Table A1.
Summary of COVID-19 vaccination policies in Canada using the policy triangle framework analysis.
| Policy Category | Date Enacted | Policy Title | Type of Policy | Content | Context | Process | Actors | Source/Website |
|---|---|---|---|---|---|---|---|---|
| Prioritization groups | 7 December 2020 | Ontario’s vaccine distribution implementation plan | Guideline | Ontario vaccination plan consisted of three phases began with high-risk groups and ended up with all eligible Ontarians. | The COVID-19 Vaccine Distribution Task Force and NACI updated preliminary guidance on key populations for early COVID-19 immunization. Additionally, other countries such as the U.S. started giving vaccinations. | The vaccine would be distributed first to people who are most vulnerable and at greatest risk, in long-term care, are frontline workers, live in isolated communities or in the red control and lockdown zones. | Health Canada, Public Health Agency of Canada (PHAC), Ministry of Health, National Advisory Committee on Immunization (NACI), COVID-19 Vaccine Distribution Task Force Members |
https://covid-19.ontario.ca/ontarios-covid-19-vaccination-plan#phase-1 accessed on 15 November 2021 |
| Prioritization groups | 11 December 2020 | Ontario Begins Rollout of COVID-19 Vaccine | Guideline | Frontline health care workers in high-risk areas such as long-term care and critical care units are eligible to get vaccinated starting 15 December 2020. | Two pilot projects were conducted in Toronto and Ottawa which confirmed the province’s readiness for the delivery and distribution of COVID-19 vaccines. | Over 2500 health care workers were anticipated to be vaccinated with Pfizer-BioNTech vaccine. | Health Canada, PHAC, COVID-19 Vaccine Distribution Task Force Members |
https://news.ontario.ca/en/release/59607/ontario-begins-rollout-of-covid-19-vaccine accessed on 15 November 2021 |
| Prioritization groups | 18 December 2020 | Ontario Expands COVID-19 Vaccine Locations | Guideline | Ontario prepared to administer additional vaccines in the province. | Ontario expected to receive up to 90,000 Pfizer-BioNTech doses from the federal government. | Doses of Pfizer vaccine were initially distributed to two hospital sites. Then, distribution was expanded to reach 17 more hospital sites. | Health Canada, PHAC, COVID-19 Vaccine Distribution Task Force, Thunder Bay Regional Health Sciences Centre |
https://news.ontario.ca/en/release/59753/ontario-expands-covid-19-vaccine-locations accessed on 15 November 2021 |
| Prioritization groups | 30 December 2020 | Ontario Releases Ethical Framework for COVID-19 Vaccine Distribution | Ethical Framework | Ontario outlined a framework to guide vaccine prioritization phases of the province’s implementation plan. | Official discussions took place to identify factors that should be considered in assessing risk, and to prioritize groups at higher risk of exposure as well as those in critical roles. | Ontario launched a new webpage detailing the province’s three-phase immunization program, information on COVID-19 vaccines, safety measures and approval standards, as well as daily updates on the number of Ontarians vaccinated. | COVID-19 Vaccine Distribution Task Force, National Advisory Committee, Ontario government, Ontario Ministry of Health |
https://www.ontario.ca/page/ethical-framework-covid-19-vaccine-distribution accessed on 15 November 2021 |
| Prioritization groups | 5 January 2021 | Ontario Accelerates COVID-19 Vaccinations for Long-Term Care Homes in Priority Regions | News release | All health care workers and essential caregivers at long-term care homes in the priority regions should receive COVID-19 vaccination by 21 January 2021. | Trudeau announced that up to 249,000 doses would be available by the end of 2020 to launch a mass inoculation campaign. Additionally, Ontario faced a sharp increase in COVID-19 caseloads and deaths. | 44 vaccine sites have been established. Over 26,000 people have been administered the Pfizer vaccine in long-term care homes and retirement homes. | PHAC and Ontario Ministry of Health |
https://news.ontario.ca/en/release/59871/ontario-accelerates-covid-19-vaccinations-for-long-term-care-homes-in-priority-regions accessed on 15 November 2021 |
| Prioritization groups | 18 January 2021 | Guidance for COVID-19 Immunization in Long-Term Care Homes and Retirement Homes” | Guidance | Staff in the long-term care Homes and retirement homes (LTCH/RH) are all identified within Phase 1 (highest priority) of the Ontario vaccine distribution implementation plan. | Ongoing large clinical trials have shown that immunization against COVID-19 has been shown to be efficacious in preventing COVID-19 illness in the short term. | Public Health Units were delegated to develop plans for immunizing staff members, essential caregivers, and residents at LTCH/RH. | Ontario Health, LTCHs/RHs, Public Health Units, Minister of Health, Minister of Long-Term Care |
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/vaccine/COVID-19_LTC_RH_immunization_guidance.pdf accessed on 15 December 2021 |
| Prioritization groups | 25 January 2021 | Ontario Adjusts Vaccination Plan in Response to Pfizer-BioNTech Shipment Delays | New release | Ontario accelerated the vaccination of residents in long-term care, high-risk retirement, and First Nations elder care homes | The federal government notified the province of further reductions and delay in Pfizer-BioNTech vaccine next shipments. | Long-term care, retirement, and First Nations elder care home residents will have a maximum interval of 21–27 days between doses, while all other categories will have a maximum gap of 42 days. | Minister of Health, COVID-19 Vaccine Distribution Task Force, Ontario Health, LTCHs/RHs, Public Health Units, Minister of Health, Minister of Long-Term Care |
https://news.ontario.ca/en/release/60091/ontario-adjusts-vaccination-plan-in-response-to-pfizer-biontech-shipment-delays accessed on 15 December 2021 |
