Additional exceptions to the extended dose interval for the COVID-19 vaccine
Advisory Alert
May 29, 2021
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To: Health Care Providers
FOR IMMEDIATE ATTENTION
Expansion of eligibility for a shorter dosing interval
Exceptions to the extended COVID-19 vaccine dosing interval were shared in the April 14, 2021, Advisory Alert, with further expansion detailed in the May 11, 2021, Advisory Alert. Today’s Advisory Alert confers additional exceptions recently announced by the Ministry of Health for those eligible to book their appointment to receive a second dose of the COVID-19 vaccine earlier than the extended four-month interval.
New medical exemptions to the extended dosing interval
Individuals on immunosuppressive therapy who are also in the authorized age group taking an anti-CD20 agent (for example rituximab, ocrelizumab, ofatumumab) may receive their second dose of the COVID-19 vaccine as indicated on the product monograph. The treating provider should decide on the timing of the vaccine to optimize the immune response elicited from the vaccine series while minimizing delays in the management of their condition. As new data becomes available and/or as vaccine supply permits, recommendations about other immunosuppressive therapies for autoimmune/inflammatory disease may follow.
Primary care providers are asked to identify their patients on immunosuppressive therapy taking an anti-CD20 agent for earlier second dose intervals and provide direction for second dose bookings.
Booking instructions
Individuals who have not yet received their first dose will be identified at time of immunization and will have their second dose booked per product monograph. Individuals who have already received a first dose of a COVID-19 vaccine and meet the newly identified criteria to receive a second dose as per the product monograph can self-identify by calling the booking centre at 705.674.2299 (toll-free: 1.800.708.2505). All those who call the booking centre and self-identify will be screened per Ministry guidelines at time of booking and must attest to their eligibility for a shortened dose interval. If eligibility is confirmed, the second dose will be booked per product monograph.
Shorter dosing interval for the AstraZeneca vaccine for patient groups that are exempt from the extended dosing interval
In addition to those patient groups* already exempt from the recommended 16-week dosing interval, further exceptions to the extended dose interval now include individuals who have already received a first dose of the AstraZeneca vaccine, who also fall under these patient groups. Second doses of the AstraZeneca COVID-19 vaccine may be offered as per the Chief Medical Officer of Health. A shortened dosing interval of 4 to 12 weeks should be made accessible, which is in accordance with the product monograph, noting favorable efficacy results in the clinical trials with a dosing interval of ≥12 weeks. At this time, the option of using an mRNA vaccine for a second dose for those who received a first dose of AstraZeneca’s vaccine is not being offered, although this may change as more data becomes available on the safety and efficacy of a “mixed-model.”
Primary care providers are asked to advise eligible patients who have received their first dose and who are eligible for their second dose as per the product monograph.
Accelerated rollout of second doses
As announced by the Government of Ontario on May 28, 2021, individuals turning 80 and over in 2021, will be eligible to book their second dose appointment beginning on May 31, 2021, at 8 a.m., followed by individuals aged 70 and over scheduled to begin the week of June 14, 2021. Individuals must do this themselves through the provincial booking system or through the local call centre as vaccine supply allows. Individuals with health conditions and previously announced eligibility for shortened second doses will continue to have first opportunities. Currently there are very limited opportunities for shorter dose intervals for these age-groups with the Pfizer and Moderna vaccines.
Based on supply and availability, second doses of the AstraZeneca vaccine will be provided at a 12-week interval. Booking eligibility will be based on the date of the first dose. Primary care providers are asked to contact their patients who received their first dose of the AstraZeneca vaccine to reschedule their second dose earlier, at the 12-week mark.
Individuals who have already received a first dose
Effective immediately, those patient groups* or individuals who have already received a first dose of a COVID-19 vaccine who are now eligible to book their appointment to receive a second dose earlier than the extended four-month interval can self-identify by calling the booking centre at 705.674.2299 (toll-free: 1.800.708.2505), between 8 a.m. and 8 p.m., seven days a week. The booking centre will work to reschedule second dose appointments for all those eligible. If the dates offered are not feasible, a waitlist option is available.
All those who call the booking centre and self-identify as eligible will be screened according to the Ministry guidelines at time of booking and they will be required to attest to their eligibility for a shortened dose interval. If eligibility is confirmed, the second dose will be booked at the appropriate interval. As appropriate, individuals must bring with them their health care provider letter to their appointment.
At time of immunization, individuals who self-identify will be assessed again to determine if they are eligible for their second dose based on the shortened interval. If at that time, it is determined that further medical consultation is required, immunization will not occur.
Additional information and resources
For additional information on the COVID-19 vaccines, as well as for specifics on how it is being rolled out locally, please visit Public Health’s COVID-19 vaccine webpage. Supplementary information and resources can be found on our COVID-19 vaccine resources webpage.
Sincerely,
Original Signed By
Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer
NOTE: All Advisory Alerts are found on our website.
This item was last modified on May 29, 2021