Last updated: December 21, 2022
Everyone ages 6 months and over can get the COVID-19, flu, and other vaccines at the same time. Bivalent booster vaccines are available for eligible individuals: Moderna Spikevax (18+) and Pfizer-BioNTech (5+). Vaccines for children ages 6 months and up are also available. Book an appointment at a City-run or hospital clinic either online or by calling 1-833-943-3900 (TTY 1-66-797-0007).
Flu season is underway and there is an increase in COVID-19, flu and other respiratory virus activity. This increase is expected to continue as the weather gets colder and people move indoors. It is important for everyone to stay up to date with their COVID-19 vaccinations as this is the best protection against getting very sick.
Staying up-to-date means getting a fall booster for anyone 5 years and older. Time your vaccine six months after a COVID-19 vaccine dose or a COVID-19 infection. Three months (84 days) may be considered based on age, risk and health status. Even if you recently had COVID-19, getting vaccinated gives hybrid immunity for stronger and longer lasting immunity.
If you received a COVID-19 booster vaccine September 2022 or later, you are up-to-date with your vaccinations at this time. The National Advisory Committee on Immunization (NACI) is currently reviewing if/when future booster doses may be required. The mRNA COVID-19 vaccines provide good protection against hospitalization and severe illness within the 3 to 6 months following vaccination.
According to NACI, it is not expected that a booster dose be routinely given every three months. With informed consent, an additional booster dose may be given at a shortened interval of at least 3 months for people at high risk of severe illness from COVID-19.
COVID-19 vaccines teach our immune system to make antibodies that protect us from the COVID-19 virus. Staying up to date with your COVID-19 vaccination, including any booster dose(s) when eligible, will reduce the risk of getting, spreading, and becoming seriously sick with COVID-19. It can also help lower the risk of long COVID. None of the vaccines contain COVID-19 and cannot give you the virus.
The vaccine is given using a needle in your upper arm. It takes at least two weeks after getting a vaccine dose to be protected. The Pfizer-BioNTech, Moderna Spikevax, Novavax Nuvaxovid, Medicago Covifenz and AstraZeneca/COVISHIELD vaccines require two doses to complete a primary series, and one dose for the Janssen vaccine. Boosters give the best protection for anyone 5 years of age and older.
The Pfizer-BioNTech and Moderna Spikevax vaccines are ‘messenger RNA’ or ‘mRNA’ vaccines. These are “monovalent vaccines” which means that they contain one strain of the COVID-19 virus – the original strain. They use mRNA to give our cells instructions to make antibodies. The mRNA does not change our DNA. mRNA vaccines are interchangeable which means that they are very similar and either one can be used. We recommend that you get the first vaccine that is available to you, regardless of any previous doses.
Learn more about how the mRNA vaccines work.
Health Canada has approved mRNA vaccines for everyone 6 months of age and older.
The following are approved:
Health Canada has approved the following Omicron-containing mRNA vaccines as boosters:
Bivalent means that the vaccine targets two strains of COVID-19 – the original strain and Omicron. The bivalent booster can give better protection against highly contagious Omicron variants. There have been no clinical trials comparing the two bivalent vaccines, and both are likely to provide strong protection to Omicron variants.
The monovalent Pfizer and Moderna vaccines, containing only the original strain of SARS-CoV-2, will still be used to complete the primary series.
Based on the Moderna Bivalent clinical trials:
Based on the Pfizer Bivalent approval:
NACI and Public Health Ontario will continue to closely monitor any potential adverse effects.
For eligibility information, visit our Vaccines Eligibility & Doses page.
Myocarditis and pericarditis are types of inflammation in different parts of the heart. In Canada, there have been rare reports of myocarditis/pericarditis after getting a COVID-19 mRNA vaccine. The situation is being closely monitored.
Most people who have gotten myocarditis/pericarditis after vaccination had a mild illness and symptoms went away without any concerns about long-term complications. Getting a COVID-19 infection puts you at more serious risk of myocarditis/pericarditis. For this reason, vaccination is still recommended as the benefits outweigh the risks.
The risk of myocarditis/pericarditis after a booster dose is lower compared to the second dose in the primary series. Current data does not show a difference in myocarditis/pericarditis risk between Moderna and Pfizer after a booster dose in adults.
See Myocarditis and Pericarditis After Covid-19 Vaccines) for more information.
Most vaccine side effects are mild and last for 1-3 days.
Severe side effects are rare. Get medical attention right away if you develop any of these symptoms after getting a vaccine:
The Novavax Nuvaxovid vaccine (also known as Novavax) was authorized for use by Health Canada on February 17, 2022, and as a booster on November 17, 2022 for adults aged 18+.
For adults (18+) unable (due to allergy) or unwilling to get a mRNA vaccine, Novavax Nuvaxovid is another option instead of a mRNA vaccine.
