COVID-19 Vaccine Information, Questions and Answers

Information provided by the City of Toronto and the Province of Ontario. The information is up to date as of October 15, 2021.

Where will Vaccinations be taking place?

More information on City-operated clinics is available online: https://www.toronto.ca

City-operated immunization clinics are just one piece of the immunization plan for Toronto. Other immunization clinics will be operated by:

• Hospital partners
• Ontario Health Team and community partners
• Mobile clinic operations
• Targeted community response
• Family doctors and pharmacies

At present, health sector partners (coordinated by the City’s Ontario Health Teams and Local Health Integration Networks) are planning to operate a number community clinics, with additional locations coming online as the vaccination effort proceeds. The present planning includes:

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Timeline for Vaccine distribution

As of March 2, 2021, the timeline is:

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Booking an Appointment for COVID-19 Vaccine

Information as of June 11, 2021

Starting Monday, June 14 at 8:00 AM, people age 12 and older who received a first dose of Pfizer or Moderna vaccine on May 9 or earlier will be eligible to book their accelerated second dose appointment in the provincial booking system. Anyone 70 years of age or older, as well as anyone who received a first AstraZeneca vaccine more than 12 weeks ago is currently eligible to book accelerated second dose appointment. Bookings can be made through toronto.ca/covid-19 or by calling the provincial vaccine booking line at 1-833-943-3900 (TTY for people who are deaf, hearing-impaired or speech-impaired: 1-866-797-0007).

The provincial government is responsible for determining when people will receive vaccinations in accordance with provincial priorities and vaccine availability. Participants for each phase of vaccination have been and will be identified in accordance with the Province’s Ethical Framework for COVID-19 vaccine prioritization. The booking portal is live: covid-19.ontario.ca/book-vaccine

More information on the Province’s vaccination plan: https://covid-19.ontario.ca/covid-19-vaccines-ontario.

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Third Doses

Information as of October 15, 2021
For the general population, two doses of the COVID-19 vaccines provides strong protection against severe illness and hospitalization. This includes protection against the Delta variant of concern. Research shows that certain people with low immune response can benefit from a third dose.

On October 7, 2021, the Government of Ontario expanded eligibility for third doses  for the following groups of people:

Residents of long-term care homes, retirement homes, elder care lodges, and elderly living in other congregate settings (e.g. assisted-living facilities, chronic care hospitals, naturally occurring congregate retirement settings/congregate senior’s apartment buildings):

• A third dose can be given at a minimum of five months (20 weeks) after the second dose
• The Government of Ontario has identified Toronto settings that meet this criteria. At this time, only those that have been identified are eligible.
• Toronto Public Health is actively working with Toronto facilities to plan and implement this roll-out.

Moderately to Severely immunocompromised individuals

A third dose can be given at a minimum of eight weeks after the second dose for:

• People undergoing active treatment* for solid tumors and hematologic malignancies
• Recipients of a solid-organ transplant and taking immunosuppressive therapy
• Recipients of chimeric antigen receptor (CAR)-T-cell or hematopoietic stem cell transplant (within two years of transplantation or taking immunosuppression therapy)
• People with moderate or severe primary immunodeficiency (e.g. DiGeorge syndrome, Wiskott-Aldrich syndrome)
• People who have Stage 3 or advanced untreated HIV infection and people with acquired immunodeficiency syndrome
• People undergoing active treatment** with the following categories of immunosuppressive therapies: anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids (refer to the Immunization of Immunocompromised Persons -Canadian Immunization Guide   for suggested definition of high dose steroids), alkylating agents, antimetabolites, tumour-necrosis factor (TNF) inhibitors, and other biologic agents that are significantly immunosuppressive (see Table 1 of the COVID-19 Vaccine Recommendations for Third Doses )

*Active treatment includes people who have completed treatment within 3 months. Active treatment is defined as chemotherapy, targeted therapies, immunotherapy, and excludes people receiving therapy that does not suppress the immune system (e.g. solely hormonal therapy or radiation therapy).

**Active treatment for people receiving B-cell depleting therapy including people who have completed treatment within 12 months.

How to get your third dose vaccination:

• Your primary care provider (PCP) or specialist (or their office/clinic) will contact you directly to provide details on how to get vaccinated:
  • Some PCP/specialists are able to administer the vaccine in their practice/clinic
  • If your PCP/specialist is not able to administer vaccine on site, they will give you a referral form or letter confirming that you are eligible for a third dose. The letter must include your full name and address (matching your ID), and your Ontario Health Card Number. Please ensure your form or letter has all the required information before coming to clinic.
  • You must present the completed referral form or eligibility letter to a City-run clinic, hospital clinic or a pharmacy that administers COVID-19 vaccines.

If readily available, you should get the same vaccine that you got for your second dose for your third dose.

More information:

• Ministry of Health: COVID-19 Vaccination Recommendations for Special Populations  
• Ministry of Health: COVID-19 Vaccine Third Dose Recommendations  

Protecting our vulnerable citizens

The City program includes a strategy to reach vulnerable populations that will have five mobile teams available to provide vaccine clinics. Mobile teams will be able to be deployed to locations like shelters, food programs and drop-ins for individuals experiencing homelessness as well as high-risk individuals living in Toronto Community Housing residential and seniors’ buildings as needed. Toronto Paramedic Services will be providing a response team of 10 paramedics to support mobile vaccinations.

