Health Care Provider COVID-19 & Influenza Immunization Tool Kit

Ottawa Public Health has created this virtual tool kit to support community partners in implementation and/or continuation of respiratory immunizations. 

For COVaxON or inventory related help or information: email Ottawa Public Health COVaxON Support Team. 

For information on vaccine storage, ordering or administering: email Vaccine Distribution Centre 

General eligibility to administer COVID-19 and Influenza vaccines:

  • Must have a designated vaccine fridge that meets the Ministry of Health vaccine storage and handling guidelines and have passed fridge inspections by Ottawa Public Health within the past 12 months
  • For COVID-19 Only: Must commit to document COVID-19 vaccine administration in COVaxON

Steps to accessing COVID-19 and Influenza vaccines: 

Step 1: Assess eligibility to administer vaccines
  • Any clinics that receive immunization supply from the publicly-funded program (beside COVID-19 and Influenza) are eligible to receive COVID-19 and Influenza vaccines.
  • For healthcare agencies and/or pharmacies, application is required to the Ministry of Health’s Universal Influenza Immunization Program (UIIP). Please visit the Ontario Ministry of Health Website for more information on this process; general applications for the 2024-2025 season with some exceptions. If you need support with the process, please email UIIP.MOH@ontario.ca. The application process opens in the Spring.
  • To administer publicly funded vaccines, a designated vaccine fridge must meet the MOH Vaccine Storage and Handling Guide and have passed a fridge inspection with Ottawa Public Health; with a fridge in good standing (monthly temperature log submission required).
  • If your facility received a pass on the current year’s vaccine fridge inspection, please continue with the onboarding process in step 2. If your facility has not yet completed an inspection, please contact Ottawa Public Health’s Vaccine Distribution Centres at vaccine@ottawa.ca to request a vaccine fridge inspection.
Step 2: For COVID-19 administration only: complete LOA and receive COVaxON training; if you are only administering influenza vaccines, please proceed to step 3

COVaxON Onboarding, Training and Support 

COVaxon is a provincially mandated application to support the administration of COVID-19 vaccinations in Ontario.Data entry into the system is mandatory for participants in the community partner vaccination initiative.As access to COVaxON can expire with non-use, please ensure that your facility has active access to COVaxON prior to the day of your immunization event. 

Steps to onboard your team into COVaxON

1. Ensure your Letter of Agreement with OPH is signed 

Letter of Agreement (LOA)

Once your dedicated vaccine fridge has passed inspection and is in good standing, vaccine providers will be asked to sign a Letter of Agreement (LOA) to administer COVID-19 vaccines. This is a legal letter for all external partners who request and administer COVID-19 vaccines from Ottawa Public Health (OPH). This agreement is a requirement from the Ontario Ministry of Health for all COVID-19 vaccine providers. It is a commitment to document COVID-19 vaccine administrations through COVaxON. 

Please email immunization@ottawa.ca if your organization is unsure if they have completed this documentation in the past or if you would like to initiate the process of completing an LOA.

2. Fill out the onboarding request form

COVaxONOnboarding Request Form

3. Upload your list of COVaxON users

Upload your list of COVaxON Users: Please complete the COVax User List Upload Form - Ottawa Public Health (anglais seulement). OPH may need to clarify some details before your accounts can be created. If  additional accounts are required later, you may request them through the same form. Once user accounts are requested, the users will receive a welcome email which provides instructions on how to finish setting their COVaxON account and details on COVaxON training.

For accounts that require reactivation and/or support, a request can be sent to covaxon@ottawa.ca.  

4. Provide users with COVaxON training 

COVaxON Technology Support

Phone: 416-849-9998

Toll Free: 1-888-333-0640

Email: covaxonsupport@ontario.ca

The support hours are Monday to Friday: 8 am to 5 pm

Ottawa Public Health’s COVaxON support team


A COVax SharePoint Site was developed for training purposes and gives COVax users who are registered under OPH’s authorized organization (AO) access to various COVax training materials, including demo session recordings, learning modules, job aids, tailored user training roadmaps, system change and much more. 

Should you require support such as access to the SharePoint site, please contact Ottawa Public Health’s COVaxON support team at covaxon@ottawa.ca and they will get back to you as soon as possible. PLEASE NOTE: The mailbox is monitored Monday- Friday between 8:00 am to 4:00 pm. 
 

