COVID-19 - Get vaccinated and find public health advice for residents and businesses.

Getting Vaccinated and Staying Up to Date

Learn what to do if you have COVID-19 symptoms, tested positive for COVID-19, or if you're a contact.

For best protection, individuals are recommended to stay up to date with all recommended COVID-19 vaccine doses, including any booster dose(s).

This is even more important for those that come into close contact with people who are immunocompromised.

Individuals are considered up to date when they have received the recommended dose(s) appropriate for their age, health status and the type of vaccine they have received. See the personalized recommendations by group section for details.

Recommended COVID-19 vaccine products

Every effort should be made to get vaccinated with an mRNA vaccine for the primary series and any booster dose(s). mRNA are highly safe and effective COVID-19 vaccines and are widely available across Niagara.

Individuals 18 years of age and older who are interested in accessing a dose of Janssen and Novavax should contact the Niagara Region Public Health COVID-19 Info-Line at 905-688-8248, press 7, then 2, to be added to a wait list, after first being assessed for eligibility.

  • Getting vaccinated with a primary series

    Everyone five years of age and older is strongly recommended to get a primary series of a COVID-19 vaccine.

    A primary series is two doses for most people. For individuals who are moderately or severely immune compromised, a primary series is completed when they have received three doses.

    The term "fully vaccinated" refers to a completed primary series that is used in some situations, such as self-isolation guidance and proof of vaccination criteria.

    Protection after a primary COVID-19 vaccine series decreases over time and a booster is advised.

  • Optimal interval between doses in a primary series

    Interval between first and second dose

    A longer interval between first and second doses leads to:

    • Greater protection after the second dose
    • Longer lasting protection
    • Fewer side-effects. For youth and young adults, this includes a lower risk of myocarditis and/or pericarditis.

    The National Advisory Committee on Immunization recommends the optimal interval between first and second doses for COVID-19 vaccines is eight weeks to maximize long-lasting protection and minimize side-effects. If you received your second dose at an interval different from eight weeks you still have very good protection against COVID-19. You don't need to restart your series.

    Some may choose to receive their second dose of vaccine at earlier than eight weeks in order to get earlier protection. This is a personal choice and should be based on a personal risk-assessment of whether earlier protection is more important than the small increase in the length and duration of protection, and slightly lower risk of side-effects.

    For example, during a surge of cases when risk is high, someone at risk of severe outcomes might reasonably choose earlier protection during the period of risk is the most important factor.

    Visit COVID-19 advice for the community to learn who is at higher risk of exposure or severe outcomes from COVID-19.

    If you have questions, contact your health care provider or our COVID-19 Info-Line at 905-688-8248.

    Interval between second and third dose

    For moderately to severely immunocompromised individuals recommended to have a three dose primary series, there should be at least two months between the second and third dose. These individuals are encouraged to speak with their treating health care provider regarding the timing of vaccination in relation to therapy for their underlying health condition and/or treatment modification in view of possible decreased vaccine effectiveness with the use of immunosuppressive therapy.

  • Staying up to date with additional doses / boosters

    Additional doses of the COVID-19 vaccines after the primary series are described as booster doses. The term "second booster dose" refers to the dose given after the primary series and first booster dose are completed.

    Booster dose is used for doses that are meant to restore protection which may have decreased over time. Many other vaccines require a booster. COVID-19 vaccine booster doses help increase protection against symptomatic infection and severe outcomes at the individual level. These doses also help to reduce transmission at the population level.

    What is considered up to date for COVID-19 vaccines will likely change over time based on how much COVID-19 is spreading, and as new evidence on additional booster doses becomes available.

Personalized recommendations by group

Individuals five years of age and older who are moderately or severely immunocompromised should follow the recommendations specific to their group.

What you need to know about eligibility

The Ministry of Health decides who is eligible for COVID-19 vaccine doses in Ontario. The National Advisory Committee on Immunization makes recommendations for the use of COVID-19 vaccine doses. When the Ministry of Health expands eligibility, Niagara Region Public Health updates the information on this page.

  • People who are moderately or severely immunocompromised

    Primary series

    A primary series for this population is three doses. This is because they may have not produced an optimal immune response to the first two doses of COVID-19 vaccine.

    Additional doses/boosters

    After the completion of a three dose primary series, moderately or severely immunocompromised people should follow the recommendations based on age for their first and second (if eligible) booster dose.

    A three dose primary series means that a first booster corresponds to a fourth dose and a second booster (if eligible) corresponds to a fifth dose.

    Vaccine products by age group

    • Ages 5 to 11, Pediatric Pfizer is given
    • Ages 12 to 29, recommended Pfizer
    • Age 30 and over, recommended Moderna

    The safety and efficacy of Novavax have not been established in individuals who are immunocompromised due to disease or treatment. There is evidence on the safety profile and effectiveness of mRNA COVID-19 vaccines in these populations based on real world use with large numbers of individuals.

