Health Care Providers COVID-19 Vaccine Information

Contact(s)

Child and Youth Vaccination

Key Sources of Information on Child/Youth COVID-19 mRNA Vaccines for Health Care Providers:

Additional:

COVID-19 Vaccine Resources

mRNA Vaccines

Patient Information

Health Care Provider Resources

Statement from the National Advisory Committee on Immunization (NACI, June 17, 2021):

“Individuals who received a first dose of an mRNA vaccine (Pfizer-BioNTech, Moderna) should be offered the same mRNA product for their second dose. If the same product is not readily available, or the product used for the first dose is unknown, another mRNA vaccine is considered interchangeable and should be used to complete the series.”

Viral Vector Vaccines

Individuals 18 years of age or older are only able to receive AstraZeneca only in the following circumstances:

  1. An allergist/immunologist’s assessment of an allergic reaction to a previous dose of an mRNA COVID-19 vaccine or any components of an mRNA COVID-19 vaccine indicate they require access to the AstraZeneca COVID-19 vaccine.
  2. A specialist’s assessment of an AEFI following a first dose of an mRNA COVID-19 vaccine determines that the individual requires access to the AstraZeneca COVID-19 vaccine for their second dose.

Due to limited supply of AstraZeneca in the province, AstraZeneca will be reserved strictly for only those who meet conditions 1 and 2. Those who have received their first dose of AstraZeneca that do not meet conditions 1 and 2 can get an mRNA to complete their series.

Anyone receiving the AstraZeneca COVID-19 vaccine should be informed of the risk of Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) and advised to seek immediate medical attention if they develop symptoms of VITT (NACI).

AstraZeneca must not be administered to anyone younger than 18 years of age.

Health Canada information on AstraZeneca COVID-19 vaccine

Vaccine Recommendations Regarding Specific Health Conditions

On May 28, 2021, the National Advisory Committee on Immunization (NACI) provided an update to its Recommendations on the use of COVID-19 vaccines for individuals who are immunosuppressed, have an autoimmune conditions, are pregnant or breastfeeding:

NACI preferentially recommends that a complete two-dose vaccine series with an mRNA COVID-19 vaccine (Pfizer-BioNTech, Moderna) should be offered to individuals in the authorized age group, including those who are immunosuppressed, have an autoimmune condition, are pregnant or are breastfeeding. If they are not able to receive an mRNA vaccine, for example because of an allergy, another authorized COVID-19 vaccine should be offered.

mRNA vaccines are preferred for use during pregnancy, due to recently published data from a study in the United States indicating the mRNA COVID-19 vaccines are safe in pregnant women. In addition, treating Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) during pregnancy, should it occur following the administration of a viral vector vaccine, can be complex.

Individuals who are immunosuppressed from disease or treatment should be informed that they may have a reduced immune response to any authorized COVID-19 vaccine series.

Individuals who are immunosuppressed, have an autoimmune condition, or who are pregnant or breastfeeding should be informed of the latest evidence on the safety of mRNA COVID-19 vaccines in order to make informed decisions.

Vaccine safety and effectiveness in these populations will continue to be closely monitored, and NACI will update recommendations as needed.”

Addressing Vaccine Hesitancy

COVID-19 Vaccine Dosing Intervals

All individuals 12 years of age and older are eligible to receive a second dose of an mRNA vaccine. The ComirnatyTM (Pfizer-BioNTech) vaccine should be administered at no less than a 21 day interval, and the SpikeVaxTM (Moderna) at no less than 28 days between vaccinations.

The province recommends a minimum interval of eight weeks between the first and second dose of AstraZeneca, however, the appropriate interval should be discussed with the individual’s allergist/immunologist or specialist but must align with the product monograph recommended interval of 4-12 weeks. The AstraZeneca dose administration interval may be based on the allergist/immunologist or specialist’s recommendation as appropriate.

COVID-19 mRNA vaccines that are administered as a booster dose (third shot) to elderly individuals in congregate care facilities (e.g. Long-Term Care, high-risk Retirement Homes, Elder Care Lodges) are eligible to receive it five months following their second dose.

Third doses of COVID-19 mRNA vaccines that are administered as a third dose to complete a primary series in immunocompromised individuals (see Eligibility Criteria for Third Doses tab) are recommended to receive it a minimum of eight weeks (56 days) following their second dose.  As per NACI, the minimum interval should be 28 days, to promote a stronger immune response. The treating provider may adjust the timing to optimize the immune response from the vaccine series and minimize delays in management of their underlying condition.

