COVID-19 Vaccines

While many people with COVID-19 have only mild illness, others may get a severe illness or they may even die. There is no way to know how COVID-19 will affect you, even if you are not at increased risk of severe complications. COVID-19 vaccination helps protect you by creating an immune response without having to experience the illness of COVID-19.

• Pfizer-BioNTech COVID-19 vaccine was authorized for use in Canada on December 9, 2020. The vaccine name was changed to Pfizer-BioNTech Comirnaty® on September 16, 2021.
• Moderna COVID-19 vaccine was authorized for use in Canada on December 23, 2020. The vaccine name was changed to Moderna Spikevax® on September 16, 2021.
• AstraZeneca COVID-19 vaccine was authorized for use in Canada on February 26, 2021. The vaccine name was changed to AstraZeneca Vaxzevria® on September 16, 2021.
• Janssen (Johnson & Johnson) COVID-19 vaccine was authorized for use in Canada on March 5, 2021.

These vaccines will be an important tool to help stop the spread of the virus.

• You will need two doses, given by an injection in the shoulder (deltoid) muscle.
• mRNA vaccines do not contain whole or live SARS-CoV-2 and therefore cannot cause a COVID-19 infection.
• mRNA vaccines have been studied for over two decades and are a new vaccine platform, but not a new technology.
• mRNA vaccines do not affect or interact with DNA and mRNA is destroyed by cells once the body has finished using its instructions.

mRNA vaccines differ from live attenuated vaccines and inactivated vaccines. Live attenuated vaccines contain a living virus or bacteria which has been weakened so it cannot cause serious harm. Inactivated vaccines are made by inactivating or killing the bacteria or virus during the manufacturing process.

Some people may experience side effects from the vaccine, but these will likely be moderate and resolve after a few days. Some of the symptoms are part of the body's response to developing immunity.

Side effects reported in clinical trials for this vaccine include:

In rare cases, serious allergic reactions (anaphylaxis) can occur. Allergic reactions can be treated and are usually temporary.

The COVID-19 vaccine is recommended for all individuals in the authorized age groups without contraindications.

• for Pfizer-BioNTech COVID-19 vaccine - 12 years of age and older.
• for Moderna, AstraZeneca and Janssen (Johnson & Johnson) COVID-19 vaccine - 18 years of age and older.
• Priority groups have been identified and people will be able to get the vaccine in a phased approach based on the Ontario’s COVID-19 vaccine rollout plan.
• The mRNA vaccines will be prioritized and distributed according to Ontario's Distribution Plan.
• The viral vector-based vaccines will be prioritized for different populations than noted in Ontario’s Distribution Plan.
• Individuals most at risk of getting the virus and/or experiencing negative health outcomes will be offered the Pfizer or Moderna vaccine first.

• Individuals with a severe allergy (anaphylaxis) to any previous COVID-19 vaccine(s) or any part of its packaging.
  • Polyethylene glycol (PEG) is in both vaccines. It can also be found in laxatives, makeup, skin care products, personal lubricants, toothpastes, and some contact lenses. It is also in cough syrup and in some food and drinks. If you are unsure of the ingredients you are allergic to, talk to a health care provider.
  • Polysorbate 80 is found in both viral vector-based vaccines (AstraZeneca and Janssen). Polysorbate 80 can also be found in medical preparations (vitamin oils, tablets, and anticancer agents), cosmetics.
• Individuals who are not in the authorized age group should not be offered the vaccine.
• Individuals who are ill with COVID-19 symptoms should wait until they are feeling better.
• Individuals who are unwell for reasons other than COVID-19 should wait until they are feeling better.
• Individuals who received another vaccine (not a COVID-19 vaccine) in the past 14 days.

The following individuals should discuss the vaccine with their health care provider for further assessment:

• Individuals who are immunosuppressed due to disease or treatment.
• Individuals with an autoimmune condition.

No. The COVID-19 vaccines do not contain mercury, formaldehyde, aluminum or fetal cells.

pork-derived materials, blood fractions or fetal cell products.