    Who is eligible

    Individuals who are moderately to severely immunocompromised:

    • Individuals receiving dialysis (hemodialysis or peritoneal dialysis)
    • Individuals receiving active treatment (for example, chemotherapy, targeted therapies, immunotherapy) for solid tumour or hematologic malignancies. Active treatment includes patients who have completed treatment within three 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 two years of transplantation or taking immunosuppression therapy)
    • Individuals with moderate to severe primary immunodeficiency (for example, DiGeorge syndrome, Wiskott-Aldrich syndrome)
    • Individuals with HIV with prior AIDS defining illness or prior CD4 count less than or equal to 200/mm3 or prior CD4 fraction less than or equal to 15% or (in children 5-11 years) perinatally acquired HIV infection
    • Individuals receiving active treatment (active treatment includes patients who have completed treatment within three months) with the following categories of immunosuppressive therapies:
      • Anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22). Active treatment for patients receiving B-cell depleting therapy includes patients who have completed treatment within 12 months.
      • High-dose systemic corticosteroids
      • Alkylating agents
      • Antimetabolites
      • Tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive

    For a full list of eligible immunosuppressive medications, see Appendix A (page 17) of the Ministry of Health COVID-19 Vaccine Booster Recommendations.

    How to receive additional doses if you're eligible

    Health care providers that are administering the vaccine at their office may also provide additional doses to their eligible patients.

    Hospitals, through their clinics, may vaccinate these individuals.

    In some instances, you may be referred elsewhere for your additional dose. If attending a Public Health clinic, individuals must come with a medical letter from their health care provider or pharmacist that includes:

    • Date and on letterhead
    • Contact information for the clinic, physician, specialist or medical practice of individual completing the form
    • Patient's name (typed / generic letters will not be accepted)
    • Patient's eligible condition (or medication) for third dose

    Prescriptions for the eligible immunosuppressant medications can also be presented at Public Health clinics for proof of eligibility.

  • Children five to 11 years old

    Primary series

    Children aged five to 11 years old are recommended to receive a primary COVID-19 vaccine series to be up to date with their COVID-19 vaccines.

    Additional doses/boosters

    Booster doses of COVID-19 vaccine are not currently recommended for this age group.

    Vaccine products by age group

    Ages five to 11, Pedatric Pfizer is given

  • People 12 to 59 years old

    Primary series

    All individuals aged 12 to 59 years old are recommended to receive a primary COVID-19 vaccine series.

    Additional doses/ boosters

    In Ontario, all individuals 12 to 59 years of age (must be at least 12 on the day of your vaccine) are eligible to get their first booster. Boosters are recommended six months after your last dose (may be given as early as three months; individuals 12 to 17 can consult with their health care provider). To book this dose at a shorter interval, call the Provincial Vaccine Contact Centre at 1-833-943-3900.

    First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 and over are also eligible for a second booster (fourth dose), recommended at least six months after your first booster.

    Vaccine products by age group

    • Ages 12 to 29, recommended Pfizer
    • Age 30 and over, recommended Moderna

    More information

    National Advisory Committee on Immunization recommendations:

    Boosters for 12 to 17 year olds

    Boosters are strongly recommended for 12 to 17 year olds who are residents of congregate living settings or who belong to racialized or marginalized communities disproportionately affected by COVID-19.

    Boosters are also strongly recommended for 12 to 17 year olds who are at higher risk of severe illness from COVID-19 due to underlying health conditions:

    • Cancer: active treatment
    • Chronic kidney disease
    • Chronic lung diseases, including uncontrolled asthma
    • Cystic fibrosis
    • Neurodevelopmental and other chronic neurological conditions including epilepsy and cerebrovascular disease Diabetes (type 1 and 2)
    • Down syndrome
    • Congenital heart disease or other chronic heart diseases, including pulmonary hypertension
    • Chronic liver disease
    • Obesity (BMI over 30)
    • Pregnancy
    • Sickle cell disease or thalassemia
    • Substance use disorders
    • Immunocompromised state, including immune deficiency, solid organ or haematopoietic stem cell transplant, HIV infection, or immunosuppressive therapy
    • Medically fragile having medically complex needs

    Boosters may be offered to all other 12 to 17 year olds in the context of increased COVID-19 activity.

    Second boosters for adults

    A second booster dose among adults younger than 70 years of age or from First Nations, Métis, or Inuit communities may be considered as these communities have a younger age distribution but increased risk for severe disease due to a variety of intersecting factors including underlying medical conditions and potential decreased access to health care.