| Prioritization groups | 12 February 2021 | Guidance on the prioritization of key populations for COVID-19 immunization | Guidance | Guidance for the equitable, ethical, and efficient allocation of authorized COVID-19 vaccines in the context of staggered arrival of vaccine supply that necessitated offering vaccines to some populations earlier than others. | Ongoing vaccine delays and reduced shipments have forced the Ontario government. | Consultations with various stakeholders to develop the initial guidance on key populations. | Collaboration between: NACI, PHAC, Health Canada, the Canadian Immunization Committee (CIC), the Pan-Canadian Public Health Network’s Special Advisory Committee on COVID-19 (SAC), and Immigration, Refugees and Citizenship Canada (IRCC). |
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/guidance-prioritization-key-populations-covid-19-vaccination.html accessed on 15 December 2021 |
| Prioritization groups | 5 March 2021 | Ontario Ready to Rollout Phase Two of COVID-19 Vaccine Distribution Plan | News release | Ontario government prepared to move into Phase Two of its COVID-19 vaccine distribution plan, with a focus on vaccinating populations based on age and risk. | Phase One of Ontario’s vaccination rollout was well underway, with 820,000 doses administered and over 269,000 Ontarians fully immunized. Over 80% of long-term care residents were fully immunized. | Vaccines was administered in hospital clinics, primary care settings, mass vaccination sites, mobile clinics and pharmacies across the province. Additionally, the province launched an online booking system. | Ministry of Health, the COVID-19 Vaccine Distribution Task Force, Ontario government, local public health unit, Ontario pharmacist association |
https://news.ontario.ca/en/release/60568/ontario-ready-to-rollout-phase-two-of-covid-19-vaccine-distribution-plan accessed on 15 December 2021 |
| Prioritization groups | 17 March 2021 | COVID-19: Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination | Guidance | Ministry of Health provided a guidance regarding the phased prioritization of HCWs for COVID-19 vaccination and prioritization decision making. | Ontario government took considerations to prioritize health care workers because the demand for COVID-19 vaccine exceeded the available supply. | Ministry of Health has identified priority health sectors based on these criteria: occupational risk of COVID-19 exposure, healthcare workers who have the highest possibility of acquiring COVID-19, COVID-19-related risk of severe illness among patients, and the criticality of the health-care sector. | Ministry of Health, Ontario Health, Public Health Units, Health Care Organizations |
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/Guidance_for_Prioritizing_HCW_covid19_vaccination_2020-01-08.pdf accessed on 15 December 2021 |
| Prioritization groups | 6 April 2021 | Ontario Moving to Phase Two of COVID-19 Vaccine Distribution Plan | News release | Ontario began administering COVID-19 vaccines to residents 50 years of age and older in 13 public health units to support vaccine rollout in “hot spot” communities in Phase 2. | Ontario has received a total of 4,022,875 doses from the federal government, including about 1.3 million that arrived in the 1st week of April. Additionally, 3065 cases of COVID-19 were reported. | Ontario government was rapidly increasing capacity in its COVID-19 vaccine rollout with the addition of over 700 pharmacies across the province. | Ministry of Health, Ontario government, Ontario Pharmacists Association |
https://news.ontario.ca/en/release/61009/ontario-moving-to-phase-two-of-covid-19-vaccine-distribution-plan accessed on 15 December 2021 |
| Prioritization groups | 23 April 2021 | Pregnant women eligible for COVID-19 vaccine as Ontario moves them to ‘highest risk’ category | Recommendation | Pregnant women have been moved to the “highest risk” category in its COVID-19 vaccine priority list and become eligible for the vaccine. | Preliminary research published in The New England Journal of Medicine that tracked more than 35,000 pregnant individuals who received the mRNA COVID-19 vaccines (Pfizer or Moderna) and did not find any obvious safety concerns for pregnant individuals or their babies. | All pregnant individuals became eligible to register for vaccination appointments under the highest risk health conditions in the Phase 2 prioritization guidance. | Ministry of health, NACI, Ontario Society of Obstetricians and Gynaecologists |
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/vaccine/COVID-19_Phase_2_vaccination_prioritization.pdf accessed on 15 December 2021 |
| Prioritization groups | 29 April 2021 | Ontario expands COVID-19 vaccine eligibility to all adults by end of May | News release | Ontario planned substantially to expand eligibility for COVID-19 vaccines in May, by accelerating its timeline so all adults to register for a first dose by the end of May. | Acceleration of vaccine timeline comes as province reported 3871 new cases. Additionally, millions of doses of the Pfizer-BioNTech and Moderna vaccines anticipated to begin arriving in Ontario. | Ontario allocated 50% of all available doses to 114 hot-spot communities and expanded COVID-19 vaccine appointments to individuals aged 50 and over, individuals with high-risk health conditions. | Ministry of health, public health units, Ontario Pharmacists’ Association |
https://news.ontario.ca/en/release/1000052/ontario-expands-covid-19-vaccination-booking-for-more-people accessed on 15 December 2021 |
| Prioritization groups | 28 May 2021 | Anticipated Schedule for Second Doses of COVID-19 Vaccines | Backgrounder | The province accelerated second doses for all Ontarians. | Ontario experienced more COVID-19 cases linked to the Delta variant | Ontario accelerated second doses, and reduced the time between 1st and 2nd dose, down from the 16 weeks interval to 4 weeks after the 1st dose. | Ministry of health, Ontario Health, mass immunization clinics, mobile clinics, hospital clinics, pharmacy clinics, Ontario pharmacists’ associations. |