Community immunity is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection. It is much safer to get herd immunity through vaccination than infecting the population.

The percentage of people who need to be immune in order to achieve community immunity varies with each disease. At this time, it is unknown how much of the population must be vaccinated against COVID-19 to begin inducing community immunity. This is an important area of research and will likely vary according to the community, the vaccine, the populations prioritized for vaccination, and other factors.

We do not have enough data to understand how long immunity can last after a COVID infection, or with a vaccine. In other types of infections, we’ve seen that sometimes natural immunity doesn’t last as long as vaccine-induced immunity.

Given the scale and urgency of the pandemic, we continue to recommend that people who had the virus get the vaccine, in case immunity from natural infection isn’t as long-lasting and there is potential we can extend that immunity by vaccinating.

Until we have more information about the impacts of the vaccine, individuals should continue to practice recommended public health measures to prevent COVID-19, regardless of vaccination status.

• Wear a face covering.
• Practice physical distancing.
• Avoid social gatherings with those outside of your immediate household.
• Limit non-essential trips outside your home.
• Wash your hands often with warm water and soap or an alcohol-based hand sanitizer.
• Avoid enclosed, poorly ventilated spaces and crowded places.
• Stay home when you are sick.

Yes. COVID-19 vaccines may be administered at the same time, or at any time before or after non-COVID-19 vaccines.

No specific safety concerns have been identified when routine vaccines are given at the same time or within days of each other; however, there is a possibility of increased temporary side effects when a COVID-19 vaccine and another vaccine are administered at the same time or within days of each other.

• In rare instances where the risks of COVID-19 vaccine administration outweigh the benefits, a medical exemption may be warranted. This occurs in consultation with your health care provider.
• Generally, few actual contraindications to COVID-19 vaccines qualify as medial exemptions, and most individuals can safely receive COVID-19 vaccines.
• Learn more about immunization exemptions.
• To learn more about medical exemptions, please refer to Medical Exemptions to COVID-19 Vaccination.

In Canada, and internationally, there have been reports of pericarditis (inflammation of the tissue surrounding the heart) and myocarditis (inflammation of the heart muscle) following vaccination with a COVID-19 mRNA vaccine (Pfizer or Moderna). Cases of myocarditis and/or pericarditis occur more often in individuals under 30 years of age, more often in males, and more often after a second dose. A higher rate of cases has been reported following Moderna vaccine. Most cases have been mild with quick recovery, normally with anti-inflammatory medication.

As of September 29, 2021, Ontario is issuing a recommendation of the use of Pfizer for individuals aged 18-24 years old effective immediately.

Individuals who received Moderna for their first dose can safely take the Pfizer vaccine for their second dose. Mixing vaccines is safe and effective, and full vaccination with two doses of the mRNA vaccine offers the greatest protection you can have against COVID-19 and the Delta variant.

Should individuals aged 18 to 24-years old wish to receive Moderna they can continue to do so with informed consent.
Severe side effects are rare. Seek medical attention right away if you develop any of these symptoms after receiving an mRNA vaccine:

• Chest pain, pressure, or tightness
• Shortness of breath
• Feelings of having a fast beating, fluttering, or pounding heart

Health Canada’s independent drug authorization process is known worldwide for its high standards and demanding reviews. Decisions to authorize vaccines for use in Canada are based only on scientific and medical evidence demonstrating that vaccines are safe and effective. These stringent requirements have not changed for the approval of COVID-19 vaccines in Canada.

Check out this video about vaccine safety in Canada.

You may be interested in Do they check vaccine safety after the vaccine has been approved? and How was Health Canada able to approve the COVID-19 vaccine so quickly?

Yes, in Canada there is ongoing monitoring and reporting of every vaccine given. If a reaction occurs after getting a vaccine that is not one of the normal side effects, an adverse event following immunization (AEFI) form is completed by your health care provider. The AEFI form will detail what vaccine was received, when it was received, the reaction that occurred and how long it took the reaction to appear after the vaccine was given.

Check out the COVID-19 Vaccine Safety in Canada website to see the AEFI reports to date.