  • People 60 years and older

    Primary series

    All individuals 60 years of age and older are recommended to receive a primary COVID-19 vaccine series.

    Additional doses/ boosters

    Two booster doses are recommended.

    The first booster (third dose) is recommended six months (minimum three months) after your second dose.

    The second booster (fourth dose) is recommended six months (minimum of three months) after your last dose.

    To book this dose at a shorter interval, call the Provincial Vaccine Contact Centre at 1-833-943-3900.

    Vaccine products by age group

    Age 30 and over, recommended Moderna

    More information:

    National Advisory Committee on Immunization recommendation:

    A second booster dose among adults younger than 70 years of age or from First Nations, Métis, or Inuit communities may be considered as these communities have a younger age distribution but increased risk for severe disease due to a variety of intersecting factors including underlying medical conditions and potential decreased access to health care.

  • Residents of long-term care and retirement homes, elder care lodges, and older adults living in other congregate settings

    Primary series

    All residents of high-risk congregate settings are recommended to receive a primary COVID-19 vaccine series.

    Additional doses/boosters

    Two booster doses are recommended. First booster (third dose) is recommended six months (minimum three months) after your second dose. Second booster (fourth dose) is recommended six months (minimum three months) after your third dose (first booster). To book the shorter interval, call the Provincial Vaccine Contact Centre at 1-833-943-3900.

    Vaccine products by age group

    Age 30 and over, recommended Moderna

  • People who received vaccines not authorized by Health Canada

    Primary series

    People who received only one or two doses of a non-Health Canada authorized COVID-19 vaccine may receive one additional dose in Ontario at least 28 days after the previous dose to complete the primary series.

    People who received one Health Canada authorized vaccine and one non-Health Canada authorized vaccine (in either order) need no additional doses to complete the primary series.

    People who received three doses (any combination of Health Canada authorized, and non-Health Canada authorized) need no additional doses to complete the primary series.

    Additional doses/boosters

    Following any additional doses needed to complete the primary series, these individuals should follow the recommendations based on age for their first and second (if eligible) booster dose.

    Vaccine products by age group

    • Ages 29 and under, recommended Pfizer
    • Age 30 and over, recommended Moderna

    More information

    If you are staying in Canada to live, work or study and have been vaccinated with vaccines not authorized by Health Canada, refer to the Public Health Agency of Canada's COVID-19 immunization recommendations.

    If you don't have proof of immunization:

    If you received a previous dose (s) of a COVID-19 vaccine but have no proof of immunization, see if you can obtain proof.

    If the COVID-19 vaccine product you received remains unknown, a new vaccine series may need to be started with a Health Canada authorized COVID-19 vaccine.

  • Revaccination: people who have lost immunity following therapy or transplant

    Primary series

    Due to a loss of immunity following therapy or transplant, certain populations are recommended to be revaccinated with a new COVID-19 vaccine primary series post-transplantation.

    Additional doses/boosters

    After revaccination with a primary series, these individuals can follow the recommendations based on age for their first and second (if eligible) booster dose.

  • People who received a primary series of AstraZeneca, Janssen, or Novavax

    Primary series

    • A primary series of AstraZeneca is two doses
    • A primary series of Janssen is one dose
    • A primary series of Novavax is two doses

    Additional doses/ boosters

    A first booster (third dose) is recommended six months (minimum three months) after your primary series.

  • People who have had COVID-19

    A previous COVID-19 infection is defined as when an individual has

    • Tested positive for COVID, either by rapid antigen or PCR test, or
    • Had COVID-19 symptoms AND lived with a confirmed case

    Primary series

    People who have had COVID-19 infection should receive their primary series. However, they are recommended to wait four to eight weeks after having COVID-19 to get the next dose in their primary series.

    Additional doses/ boosters

    People who get COVID-19 after a complete primary series are recommended to wait three months after having COVID-19 to get their booster dose(s).

    More information

    The National Advisory Committee on Immunization recommends the following intervals before vaccination.

    Primary series recommendations from the National Advisory Committee

    Individuals who had a COVID-19 infection before starting or completing their primary vaccine series can receive their next dose:

    • Eight weeks after symptoms started or after testing positive (if they had no symptoms)

    Additional doses/ boosters recommendations from the National Advisory Committee

    Individuals who are eligible for a booster and/or second booster dose and who had a COVID-19 infection after completing their primary vaccine series can receive a booster dose:

    • For the first booster. Three months after symptoms started or after testing positive (if they had no symptoms) and if it has been at least six months since completing the primary series
    • For the second booster. Three months after symptoms started or after testing positive (if they had no symptoms) and if the minimum interval since the previous booster dose has been met

For questions about COVID-19 vaccination, call the COVID-19 Info-Line at 905-688-8248 or 1-888-505-6074, press 7.