Adverse Events Following Immunization Guidance and Recommendations

Advisory Alert

August 20, 2020

*Cette information est seulement disponible en anglais.

To: Local Health System Partners


Reporting AEFIs in Ontario

The Health Protection and Promotion Act (HPPA) Section 38 and Reg. 569 requires all health care providers to report Adverse Events following Immunizations (AEFIs). At the local level, Public Health Sudbury & Districts receives reports of AEFIs from multiple sources. Reports are submitted using the Ontario AEFI reporting form.

AEFI Reporting Guidance

Health providers (i.e. physicians, nurses, and pharmacists) are required by law to report AEFIs. Vaccine recipients or their caregivers may also voluntarily report AEFIs to public health.

The Infectious Diseases Protocol for AEFIs: Appendix B (PDF) and the Adverse Events of Special Interest (AESIs) for COVID-19 Vaccines Surveillance document (PDF) provide reporting criteria, provincial surveillance case classifications as well as types of adverse events which are reportable. This is required for all AEFIs classified as a “Confirmed Case” for provincial surveillance and reporting purposes.

In general, any adverse event following immunization should be reported to your local public health unit for further follow-up and investigation if:

A causal relationship does not need to be proven and submitting a report does not imply causality.

The AEFI Fact Sheet for Health Care Providers also contains information on the types of adverse events that should be reported. If there is any doubt as to whether or not an event should be reported, a conservative approach should be taken and the event should be reported.

Reporting adverse events following immunization:

Public Health Investigation of AEFIs

AEFI reports received by Public Health Sudbury & Districts are investigated, assessed, and documented according to provincial surveillance guidelines, as required by the Ontario Public Health Standards (OPHS).

Information gathered during the investigation should provide enough detail to:

Recommendations are provided verbally by a public health nurse to the reporting client or health care provider. Written recommendations will only be provided on a case-by-case basis.

Additional Information

Public Health Sudbury & Districts reviews all reported adverse events following immunization. To ensure maximum protection against COVID-19 and the Delta variant, anyone born in 2009 or earlier should get their first dose and anyone eligible for a second dose should attend a walk-in, pop-up, or mobile clinic or book their second dose as soon as possible. Select groups at highest-risk are eligible for a third dose of the COVID-19 vaccine based on the recommendation of the Chief Medical Officer of Health and other health experts.

Please visit Public Health Sudbury & District’s vaccination clinics for COVID-19 site for more information. Select primary care providers and pharmacies are also offering COVID-19 vaccination.

For additional information on adverse events following immunization, visit our Vaccine Related Adverse Events web page.

For more information on the COVID-19 vaccines, as well as for specific answers to your frequently asked questions visit our FAQ web page.


Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

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This item was last modified on August 20, 2021