COVID-19 Vaccines (last update November 9, 2021)

Updated November 9, 2021

Starting November 6, the following vulnerable populations will be eligible for a booster dose of the COVID-19 vaccine, if at least six months have passed since their last dose:

o Individuals aged 70 and over (born in 1951 or earlier);

o Health care workers and any staff member working in-person in a health care organization, including workers not providing direct patient care but frequently in the patient environment;

o Designated essential caregivers in congregate settings (including long-term care home and retirement home staff and designated caregivers);

o Individuals who received a complete series of a viral vector vaccine (two doses of the AstraZeneca vaccine or one dose of the Janssen vaccine); and

o First Nation, Inuit and Metis adults and their non-Indigenous household members.

 

COVID-19 vaccine can be administered at the same time as influenza and other vaccines.

Appointments will be required for all first, second and third doses and walk-ins will no longer be offered at Halton Region Community COVID-19 vaccination clinics after Friday, November 5. Starting Saturday, November 6, eligible individuals can book appointments at a Halton Region Community COVID-19 Vaccination Clinic at halton.ca/covidvaccines.

Clinics are located at FirstOntario Arts Centre (Milton), YMCA (Oakville), Gary Allan Learning Centre (Burlington) and Gellert Community Centre (Halton Hills). COVID-19 vaccine is also available at more than 100 pharmacies across Halton Region, participating physician offices and pop-up clinics.

People are reminded that those who have received two doses of COVID-19 vaccine still have excellent protection against the virus. There is currently no evidence of widespread waning of protection against severe disease in the general Canadian population who have been fully vaccinated. However, lower vaccine effectiveness against severe disease has been identified mainly in residents in long-term care homes, with some evidence of decreased effectiveness in elderly adults, particularly those 80 years of age and over.

 

Updated October 1, 2021

Patient Eligibility for a 3rd Dose of COVID-19 Vaccine 

Note: Patient’s must meet one or more of the criteria below, additional reasons for referral will not be accepted.

☐ Recipient of a Solid Organ Transplant and taking immunosuppressive therapy.

☐ Recipient of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy).

☐ Individuals with moderate to severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome).

☐ Individuals with stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome.

☐ Individuals receiving active treatment1 for solid tumour or malignant hematologic disorders.

☐ Individuals receiving active treatment with the following categories of immunosuppressive therapies: anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22 – including those who have completed treatment within 12 months), high-dose systemic corticosteroids, alkylating agents, antimetabolites, or tumor necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive.

1 Active treatment includes patients who have completed treatment within 3 months. Active treatment treatment is defined as chemotherapy, targeted therapies, immunotherapy, and excludes individuals receiving therapy that does not suppress the immune system (e.g. solely hormonal therapy or radiation therapy). See Ontario Health/Cancer Care Ontarios Frequently Asked Questions for more information.
2 Active treatment for patients receiving B-cell depleting therapy includes patients who have completed treatment within 12 months.

To check if your medication qualifies you for a booster click here: https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/vaccine/COVID-19_vaccine_third_dose_recommendations.pdf

(look under “covid-19 vaccine third dose recommendations” on page 2 of the document)

PLEASE CONTACT OUR OFFICE IF YOU THINK YOU ARE ELIGIBLE TO RECEIVE THE COVID VACCINE TO RECEIVE IT IN OUR OFFICE OR TO GET A REFERRAL LETTER TO RECEIVE A VACCINE AT A PUBLIC HEALTH CLINIC OR PHARMACY.

 

Updated May 19, 2021

  •   Health Canada has authorized the use of the Pfizer-BioNTech vaccine for children 12 years and older only. To be eligible, children must have had their 12th birthday at the time of their first dose.
  •   All Halton residents 18+ are eligible to book appointments online at halton.ca/COVIDvaccines.
  •   Starting Friday, May 21, those eligible for a shortened interval (see below) will be able to reschedule their second dose appointment online at halton.ca/COVIDvaccines.
  •   Public Health Units are waiting for guidance from the Province regarding remaining supply of AstraZeneca vaccine and direction on second doses. As soon as we are given direction, we will communicate it to physicians and pharmacies through a COVID-19 Vaccine Update.SHORTENED INTERVAL ELIGIBILITY
  •   Starting Friday, May 21, eligible groups outlined below will be able to book their second dose appointment online at halton.ca/COVIDvaccines
  •  Physician completed exception forms are required for persons with medical exceptions:

– Transplant recipients including solid organ transplants and hematopoietic stem cell transplants (including patients waitlisted for transplant)
– Individuals with malignant hematologic disorders and non-hematologic malignant solid tumors receiving active treatment (chemotherapy, targeted therapies, immunotherapy) – excluding individuals receiving solely hormonal therapy or radiation therapy                                                  – Individuals undergoing hemodialysis or peritoneal dialysis

High-risk health care workers – only patient-facing health care workers are eligible at this time
– All hospital and acute care staff in frontline roles with COVID-19 patients and/or with a high-risk exposure to COVID-19, including nurses, personal support workers and those performing aerosol-generating procedures
– All patient-facing health care workers involved in the COVID-19 response
– Medical first responders (e.g.,paramedics)
– Community health care workers serving specialized populations (e.g., needle exchange/syringe programs, Indigenous health care service providers)
– Long-term care home and retirement-home health care workers, including nurses, personal support workers and Essential Caregivers
– Home and community health care workers, including nurses and personal support workers caring for recipients of chronic homecare and seniors in congregate living facilities or providing hands-on care to COVID-19 patients in the community

– All First Nations, Inuit and Metis people, as well as one household family member.

