COVID-19 vaccine additional exceptions to the extended dosing interval
May 11, 2021
*Cette information est seulement disponible en anglais.
To: Local Health System Partners
FOR IMMEDIATE ATTENTION
Additional exceptions to the extended dosing schedule for the COVID-19 vaccine
Exceptions to the extended COVID-19 vaccine dosing interval were shared in the April 14, 2021 Advisory Alert*. Today’s Advisory Alert contains details of additional exceptions recently announced by the Ministry of Health. The province is adding high-risk health care workers, dialysis patients and all First Nations, Inuit and Métis adults to the list of those eligible to book their appointment to receive a second dose of the COVID-19 vaccine earlier than the extended four-month interval. Further details are below.
Individuals who are on dialysis
Patients who are on hemodialysis or peritoneal dialysis are recommended to receive their COVID-19 vaccine at the dose interval as indicated in the product monographs. Where possible and appropriate, patients can be vaccinated at their dialysis unit. If this is not possible for either the first dose or second dose, patients will require a letter from their dialysis unit or nephrologist to confirm that they are eligible to receive their second dose as per the product monograph, identifying the reason for the exception. The letter should be presented by the patient at their COVID-19 vaccination appointment(s).
Dosing intervals indicated on the product monograph are Pfizer-BioNTech at 21 days, Moderna at 28 day, and AstraZeneca at 12 weeks.
Individuals who have already received first dose
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) OR 1-844-782-2273.
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.
Primary care providers are requested to advise eligible patients who have received their first dose and who are eligible for their second dose at the product monograph timeline.
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.
Individuals who are eligible to receive their second dose earlier but who have not yet been immunized
These individuals are asked to identify at the time of booking their vaccination appointment that they are eligible to receive their second dose earlier than the extended four-month interval. Eligibility will be re-assessed per Ministry guidance at the time of immunization and those who are confirmed eligible for the shorter second dose timeline, will be re-booked at the shorter interval prior to leaving the immunization center.
Individuals who book via the online provincial booking system will automatically be scheduled for their second dose at 16 weeks as the system does not presently allow for exceptions. Therefore, patients are asked to self-identify at time of vaccination and, if appropriate, bring with them their health care provider letter to their dose one appointment. A dose two appointment will be scheduled appropriately at that time.
The clinic staff will record in COVaxON that this client is eligible for a shortened interval. In addition, they will mark the patient’s vaccine receipt with “Return in 28 Days”. Note that caregivers are not exempted from the extended four-month interval.
Please note that the province is developing an online rebooking option that will support the shortened interval to be used after the patient gets their first dose at the clinic. More information will be provided as it becomes available.
Shortened second dose interval for high-risk health care workers
Certain high-risk health care workers** are eligible to book their second dose of the COVID-19 vaccine at a shortened interval. Booking will begin by the end of the week of May 10, 2021, with details forthcoming. If you or your staff belong to this group, please stay tuned for additional booking details.
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.
Original Signed By
Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer
NOTE: All Advisory Alerts are found on our website.
*Excerpt from the above mentioned Advisory Alert dated April 14, 2021.
Exceptions to extended COVID-19 vaccine dosing intervals
On March 26, 2021, the provincial Vaccine Clinical Advisory Group (VCAG) Recommendations of Exceptions to Extended Dose Intervals for COVID-19 vaccines, released its findings which are summarized here.
Exceptions to the extended dose intervals were recommended. These exceptions include transplant recipients as well as individuals with malignant hematologic disorders and non-hematologic malignant solid tumours receiving active treatment (chemotherapy, targeted therapies, immunotherapy), excluding individuals receiving solely hormonal therapy or radiation therapy. These populations should receive COVID-19 vaccines at the dose interval as indicated in the product monograph. This means that the second dose of the Pfizer-BioNTech, Moderna, or AstraZeneca COVID-19 vaccine should be provided at an interval of 21 days, 28 days, or 12 weeks respectively. The National Advisory Committee for Immunization continues to review evidence which informs the provincial VCAG recommendations.
**High-risk health care workers who will be eligible for the shortened second-dose interval are:
- All hospital and acute care staff in frontline roles with COVID-19 patients and/or with a high-risk of exposure to COVID-19, including nurses and personal support workers and those performing aerosol-generating procedures:
- Critical Care Units
- Emergency Departments and Urgent Care Departments
- COVID-19 Medical Units
- Code Blue Teams, rapid response teams
- General internal medicine and other specialists involved in the direct care of COVID-19 positive patients
- All patient-facing health care workers involved in the COVID-19 response:
- COVID-19 Specimen Collection Centers (e.g., Assessment centers, community COVID-19 testing locations)
- Teams supporting outbreak response (e.g., IPAC teams supporting outbreak management, inspectors in the patient environment, redeployed health care workers supporting outbreaks or staffing crisis in congregate living settings)
- COVID-19 vaccine clinics and mobile immunization teams
- Mobile Testing Teams
- COVID-19 Isolation Centers
- COVID-19 Laboratory Services
- Current members of Ontario’s Emergency Medical Assistance Team (EMAT) who may be deployed at any time to support an emergency response
- Medical First Responders
- Firefighters providing medical first response as part of their regular duties
- Police and special constables providing medical first response as part of their regular duties
- Community health care workers serving specialized populations including:
- Needle exchange/syringe programs and supervised consumption and treatment services
- Indigenous health care service providers including but not limited to:
- Aboriginal Health Access Centers, Indigenous Community Health Centers
- Indigenous Interprofessional Primary Care Teams, and Indigenous Nurse Practitioner-Led Clinics
- Long-term care home and retirement-home health care workers, including nurses and personal support workers and Essential Caregivers
- Individuals working in Community Health Centers serving disproportionally affected communities and/or communities experiencing highest burden of health, social and economic impacts from COVID-19
- Critical health care workers in remote and hard to access communities, e.g., sole practitioner
- Home and community care 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
This item was last modified on May 11, 2021