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Vaccine Interval Guide
Vaccine Interval Guide
Primary Series: Most individuals need two doses of a COVID-19 Vaccine (mRNA, Novavax1) to
complete a primary series. Those aged six months to four years will require two to three doses,
depending on vaccine product. Immunocompromised individuals are recommended to receive
an additional dose to complete their primary series.
Booster Doses: All Individuals five years of age and older are eligible to receive a booster dose once
their primary series is complete. The interval for receiving a booster is six months (168 days) after
their last dose or confirmed COVID-19 infection.2
COMIRNATY/PFIZER
Age: 5-11 years Mixing Doses !
or
Dilute: With 1.3ml Children who did not complete
Dose: 10mcg/0.2ml their primary series before
SPIKEVAX/MODERNA turning five and received Pfizer
Age: 6-11 years (3mcg) are recommended to
or
Dilute: NO complete a 3-dose series using
Dose: 50 mcg/0.5ml the correct dose for their age at
50mcg/0.25ml the time of administration (i.e.,
Primary Series Intervals Between Doses Pfizer 10mcg).5
Recommended: 56 days Minimum: 28 days Booster Doses
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Booster Doses Recommendations
Individuals 5 years and older who have not received a booster dose since September 1, 2022,
remain recommended to receive a booster dose if it has been at least six months (168 days) since
their last dose or confirmed COVID-19 infection.2 If a booster dose has been received on or after
September 1, 2022 (either monovalent or bivalent), there is no current evidence that substantiates
the need for an additional dose, beyond the high-risk groups listed below.
Ontario’s Spring 2023 Booster Recommendations:
Individuals in specific high-risk populations are recommended to receive a spring
booster dose if at least six months (168 days) have passed since their last dose or
confirmed COVID-19 infection.2
High-Risk Groups:
• Individuals aged 65 years and older
• Residents of long-term care homes, retirement homes, elder care lodges, and other congregate
living settings for seniors
• Individuals 18 years and older living in congregate care setting for people with complex medical
needs
• Pregnant individuals
• Individuals aged 18 years and older who are moderately to severely immunocompromised
• Individuals aged 55 years and older who identify as First Nations, Inuit or Métis and their non-
Indigenous household members aged 55 years and older.
Boosters for Children Aged 5-11 Years
COMIRNATY/PFIZER Bivalent SPIKEVAX/MODERNA Bivalent BA.1
Age: 5-11 years Age: 6-11 years
Dilute: With 1.3ml Dilute: NO
Dose: 10mcg/0.2ml Dose: 25mcg/0.25ml
This document can be used as a reference for vaccine clinics and vaccine administrators to support COVID-19
immunization and is not intended take the place of medical advice, diagnosis or treatment, or legal advice. In
the event of conflict between this document and any applicable emergency orders, or directives issued by the
Minister of Health, Minister of Long-Term Care, or the Chief Medical Officer of Health, the order or directive
prevails. Check the Ministry of Health COVID-19 website for updates to COVID-19 Vaccine Guidance.
1 Novavax may be offered as a primary series to individuals who are aged 12 years and older and as a booster
dose to individuals 18 years and older without contraindications to the vaccine who are not able or willing to
receive an mRNA COVID-19 vaccine. Janssen may be offered to individuals who are aged 18 years and older
without contraindications to the vaccine who are not able or willing to receive either an mRNA vaccine or a
Novavax vaccine. Informed consent is required.
2 A previous infection with SARS-CoV-2 is defined as: Confirmed by a molecular (e.g., PCR) or rapid antigen
test; or Symptomatic AND a household contact of a confirmed COVID-19 case.
3 For immunocompromised children aged six months to four years there is a preferential recommendation
for monovalent Moderna (25 mcg) due to feasibility of series completion of the primary series rather than
any safety signals observed. A 4-dose primary series with Pfizer-BioNTech (3 mcg) may have feasibility
challenges.
4 Pfizer is preferred for those 5-29 receiving a primary series and those <18 years receiving a booster dose.
5 For guidance on managing COVID-19 vaccine administration errors and deviations, please see the
Government of Canada’s Planning guidance for immunization clinics for COVID-19 vaccines: Managing vaccine
administration errors or deviations and the Ontario Immunization Advisory Committee’s (OIAC)
Recommendations: Management of Age-Related COVID-19 Vaccine Administration Errors . Where there is
conflict between the two resources above, please refer to OIAC recommendations.
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