Immunocompromised individuals were not a part of clinical trials for any of the vaccines. This means no research was done on this population so there is no information available on safety and effectiveness of the vaccine. The National Advisory Committee on Immunization (NACI) recommends you speak with your health care provider to determine if the benefits of the vaccine outweigh the potential risks.

You will be asked to provide verbal confirmation that you have consulted your treating provider when you arrive at the clinic.

Although pregnant and breastfeeding people were not a part of clinical trials for any of the vaccines, real world evidence shows that mRNA vaccines (Moderna or Pfizer) are safe for this population. A review following vaccination of over 35,000 pregnant women in the United States demonstrated that these women developed strong immunity without safety issues.

The National Advisory Committee on Immunization (NACI) strongly recommends that pregnant or breastfeeding individuals receive a complete mRNA vaccine series.

See the COVID-19 Vaccination Pregnancy Decision Making Tool for more information about vaccination during pregnancy and while breastfeeding.

There is no need to avoid pregnancy following vaccination with mRNA vaccines.

1. If you have a history of significant allergic reactions and/or anaphylaxis to any food, drug, venom, latex, or other allergens not related to mRNA vaccines, you can be vaccinated with and will be asked to wait 30 minutes for observation after you receive your vaccine.
2. If you have allergy issues such as allergic rhinitis, asthma or eczema, you can be vaccinated, and will be asked to wait 15-30 minutes after your vaccine for observation.
3. If you have had an allergic reaction and/or anaphylaxis that occurred after a vaccine, an investigation will need to be done by your local health department. If you have a history of a reaction to a vaccine outside of the normal side effects, please phone the Durham Health Connection Line to have them initiate an investigation.
4. If you have had an allergic reaction including anaphylaxis to a previous dose of a COVID-19 mRNA vaccine or to any of its components, you should not receive any mRNA COVID-19 vaccine in a general vaccine clinic. An investigation will need to be completed by your local health department. If you experienced an allergic reaction including anaphylaxis, please phone the Durham Health Connection Line to have them initiate an investigation.

The components include polyethylene glycol and, due to potential cross-reactivity, polysorbate.

• Delay vaccination if you:
  • have a fever, or
  • are sick with COVID-19 symptoms, or
  • have received a vaccine in the past 14 days, or
  • were diagnosed with myocarditis or pericarditis following mRNA vaccination.
• If you are on blood thinner medication, a smaller needle will be used, and you will need to apply pressure for longer after getting the vaccine to reduce bruising.

As a precautionary measure, individuals who were diagnosed with myocarditis/pericarditis after a previous dose of an mRNA COVID-19 vaccine should wait to receive their second dose until more information is available. The National Advisory Committee on Immunization (NACI), Public Health Ontario (PHO) and the Ministry of Health continue to follow this closely and will update this recommendation as more evidence becomes available.

Yes. Individuals who previously tested positive for COVID-19 are encouraged to get the vaccine if they are no longer symptomatic and meet other eligibility criteria.

Reinfections with COVID-19 are possible, it is important to protect yourself by getting the vaccine.

Seek medical attention if you have trouble breathing, develop hives, or develop swelling of the face and throat. As with all vaccines, vaccine side effects will continue to be monitored as people receive the vaccine.

If you develop a reaction to the vaccine, contact your health care provider who will report the side effect directly to public health. Public health will keep track of the reported side effects to make sure the vaccine continues to be safe.

• Individuals with a severe allergy (anaphylaxis) to any previous COVID-19 vaccine(s) or any part of its packaging.
  • Polyethylene glycol (PEG) is in both vaccines. It can also be found in laxatives, makeup, skin care products, personal lubricants, toothpastes, and some contact lenses. It is also in cough syrup and in some food and drinks. If you are unsure of the ingredients you are allergic to, talk to a health care provider.
  • Polysorbate 80 is found in both viral vector-based vaccines (AstraZeneca and Janssen). Polysorbate 80 can also be found in medical preparations (vitamin oils, tablets, and anticancer agents), cosmetics.
• Individuals who are not in the authorized age group should not be offered the vaccine.
• Individuals who are ill with COVID-19 symptoms should wait until they are feeling better.
• Individuals who are unwell for reasons other than COVID-19 should wait until they are feeling better.
• Individuals who received another vaccine (not a COVID-19 vaccine) in the past 14 days.

