COVID-19 Vaccines

The following individuals are at increased risk of COVID-19 disease and should receive COVID-19 vaccine dose(s) as soon as it becomes available in the fall and should receive an additional dose in the spring:

• Adults 80 years and older.
• Adult residents of long-term care homes and other congregate living settings for seniors.
• Individuals six months of age and older who are moderately to severely immunocompromised (due to specific underlying condition or treatment).*
• Individuals 55 years and older who identify as First Nations, Inuit, or Metis and their non-Indigenous household members who are 55 years and older.

Adults aged 65 to 79 years should receive COVID-19 vaccine dose(s) as soon as it becomes available in the fall and may receive an additional dose in the spring. Certain individuals in this age group are at increased risk of severe COVID-19 disease and would benefit from doses in the fall and spring.

*Individuals with immunocompromising conditions, including those receiving immunosuppressive therapy, are at increased risk for prolonged infection, serious complications from SARS-CoV-2 infection as well as reduced immune responses to vaccination. Additional doses may help improve the immune response and vaccine effectiveness.

The following individuals are considered to be moderately to severely immunocompromised and are recommended to receive an additional dose this spring:

• 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). See re-vaccination information.
• Immunocompromised due to chimeric antigen receptor (CAR) T cell therapy targeting lymphocytes. See re-vaccination information
• 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 last 12 months before starting vaccine series, or severe immune compromise with CD4 <200 cells/µL 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.

The following individuals are at increased risk of SARS-CoV-2 exposure or severe COVID-19 disease and should receive COVID-19 vaccine dose(s) as soon as it becomes available in the fall:

• Residents in long-term care homes and other congregate living settings who are aged 17 years and under.
• Pregnant individuals.
• Individuals from First Nations, Métis and Inuit communities who are aged 54 years and under.
• Members of underserved communities.
• Health care workers and other care providers in facilities and community settings as per NACI.
• Individuals six months of age and older with underlying medical conditions, including children with complex health needs.

The following individuals, may receive COVID-19 vaccine dose(s) as soon as it becomes available in the fall:

• Children six months to four years of age.
• Individuals with significant exposure to birds or mammals through interactions with birds or mammals (such as poultry, livestock, slaughterhouse and processing plant workers, wildlife officers/researchers, and veterinarians)

Not previously vaccinated

A primary series should be initiated or completed during fall 2025.

A primary series of one (1) dose of COVID-19 vaccine is recommended for those aged five years and older who have not received any COVID-19 vaccines prior to the 2025-2026 season and are not immunocompromised. For those aged five and older who have not been previously vaccinated and are moderately to severely immunocompromised, two (2) doses are recommended for a primary series, and a third dose may also be offered.

A primary series of two (2) doses of COVID-19 vaccine is recommended for children aged six months to four years who have not received any COVID-19 vaccines prior to the 2025-2026 season and are not immunocompromised. For those aged six months to four years who have not been previously vaccinated and are moderately to severely immunocompromised, three (3) doses are recommended for a primary series.

Previously vaccinated

High-risk populations groups 1 and 2 should, and priority populations may receive doses as soon as they are available. The general population may receive doses starting on October 27, 2025.

For more information about vaccine schedules and intervals for previously vaccinated individuals, see Ontario Ministry of Health updates.

Re-vaccination

Speak to your health care provider if you have received a hematopoietic stem cell transplant (autologous or allogeneic) or have had (CAR)-T-cell therapy after previous COVID-19 vaccination(s).

Individuals must:

• Be eligible for a dose of COVID-19 vaccine. For more information, see the Ontario Ministry of Health updates.
• Be unable to leave home due to medical, physical, cognitive or psychosocial needs/conditions. Lack of transportation is not considered a barrier.
• Consent to receiving the vaccine in their home.
• Have no contraindications to the COVID-19 vaccine.
• Have been advised by their health care provider (e.g. family doctor, specialist, nurse practitioner) to receive the vaccine.