https://news.ontario.ca/en/release/1000217/ontario-accelerates-rollout-of-second-shots-targeting-a-two-dose-summer accessed on 15 December 2021 |
| Prioritization groups | 2 July 2021 | Youth Aged 12–17 Across Ontario Eligible for Accelerated Second Dose | News release | Ontario accelerated second dose eligibility to all children and youth aged 12 to 17. | Ontario administered over 15 million doses of COVID-19 vaccines, with more than 77% of adult Ontarians having received their first dose and more than 42% fully immunized. | Ontario government released Executive Officer Notice, which indicates that certain eligible pharmacies can administer injectable COVID-19 vaccines to eligible Ontarians. Government of Canada funds three new projects to encourage COVID-19 vaccination in Canada through the Immunization Partnership Fund (IPF). |
Ministry of health, Ontario Health, mass immunization clinics, mobile clinics, hospital clinics, pharmacy clinics, Ontario pharmacists’ associations. |
https://news.ontario.ca/en/release/1000453/youth-aged-12–17-across-ontario-eligible-for-accelerated-second-dose accessed on 22 December 2021 |
| Prioritization groups | 17 August 2021 | Ontario’s Updated COVID-19 Vaccination Eligibility (Booster doses) | Backgrounder | Ontario government has announced it will offer third doses of COVID-19 vaccines to the most vulnerable, including transplant patients and people in long-term care. | (U.S. FDA) has authorized COVID-19 vaccine boosters for the immunocompromised. WHO recommended that immunocompromised people be given an additional dose of COVID-19 vaccine. |
The province began offering third doses of a COVID-19 vaccine after eight weeks of receiving the second dose to vulnerable populations such as transplant recipients, patients with cancers, long-term care homes, and First Nations elder care lodges. | Ontario health, Ontario government, Health care provider such as their primary care provider, specialist, or their hospital specialty program |
https://news.ontario.ca/en/backgrounder/1000751/ontarios-updated-covid-19-vaccination-eligibility accessed on 22 December 2021 |
| Prioritization groups | 14 September 2021 | Expanded Eligibility for Third Doses of the COVID-19 Vaccine | Backgrounder | Ontario government expanded eligibility for third doses of the COVID-19 vaccine to additional groups that face the highest risk of serious illness from the virus. | Eligibility was expanded to provide extra protection against the Delta variant. Additionally, there was an increase of the daily reported new cases | NACI recommended that the booster dose of an authorized mRNA COVID-19 vaccine should be also offered to long-term care residents and seniors living in other congregate settings who have already received a primary COVID-19 vaccine series. | Ontario Health, Health Canada, NACI, Public health unit, transplant clinics and cancer clinics |
https://news.ontario.ca/en/backgrounder/1000805/expanded-eligibility-for-third-doses-of-the-covid-19-vaccine accessed on 22 December 2021 |
| Prioritization groups | 26 November 2021 | Importance of COVID-19 Vaccination in Pregnant, Recently Pregnant and Breastfeeding People | Statement | NACI recommended that all individuals who are pregnant or trying to become pregnant should receive COVID-19 vaccines, during any trimester of the pregnancy and/or while breastfeeding. | Public Health Agency of Canada has announced that one key group that appears to have lower uptake of COVID-19 vaccines is people who are pregnant. | Government of Canada website and PHAC on TV news channels: reassured the pregnant women that there is no evidence to suggest any adverse pregnancy or neonatal outcomes associated with COVID-19 vaccination. | NACI, Health Canada, the Society of Obstetricians and Gynaecologists of Canada (SOGC) |
https://www.canada.ca/en/public-health/news/2021/11/statement-from-the-chief-public-health-officer-of-canada---importance-of-covid-19-vaccination-in-pregnant-recently-pregnant-and-breastfeeding-people.html accessed on 22 December 2021 |
| Vaccine approval & distribution | 9 December 2020 | Health Canada authorized Pfizer-BioNTech COVID-19 Vaccine | Statement | The initial indication of the vaccine is for use in people 16 years of age or older with 2 doses 21 days apart. | Health Canada has determined that the Pfizer-BioNTech vaccine meets the Department’s stringent safety, efficacy and quality requirements for use in Canada. Additionally, the FDA and ACIP issued recommendations for use of the Pfizer-BioNTech COVID-19 Vaccine | Important safety information was communicated via the Recalls and Safety Alerts Database on the Healthy Canadians Web Site. Additionally, through the MedEffect™ e-Notice email notification system, social media channels, including LinkedIn and Twitter. | The Government of Canada, Health Canada, Pfizer Canada, NACI, Health professional |
https://www.canada.ca/en/health-canada/news/2020/12/health-canada-authorizes-first-covid-19-vaccine0.html accessed on 22 December 2021 |
| Vaccine approval & distribution | 23 December 2020 | Authorization of Moderna COVID-19 Vaccine with English-only Vial and Carton Labels | Letter | Moderna COVID-19 Vaccine was authorized in accordance with the Interim Order Respecting the Importation, Sale, and Advertising of Drugs for Use in Relation to COVID-19 in individuals 18 years of age and older. | NACI, FDA and ACIP issued recommendations for use of the Moderna COVID-19 vaccine in people aged 18 years and older. | Canada has secured contracts with Pfizer-BioNTech for access to 20 million doses and with Moderna for 40 million doses by the end of 2021. | The Government of Canada, Health Product Risk Communication, Health Canada, NACI, Health professional |
https://recalls-rappels.canada.ca/en/alert-recall/authorization-moderna-covid-19-vaccine-english-only-vial-and-carton-labels accessed on 17 January 2022 |