The following individuals should discuss the vaccine with their health care provider for further assessment:

• Individuals who are immunosuppressed due to disease or treatment.
• Individuals with an autoimmune condition.

Creating a new vaccine can take years. The COVID-19 vaccine happened so quickly for many reasons including:

• advances in science and technology,
• international collaboration among scientists, health professionals, researchers, industry and governments; and
• increased funding to find a vaccine.

Health Canada developed a fast-track review process to assess COVID-19 vaccines. Vaccine manufacturers were able to submit research and new evidence for review by Health Canada as it becomes available and throughout clinic trials. Previously, all clinical trials had to be completed prior to applying for Health Canada approval. Health Canada has implemented greater scientific resources, so reviews are completed in a timely manner without compromising any standards for vaccine use in Canada.

Vaccines are only approved once evidence shows that COVID-19 vaccines are safe, effective, of good quality and that the benefits outweigh any risks.

Check out this video for more information about how the COVID-19 vaccine was developed.

The clinical trials included over 70,000 people; 43,448 people were included in the Pfizer trials; 30,000 people were included in the Moderna vaccine trials.

Approximately 42 per cent of global participants have racially and ethnically diverse backgrounds.

Clinical trials include a wide variety of people to be sure the evidence will support the diverse needs of our population. There are some groups of people who were not included in the clinical trials, including people who are pregnant or breast/chestfeeding, people under the age of 16, or people who have weaker immune systems. Vaccine clinical trials typically start with healthier people and, if successful, go on to other at-risk populations. This can take additional time to decide if a vaccine is effective but is very important as these people are at greater risk of adverse COVID-19 impacts.

The vaccine trials included people over the age of 65 and the vaccine was found to be safe and effective in this age group.

The clinical trials included over 55,000 people; 44,325 people were included in the Janssen trials; 11,636 people were included in the AstraZeneca vaccine trials.

Approximately 20 per cent of global participants in the AstraZeneca trials and 40 per cent of global participants in the Janssen trials have racially and ethnically diverse backgrounds;

The majority of the people in the clinical trials were under the age of 65 and healthy. There are some groups of people who were not included in the clinical trials, including people who are pregnant or breastfeeding, people under the age of 18, or people who have weaker immune systems. Vaccine clinical trials typically start with healthier people and, if successful, go on to other at-risk populations. This can take additional time to decide if a vaccine is effective but is very important as these people are at greater risk of adverse COVID-19 impacts.

Credible information is based on up-to-date evidence that comes from proper research. Unless you have special training in ‘research methods’, it can be hard to tell if health information is based on proper research. Look for the following when trying to find credible information:

• Is the information current?
  The website should clearly show when the information was posted, reviewed or last updated. The dates can often be found at the bottom of the page.
• Is there evidence to support the advice?
  Even an expert opinion is still just a point of view unless it’s supported by evidence. The site should provide references and sources for evidence such as articles from trustworthy medical journals or texts or include reports or statistics.
• Is the information peer reviewed?
  Peer reviewed means that it has been reviewed by other experts in the field. The site should specify the type of peer review (for example, a board or committee of experts that is not in a conflict of interest). Websites that are not peer reviewed may have unproven claims that seem too good to be true. Unfortunately, when something seems too good to be true, it usually is.
• Does the site explain or provide references?
  The website should be specific about the source of any information by providing a list of references, studies or articles.