If you or someone you know meets the above criteria, you may be eligible for COVID-19 vaccine homebound immunization. Some pharmacies offer homebound vaccination services, check with your local participating pharmacy.

Please check back in the fall of 2026 for Health Department homebound COVID-19 vaccine appointment availability.

• As of March 13, 2026, COVID-19 enhanced vaccine certificates will no longer be available for print or download.
• Starting in fall 2026, individuals with a green photo health card can view and download COVID-19 vaccine records using the Immunize Connect Ontario (ICON) online portal.
• If you do not have computer, a photo health card, or need help, call the Durham Health Connection Line at 905-668-2020 or 1-800-841-2729.

For more information, visit the COVID-19 Vaccination Portal.

Why should I get my child vaccinated? They don’t get as sick from COVID-19.

Not all children have only mild symptoms. Vaccination is the preferred and safest method to provide additional protection for all children, including those six months to under five-years old. Having children vaccinated also provides further protection to their family members, especially if they have family members who are at risk for more severe illness.

Even if a child has already had COVID-19, vaccination is still important. While infection alone provides some protection, vaccination after infection helps further improve the immune response.

Have long-term side effects of the COVID-19 vaccine for children been determined?

COVID-19 vaccines, like all medicines can cause side effects, although not everyone may experience them. The most frequently reported short-term side effects for children following the COVID-19 vaccine include redness and pain at injection site, fatigue, headache, chills, muscle aches and loss of appetite. These side effects are typically mild to moderate and on average did not last longer than three days.

My child is afraid of needles. How can I help them?

We know it’s normal for kids to be anxious about getting needles. Here are some tips:

Before the appointment:

• Talk about what to expect (explain that the needle might feel like a pinch that only lasts a few seconds).
• Explain why the vaccine is important (to them, to their family, to school mates, etc.).
• Talk to them about what might work best for them. Is it a favourite stuffy? Do they need to listen to music or play a game on your phone/table to help keep them distracted?

During the appointment:

• Stay calm yourself! Children see and feel what their parents are doing. Speak in a positive, normal voice to help calm your child. Demonstrate a calm optimistic presence. Take slow breaths before, during and after the needle together.
• If your child is small enough, you can hold them on your lap while they get their vaccine.
• Practice deep breathing exercises together. For example - try square breathing. Picture a square. Each inhale lasts four seconds and is one side of the square, moving clockwise and alternating.
• If using distraction, choose a distraction that involves multiple senses (sight, hearing and touch).

The Health Department also encourages you to look at the CARD system to help your children through the vaccine process. Comfort Ask Relax and Distract. Get more information from the Government of Ontario's resource Nervous About Getting Needles? Immunizers at our clinics are familiar with the CARD system.

What if my child has allergies?

• Children with severe food, insect bite and medication allergies should receive the COVID-19 vaccine and will be monitored for a longer period at the clinic after getting their vaccine.
• COVID-19 vaccines do not contain preservatives, antibiotics, adjuvants, common food allergens, human materials, and animal derived materials.

If your child has had a severe allergic reaction to a vaccine or medical product, please speak with your child’s health care provider prior to getting the vaccine. The vaccine is not recommended for your child if they have had a known allergic reaction to a previous dose of the COVID-19 vaccine or a vaccine ingredient.

Learn more about COVID-19 vaccination for children

• Walk through one of our children’s clinics with a public health nurse
• Colton shares why he is happy to get the COVID-19 vaccine
• Hear how these three sisters feel about getting the COVID-19 vaccine

What options are available to help decrease my child’s pain and/or fear of needles?