| Vaccine approval & distribution | 26 February 2021 | Authorization of AstraZeneca COVID-19 Vaccine with English-only Vial and Carton Labels | Letter | AstraZeneca COVID-19 Vaccine was authorized in accordance with the Interim Order Respecting the Importation, Sale, and Advertising of Drugs for Use in Relation to COVID-19 in individuals 18 years of age and older. | WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) recommended AstraZeneca vaccine for all age groups 18 and above. | The government of Canada has secured 2 million doses of the AstraZeneca COVID-19 vaccine through an agreement with Verity Pharmaceuticals Canada Inc./Serum Institute of India | The Government of Canada, Health Canada, NACI, Health professional |
https://recalls-rappels.canada.ca/en/alert-recall/authorization-astrazeneca-covid-19-vaccine-english-only-vial-and-carton-labels accessed on 17 January 2022 |
| Vaccine approval & distribution | 5 March 2021 | Authorization of Janssen COVID-19 Vaccine with English-only Vial and Carton Labels | Letter | Janssen COVID-19 Vaccine was authorized in accordance with the Interim Order Respecting the Importation, Sale and Advertising of Drugs for Use in Relation to COVID-19 in individuals 18 years of age and older. | FDA issued an (EUA) that allows the Janssen COVID-19 Vaccine to be distributed in the U.S for use in individuals 18 years of age and older. | Important safety information was communicated with healthcare professionals and Canadians via the Recalls and Safety Alerts Database on the Healthy Canadians Web Site. | The Government of Canada, Health Canada, NACI, Health professional |
https://recalls-rappels.canada.ca/en/alert-recall/authorization-janssen-covid-19-vaccine-english-only-vial-and-carton-labels accessed on 23 January 2022 |
| Vaccine approval & distribution | 1 April 2021 | Ontario Expanding Pharmacy and Primary Care Locations for COVID-19 Vaccinations | News release | Ontario government increased capacity in its COVID-19 vaccine rollout. All of the new locations will be offering the AstraZeneca vaccine to individuals aged 55 and over. | Earlier in March Ontario began offering the vaccine to individuals aged 60 and over at pharmacies and primary care settings. Additionally, the province was expecting to receive 1,584,180 doses of Pfizer vaccine and 751,500 doses of Moderna vaccine. | Ontario government extended booking for COVID-19 vaccination appointments to more age groups (Individuals aged 60 and over) through its provincial booking system. | Ontario government, Ontario Pharmacist Association |
https://news.ontario.ca/en/release/60976/ontario-expanding-pharmacy-and-primary-care-locations-for-covid-19-vaccinations accessed on 23 January 2022 |
| Vaccine approval & distribution | 5 May 2021 | Health Canada authorized the use of the Pfizer COVID-19 vaccine for children 12 to 15 years of age | Statement | Health Canada authorized the use of the Pfizer-BioNTech COVID-19 vaccine in children 12 to 15 years of age. | Clinical trials results were approved by Health Canada after showing that Pfizer vaccine is “safe and effective” for the younger age group with an efficacy rate of 100% | Ontario public health units began providing vaccines to those aged 12 and over in pop-up and mobile clinics, as well as for walk-in appointments | Public Advisories and Risk Communications, Health Canada, PHAC, NACI |
https://covid-vaccine.canada.ca/info/regulatory-decision-summary-detailTwo.html?linkID=RDS00802 accessed on 23 January 2022 |
| Vaccine approval & distribution | 17 August 2021 | Ontario Makes COVID-19 Vaccination Policies Mandatory for High-Risk Settings | Directive #6 for COVID-19 Vaccination Policy in Health Settings |
A directive was issued to mandate hospitals and community care service providers to have a COVID-19 vaccination policy for employees, staff, contractors, students and volunteers, and for ambulance services. | On July 27, 2021, CDC updated information about Delta variant as it is highly contagious and released updated guidance on the need for urgently increasing COVID-19 vaccination coverage. | Individuals are required to provide proof of being fully vaccinated against COVID-19, or a medical reason for not being vaccinated, or a completion of a COVID-19 vaccination educational session | Ontario government and Ministry of Health |
https://www.ontariomidwives.ca/sites/default/files/2021%2008%2017%20CMOH%20Directive%206.pdf accessed on 23 January 2022 |
| Age groups and types of vaccine | 1 March 2021 | AstraZeneca COVID-19 vaccine is not recommended in people aged 65 and older | Statement | NACI recommended the use of the AstraZeneca vaccine be limited to individuals between the ages of 18 and 64. | No sufficient evidence on the safety of AstraZeneca in people aged 65 years and older. | Ontario health minister suspended the administration of AstraZeneca vaccine to seniors over the age of 65. |
NACI, PHAC, Health Canada, Infectious diseases specialists |
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/summary-updated-statement-16-march-2021.html accessed on 25 January 2022 |
| Age groups and types of vaccine | 16 March 2021 | Canada changed its guidelines on the AstraZeneca-Oxford COVID-19 vaccine | Recommendation | The recommendation on the use of AstraZeneca COVID-19 vaccine has been updated to include use in those 65 years of age and older. | Observational studies of vaccine effectiveness from the United Kingdom demonstrated high safety and effectiveness of the AstraZeneca vaccine in those 65 years or older | Ontario announced that those aged 60–64 could receive vaccines ahead of older age groups, who are at greater risk of hospitalization and death from COVID-19. | NACI, PHAC, Health Canada, Infectious diseases specialists |
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/march-16-2021.html#appc accessed on 23 January 2022 |