Novavax is a ‘protein subunit’ vaccine. It uses small pieces of a protein that look like the spikes on the COVID-19 virus. These proteins teach our immune system to make antibodies that recognize and fight COVID-19.
Some people may have mild to moderate side effects from this vaccine that may last one to three days. Common side effects include redness, pain or swelling at the injection site, mild fever, headache, feeling tired, muscle aches, joint pain, nausea and/or vomiting. Contact your health provider if side effects do not go away after 3 days.
Myocarditis and pericarditis are types of inflammation in different parts of the heart that can occur after getting COVID-19 and be serious. This has rarely occurred after getting Novavax and is being closely monitored. Get medical attention if you develop chest pain, shortness of breath, or racing heartbeat after vaccination.
People with a serious allergy to another COVID-19 vaccine or polyethylene glycol (PEG) can consider getting Novavax.
Health Canada approved the Medicago vaccine (also known as Covifenz) on February 24, 2022, for adults 18 to 64 years of age.
The Medicago vaccine is a plant-based vaccine. It uses virus-like particles (VLP) that look like the COVID-19 virus and teach our immune system to make antibodies that recognize and fight COVID-19.
This vaccine is currently not available in Canada.
An AEFI is any time you feel unwell more than what you were told to expect after receiving a vaccine. If you think you are experiencing an AEFI, contact your health care provider and let them know you feel unwell and recently received a vaccine.
AEFIs are reported by your health care provider to Toronto Public Health (TPH), who helps your provider investigate if your illness was caused by the vaccination. TPH reports AEFIs to the Ontario Ministry of Health, Public Health Ontario, and the Public Health Agency of Canada to make sure that vaccines are as safe as possible, even after they are approved. Companies that produce vaccines do not help with investigations of AEFIs, but they are aware of reports for the safety of their products.
The vaccine contains an active ingredient that gives our body instructions to make antibodies. Other vaccine ingredients include lipids (fats), salts, sugars and buffers.
COVID-19 vaccines do not contain eggs, gelatin (pork), gluten, latex, preservatives, antibiotics or aluminum.
People with severe allergies to any of the vaccine ingredients should speak with their physician/allergist about getting the vaccine. Some people with allergies to an ingredient can still be safely vaccinated.
If you get a serious reaction after your first dose, talk to your health care provider about future vaccinations. Sometimes you can still be safely vaccinated, or can received a different vaccine.
Polyethylene glycol (PEG) is in the Pfizer BioNTech and Moderna vaccines, including the bivalent boosters. PEG can also be found in laxatives, makeup, skin care products, personal lubricants, toothpastes, and some contact lenses. It is also in cough syrup, over-the-counter medications, and in some food and drinks.
Tromethamine is in the Pfizer BioNTech and Moderna vaccine, including bivalent boosters. It helps to make the vaccine stable. Tromethamine can be found in dyes used for CT or MRI scans, medications, cosmetics, perfumes and skin creams.
Polysorbate-80 is in the Novavax (NUVAXOVID), Medicago Covifenz, AstraZeneca/COVISHIELD and Janssen (Johnson & Johnson) vaccines. It is used to hold (or bind) the vaccine ingredients together. Polysorbate-80 can be found in most processed food, sauces, condiments, soups, ice cream, chewing gum, soaps, creams, bath gels, shampoo, body butter, cosmetics, vitamins, heart medication and contraceptives (birth control).
Talk to your health care provider if you have questions about getting vaccinated and to understand the benefits of getting the vaccine compared to the risks of getting the COVID-19 infection. For most people, getting a COVID-19 vaccine is the safest choice.
See COVID-19: Where to Get Vaccinated to find a vaccine clinic near you.
Watch North York General Hospital’s video on getting the COVID-19 vaccine during pregnancy:
Source: North York General Hospital
There is no evidence the vaccines impact fertility, menstrual irregularities, puberty, or normal growth and development.
The main ingredient in the vaccine is mRNA and that lasts in your body for a few days before it is removed from the body. The body develops an immune response in the first few weeks after vaccination. Some may have a temporary change in their menstrual cycle because of this immune response. A menstrual cycle can also temporarily change from everyday life including stress, changes in weight and exercise. The World Health Organization recommends not delaying vaccination if menstruating.
A COVID-19 infection can also affect menstruation. For example, in one study, one out of five patients with confirmed COVID-19 infection had temporary changes in the length of their cycle and the amount of bleeding.
People with stable health conditions can get vaccinated. Conditions include: diabetes, high blood pressure, heart disease, respiratory diseases, including asthma or COPD, hepatitis B, C and HIV.
People with a weak immune system because of illness, treatment or an autoimmune condition:
See our COVID-19: Vaccine Resources page