Eligibility Criteria for Third Doses

The individuals currently eligible for a third dose are limited to:

  • Individuals aged 70 and over (born in 1951 or earlier);
  • Health care workers and designated essential caregivers in congregate settings (including long-term care home and retirement home staff and designated caregivers).  See COVID-19 Vaccine Third Dose Recommendations (November 3, 2021) for more specific information on how health care workers are being defined for the purposes of third dose eligibility;
  • Individuals who received a complete series of a viral vector vaccine (two doses of the AstraZeneca vaccine or one dose of the Janssen vaccine);
  • First Nation, Inuit and Métis adults and their non-Indigenous household members;
  • Transplant recipients (including solid organ transplant and hematopoietic stem cell transplants);
  • Patients with hematological cancers (examples include lymphoma, myeloma, leukemia) on active treatment (chemotherapy, targeted therapies, immunotherapy) for malignant hematologic disorders;
  • Residents of high-risk congregate settings including long-term care homes, retirement homes and First Nations elder care lodges;
  • Those undergoing active treatment for solid tumors;
  • Those who are in receipt of chimeric antigen receptor (CAR)-T-cell;
  • Those with moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome);
  • Stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome; and
  • Those undergoing active treatment with a qualifying immunosuppressive agent. A list of qualifying immunosuppressive agents can be found in Table 1 of the updated Ministry of Health document COVID-19 Vaccine Third Dose Recommendations (November 3, 2021)

See also: Guide to Verifying Immunosuppressive Prescriptions for Third Doses of COVID-19 Vaccine (Ontario Ministry of Health)

COVAXon Basics for Health Care Providers

Getting Involved in COVID-19 Vaccine Administration

How do I order COVID-19 vaccine for my practice/clinic?

If you are interested in ordering COVID-19 vaccine for your practice and/or clinic, please contact the Health Unit at covidinventory@healthunit.ca  

In order to provide COVID-19 vaccine in the province of Ontario, you must have access to the Covax documentation system. The Health Unit is able to request access to Covax for you and/or your staff and can provide a brief virtual orientation session to Covax and the COVID-19 vaccine ordering process. Please contact the health unit at covax@healthunit.ca for more information.

If you are a pharmacy and would like to start offering the COVID-19 vaccine, you must contact the Ontario Pharmacists Association for further direction on how to get involved in the COVID-19 vaccine roll-out. COVID-19 vaccine allocation is provided to pharmacies directly from the Ministry of Health in partnership with the Ontario Pharmacists Association. Pharmacies use Covax for documentation and can reach out to the Health Unit for further information and/or training related to Covax.

How do I get involved in working in a COVID-19 mass immunization clinic as a physician, nurse practitioner, or pharmacist?

If you're interested in getting involved in vaccinating at a mass immunization clinic, please contact the Health Unit at covax@healthunit.ca for information. 

How to Request Access to Covax

Covax is the provincial documentation system for the COVID-19 vaccine. In order to provide vaccination in Ontario, you must have a profile in the Covax. The Health Unit is able to request access to Covax for you and/or your staff and can provide orientation to Covax and the COVID-19 vaccine ordering process. Please contact us at covax@healthunit.ca for further information.

How to Set a Password

You will receive an email from Salesforce, which contains a link. When you click on this link it will provide you with prompts to successfully set up your password. The link found in the email is only active for a 24-hour period.  You can contact the health unit to request a password reset if the link is no longer active.  

Covax is web-browser sensitive and the following web-browsers are recommended:

  • Safari
  • Edge
  • Mozilla Firefox
  • Chrome

2-Step Authentication

Each time you log on to Covax, you will need to validate your identity using Two-factor Authentication (2FA), (often referred to as 2-step authentication) which adds a second layer of security.

You will need to download the free Salesforce Authenticator App on your personal cell phone at the same time as you set up your Covax account. You will be prompted to use the 2-factor authentication each time you sign into Covax, and will need your cell phone each time you log on.

Contact us at covax@healthunit.ca if you require further assistance.   

How to Log On and Off

Open a new tab in your web browser and go to covaxon.my.salesforce.com.

Log on with your username and password. You will then be prompted to the 2-factor authentication using your personal cell phone. You can contact the provincial COVAXon support services desk at 1-888-333-0640 if you are having any difficulty logging on to Covax.

