age and older who are not members of a high-risk or priority population may receive COVID-19 vaccine dose(s) this fall starting October 27 (one dose annually).  Those who have not completed their primary series should do so.

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 where possible. If administered into the same muscle, injections should be separated by at least 2.5 cm (1 inch).

COVID-19 immunization schedules

Primary series

*Spikevax (Moderna) is the only approved vaccine for children under five years.

**If both Spikevax (Moderna) and Comirnaty (Pfizer-BioNTech) were used in the same schedule, the number of doses should follow the Comirnaty (Pfizer-BioNTech) schedule.

Completed primary series

For individuals who completed their primary series, use a minimum interval of three months from their last dose. 

Incomplete or no immunization records

Individuals with incomplete or no immunization records should be considered unimmunized and should receive COVID-19 vaccines on a schedule appropriate for their age and risk factors. 

After SARS-CoV-2 infection

Following a test-confirmed SARS-CoV-2 infection:

• Individuals with an incomplete primary series should receive their next dose after eight weeks if they are not immunocompromised. If individuals are immunocompromised, use an interval of four to eight weeks.
• Individuals who were previously vaccinated may receive their next dose at a minimum interval of three months.

Specific 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
• Moderately to severely immunocompromised individuals
• Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor (CAR) T cell therapy recipients

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 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 safer interval.

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 related to receiving a COVID-19 vaccine should be reported using the adverse event following immunization form to understand any effects of the vaccines in practice. This includes both immediate and delayed reactions, particularly if they require medical consultation or are unusual and unexpected. 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

Adverse events should be reported upon first presentation. Multiple reports per patient will be collated. Completed forms should be sent to your local public health unit for investigation. Learn more about the reporting criteria.

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

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 successors of an individual who has died after vaccination. This program is administered by RCGT Consulting on behalf of the Public Health Agency of Canada.

Medico-legal questions related to COVID-19 vaccination

For other legal inquiries, please contact OMA Legal Affairs.