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Symptoms of COVID-19 can be difficult to distinguish from other respiratory illnesses like the flu and RSV. If sick, patients should follow provincial guidance on isolation duration and masking.
For more information on clinical signs and symptoms, surveillance, laboratory testing, IPAC, reporting and patient resources, please see Respiratory Viruses Information for Health Professionals.
See the Ontario Ministry of Health’s Current Case Definition for COVID-19.
For guidance about testing:
Effective October 1, 2024 in Ontario, publicly funded COVID-19 testing (rapid antigen tests and PCR testing) will only be available to:
To find out about test availability and to arrange to take a test, individuals meeting the above criteria will contact their primary care provider or pharmacist.
The distribution of free rapid antigen tests kits to the public has been discontinued by the Provincial government. Toronto Public Health will no longer order or distribute rapid antigen test kits.
HCPs can order RATs to distribute to their patients free of charge as “eligible persons” under the Provincial Antigen Screening Program (PASP) Agreement. This is in addition to orders placed for RATS for their employees. HCPs not currently enrolled in PASP that would like to distribute RATs to employees and/or patients, can enroll here.
Orders will continue to be through the PPE Supply Portal. For assistance in creating an account or accessing an existing account, or for any questions about orders and shipment, please contact sco.supplies@supplyontario.ca.
Please see the TPH COVID-19 webpage for more information and updates for your patients.
TPH would recommend discarding test kits if they have expired.
As noted by Health Canada “Rapid tests are medical devices, which means they have an expiry date. This is known as a shelf-life. Health Canada authorizes the shelf-life of rapid tests and has granted several shelf-life extensions. The expiry date is determined by the manufacturer and is printed on the labelling during the manufacturing process. However, expiry dates may be impacted by shelf-life extensions even after products have been distributed. Contact the manufacturer of your rapid test to confirm its expiry date.”
For disposal, please note:
Waste generated from rapid antigen tests is considered hazardous waste under the Environmental Protection Act (EPA) and its regulation, and requires proper management and disposal of rapid antigen tests at a waste disposal site.
Kindly note that unused, expired, and/ or damaged tests/ test kits cannot be returned to any central government warehouse due to quality control considerations. Organizations are encouraged to review the Ministry of Environment, Conservation, and Parks (MECP) guidelines regarding the proper and safe disposal of waste from rapid antigen tests.
Unused/ expired rapid antigen tests are to be disposed of following the same guidelines as used rapid antigen tests.
Approved facilities for final disposal of biomedical waste include:
To view COVID-19 test results online:
If you are not providing COVID-19 vaccine in your practice, you can direct your patients to book their vaccine appointment using the Province’s registration system. COVID-19 vaccines are available by appointment at Toronto Public Health clinics for children 6 months to 4 years of age
To order Pfizer-BioNTech and Moderna COVID-19 vaccines, complete the TPH COVID-19 Vaccine Program Enrollment Request Form and the onboarding process. Please only complete this form once for each primary care or general pediatric practice. Once complete, access to the ordering portal will be provided.
Email questions about enrolling in the Toronto Primary Care COVID-19 Vaccine Program to COVIDVaccineOrder@toronto.ca.
Toronto Paramedic Services offers fall vaccinations for homebound residents with medical, physical, cognitive, or psychosocial barriers, where transportation and other access solutions are unavailable or unsuitable.
Vaccines available for the 2024-2025 season include flu and COVID-19.
Primary care providers:
Note: Primary care providers must register eligible patients this year even if the patient previously received a homebound influenza or COVID-19 vaccination. Registered patients will be screened again by Toronto Paramedic Services during the booking process.
The updated fall/winter 2024-2025 COVID-19 KP.2 vaccine is available now for eligible individuals who live in Ontario, and are at high risk from COVID-19 or a priority population.
The vaccine will be available to anyone 6 months of age and older beginning October 28, 2024.
| KP.2 COVID-19 Vaccine | Vaccine Platform | Age for use in Ontario | Dosage Volume |
|---|---|---|---|
| Moderna Spikevax | messenger RNA | 6 months to 11 years | 0.25 mL/25 ug |
| Moderna Spikevax | messenger RNA | 12 years + | 0.5 mL/50 ug |
| Pfizer COMIRNATY | messenger RNA | 12 years + | 0.3 mL/30mcg |
Recommended high-risk and priority populations:
*COVID-19 vaccine may be offered at any stage of the pregnancy (i.e., in any trimester) and while breastfeeding.
Individuals six months of age and older who are not at increased risk of COVID-19 infection or severe illness from COVID-19 are recommended to wait until October 28, 2024 to receive a COVID-19 vaccine.
See NACI guidance for further information.
Visit TPH’s COVID-19: Vaccines for more information to share with patients.
| Current Age | Health Status | Vaccination History | # of Doses of Moderna to Give | Interval Between Doses |
|---|---|---|---|---|
| 6 months to 4 years | Immuno-competent | 0 doses | 2 doses | 8 weeks |
| 1 dose Moderna | 1 dose | 8 weeks | ||
| 1 dose Pfizer | 2 doses | 8 weeks | ||
| 2 doses with ≥1 doses Pfizer | 1 dose | 8 weeks | ||
| 2 doses both Moderna | 1 dose | 6 months° | ||
| ≥3 doses, any product | 1 dose | 6 months° |
°For previously vaccinated individuals, the recommended interval is 6 months from the last COVID-19 vaccine dose, and a minimum of 3 months from the last dose may be used.
| Current Age | Health Status | Vaccination History | # of Doses of Moderna or Pfizer to Give | Interval Between Doses |
|---|---|---|---|---|
| 5 years + | Immuno-competent | 0 doses | 1 dose | |
| ≥1 dose, any product | 1 dose | 6 months^° |
^ Children who started the primary series at less than 5 years of age and turn 5 years of age before completing the series, should get 1 dose this fall/winter with a minimum 8-week interval after their last dose.