Step 3: Please confirm authorizing mechanism is available for Epinephrine, Influenza vaccine and/ or COVID-19 vaccine administration for nursing staff if they are to administer on behalf of a nurse practitioner or physician.

Directives and direct orders allow nursing staff to perform the controlled act of immunization.

Medical Directive Templates: If an authorizing health professional would like a template to assist them in the creation of their own medical directive, please email your request to immunization@ottawa.ca.
 Step 4: Information on vaccine administration, vaccine products and their preparation 
Health care professionals who are interested in receiving copies of Ottawa Public Health’s immunization competency modules can email immunization@ottawa.ca to request the following modules:
  • Module 1 Consent and Documentation
  • Module 2 Vaccine Storage, Handling and Giving
  • Module 3 Vaccination Emergencies

Learning Resources 

Management of Adverse Events

COVID-19 vaccine products:

Ontario Ministry of Health’s COVID-19 Vaccine Health Care Provider Factsheet includes useful guidance for health care professionals on the administration of COVID-19 vaccines, including information on eligibility and summaries of vaccine product formulations.

Additional Information Sources:

Influenza vaccine products:

Influenza vaccine is recommended for everyone six months of age and older who does not have contraindications to the vaccine.

Detailed product recommendations from NACI are available at: 

 Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2024-2025

 

Vaccine

Age indication

Influenza Vaccine Formulation

Dosage and Route of Administration

Format

Most common allergens

FluLaval® Tetra

six months of age and older

Quadrivalent Inactivated Vaccine (QIV or IIV4-SD)

0.5mL IM
  • Multi-dose vial (MDV)
  • Egg Protein*
  • Thimerosal

Fluzone® Quadrivalent

six months of age and older

Quadrivalent Inactivated Vaccine (QIV or IIV4-SD)

0.5mL IM
  • Multi-dose vial (MDV)
  • Pre-filled Syringes (PFS)
  • Egg Protein*
  • Thimerosal** (multi-dose vial only)

Flucelvax® Quadrivalent

six months of age and older

Quadrivalent Inactivated Vaccine (QIV or IIV4-cc)

0.5mL IM
  • Pre-filled Syringes (PFS)

  • Does NOT contain egg protein or thimerosal 

Fluzone® High-Dose Quadrivalent

65 years of age and older

High-Dose Quadrivalent Inactivated Vaccine (QIV-HD or IIV4-HD)

0.7mL IM
  • Pre-filled Syringes (PFS)
  • Egg Protein*

Fluad®

65 years of age and older

Adjuvanted Trivalent Inactivated Vaccine (TIV-adj or IIV3-Adj)

0.5mL IM
  • Pre-filled Syringes (PFS)
  • Egg protein*
  • Kanamycin
  • Neomycin

^ Any component in a vaccine may be a potential allergen. This table identifies the most common allergens.

* Egg allergy is not a contraindication to receiving the influenza vaccine

**Thimerosal-free QIVs in pre-filled syringe format are available for those with a thimerosal allergy. 

Important notes:

  • Fluzone® Quadrivalent and Fluzone® High-Dose Quadrivalent are different products. Fluzone® High-Dose Quadrivalent is only authorized for those 65 years of age and older. Please use caution when administering Fluzone® products to ensure that the right vaccine is being administered to the right person.

Choosing between QIV standard dose (SD), QIV High Dose (HD) and TIV-Adj for patients 65 years of age and older:

Rather than delay vaccination for a particular product, the recommendation is to vaccinate older adults with either the QIV, QIV-HD or TIV-adj which all protect against the flu.

When available, high-dose QIV and TIV-adj should be offered over standard-dose inactivated influenza vaccine.

However, NACI states that any of the available age-appropriate influenza vaccines can be used. There is no preferential recommendation for the use of QIV-HD versus TIV-adj vaccine for this age group.

To date, no studies have directly compared QIV-HD and TIV-adj formulations or TIV-adj and QIV formulations.

Please consider the following information when discussing vaccine options:

  • There is limited evidence directly comparing QIV-HD and TIV-adj against each other.
  • QIV-HD and TIV-adj both appear to provide better protection compared to QIV standard dose.
  • QIV-HD and TIV-adj are both effective alternatives to QIV, with no identified difference in safety, based on direct evidence among adults 65 years of age and older.
  • Given there have been no confirmed naturally occurring B/Yamagata lineage virus detections since March 2020, the additional B/Yamagata lineage strain found in the QIV-HD is no longer warranted, but continues to be offered in some formulations. 