| Age groups and types of vaccine | 29 March 2021 | vaccine committee recommends suspending AstraZeneca use for people under 55 | Public Advisory | The National Advisory Committee on Immunization’s (NACI) recommended that AstraZeneca COVID-19 vaccine should not be used in adults under 55 years of age at this time | Adverse events in Europe following immunization with the AstraZeneca COVID-19 vaccine | Ontario suspended the use of the vaccine for anyone below the age of 55. Additionally, the safety of AstraZeneca COVID-19 vaccine was further investigated | NACI, PHAC, Health Canada, Infectious diseases specialists, a panel of medical experts |
https://recalls-rappels.canada.ca/en/alert-recall/adverse-events-europe-following-immunization-astrazeneca-covid-19-vaccine#public-public accessed on 23 January 2022 |
| Age groups and types of vaccine | 14 April 2021 | The use of AstraZeneca COVID-19 vaccine is not restricting in any specific populations at this time | Statement | Health Canada is not restricting the use of the Oxford-AstraZeneca COVID-19 vaccine in any specific populations. | Available data from Europe and from the United Kingdom and AstraZeneca, showed that no specific risk factors have been identified. | Ontario started offering the AstraZeneca vaccine to individuals aged 55 and older. |
NACI, PHAC, Health Canada, Ontario government, Ministry of Health |
https://www.canada.ca/en/health-canada/news/2021/04/health-canada-provides-update-on-safety-review-of-astrazeneca-and-covishield-covid-19-vaccines.html accessed on 23 January 2022 |
| Age groups and types of vaccine | 19 April 2021 | Ontario Safely Expands Age Eligibility for AstraZeneca COVID-19 vaccine to 40+ | Statement | Ontario expanded AstraZeneca COVID-19 vaccination eligibility to individuals aged 40 and over | Health Canada announced that AstraZeneca vaccine is not restricted to any specific populations | Ontario government began offering AstraZeneca vaccine for individuals aged 40 and over at 20 pharmacy locations in hot-spot communities | Health Canada, NACI, Ontario government, APO |
https://news.ontario.ca/en/statement/61204/ontario-safely-expands-age-eligibility-for-astrazeneca-covid-19-vaccine-to-40 accessed on 23 January 2022 |
| Age groups and types of vaccine | 3 May 2021 | NACI: mRNA vaccines still preferred: Pfizer-BioNTech and Moderna | Recommendation | NACI preferentially recommends the use of Moderna or Pfizer mRNA COVID-19 vaccine to individuals 30 years of age and older | Johnson & Johnson and AstraZeneca vaccines have been linked to a new and extremely rare blood clotting syndrome. | The federal government reassured Canadians that all vaccines approved for use in Canada are safe and effective. | Safety alerts by Health Product Risk Communications (HPRC), NACI, PHAC, Health Canada, |
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/summary-updated-statement-may-3-2021.html accessed on 26 February 2022 |
| Age groups and types of vaccine | 11 May 2021 | Ontario Pauses Administration of AstraZeneca Vaccine | Statement | Ontario announced that the Oxford-AstraZeneca COVID-19 vaccine will no longer be offered to Ontarians as a first dose because of serious blood clotting condition connected to the vaccine. | Ontario has recorded 8 cases of rare blood clots linked to AstraZeneca | Ontario paused the use of AstraZeneca COVID-19 vaccine as a first dose. Additionally, Ontario asked Canada’s federal and NACI to release guidance on the safety and efficacy of mixing COVID-19 vaccines | Health experts at Public Health Ontario, the Science Advisory Table, NACI, Health Canada, PHAC, Public health units |
https://news.ontario.ca/en/statement/1000103/ontario-pauses-administration-of-astrazeneca-vaccine accessed on 26 February 2022 |
| Age groups and types of vaccine | 29 September 2021 | Ontario Recommends the use of Pfizer-BioNTech COVID-19 vaccine for Individuals Aged 18–24 Years Old | Statement | Ontario issued a preferential recommendation of the use of Pfizer-BioNTech vaccine for individuals aged 18–24 years old. | An observed increase in Ontario’s pericarditis/myocarditis cases following vaccination with Moderna compared to Pfizer in the 18- to 24-year-old age group, particularly among males. | On a teleconference Ontario recommended that individuals between the ages of 18 to 24 receive a Pfizer COVID-19 vaccine rather than Moderna due to a rise in rare cases of myocarditis or heart inflammation. | Ontario’s Children COVID-19 Vaccine Table, Ontario Vaccine Clinical Advisory Group, Public Health Ontario, Ministry of health, public health units and pharmacies |
https://news.ontario.ca/en/statement/1000907/ontario-recommends-the-use-of-pfizer-biontech-covid-19-vaccine-for-individuals-aged-18–24-years-old accessed on 26 February 2022 |
| Policy on vaccine dosing | 25 January 2021 | Ontario Adjusts Vaccination Plan in Response to Pfizer-BioNTech Shipment Delays | News release, Documents | Ontario changed the interval time between 2 doses of Pfizer to 21–27 days for long-term care, retirement, and First Nations and up to 42 days for all other groups. | The federal government notified the province of further reductions in Pfizer-BioNTech vaccine shipments | Accelerate vaccination of the most vulnerable populations across Ontario with the goal of visiting each home in the province to administer the first doses by 5 February 2021. | The federal government, Ontario government, NACI, and Ministry of health |
https://news.ontario.ca/en/release/60091/ontario-adjusts-vaccination-plan-in-response-to-pfizer-biontech-shipment-delays accessed on 26 February 2022 |
| Policy on vaccine dosing | 16 March 2021 | Extending the interval for the second dose of COVID-19 vaccines up to four months after the first does | Policy document and recommendation | Ontario extended the timeline for the second dose of vaccine up to four months after the first dose to provide further protection. | NACI recommended extending the vaccination dose interval up to four months for all approved COVID-19 vaccines based on evidence-based trials. | Studies were conducted to examine the effectiveness of extending the interval between doses of COVID-19 vaccine due to the limited vaccine supply. | NACI, federal government’s COVID-19 immunity task force, infectious disease specialists, Ontario government, and Ministry of health |
