COVID-19: Vaccines

Recommendations for Spring 2025 COVID-19 Vaccination

The National Advisory Committee on Immunization (NACI)  recommends individuals who are at higher risk of getting very sick from a COVID-19 infection be vaccinated with an additional COVID-19 vaccine this spring including:

• Adults 65 years of age and older, especially 80 years of age and older.
• Adult residents of long-term care homes and other congregate living settings for seniors.
• Individuals 6 months of age and older who are moderately to severely immunocompromised (due to an underlying condition or treatment).
• Individuals 55 years and older who identify as First Nations, Inuit, or Metis and their household members who are 55 years and older.
• Pregnant individuals.*

*COVID-19 vaccine may be offered at any stage of the pregnancy (i.e., in any trimester) and while breastfeeding.

NACI also recommends that all individuals 6 months of age and over who are not high-risk are not recommended to be vaccinated in the spring even if they missed their dose in the fall/winter (2024/2025). They will be eligible to be vaccinated in the fall/winter (2025/2026).

Available COVID-19 Vaccines

Publicly funded COVID-19 vaccines are made available by the Ontario Ministry of Health.

The COVID-19 vaccines available in Ontario:

• Moderna KP.2 for those 6 months of age and older
• Pfizer KP.2 for those 12 years of age and older

Note: The Novavax vaccine will not be available in Ontario for 2024/25. Individuals who are unable to receive an mRNA vaccine, should speak with their health care provider about treatment options, including the use of Paxlovid, to reduce the duration and severity of illness.

Both Moderna and Pfizer vaccines can be used interchangeably, as long as the vaccine provided is the vaccine approved by age.

Recommended Interval for Spring Vaccine

Between April to June 2025, those who are at high-risk of getting very sick from COVID-19 should receive their vaccine.

Previously vaccinated individuals who are not high-risk are recommended to receive a dose in Fall 2025, even if they missed their dose in fall/winter 2024.

Previously vaccinated individuals who are high risk are recommended to receive a Spring dose at a minimum of 3 months from the last dose. For those who are high risk and had a recent infection (test-positive):

• Updated guidance from NACI states that the interval from infection to COVID-19 vaccination is a guide but not a requirement.
• Someone who was previously vaccinated and has had a recent test positive infection, a minimum interval of 3 months may be considered, but is not required.
• Testing for previous infection is not needed prior to vaccination.
• In general, having some spacing between an infection and vaccination may result in a better immune response from the vaccination.  However, the benefit of getting vaccinated earlier, with less spacing, maybe beneficial especially when considering the risk for exposure to infection, living in a congregate setting, and risk for severe infection to the individual.
• COVID-19 vaccination in individuals previously infected has a good safety profile and is well tolerated.

See schedules below.

Vaccine Use by Age

Immunization schedule for non high-risk – Children 6 months to 4 years of age

Current Age	Health Status	Vaccination History	# of Does of vaccine to give	Interval between doses
6 months to 4 years	Immunocompetent	0 does	2 doses*	8 weeks
		1 dose Moderna	1 dose*	8 weeks
		1 dose Pfizer	2 doses*	8 weeks
		2 doses with ≥1 doses Pfizer	1 dose*	8 weeks
		2 doses both Moderna	1 dose	6 months°
		≥3 doses, Pfizer and/or Moderna	1 dose	6 months°

* Dose(s) required to complete the primary series
° The recommended interval is 6 months, and the minimum interval is 3 months

Immunization schedule for– Immunocompetent Children ages 5 years and older

Current Age	Health Status	Vaccination History	# of Doses of vaccine to give	Interval between Doses
≥5 years	Immunocompetent	0 doses	1 dose*	–
		≥1 dose at ≥ 5 years	1 dose	6 months°
		1 dose at < 5 years	1 dose*	8 weeks
		≥2 doses	1 dose	6 months°

* Dose(s) required to complete the primary series
° The recommended interval is 6 months, and the minimum interval is 3 months

Vaccination if Immunocompromised

Receiving a vaccine is important for individuals who are moderately to severely immunocompromised and at increased risk of severe illness from COVID-19.