• Government of Canada: Vaccines for COVID-19
• Government of Canada: Recommendations on the use of COVID-19 vaccines
• Ontario’s COVID vaccines for Ontario
• Ontario’s COVID-19 Vaccination Plan
• Ontario’s COVID-19 pharmacy vaccine locations
• Public Health Ontario: COVID-19 vaccines
• Public Health Ontario: COVID-19 vaccines: mRNA vaccines
• Facts about.... COVID-19 vaccines
• Durham Region Health Department COVID-19 Update page

• Scarborough Health Network
• Sick Kids
• Vaccine Confidence Line (available at the Provincial Vaccine Contact Centre)
  1-833-943-3900 (TTY for people who are deaf, hearing-impaired or speech-impaired: 1-866-797-0007)

Fact: None of the COVID-19 vaccines approved for use in Canada use the live virus that causes COVID-19. The vaccines work by teaching the immune system how to recognize and fight the "spike proteins" found on the COVID-19 virus. Sometimes this process can cause symptoms, such as fever. These symptoms are a sign of the immune response to vaccine. These symptoms are minor and resolve in a few days. Most people who get the vaccine continue to go about their daily activities as usual.

After getting the COVID-19 vaccine, it takes about two weeks to build immunity. It is possible that someone could become infected with the COVID-19 virus before or just after getting the vaccine and get sick. This happens because the vaccine has not had enough time to provide protection in the body.

Fact: COVID-19 vaccines do not alter your DNA. mRNA vaccines do not affect or interact with DNA and mRNA is destroyed by cells once the body has finished using its instructions.

Fact: mRNA technology has been around and studied for over two decades, it is not new technology but is a new platform for vaccines.

Fact: The COVID-19 vaccines were developed quickly. This is because of advances in science and technology, international collaboration among scientists, health professionals, researchers, industry and governments, and increased funding to find a vaccine.

Health Canada developed a fast-track review process to assess COVID-19 vaccines. Vaccine manufacturers are able to submit research and new evidence for review by Health Canada as it becomes available and throughout clinic trials. Previously, all clinical trials had to be completed prior to applying for Health Canada approval. Health Canada has implemented greater scientific resources, so reviews are completed in a timely manner without compromising any standards for vaccine use in Canada.

Vaccines are only approved once evidence shows that the vaccine is safe, effective, of good quality and that the benefits outweigh any risks; the COVID-19 vaccine is not an exception to this important rule.

Fact: The first two COVID-19 vaccines authorized for use in Canada contain mRNA and other, normal vaccine ingredients, such as fats (which protect the mRNA), salts, as well as a small amount of sugar. These COVID-19 vaccines were not developed using fetal tissue, and they do not contain any material, such as implants, microchips or tracking devices. The Pfizer-BioNTech and Moderna vaccines do not contain gelatin or pork products.

Fact: In Canada there is ongoing monitoring and reporting of every vaccine given. If a reaction occurs after getting a vaccine that is not one of the normal side effects, an adverse event following immunization (AEFI) form is completed by your health care provider. The AEFI form will detail what vaccine was received, when it was received, the reaction that occurred and how long it took the reaction to appear after the vaccine was given.

Fact: During the clinical trials for both the Pfizer-BioNTech and Moderna COVID-19 vaccines, seven cases of Bell’s palsy were reported weeks after receiving the vaccine. More than 70,000 people were involved in the two clinical trials. The frequency of these cases is no greater than the frequency of Bell’s palsy in the general population.

Fact: The COVID-19 vaccine is safe and effective.

With any medication, the COVID-19 vaccine can have side effects but most of them are mild and short term, not serious or dangerous. Some people who receive the vaccine experience pain where they were injected, body aches, headache or fever lasting a day or two. These side effects are a sign of the immune response to vaccine. These symptoms are minor and resolve in a few days. Most people who get the vaccine continue to go about their daily activities as usual.

Becoming infected with the COVID-19 virus can lead to a variety of symptoms ranging from mild to severe. The most common symptoms of COVID-19 are fever, dry cough, and tiredness. Other symptoms that are less common and may affect some patients include loss of taste or smell, aches and pains, headache, sore throat, nasal congestion, red eyes, diarrhea, or a skin rash. Complications from COVID-19 can include serious conditions, like pneumonia or kidney failure and, in some cases, death.

At this time, we know the COVID-19 vaccine helps to fight off COVID-19 if you come into contact with it, but we do not know if you are able to pass it to others.