https://mcusercontent.com/52d9e9dfa66c8bca909aa4569/files/5bf00393-47ba-465c-9bdd-28a0bd32eccc/2021_03_24_Extended_Dose_Key_Messages_2021_03_19_FINAL_EN_AODA.01.pdf accessed on 26 February 2022 https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/naci-summary-extended-dose-interval-covid-19-en.pdf accessed on 26 February 2022 |
| Policy on vaccine dosing | 10 May 2021 | High-Risk Health Care Workers Eligible to Receive a Second Dose of the COVID-19 vaccine at a Shortened Interval | Backgrounder | Ontario government added high-risk health care workers to the list of those eligible to receive their second dose of the COVID-19 vaccine earlier than the extended four-month interval. | Canada’s deputy chief public health officer announced that the time interval between first and second vaccine dose can be shortened as more vaccine supply deliveries arrive. | Certain high-risk health care workers were eligible to book their second dose of the vaccine at an interval shorter than four months. | Ontario government, Ministry of Health, Canadian health officials, Government officials. |
https://news.ontario.ca/en/backgrounder/1000089/high-risk-health-care-workers-eligible-to-receive-a-second-dose-of-the-covid-19-vaccine-at-a-shortened-interval accessed on 26 February 2022 |
| Policy on vaccine dosing | 1 June 2021 | Canada recommends mixing and matching AstraZeneca, Pfizer and Moderna COVID-19 vaccines | Recommendation | Canada advised Canadians to combine either the AstraZeneca-Oxford, Pfizer-BioNTech or Moderna shots interchangeably in certain situations. | NACI recommended that a first shot of the AstraZeneca vaccine can be followed by either Moderna or Pfizer. | The choice was left to Ontarians who received their first dose of the AstraZeneca COVID-19 vaccine to either receive a second dose of the AstraZeneca vaccine, or an mRNA (Pfizer or Moderna) vaccine for their second dose. | PHAC, NACI, Health Canada, Ontario Ministry of Health, Ontario government |
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/rapid-response-interchangeability/summary.html accessed on 14 February 2022 |
| Vaccination and travel | 21 June 2021 | Government of Canada’s first phase to easing border measures for travellers entering Canada | News release | The Federal Government announced that fully vaccinated travellers will no longer be subject to quarantine requirements. | Due to the improving epidemiological situation in Canada, 79% of people aged 12 and older in Canada received at least one dose. Additionally, other countries started easing border restrictions such as the US | Proof of vaccination was required from all travellers as well as a pre-arrival COVID-19 molecular test result before arriving in Canada. | Canadian airports, PHAC, Canada Border Services Agency, Transport Canada, Ministry of public Safety and Emergency Preparedness |
https://www.canada.ca/en/public-health/news/2021/06/government-of-canadas-first-phase-to-easing-border-measures-for-travellers-entering-canada3.html accessed on 14 February 2022 |
| Vaccination and travel | 7 September 2021 | New measures for fully vaccinated international travellers to Canada will come into force | Travel Advisory | Fully vaccinated foreign nationals meeting the conditions to enter Canada for discretionary (non-essential) purposes are allowed to travel. | Between August 9 and 26, the illness severity and hospitalization rates remain manageable as Canada’s vaccination rates continue to rise. | Mandatory pre-arrival molecular test result. Mandatory submission of the proof of vaccination via ArriveCAN. |
Canadian airports, PHAC, Canada Border Services Agency, Transport Canada, Ministry of public Safety and Emergency Preparedness |
https://www.canada.ca/en/border-services-agency/news/2021/09/travel-advisory-reminder--on-september-7-new-measures-for-fullyvaccinated-international-travellers-to-canada-will-come-into-force.html accessed on 14 February 2022 |
| Vaccination and travel | 19 November 2021 | Adjustments to Canada’s border and travel measures | Backgrounder | Eliminating COVID-19 testing for air and land crossings of less than 72 h. | Travel restrictions were based on the epidemiological situation in Canada and internationally. | Expanding the list of accepted vaccines for the purpose of travel including Sinopharm, Sinovac and COVAXIN, to match the WHO Emergency Use Listing. | Canadian airports, PHAC, Canada Border Services Agency, Transport Canada, Ministry of public Safety and Emergency Preparedness |
https://www.canada.ca/en/public-health/news/2021/11/adjustments-to-canadas-border-and-travel-measures.html accessed on 14 February 2022 |
| Vaccination and education | 8 April 2021 | Additional Protections for Schools to Keep Students and Staff Safe | News release | Education workers providing direct support to students with special needs across Ontario are eligible to register for a COVID-19 vaccine. | New measures were introduced to protect schools against COVID-19 to have a safe return to schools. | vaccinations were distributed during Spring break starting with priority neighborhoods in Toronto and Peel, then rolling out to priority neighborhoods in other hot spot regions. Additionally, schools remain open for in-person learning. | Ontario government, Ministry of Health, Ministry of Education |
https://news.ontario.ca/en/release/61052/additional-protections-for-schools-to-keep-students-and-staff-safe accessed on 20 November 2021 |
| Vaccination and education | 16 August 2021 | Ontario Working with Public Health Units to Run COVID-19 Vaccination Clinics in Schools | News release | Ontario government worked with public health units and publicly funded school boards to plan and host vaccination clinics in or nearby schools to continue to fight COVID-19. | Clinics ran before school starts and during the first few weeks of school to have a safe return to schools. | More than 69% of youth aged 12 to 17 received a first dose of the COVID-19 vaccine and 56% received a second dose. | Ontario government, Ministry of Health, Ministry of Education, public health units |