As indicated by NACI, the following individuals are considered to be moderately to severely immunocompromised and are recommended to receive additional dose(s) as detailed in the immunization schedules section above:

• Solid tumor or hematologic malignancies or treatments for these conditions.
• Solid-organ transplant and taking immunosuppressive therapy.
• Hematopoietic stem cell transplant (HSCT) (within 2 years of transplantation or taking immunosuppression therapy).
• Immunocompromise due to chimeric antigen receptor (CAR) T cell therapy targeting lymphocytes.
• 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 <1 5%, 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

Please refer to Ministry of Health  guidance for more information and schedules below.

Immunization schedule for– Moderate to Severely immunocompromised Children 6 months to 4 years of age

Current Age	Health Status	Vaccination History	# of Doses Recommended	Interval between Doses
6 months to 4 years	Immunocompromised	0 doses	3 doses* and 1 additional dose	4 to 8 weeks 6 months°
		1 dose Moderna	2 doses* and 1 additional dose	4 to 8 weeks 6 months°
		1 dose Pfizer	3 doses* and 1 additional dose	4 to 8 weeks 6 months°
		2 doses both Moderna	1 dose* and 1 additional dose	4 to 8 weeks 6 months°
		2 doses with ≥1 doses Pfizer	2 doses* and 1 additional dose	4 to 8 weeks 6 months°
		3 doses with ≥1 doses Pfizer	1 dose* and 1 additional dose	4 to 8 weeks 6 months°
		3 doses all Moderna	1 dose and 1 additional dose	6 months°
		≥4 doses Pfizer and/or Moderna	1 dose and 1 additional dose	6 months°

Immunization schedule for– Moderate to Severely immunocompromised 5 years of age and older

Current Age	Health Status	Vaccination History	# of Additional Doses Recommended	Interval Between Doses
≥5 years	Immuno-compromised (IC)	0 doses	2 doses*^ and 1 additional dose	4 to 8 weeks 6 months°
		1 dose at ≥5 year	1 dose*^ and 1 additional dose	4 to 8 weeks 6 months°
		1 dose Moderna at <5 years	2 doses* and 1 additional dose	4 to 8 weeks 6 months°
		1 dose Pfizer at <5 years	3 doses* and 1 additional dose	4 to 8 weeks 6 months°
		2 doses Moderna with ≥1 dose at <5 years	1 dose* and 1 additional dose	4 to 8 weeks 6 months°
		2 doses with ≥1 doses Pfizer at <5 years	2 doses* and 1 additional dose	4 to 8 weeks 6 months°
		≥2 doses at ≥5 years	1 dose and 1 additional dose	6 months°
		3 doses with ≥1 doses Pfizer at <5 years	1 dose* and 1 additional dose	4-8 week 6 months°
		≥3 doses Moderna with ≥1 dose at <5 years	1 dose and 1 additional dose	6 months°
		≥4 doses with ≥1 doses Pfizer at <5 years	1 dose and 1 additional dose	6 months°
	IC: HSCT recipient or CAR T cell therapy	0 doses	3 doses* and 1 additional dose	4-8 weeks 6 months°
		1 dose	2 doses* and 1 additional dose	4 to 8 weeks 6 months°
		2 doses	1 dose* and 1 additional dose	4 to 8 weeks 6 months°
		≥3 doses	1 dose* and 1 additional dose	6 months°

^ A 3rd dose (for the primary series) may be offered 4 to 8 weeks after the previous dose

Co-administration of Vaccines

Moderna and Pfizer vaccines may be given at the same time with other vaccines, or at any time before or after other non-COVID-19 vaccines (live or non-live vaccines), including influenza vaccine, respiratory syncytial virus (RSV) vaccine and/or the RSV monoclonal antibody, Beyfortus®.

Residents Without OHIP Cards

Learn more on where people without OHIP cards can get vaccinated.

If You Received a Vaccine Outside of Ontario/Canada

Everyone six months of age and older who has been vaccinated outside of Canada with one or more vaccine(s) not approved by Health Canada can receive a dose of the updated COVID-19 vaccine if it has been at least six months since the last COVID-19 vaccine.

If you live in Toronto and got COVID-19 vaccines outside of Ontario or Canada, learn more about how to document any dose(s) received outside of Ontario or Canada by visiting COVID-19: Proof of Vaccination.