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How the Vaccines Work

Pfizer and Moderna

The coronavirus that causes COVID-19 disease has a “spike protein” that is only found on the virus surface. The vaccines give instructions to cells to make the spike protein so that the body can learn to recognize the virus. These instructions are called messenger RNA (mRNA). The body makes antibodies against the spike protein to protect us from getting sick if we are exposed to the virus. The vaccines do not contain the virus and so cannot give infect people with COVID-19.
Health Canada has approved the Pfizer-BioNTech and Moderna mRNA vaccines, which were tested in large clinical trials to make sure that they are safe and effective. In these trials, the vaccines were 94-95% effective. Millions of people around the world have been vaccinated against COVID-19.

AsteraZeneca Oxford

This vaccine is a “viral vector”: a weakened cold virus that is designed to teach the immune system how to fight COVID-19. This vaccine can be stored in normal fridges, making it accessible for pharmacies across Canada. To learn about the ingredients, and how it is given, visit: Canada.ca

Janssen

By Johnson and Johnson
This vaccine also uses the viral-vector method: a weakened cold virus is used to train the immune system how to fight it COVID-19. More information on ingredients and how it is given can be found at Canada.ca

Approved COVID-19 Vaccines

• Pfizer-BioNTech’s vaccine can be given to people 16 years and older with 2 doses at least 21 days apart.
• Moderna vaccine can be given to people 18 years and older with 2 doses at least 28 days apart.
• AstraZeneca vaccine can be given to people 18 years and older, with 2 doses at least 4-12 weeks apart
• Janssen vaccine can be given to people 18 years and older, with 2 doses given at least 2 weeks apart

The vaccines are safe for seniors and people with stable health conditions such diabetes and high blood pressure. People with stable hepatitis B, C or HIV, may receive COVID-19 vaccines. People with food, insect bite, medication or environmental allergies can get the vaccine as long as they do not have an allergy to any of the vaccine ingredients. If you allergy concerns, we recommend reviewing the list of non-medical ingredients in the vaccine in advance of getting it, or speaking with your family healthcare provider.

Important to Know

Both vaccines require two doses to provide the most protection. If you miss your second appointment, schedule another appointment as soon as possible. It may take another two weeks after your second dose for your body to build a good immune response against COVID-19. There is a small chance that you may still get COVID-19 after vaccination. Currently, there is no information on how long the vaccine’s protection will last. If vaccine protection decreases, a booster dose may be recommended in the future.

Side Effects and Risks

Some people may have side effects from the vaccines. Common side effects include:

• redness, pain or swelling at the injection site
• headache, feeling tired, muscle aches, joint pain
• fever, chills, nausea, vomiting
• pain or swelling under the armpit (in the Moderna vaccine only)
• enlarged lymph nodes (this is less common)

Side effects are more common after the second dose. Side effects usually last one to three days. The side effects can be a sign that your body is developing an immune response to the vaccine. In rare cases, serious allergic reactions (anaphylaxis) can occur. Allergic reactions can be treated and are usually temporary. Seek medical attention if you have trouble breathing, hives, or swelling of the face and throat. If you have a reaction to the vaccine, speak with your health care provider to report the symptoms directly to public health. Public health will track reported side effects to ensure vaccine safety.

Delay vaccination if you:

have a fever or COVID-19 symptoms. COVID-19 vaccine cannot be given with other vaccines. If you have just received a vaccine, wait 14 days before getting the COVID-19 vaccine.

Speak with a health care provider first, if you:

• are pregnant, could be pregnant or are breastfeeding
• have a bleeding disorder or weakened immunity due to illness or treatment
• had an allergic reaction within four hours after receiving your first dose of the COVID-19 vaccine

Do not get this vaccine if you:

• have known severe allergies/reactions to any vaccine ingredients, including polyethylene glycol or tromethamine (in Moderna vaccine only)
• had a severe reaction to your first dose of COVID-19 vaccine

Continue to protect yourself and others

Until there are enough vaccines for everyone, and until we know that the vaccine prevents the spread of most COVID-19 infections, it is important to continue physical distancing, wearing a mask, and staying home if you are sick. Health care and other staff must still wear personal protective equipment (PPE), even after vaccination.

What about people with autoimmune or immune-compromised conditions?

If you have an autoimmune or immunodeficiency condition, or are immunosuppressed due to disease or treatment, we can discuss the benefits and risks of vaccination given your particular situation. People with these conditions were not included in the trials for the currently available vaccines, although vaccination may still be a good idea for you to reduce your risk of infection.

Can people who have been vaccinated still spread the virus?

It is possible that people who have been vaccinated can still spread the virus. And while the vaccine appears to offer very high immunity for those who have received both doses – again, up to 95% – it is still not 100% effective. That’s why it is important to continue with current safety protocols, like social distancing and wearing appropriate PPE until further public health measures can be eased.

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For information on Vaccine availability, please check out the Frequently Asked Questions document below:

For more information:

Talk to your health care provider, or visit our website at toronto.ca/COVID19.
Ontario COVID-19 Vaccine information: covid-19.ontario.ca/getting-covid-19-vaccine-ontario

Resources

National Advisory Committee on Immunization. Recommendations on the use of COVID-19 Vaccines. January 12, 2021. Available at https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines.html