Who:

Individuals 18 years of age and older.

Must be 18 years of age at the time of immunization.

Interval criteria: A minimum of 84 days after SECOND dose

Who:

5 to 11 years of age at time of immunization.

Interval criteria:

A minimum of 6 months after SECOND dose is recommended.

Who:

Adolescents 12 to 17 years of age at time of immunization.

Interval criteria:

A minimum of 168 days after SECOND dose is recommended and associated with a lower risk of myocarditis and pericarditis.

With informed consent, youth 12-17 years of age may receive a booster dose at a minimum of 84 days after completion of their second dose of a 2-dose primary COVID-19 vaccine series.

Who:

Primary series completed with only viral vector vaccines.

Individuals who received two doses of AstraZeneca/COVISHIELD COVID-19 vaccine.

Individuals who received one dose of Janssen/Johnson & Johnson COVID-19 vaccine.

Interval criteria:

A minimum of 84 days after SECOND dose

Who:

Residents of long-term care homes, retirement homes, elder care lodges, and older adults living in other congregate settings (e.g., assisted-living facilities, chronic care hospitals, naturally occurring congregate retirement settings/congregate senior’s apartment buildings, older adults living in congregate settings for people with developmental disabilities, mental health and addictions issues, etc.).

Interval criteria:

A minimum of 84 days after SECOND dose

Pfizer is currently the only vaccine that will be offered to youth ages 12 to 17 at vaccine clinics across Durham Region.

For individuals 18 years of age and older, either Moderna or Pfizer vaccine may be used as a third dose (regardless of which COVID-19 vaccine was used in the primary series). Both the Moderna and Pfizer COVID-19 vaccines provide strong protection against COVID-19 and its variants. It is safe and effective to mix COVID-19 vaccines.

It is recommended that individuals 12 years of age and older, infected with COVID-19 after their primary series but before their booster dose, receive their booster dose 3 months after symptoms started or after testing positive (if no symptoms were experienced).

For youth 12 to 17 years old, this is provided it is at least 6 months from completing the primary series.

Emerging evidence indicates that a longer interval between COVID-19 infection and vaccination is associated with improved antibody responses to COVID-19 vaccines.

COVID-19 infection is defined as a COVID-19 case confirmed by a molecular (e.g. PCR) or rapid antigen test, or an individual who is symptomatic AND is a household contact of a confirmed COVID-19 case.

With informed consent, individuals may receive a booster dose once they are considered no longer infectious, symptoms of illness are completely resolved, and their isolation period is completed.

Pfizer is recommended for individuals aged 12 to 29 due to lower reported rates of myocarditis/pericarditis following vaccination with Pfizer compared to Moderna. Moderna can be administered with informed consent of this increased risk.

Who: Individuals 5 years of age and older (must be at least 5 years of age at the time of vaccination) with one of the medical conditions listed below:

Individuals receiving dialysis (hemodialysis or peritoneal dialysis).

Individuals receiving active treatment (e.g., chemotherapy, targeted therapies, immunotherapy) for solid tumour or hematologic malignancies. Active treatment includes patients who have completed treatment within 3 months.

Recipients of solid-organ transplant and taking immunosuppressive therapy.

Recipients 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 HIV with prior AIDS defining illness or prior CD4 count ≤ 200/mm3 or prior CD4 fraction ≤ 15% or (in children 5-11 years) perinatally acquired HIV infection

First, second and third dose interval: Minimum 56 days between each dose.

Who: Individuals 5 years of age and older (must be at least 5 years of age at time of immunization) receiving 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 CIG for suggested definition of high dose steroids), alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive.

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

First, second and third dose interval: Minimum 56 days between each dose.

Who: Individuals 18 years of age and older (must be 18 years of age at the time of immunization).

Interval criteria: A minimum of 140 days after THIRD dose. With informed consent, individuals may receive a fourth dose at a minimum of 84 days after their third (booster) dose.