MEDICAL ADVISORY: Fourth Doses (Second Booster) of COVID-19 Vaccines
Issued by: Azim Kasmani, MD, FRCPC, Associate Medical Officer of Health
Ontario Expanding Fourth Dose Eligibility
Beginning on April 7, 2022, individuals 60 years of age and older (on or after their 60th birthday) as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members 18 years and older (on or after their 18th birthday) are eligible for a fourth dose of COVID-19 vaccine.
- Fourth doses will be offered to these individuals at an interval of five months (140 days)
since their last booster dose. The minimum interval with informed consent for the fourth dose is three months (84 days) from the third (booster) dose.
- Eligible individuals can book their fourth dose appointment
- Online through the COVID-19 vaccination portal (if it has been at least five months since last dose)
- By calling the Provincial Vaccine Contact Centre at 1-833-943-3900 (if it has been three to five months
since last dose)
- At participating pharmacies
- At health care provider offices administering COVID-19 vaccines
- Individuals who received a three-dose primary series are not yet eligible for a second booster (fifth dose)
National Advisory Committee on Immunizations (NACI) Recommendation for Second Booster Doses of COVID-19 Vaccine
- NACI strongly recommends a second booster dose of COVID-19 vaccine should be offered to
- Adults 80 years of age and older living in the community
- Residents of long-term care or other congregate living settings for seniors
- NACI recommends second booster doses should be provided six
months after receiving the previous booster dose, but that the interval may need to be balanced with local and current COVID-19 epidemiology
- Shorter intervals may be indicated for the older adult populations in the settings specified above (must meet minimum interval of three months)
- Timing of recent COVID-19 infection should also be considered
- Recommended to receive a booster dose three months after symptoms started or after testing positive (if they had no symptoms) and if they have met the minimum interval since receiving last dose
Recommendations on Vaccine Product and Dosage for Second Booster Dose
- Moderna Spikevax vaccine is recommended as a second booster dose for eligible individuals 30 years of age and older regardless of which product was received for the primary series or first booster dose
- A full dose (100 mcg) is recommended for residents of long-term care homes, retirement homes or seniors in other congregate living settings, adults 70 years of age and older, and all eligible immunocompromised individuals
- A half dose (50 mcg) is recommended to anyone else 30 - 69 years of age
- Pfizer-BioNTech’s Comirnaty vaccine is recommended as a second booster dose for individuals 18 - 29 years of age
- The full dose (30 mcg) is recommended
- The Novavax
Nuvaxovid COVID-19 vaccine may be offered as a booster dose to eligible individuals who are unable or unwilling to receive an mRNA COVID-19 vaccine. For more information on the use of Novavax Nuvaxoid COVID-19 vaccine as a booster dose, please refer to the recent medical advisory.
- Patients interested in this vaccine should call the COVID-19 Info Line (905-688-8248 or 1-888-505-6074, press 7)
More
Information