Updated May 12, 2021 

  • Today the Province of Ontario announced that it is pausing the administration of first dose AstraZeneca COVID-19 vaccine out of an abundance of caution and due to the increasing reports of Vaccine-Induced Thrombotic Thrombocytopenia (VITT).
  • The Province is currently determining how to provide second doses to those who received AstraZeneca.
  •  Second doses may possibly be provided by another vaccine. The Province will provide guidance on second doses of AstraZeneca shortly.
  • Physicians and pharmacists who are currently offering the AstraZeneca vaccine will receive further details about what to do with their current AstraZeneca supply.
  • People who received the first dose of AstraZeneca did the right thing. They were offered the first vaccine they were offered, protecting themselves and their community.

 

Updated May 7, 2021

Dear Patients,

Eligibility for the AstraZeneca (AZ) vaccine has been expanded to include those 40 and older. This is great news as it means more Ontarians will be able to have the protection offered through this vaccine. With Ontario facing the most devastating wave of COVID-19 yet, and more contagious variant strains circulating, it is so important that you protect yourself and that includes through vaccination. We are encouraging you to get vaccinated as soon as you can. If you still have questions after reading this information, please call our office.

Waiting for your ‘preferred’ vaccine risks potentially getting COVID-19 and associated illness. Everyone needs to individually weigh their risks of becoming seriously ill from COVID-19. There are many factors including personal health, possible COVID contacts through work, etc. and which region you live in. In Halton (which is considered high risk) in most circumstances,  the first vaccine available to you would be your best option. If you need help to decide which is best for you personally, please call our office to set up an appointment to discuss with us.  Only COVID-19 vaccines that Health Canada determines to be safe and effective are approved for use, and all are highly effective in preventing severe illness, hospitalization, and death from COVID-19, including AstraZeneca. Health Canada has determined that the benefits of the AstraZeneca/COVISHIELD vaccine in protecting Canadians from COVID-19 continue to outweigh the risks. This is the same advice we as family doctors give to our own family members and loved ones.

The benefits outweigh the risks in most cases– There is a lot of information out there. As you weigh the risk of potential vaccine side effects against the chance of contracting COVID-19 and perhaps becoming seriously ill or dying from the virus, please remember this: incidents of serious clotting from the AZ vaccine are extremely rare, these can be treated, and overall, the benefits of the AZ vaccine far outweigh the risks. The rare but serious side effect is thought to be immune mediated and does not develop through the same process as usual types of bleeding or clotting problems. A previous blood clot or family history of blood clots does not increase the risks of clotting from the AZ vaccine – in fact, COVID-19 infection can cause blood clots. As COVID-19 has been associated with causing blood clots, ALL COVID-19 vaccines continue to be recommended for people who have had a blood clot in the past, or who have a family history of blood clots and who are receiving blood thinning medications. See more information from Thrombosis Canada.

Healthcare professionals are aware of, and ready to respond as needed to side effects – This information for after your vaccine includes a list of possible side effects. Within the first day or two of COVID-19 vaccination, they include arm pain and flu-like symptoms. Health Canada advises patients to be aware of the remote possibility of serious side effects, including clots after AZ vaccination, and to seek immediate medical attention and mention their vaccination if symptoms occur after getting the vaccine. In the 4 to 28 days following AZ vaccination, particular signs to watch for are:

  • shortness of breath
  • pallor, swelling or coldness in an arm or leg
  • persistent and severe or worsening headaches or blurred vision
  • multiple small bruises, red or purple spots, or blood blisters under the skin.
  • focal neurological symptoms, such as weakness or numbness in an arm or leg
  • seizures
  • back pain
  • chest or abdominal pain
  • unusual bleeding

Vaccine side effects will continue to be monitored as people receive the vaccine. If you get 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.

Our office does not have ANY vaccines but we will let you know when we know more. Some questions have arisen that we want to continue to answer at this stage – please see below, and you can find more detail here.  

