COVID-19: Vaccine Eligibility & Doses

Everyone aged six months and older is eligible to start or complete a primary series with a COVID-19 mRNA vaccine. A primary series is typically the first two or three doses to give a strong initial immune response.

The Ontario Ministry of Health will provide more details on the use of COVID-19 vaccines for people who have not been previously vaccinated or did not yet complete their primary series. More information will be available in the coming weeks.

The Novavax COVID-19 vaccine (protein subunit vaccine) is an option for people 12 years of age and older, who have not been able, due to medical reasons, or are not willing to receive an mRNA COVID-19 vaccine. It can also be used to complete a primary series that was started using a viral vector vaccine.

Interval between doses

To further improve protection and effectiveness of the vaccine, the National Advisory on Immunization (NACI) and the Ontario Ministry of Health recommends 8 weeks as the optimal interval between doses in the primary series. Evidence will continue to be monitored and information will be updated as needed.

Learn more about the administration of the COVID-19 vaccine, information about the vaccines, vaccine use by age, and where to get vaccinated.

Some people who have weakened immune systems may have a lower antibody response to the two dose series due to their underlying condition(s). Getting three doses of the COVID-19 vaccine, as part of your first COVID-19 vaccine series, is recommended for people who are moderately to severely immunocompromised to help build antibodies and for better long-term protection.

It is important to speak with your doctor or specialist about the timing for you to have the best possible immune response from the vaccine and minimize delays in your treatment. Advise the health care provider giving you the vaccination that you are immunocompromised.

A COVID-19 booster is a vaccine dose given after you have completed the primary vaccine series. It helps improve protection against COVID-19 that may have decreased over time and boosts the immune response even if you had a COVID-19 infection in the past. Health Canada authorized mRNA vaccines (Pfizer-BioNTech and Moderna Spikevax), and Novavax Nuvaxovid (protein subunit vaccine) as booster doses regardless of which vaccine was used for your primary series.

NACI and the Ontario Ministry of Health recommends all eligible people get the updated COVID-19 booster later in September. It is especially important for people who are at higher risk of COVID-19 infection or hospitalization to get the updated COVID-19 vaccine. More details about eligibility based on age and risk of COVID-19 infection or severe disease is expected in the coming weeks. It is expected that people who are at higher risk for getting very sick will be eligible first.

Once eligible, you can receive a booster dose if it has been at least 6 months from your previous COVID-19 vaccine dose or known infection.

For certain people with weakened immune systems, talk with your health care provider about your risks and benefits of getting a booster before Fall 2023.

With informed consent, the Novavax COVID-19 vaccine is an option for people 18 years of age and older, who have not been able, due to medical reasons, or are not willing to receive an mRNA COVID-19 vaccine.

More Information:

• Ministry of Health: COVID-19 Vaccine Guidance

* Moderate to severely immunocompromised people, aged six months and over, are eligible for an additional dose to complete a primary series plus boosters (if 5 years of age and over)

Re-vaccination is recommended with a new COVID-19 vaccine primary series (three doses) and booster given the loss of immunity following:

• hematopoietic stem cell transplant (HSCT)
• hematopoietic cell transplants (HCT) (autologous or allogeneic)
• CAR-T-cell therapy

Optimal timing should be determined on a case-by-case basis in consultation with your clinical team.

Please bring your referral form/letter to EACH of your vaccination appointments, highlighting this is to restart your primary series.

Everyone aged six months and older, without OHIP cards, may get vaccinated at any clinic or pharmacy clinic offering COVID-19 vaccines. Appointments for City immunization clinics must be made through the Provincial Vaccine Contact Centre at 1-833-943-3900.

Required Identification

For all clinics, bring an acceptable form of identification which may include non-Canadian and expired documents such as a driver’s licence or passport, a piece of mail with your name on it, a pay stub or a student card. Those 18 or older must provide photo ID.

Vaccines approved by Health Canada or are on the World Health Organizations (WHO) COVID-19 Vaccine Emergency Use Listing:

• If you completed a primary series and are five years of age and older, you may receive a bivalent booster dose at least sixmonths since your last COVID-19 vaccine or infection
• Everyone five years and older who did not get a booster dose are recommended to get it in the Fall 2023
• If you did not complete the primary series of the non-Health Canada approved vaccine (e.g. only received one dose of a two dose series) and documented this dose, an additional Health Canada approved vaccine dose is required to complete your primary series

Vaccines approved for use in Canada are currently Comirnaty (Pfizer-BioNTech), SpikeVax (Moderna), Vaxzevria (AstraZeneca), and Nuvaxovid (Novavax).

Vaccines not authorized by Health Canada and are not on WHO’s COVID-19 Vaccine Emergency Use Listing:

• Document any dose(s) received and additional Health Canada approved doses will be required to complete the primary series
  • For people aged five years and over, one Health Canada approved dose is required
  • For people aged five years and over who are moderately to severely immunocompromised, two Health Canada approved doses are required

Unsure About Which Vaccine You Received

• If you received a previous dose and you do not have proof of vaccination, please contact the health care provider who gave you the COVID-19 vaccine(s) to receive a copy of your vaccination record.
• If the COVID-19 vaccine product used for your previous dose(s) remains unknown, or if written proof of vaccination is provided for a vaccine whose generic or trade name is not recognized, a new vaccine series should be started with a Health Canada authorized COVID-19 vaccine.
  • If you know the date of your previous COVID-19 immunization, wait at least 28 days before getting a new Health Canada authorized COVID-19 vaccine series.

If you are eligible for an additional dose(s), including a mRNA dose needed to complete your series or a booster dose, you can book an appointment at any City-run immunization clinic using your green photo Ontario Health Card (OHIP) number through the provincial portal or by calling 1-833-943-3900 (TTY 1-866-797-0007).

With an older red and white OHIP card number or with no OHIP number at all you can book an appointment by calling 1-833-943-3900 (TTY 1-866-797-0007). Walk-in appointments are also accepted. You do not need to wait until your out-of-province dose(s) is documented by Toronto Public Health.

Even with a previous COVID-19 infection, people who have not started/completed their primary series or those who are eligible for a booster dose, are still strongly recommended to complete their COVID-19 series. Immunity from an infection may not last and people can be infected with COVID-19 again.

Hybrid immunity means having protection from being vaccinated for COVID-19 and a recent past COVID-19 infection. A past COVID-19 infection can provide natural immunity, but it does not last long – especially with Omicron variants. You have a higher risk of getting COVID-19 again if you are not up-to-date with your vaccinations.

If you have had COVID-19 in the past you should still stay up to date with your vaccinations to get the benefit of hybrid immunity.

Every COVID-19 infection increases the risk for long COVID. To maximize the immune response after you have had COVID‑19, you should wait the following intervals after symptoms started or a positive test (if you had no symptoms) before receiving your next dose:

If completing your primary series:

• Two months if you are not immunocompromised and have no history of multisystem inflammatory syndrome in children (MIS-C)
• One to two months (28 to 56 days) if you are immunocompromised but have no history of MIS-C
• if you have a history of MIS-C, until clinical recovery has been achieved or up to 90 days since the onset, whichever is longer, regardless of immunocompromised status

If getting a booster dose:

• Six months after positive COVID-19 test or after having symptoms post contact with someone who had a positive test