Up to two thirds of children experience some type of fear of needles. Some tips for parents and caregivers to help reduce pain and fear of needles include:

• Preparing your child before the appointment.
• Use of topical anesthetics prior to vaccination (discuss application with your child’s pharmacist or health care provider).
• Your presence as a parent or caregiver to offer support during vaccination.
• Letting your child sit on your lap if possible.
• Distraction such as toy, singing, special object, counting or electronic device.
• Being honest. For example., Instead of saying, "the needle won’t hurt", you could say, "some people feel pressure or a pinch".
• Encouraging your child to relax their arm and be still
• Remaining calm and positive

Please speak to your child’s health care provider if you have questions or concerns about pain management and needle fear.

When should I call a health care provider if my child is feeling unwell after their vaccine?

If your child has a high fever (over 40°C or 104°F) or side effects that are worrying you or do not seem to be going away after a few days, contact your child’s health care provider or seek medical attention.

Go to the nearest emergency department or call 911 if they have serious drowsiness, seizures/convulsions, hives, swelling of the face, throat or mouth, trouble breathing or other serious symptoms.

Seek medical attention if your child develops any of the following symptoms after receiving the vaccine: chest pain, shortness of breath and/or palpitations (pounding or racing heart) or feeling of a rapid or abnormal heart rhythm. These may be symptoms of myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the sac of the heart), which is very rare and treatable.

Is Novavax Nuvaxovid® COVID-19 vaccine available for eligible adults?

Novavax (non-mRNA) vaccine is not currently available in Ontario. Speak with your health care provider if you are unable to receive an mRNA vaccine.

Are there any side effects?

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

Common side effects reported in clinical trials for these vaccines include:

• Pain, tenderness, itchiness, redness or swelling at the injection site
• Headache
• Tiredness or feeling unwell
• Muscle or joint pain
• Fever or chills
• Nausea
• Swelling or tenderness under the armpit (Moderna only)
• Vomiting or diarrhea

In rare cases, serious allergic reactions (anaphylaxis) can occur. Seek immediate medical attention if you have trouble breathing, have hives, or swelling of the face and throat.

Rare cases of myocarditis (inflammation of the heart muscle) and/or pericarditis (inflammation of the lining around the heart) have been reported following vaccination with COVID-19 mRNA vaccines.

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

Can COVID-19 vaccines be mixed?

mRNA vaccines (Pfizer and Moderna)

• Yes, the National Advisory Committee on Immunization (NACI) recommends that regardless of which product is offered to start a primary series, the series can be safely completed with another mRNA vaccine.
• A mixture of COVID-19 vaccine formulations (e.g., KP.2, JN.1, XBB, L.P.8.1) can be used to complete a primary series. The previous dose(s) should be counted, and the series does not need to be restarted.
• Mixing COVID-19 vaccines is safe, effective, and enables Ontarians to benefit from the protection of a booster dose.

Novavax Nuvaxovid®

Novavax is not currently available in Ontario. Individuals may receive mixed doses of Novavax Nuvaxovid® and mRNA vaccines. Those who are unable to receive an mRNA vaccine, should speak with their health care provider.

Do the COVID-19 vaccines contain mercury, formaldehyde, aluminum or fetal cells?

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

Are the COVID-19 vaccines halal?

Yes, the two mRNA vaccines Pfizer-BioNTech and Moderna are halal, they do not contain gelatin or pork products.

Are the mRNA vaccines vegan?

Yes, the mRNA COVID-19 vaccines are vegan. The lipids and cholesterol are plant-based or synthetic. There are no pork-derived materials, blood fractions or fetal cell products.

Can I get a a dose of the vaccine if I was diagnosed with myocarditis/pericarditis after a COVID-19 vaccine?

In most circumstances, further doses of mRNA COVID-19 vaccines should be deferred for people who experienced myocarditis (with or without pericarditis) within six weeks of receiving a previous dose of an mRNA COVID-19 vaccine.

Individuals with a history of pericarditis and who either had no cardiac investigation or normal cardiac investigations, can receive the next dose once they are symptom free and at least 90 days has passed since vaccination.