Individuals may consider delaying COVID-19 immunization by 3 to 6 months if someone had a recent test-confirmed COVID-19 infection and were previously vaccinated.
Hybrid immunity, having protection from being vaccinated for COVID-19 and a recent past COVID-19 infection, can provide natural immunity but it does not last long. Individuals have a higher risk of getting COVID-19 again if they are not up to date with their vaccinations. Encourage patients to stay up to date with their vaccinations to get the benefit of hybrid immunity.
Moderately to severely immunocompromised individuals who are 6 months to 4 years of age who have not been previously vaccinated should receive an additional dose of vaccine to be fully protected.
Moderately to severely immunocompromised individuals who are 5 years of age and older and never received a COVID-19 vaccine should receive 2 doses of COVID-19 vaccines. Please refer to Ministry of Health guidance for more information.
| Current Age | Health Status | Vaccination History | # of Additional Doses Recommended | Interval Between Doses |
|---|---|---|---|---|
| 6 months to 4 years | Immuno-compromised | 0 doses | 3 doses | 4-8 weeks |
| 1 dose Moderna | 2 doses | 4-8 weeks | ||
| 1 dose Pfizer | 3 doses | 4-8 weeks | ||
| 2 doses both Moderna | 1 dose | 4-8 weeks | ||
| 2 doses with ≥1 doses Pfizer | 2 doses | 4-8 weeks | ||
| 3 doses with ≥1 doses Pfizer | 1 dose | 4-8 weeks | ||
| 3 doses all Moderna | 1 dose | 6 months° | ||
| ≥4 doses, any product | 1 dose | 6 months° |
°For previously vaccinated individuals, the recommended interval is 6 months from the last COVID-19 vaccine dose, and a minimum of 3 months from the last dose may be used.
| Current Age | Health Status | Vaccination History | # of Additional Doses Recommended | Interval Between Doses |
|---|---|---|---|---|
| 5 years + | Immuno-compromised | 0 doses | 2 doses | 4-8 weeks |
| 1 dose XBB or KP.2 | 1 dose¥ | 4-8 weeks | ||
| 1 dose non-XBB/non-KP.2 | 2 dose¥ | 4-8 weeks | ||
| 2 doses with ≥1 doses non-XBB/non-KP.2 | 1 dose¥ | 4-8 weeks | ||
| 2 doses, XBB | 1 dose | 6 months° | ||
| ≥3 doses, any product | 1 dose | 6 months° | ||
| IC: HSCT recipient or CAR T cell therapy | 1 dose XBB or KP.2 | 2 doses | 4-8 weeks | |
| 2 doses XBB and/or KP.2 | 1 dose | 4-8 weeks | ||
| ≥3 doses XBB | 1 dose | 6 months° |
¥ An additional dose may also be offered if recommended by the client’s healthcare provider.
^ Immunocompromised children who started the primary series at less than 5 years of age and turn 5 years of age before completing the series, should continue the primary series schedule that was initiated (i.e., continue schedule as if child is under 5 years of age.
An AEFI is an unwanted or unexpected health effect that happens after someone receives a vaccine, which may or may not be caused by the vaccine. A causal relationship does not need to be proven before reporting. Of particular interest are unusual or unexpected events, or serious reactions requiring urgent care.
Toronto health care providers are required to report all Adverse Events Following Immunization (AEFI) to TPH under the Health Protection and Promotion Act.
Complete the AEFI Reporting Form and fax it to 416-696-3492 or email it to AEFI@toronto.ca.
To stay up-to-date about AEFIs reported following COVID-19 vaccinations, visit the Public Health Agency of Canada’s weekly report, Reported side effects following COVID-19 vaccination in Canada, regularly.
More information about COVID-19 vaccines:
For guidance about COVID-19 treatment:
In Canada, oral nirmatrelvir/ritonavir (Paxlovid™) and intravenous remdesivir (Veklury®) are Health Canada approved COVID-19 treatments for outpatient use. Individuals must have a positive COVID-19 test to receive treatment (PCR or rapid antigen test [including self-administered]). COVID-19 medications are recommended for patients who present within five days (Paxlovid) or seven days (Remdesivir) of symptom onset.
Individuals who may be eligible for treatment and have an initial negative rapid antigen test result are strongly recommended to seek laboratory-based or rapid molecular testing as soon as possible given the short time frame for receiving therapeutics.
For information on testing and treatment, including eligibility and locations:
For information on how primary care providers and other health care providers can access remdesivir treatment for COVID-19 for patients in the community please see Ontario Health’s, Access to Antiviral Therapy for COVID-19 in the Community.
In Toronto, virtual clinical assessments, prescribing of Remdesivir and referral to Home and Community Support Services (HCCSS) for Remdesivir treatment continues to be supported by the UHN Connected Care Hub.
For information about prevention and management of respiratory outbreaks in LTCH & RH: Infection Prevention & Control Information for Long-Term Care Homes & Retirement Homes