https://news.ontario.ca/en/release/1000745/ontario-working-with-public-health-units-to-run-covid-19-vaccination-clinics-in-schools accessed on 20 November 2021 |
| Vaccination and entertainment | 1 September 2021 | Ontario to Require Proof of Vaccination in Select Settings | Backgrounder | Ontarians need to be fully vaccinated to access certain public settings and facilities. | To further protect Ontarians as the province continues to confront the Delta-driven fourth wave of the COVID-19 | Ontario government released regulations and guidance for businesses and organizations to support them in implementing proof of vaccination requirements by enhancing digital vaccine receipt that features a QR code. | Ontario government, Ministry of Health, Ontario Digital Service, Ministry of Digital Government |
https://news.ontario.ca/en/backgrounder/1000780/new-requirement-for-proof-of-vaccination-in-certain-settings-frequently asked-questions accessed on 20 November 2021 |
| Vaccination and entertainment | 24 September 2021 | Ontario increasing capacity limits for events requiring proof of vaccination | -Policy order in Council -REOPENING ONTARIO (A FLEXIBLE RESPONSE TO COVID-19) ACT, 2020 |
Capacity limit was increased in many of the indoor settings where proof of vaccination is required. | As of September 24, the success of Ontario’s vaccine rollout, which has resulted in one of the highest vaccination rates in the world, had seen 80% of eligible Canadians be fully vaccinated. | Meeting and event spaces were increased to up to 50% capacity. Additionally, certain outdoor event venues where patrons stand, capacity limits were increase to up to 75% | Ontario government, Ministry of Health, Workers in businesses and events |
https://news.ontario.ca/en/release/1000864/ontario-cautiouslyeasing-capacity-limits-in-select-settings-where-proof-of-vaccination-is-required accessed on 20 November 2021 https://files.ontario.ca/solgen-678-21-amending-364-20.pdf accessed on 20 November 2021 |
| Vaccination and entertainment | 15 October 2021 | Enhanced COVID-19 vaccine Certificate with QR Code and Verify Ontario App Available for Download | Memorandum to: Municipal Chief Administrative Officers and Clerks | Enhanced vaccine certificate with official QR code available for download starting October 15. | Ontario required patrons to provide proof of identification and of being fully vaccinated against COVID-19 to access certain non-essential businesses and settings. | Ontario has updated regulations, guidance, and Questions and Answers for businesses to support the implementation of the enhanced vaccine certificate with a QR code and the Verify Ontario app. | Ontario government, Ministry of Health, Ontario Digital Service, Ministry of Digital Government |
https://news.ontario.ca/en/release/1000979/enhanced-covid-19-vaccine-certificate-with-qr-code-and-verify-ontario-app-available-for-download-starting-october-15 accessed on 20 November 2021 |
| Vaccination and work | 5 February 2021 | Nurses (RN/RPN)—Province Wide—COVID-19 mRNA Vaccination Order | Chief Medical Officer of Health Orders, and Ontario laws | Ministry of health announced an order indicates that: a Registered Nurse or Registered Practical Nurse may initiate a COVID-19 mRNA vaccination of vaccine recipients. | 1-Moderna and Pfizer vaccines were authorized by the government of Canada, and COVID-19 Immunization Program was expanded. | Ontario government announced that health care professionals such as nurse practitioners, registered nurses, pharmacists, pharmacy students and pharmacy technicians who are able to administer the vaccine can register and apply through Ontario’s Matching Portal | Ministry of Health, Ontario laws Health care professionals, OPA |
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/orders/OrderS5_Nurses_2021_02_05.pdf accessed on 20 November 2021 |
| Vaccination and work | 4 May 2021 | Ontario Responds to High Vaccination Rates, Modifies Restrictions in Long-Term Care Homes | Directive #3, issued by the Chief Medical Officer of Health | long-term care homes can safely resume activities such as communal dining and indoor events and gatherings, with precautions. | 95% of long-term care residents were fully immunized and more than 85% of staff received at least their first dose. | Ontario responded to high levels of COVID-19 vaccination in many long-term care homes by making changes that helped homes safely resumed communal dining and social activities | Ontario government, Ministry of Health, Ontario’s Ministry of long-term care, Long-term care homes |
https://www.ontario.ca/page/covid-19-guidance-document-long-term-care-homes-ontario accessed on 20 November 2021 |
| Vaccination and work | 31 May 2021 | Ontario Mandates Immunization Policies for Long-term Care Homes | Minister’s Directive Ontario Regulation 79/10 under the Act |
Ontario took further action to protect long-term care home residents by becoming the first province in Canada to make it mandatory for homes to implement COVID-19 immunization policies for staff. | On 21 May 2021, Ontario resumed outdoor visits with long-term care home residents. | To promote immunization rates, long-term care home staff were allowed to use paid sick leave to get vaccinated or recover from symptoms resulting from vaccination. | Ontario government, Ministry of Health, Ontario’s Ministry of long-term care, Long-term care homes |
https://www.ontario.ca/page/ministers-directive-long-term-care-home-covid-19-immunization-policy?_ga=2.36946281.816317635.1637828338-424476654.1636403002 accessed on 20 November 2021 |