The National Advisory Committee on Immunization (NACI), Public Health Ontario (PHO), and the Ontario Ministry of Health (MOH) are following this closely and will update this recommendation as more evidence becomes available.

Can I get the vaccine if I am immunocompromised?

Since all Health Canada authorized COVID-19 vaccines are not live vaccines, they are considered safe in autoimmune conditions and immunocompromised persons (due to disease or treatment), however there is limited data on efficacy.

Individuals who were immunocompromised due to disease or treatment were excluded from some of the Phase III trials for COVID-19 vaccines available at present and those with autoimmune conditions had very small representation.

Individuals that are moderately to severely immunocompromised are recommended to receive their primary series in the fall but can begin or finish their primary series in the spring. An additional dose of COVID-19 vaccine is recommended in the spring for those who have completed their primary series and are moderately to severely immunocompromised, with a three to six month interval from their previous dose.

Some immunocompromised individuals may be eligible for additional dose(s) following a discussion with your health care provider.

For more information, visit three-dose primary series and boosters for individuals who are immunocompromised.

Can I get the vaccine if I am pregnant and/or breastfeeding?

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 vaccines in pregnancy website for more information about vaccination during pregnancy and while breastfeeding.

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

The Scarborough Health Network’s VaxFacts Clinic, in partnership with Scarborough Health Network’s VaxFacts, is available to support people who are pregnant, breastfeeding or planning to conceive. Book a 1:1 appointment to discuss your questions or concerns related to the COVID-19 vaccine.

Can I get vaccinated if I have had previous allergic reactions?

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 to 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 call the Durham Health Connection Line at 905-668-2020 or 1-800-841-2729 to have them initiate an investigation.

4. If you have had an allergic reaction including anaphylaxis to a component of a COVID-19 mRNA vaccine, you should not receive any COVID-19 mRNA vaccine in a general vaccine clinic. Please contact your health care provider to assess your need to receive a COVID-19 mRNA vaccine in a controlled setting.
   
   If you experienced an allergic reaction including anaphylaxis following a COVID-19 mRNA vaccine, an investigation will need to be completed by your local health department. Please call the Durham Health Connection Line at 905-668-2020 or 1-800-841-2729 to have them initiate an investigation.

If a person develops an adverse reaction to a vaccine, what should they do?

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. Please call the Durham Health Connection Line at 905-668-2020 or 1-800-841-2729 to have them initiate an investigation. Public health will keep track of the reported side effects to make sure the vaccine continues to be safe.

How was Health Canada able to approve the COVID-19 vaccine so quickly?

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.

To learn more about COVID-19 vaccine and the approval process, visit Health Canada's website.

• Talk to your health care provider
• Book a phone appointment with expert doctors to discuss any questions or concerns about vaccines through the Scarborough Health Network VaxFacts Clinic.
• Provincial call line (multiple languages)
• COVID-19 communication resources
• Government of Canada - vaccines for children: COVID-19
• Max the vax – a web page full of COVID-19 vaccination related resources for kids and caregivers; available in both English and French
• About Kids Health
• Immunize Canada
• Canadian Pediatric Society

• COVID-19 vaccines and Indigenous Peoples - Government of Canada
• Vaccine facts - Government of Ontario: Questions and answers about COVID-19 vaccines (multiple languages)
• Indigenous Primary Health Care Council
  • Vaccinating youth aged 12 - 17
  • Variants of concern
  • Variant of concern: Omicron
  • Guide to isolating
  • Indigenous prioritization for vaccination
  • Post-vaccination COVID-19 cases
• Indigenous vaccine posters
• Information and resources to build vaccine confidence for First Nations, Inuit and Metis People
• COVID-19 Indigenous awareness resources - Government of Canada
• Ministry of Health - COVID-19 documents in other languages
• First Nations, Inuit and Métis perspectives and knowledge sharing on COVID-19 vaccines - Women’s College Hospital Partners