Log off can be found in the top right-hand corner of the Covax screen when you click on the little creature in the circle.

Covax is web-browser sensitive and the following web-browsers are recommended:

  • Safari
  • Edge
  • Mozilla Firefox
  • Chrome

How to Request a Password Reset

The Health Unit is able to request a password reset. Please contact us at covax@healthunit.ca to request a password reset.

Why my account isn't working (30 day de-activation) and how to resolve

Covax accounts are disabled after a 30-day period with no activity. The Health Unit is able to reactivate your Covax account. Please contact  us at covax@healthunit.ca to request a reactivation of your account.

How to Search for Clients

Using the tabs on the top of the Covax page, click on the ‘Client Search’ tab. This will open a window requesting the client's Ontario Health Card Number. Enter the Health Card number.

  • If the client has been entered into Covax, the search will generate a result.

  • If the client has not been entered into Covax, you will be prompted to search for the client in the Ontario Health Card Provincial registry using the health card number. 
  • If client has an Ontario Health Card number they will be found in the provincial registry, even if the client has an expired health card or an older red and white health card.
  • If a client has an Ontario Health Card and are not found in the system, please contact the COVaxon Support Desk Services for support. Do not create a new client record for client unless directed by the support desk. 

In Ontario, we provide free vaccine to all people, regardless of whether they are a permanent resident of Ontario. In the instance of vaccinating a client who does not have an Ontario Health Card, they will not be in the provincial registry and you may have to create the client. 

If this is the client's second dose of vaccine in Ontario, they will be in Covax. If this is the first dose of vaccine in Ontario, they may not be in Covax. 

Use other search parameters to attempt to search for client in Covax. If not found, create a new client record for client. 

Check-in, Dose Administration and Check-out

These functions are found in the upper right-hand corner of the client file. Once a client is connected to the correct vaccination event, you are able to click on the check-in, dose administration, and check-out functions to document that the client has received the vaccine and send the vaccine receipt to client via email. 

Contact the Health Unit at covax@healthunit.ca if you are having any difficulty using these functions in Covax, finding the correct vaccination event, or finding active inventory in the vaccination event.

Simpilfied Flow for Primary Care

This process was created for Primary Care Practitioners and combines the check-in, dose administration, and check-out functions into one simplified version. The simplified flow can be found in the top right-hand corner of the clients file. Click on simplified flow and follow the prompts.

Contact the Health Unit at covax@healthunit.ca if you are having any difficulty using simplified flow, finding the correct vaccination event, or finding active inventory in the vaccination event.

Vaccination Events

A vaccination event is a clinic and/or location that a client is receiving a vaccine. The vaccination event is created by the Health Unit when a vaccination order is made. When the vaccine is physically allocated to different locations the vaccination event is virtually allocated the vaccine. All clients who are vaccinated at a specific location need to be connected to the vaccination event in order to have their dose documented. 

Contact the Health Unit at covax@healthunit.ca if you are having difficulty finding the correct vaccination event, or finding active inventory in the vaccination event.

Note: Vaccination events can represent a mobile clinic, and are not necessarily physical locations. 

Inventory Reconciliation

Complete the inventory form after each day that COVID-19 vaccine doses have been administered.  

Offices can monitor their own inventory at the vaccination event level.  At the end of each day that your office/clinic/practice administers vaccine, ensure that your physical inventory matches the Covax inventory. 

Covax automatically adjusts inventory for all doses administered; however, all wastage, extra doses, or clients who do not provide consent will need to be adjusted manually. For more information on how to make these adjustments to the virtual inventory, the Health Unit can provide a 15-minute virtual live demonstration on how to make the adjustments. 

Contact us at covax@healthunit.ca if you are having difficulty reconciling your inventory. 

Emerging Research

PHO provides, and regularly updates, synopses of key research articles related to COVID-19:

Emerging Topics: Synopsis of COVID-19 Key Research Articles

COVID-19 Serology

COVID-19 Antibody (Serology) Testing Summary for Clinicians

Medical Exemptions to COVID-19 Vaccines

Medical Exemptions to COVID-19 Vaccination Version 1.0 (Ministry of Health, September 14, 2021)

See also: COVID-19 Information for Healthcare Providers, Hospitals and Long-Term Care

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705-746-5801

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