| Vaccination and work | 27 September 2021 | Ontario Adding New Resources to Protect Workers | New release | Ontario launched the new Workplace Safety Plan Builder | These actions are to support workers and to contribute to a prosperous and stable economy as part of the province’s 2021 budget. | Workplaces were allowed to use the “Workplace Safety Plan Builder” tool to create and adjust their plans and to support them to remain open. | Ontario government, public health units, Ministry of Labour, Training and Skills Development inspectors. |
https://news.ontario.ca/en/release/1000874/ontario-adding-new-resources-to-protect-workers accessed on 20 November 2021 |
| Vaccination and work | 1 October 2021 | Ontario Taking Additional Steps to Protect Long-Term Care Home Residents | New release | Ontario made COVID-19 vaccinations mandatory for all in-home staff by November 15, 2021, unless a staff member has a valid medical exemption. | Vaccination rates of staff in many homes were not high enough to face the risk of the Delta variant, which with put vulnerable residents at risk. | Staff who do not have all required doses or a valid medical exemption by the deadline will not be able to enter a long-term care home to work. | Ontario government, Ministry of Health, Ontario’s Ministry of long-term care, Long-term care homes |
https://news.ontario.ca/en/release/1000917/ontario-taking-additional-steps-to-protect-long-term-care-home-residents accessed on 20 November 2021 |
| Vaccination and work | 6 October 2021 | Mandatory COVID-19 vaccination for federally regulated transportation employees and travellers | Backgrounder | Mandatory vaccination for the federal workforce and federally regulated transportation sectors by 30 October 2021. | Mandatory vaccination for the federally regulated air, rail, and marine sectors helps limit the risk of spreading the Delta variant COVID-19 and helps prevent against future outbreaks. | All federal employees in the Core Public Administration must prove their immunization status. Otherwise, they will be placed on administrative leave without pay beginning November 2021. | Prime Minister of Canada, Ministry of Transport, Ministry of Intergovernmental Affairs, Ministry of Finance |
https://www.canada.ca/en/transport-canada/news/2021/10/mandatory-covid-19-vaccination-requirements-for-federally-regulated-transportation-employees-and-travellers.html accessed on 20 November 2021 |
| Vaccination and vulnerable groups | 17 June 2021 | Canada launched the Vaccine Injury Support Program | Statement | Canada launched the Vaccine Injury Support Program to provide financial support to those who experienced a serious and permanent injury after receiving an authorized vaccine | there have been 5989 reports of adverse events following a COVID-19 vaccine. Of those, 1126 were considered serious. over two dozen confirmed cases of vaccine-induced immune thrombotic thrombocytopenia, related to the AstraZeneca COVID-19 vaccine | The financial support was available to the dependents of those who have died after receiving a vaccination, which included income replacement, payment for injuries, death benefits including funeral expenses, and uncovered medical expenses | Health Canada, PHAC (Public Health Agency of Canada), Vaccine Injury Support Program (VISP) |
https://www.canada.ca/en/public-health/news/2021/06/statement-from-the-chief-public-health-officer-of-canada-on-june-17-2021.html accessed on 20 November 2021 https://vaccineinjurysupport.ca/en accessed on 3 December 2021 |
| Vaccination and vulnerable groups | 22 June 2021 | Ontario Providing Accessible Rides to COVID-19 Vaccination Sites | New release | Ontario government invested $3.7 million in a partnership with the Ontario Community Support Association to help people with disabilities get to and from vaccination sites | Some Ontario residents faced barriers in traveling to vaccination sites | Minister for Seniors and Accessibility announced that the “Accessible Drive to Vaccines program” will ensure that anyone who wants a vaccine is able to go to vaccination sites | Ontario Community Support Association (OCSA), Ministry of Seniors and Accessibility, Government of Canada |
https://news.ontario.ca/en/release/1000389/ontario-providing-accessible-rides-to-covid-19-vaccination-sites accessed on 3 December 2021 https://www.ontario.ca/page/covid-19-support-people#section-5 accessed on 3 December 2021 |
| Vaccination and vulnerable groups | 6 August 2021 | Ontario Rolls Out Vaccine Clinic on Wheels | New release | GO buses travelled to events and community hubs, making it easier to receive COVID-19 vaccine. | Some Ontario residents faced barriers in traveling to vaccination sites, and not yet having their first or second doses. | The GO-VAXX buses travelled to malls, festivals, and events across the Greater Golden Horseshoe Region. No appointments were needed, and anyone aged 12 and over could get their first or second dose | Ontario government, Ministry of Transportation, Metrolinx bus company |
https://news.ontario.ca/en/release/1000683/ontario-rolls-out-vaccine-clinic-on-wheels accessed on 3 December 2021 https://www.ontario.ca/page/go-vaxx-bus-schedule accessed on 3 December 2021 |
| Vaccination and vulnerable groups | 7 September 2021 | COVID-19: Vaccination Policy—implementation guidelines issued by the Ministry of Children, Community and Social Services | Ontario Laws O. Reg. 364/20: Rules for Areas at Step 3 and at the Roadmap Exit Step |
All staff in Education and Community Partnership programs must ensure compliance with a COVID-19 vaccination policy | CDC recommendations was to increase the vaccination rates for places where service providers can serve as a home for residents or clients, or service setting for vulnerable children | Employees, staff, and students are needed to provide one of the following: Proof of full vaccination, A medical reason for not being vaccinated, or completing an educational session about the benefits of COVID-19 vaccination | Ministry of Children, Community and Social Services, Ministry of Health |
https://www.ontario.ca/page/covid-19-vaccination-policy-implementation-guidelines-issued-ministry-children-community-and#foot-2 accessed on 3 December 2021 |