For more vaccine information:

VaxFacts+  can help community members and families to get the most accurate information.

How COVID-19 Vaccines Work

COVID-19 vaccines teach our immune system to make antibodies that protect against COVID-19. These antibodies can recognize and attack the virus when it enters the body.

The vaccine is given using a needle in your upper arm. It takes at least two weeks after getting a vaccine dose to be protected. It is safe to get the vaccine at the same time with other vaccines, or at any time before or after other non-COVID-19 vaccines (live or non-live vaccines), including influenza vaccine, respiratory syncytial virus (RSV) vaccine and/or the RSV monoclonal antibody, Beyfortus®.

mRNA vaccines, like the Pfizer-BioNTech Comirnaty and Moderna Spikevax vaccines, provide your body with instructions (mRNA) to make antibodies. The COVID-19 vaccine is the first vaccine using mRNA technology to be approved for use, but it was in development for many years prior to the COVID-19 pandemic.

Protein subunit vaccines, like Novavax, contain harmless and purified pieces (proteins) of the virus which have been specifically selected for their ability to trigger immunity. Your body then uses these to make its own instructions to make antibodies.

Novavax vaccine will not be available in Ontario for 2024/25. Individuals who are unable to receive an mRNA vaccine, should speak with their health care provider about treatment options, including the use of Paxlovid, to reduce the duration and severity of illness.

If unable to receive an mRNA vaccine

Novavax vaccine will not be available in Ontario for 2024/25.
Individuals who are unable to receive an mRNA vaccine, should:

• Speak with their health care provider about treatment options, including the use of Paxlovid, to reduce the duration and severity of illness.
• Layer other personal preventive measures to reduce the risk of infection from COVID-19.
• Take some steps to protect yourself and others during respiratory illness season include:
  • consider wearing a tight-fitting, well-constructed mask in indoor public settings, especially if you are at higher risk of severe infection
  • wash your hands often
  • cover your mouth when you cough or sneeze
  • regularly clean high touch surfaces
  • optimize indoor air quality

For more information visit Protection from COVID 19 and other respiratory illnesses | ontario.ca .

Vaccine Safety

Health Canada has approved COVID-19 vaccines as safe and effective. They meet quality standards, and the benefits of the vaccines outweigh the risks of a COVID-19 infection.

Health Canada and Public Health Agency of Canada continue to monitor the safety of all COVID-19 vaccines approved in Canada and will take appropriate action as needed.

Potential Side Effects and When to Get Medical Attention

Most vaccine side effects are mild and last for one to three days. Common side effects include:

• Sore arm near the injection site
• Feeling tired
• Headache
• Achy muscles or joints
• Fever and chills

Severe side effects are rare. Get medical attention right away if you develop any of these symptoms after getting a vaccine:

• Signs and symptoms of severe allergic reaction, including hives, swelling of the mouth or throat or trouble breathing, hoarseness or wheezing.
• High fever (over 40°C)
• Seizures
• Other serious reactions

Report any severe reactions to the COVID-19 vaccine to your health care provider. Health care providers are required to report Adverse Events Following Immunizations (AEFIs) to Toronto Public Health.

Vaccine Allergies

COVID-19 vaccines do not contain eggs, gelatin (pork), gluten, latex, preservatives, antibiotics or aluminum.

People with allergies, including serious allergies to food, medications, and insect bites can get the COVID-19 vaccine. Allergic reactions can be treated and are usually temporary. People are monitored for 15 minutes after vaccination for any reactions.

People with severe allergies to any of the vaccine ingredients should speak with their physician/allergist about getting the vaccine. Some people with allergies to an ingredient can still be safely vaccinated.

If you get a serious reaction after your first dose, talk to your health care provider about future vaccinations. Sometimes you can still be safely vaccinated or can received a different vaccine.

Resources

• Vaccine Data on COVID-19 Pandemic Archived Dashboards
• Archived: COVID-19 Pandemic City Immunization Strategies
• Adverse Events Following Immunization
• Adverse Events Following Immunization (AEFIs) for COVID-19 in Ontario
• Reported Side Effects Following COVID-19 Vaccination in Canada
• Vaccine Injury Support Program