 

  • Appropriate steps taken – The vaccines were developed so fast because it was a top priority for everyone in the field and billions of dollars from governments and companies around the world were spent on getting it developed. The scientific world cooperated in ways they had not before. The bureaucratic process was super-fast because of the importance of getting this through. Currently there are four covid-19 vaccines approved by Health Canada, 2 mRNA and 2 viral vector.
  • New technology – mRNA has been studied and used for cancer treatments for upwards of 30 years, but this is the first vaccine using the technology. There are two vaccines made this way (Pfizer and Moderna). mRNA vaccines cannot give someone COVID-19 as they do not use the live virus that causes COVID-19. They also do not affect or interact with our DNA in any way.
  • Viral vector vaccines – there are n ow two vaccines that were just approved by Health Canada that use older technology. Janssen (Johnson & Johnson) and Oxford-AstraZeneca. 
  • Effectiveness – In clinical studies, very few people got COVID-19 within 12 days of getting the first dose of the Pfizer vaccine (93%). This result is similar to the Moderna vaccine (92%), which is the other COVID-19 vaccine now approved for use in Canada. The effectiveness is more robust 14 days after the second dose for each vaccine. The AstraZeneca vaccine showed 59.5% efficacy in preventing SARS-CoV-2 infection and is used both for preventing the occurrence of COVID-19 infection and diminishing the severity of the infection. The Janssen vaccine showed 66.1% efficacy in preventing SARS-CoV-2 infection and is used both for preventing the occurrence of COVID-19 infection and diminishing the severity of the infection.
  • Efficacy against severe disease and hospitalization – All of the approved vaccines have a high efficacy rate against severe disease. In the clinical trials, efficacy against severe disease was shown to be:
    • Pfizer: 75-100% (after dose 2)
    • Moderna: 100% (14 days after dose 2)
    • AstraZeneca: 100% (after dose 2)
    • Janssen: 85.4% (28 days after dose)

Each of the 4 approved vaccines are safe and effective based on most relevant science-based information and almost everyone should get the vaccines. See below for further considerations.

 

  • Pregnancy/breastfeeding – Pregnant and breastfeeding women were not included in trials for the currently available vaccines. However, the Society of Obstetricians and Gynaecologists of Canada has stated: The SOGC supports the use of all available COVID-19 vaccines approved in Canada in any trimester of pregnancy and during breastfeeding in accordance with regional eligibility (April 20, 2021). The Ontario Ministry of Health guidance states that pregnant women should discuss risks and benefits with their family physician or primary healthcare provider. The Ministry also points out that mRNA and viral vector vaccines are not live vaccines and are not expected to be a risk to the breastfeeding infant. If you are pregnant or breastfeeding, we will discuss the risks and benefits to help you make an informed decision about receiving the vaccine. 
  • Allergies – People who have ever had a severe allergic reaction (i.e., anaphylaxis) to a previous dose of a Covid-19 vaccine or any of the ingredients in the vaccine should not receive it, including including polyethylene glycol (PEG) or polysorbate 80. We will discuss any allergies or other health conditions you may have before you receive the vaccine. If needed, we can seek input from an allergist-immunologist. Patients with food, drug or environmental allergies, do NOT need an allergist assessment, but should be observed for a minimum of 15-30 minutes following vaccination.
  • Autoimmune conditions/Immunocompromised – If you have an autoimmune or immunodeficiency condition, or are immunosuppressed due to disease or treatment, we will discuss the benefits and risks of vaccination given your particular situation and come to a decision together. People with these conditions were not included in the trials for the currently available vaccines, although vaccination may be a good idea for you to reduce your risk of getting a COVID-19 infection. Patients on immune suppressing medications should have a discussion of their vaccination timing in relation to other treatments or possible treatment modifications with their prescribers. 

 

Our office has remained accessible to you, by phone, by video or in person as it was deemed necessary. We thank you for your understanding as we help you in your health in these different ways. Thank you all for what you have done to keep yourselves, your loved ones, and your communities safe. Thank you to those frontline workers who have faced fears and yet continued to provide the services that we have needed to function. We look forward to when the vaccine allows us to return to a life that is more connected. In the meantime – Wear a mask, keep your distance, wash your hands. AND be calm, be safe, be kind. 

 

Pfizer Ingredient list (non-medicinal)

  • ALC-0315 = ((4-hydroxybutyl) azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate)
  • ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide (found in Restoralax, ClearLax, PEG3350)
  • 1,2-distearoyl-sn-glycero-3-phosphocholine
  • cholesterol
  • dibasic sodium phosphate dihydrate
  • monobasic potassium phosphate
  • potassium chloride
  • sodium chloride
  • sucrose
  • water for injection

Moderna ingredient list (non-medicinal)

  • 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC)
  • Acetic acid
  • Cholesterol
  • Lipid SM-102
  • PEG2000 DMG 1,2-dimyristoyl-racglycerol, (found in Restoralax, ClearLax, PEG3350), Methoxy-polyethyleneglycol 
  • Sodium acetate
  • Sucrose
  • Tromethamine
  • Tromethamine hydrochloride
  • Water for injection

Janssen ingredient list (non-medicinal)

  • 2-hydroxypropyl-β-cyclodextrin (HBCD)
  • Citric acid monohydrate
  • Ethanol
  • Hydrochloric acid
  • Polysorbate-80
  • Sodium chloride
  • Sodium hydroxide
  • Trisodium citrate dihydrate
  • Water for injection

Oxford-AstraZeneca ingredient list (non-medicinal)

  • Disodium edetate dihydrate (EDTA)
  • Ethanol
  • L-Histidine
  • L-Histidine hydrochloride monohydrate
  • Magnesium chloride hexahydrate
  • Polysorbate 80
  • Sodium chloride
  • Sucrose
  • Water, for injection