For more information on high-dose QIV, TIV-Adj and QIV, please refer to the  Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2024-2025.

More information for individuals 65 years of age and older can be found here Health Care Providers Q&A for individuals 65 years of age and older.

Step 5: Immunization Clinic Print Resources

Creating clinic posters and directional signage may be helpful for patients, caregivers and families to access your clinic. Ottawa Public Health has compiled the following documents to assist you in hosting a clinic. Please feel free to utilize these documents to support the organization of immunization services.

  • Ottawa Public Health’s Hand Hygiene poster
  • COVID-19 Vaccine: Utilize your established consent processes for vaccine administration

Please note: Health care professionals are asked to document doses on COVaxON within 24 hours of administration, as per the Letter of Agreement.
Step 6: Order vaccine and supplies

 

 

  • Vaccine supplies (needles, syringes, cotton balls) can also be ordered on the Covid-Related Vaccine Order Form

  • The Authorized Organization name and number can be found in the vaccination event within COVaxON under your facility. 

image of COVaxON page with areas listing authorized organization name and number highlighted for web-page viewers to identify where to find this information

 

Influenza vaccines: Please complete an Influenza Vaccine Order Form 2024-2025. 

For detailed information on influenza vaccine distribution from Ottawa Public Health, please see the following Public Health Alert: Key dates and information for 2024-2025 Universal Influenza Immunization Program roll-out in Ottawa - Ottawa Public Health

Vaccine Distribution Centre Contact Information

Should you require support with vaccine supply:

  • Email:
  • Phone:
    • COVID-19 vaccine - 613-580-3000
    • Influenza vaccine - 613-580-6744 (choose options 1, 8 then 3)
Step 7: Immunization clinic day reminders

Staff entering administration information into COVaxON should log into the program prior to the administration date to ensure that their password has not expired; accounts that have been inactive for 30 days will need to have their password reset. Contact covaxon@ottawa.ca to request a password reset.

Consent forms (if using) can be made available to patients (or power of attorney, if applicable) and completed prior to administration.

  • Immunizations given for COVID-19 will need to be recorded in COVaxON
  • Immunizations given for COVID-19 can be reported in Daily Tally Sheet
  • Influenza can be recorded and documented as per your facility’s policy.

Frequently asked questions

Which vaccine products are available for COVID-19 vaccination?

The list of approved vaccines can be found in the Ministry of Health’s COVID-19 Vaccine website, and Ottawa Public Health will fulfill vaccine orders based on current availability of vaccines. We will reach out if changes need to be made to your order. 
What are the current recommendations for COVID-19 doses?

Refer to Ontario’s website on COVID-19 vaccines for the latest guidelines.

Can Ottawa Public Health (OPH) visit my practice for this training support and/or to help administer vaccines?

Unfortunately, OPH doesn’t have the capacity to provide in-person immunization support. OPH is shifting back to pre-pandemic operations and staffing capacity based on provincial direction. Many organizations were onboarded over the last few years with OPH support, and we hope your organization continues to build on this experience and knowledge transfer. 

OPH will continue to ensure access to vaccine supply and up-to-date COVID-19 & influenza immunization information to health care providers. Our goal is to help you to build and maintain capacity to deliver immunizations directly or in collaboration with community partners.

Can we transport vaccines between our multiple sites?

You are encouraged to create an internal policy for vaccine transport to comply with requirements in the following guidance:

Where can I find information on the appropriate billing codes for COVID-19 immunization and influenza vaccine administration reimbursement? 

The Ministry of Health and Long-Term Care also publishes OHIP bulletins to update on billing concerns, which include COVID-19. Questions regarding submission of billing codes can be directed to the Ministry of Health and Long-Term Care’s Service Support Contact Centre at SSContactCentre.MOH@ontario.ca

What is vaccine availability currently like?

All available influenza vaccines under the publicly funded program are available this year. KP.2 COVID-19 vaccines are available; OPH will provide vaccine based on supply received from the province. 

How often can I order vaccines? 

Vaccines are available for order at your convenience. Please use the Influenza Vaccine Order Form 2024-25 or the COVID-19 vaccine online order form. We typically suggest that vaccines are ordered on a weekly basis (planning for the week ahead) to avoid reaching the expiry date. 

How long before delivery does my vaccine order need to be placed? 
Please see current processing times on our website to plan accordingly. 

Does the LOA signed at a previous clinic apply if I change clinics and /or my practice relocates?

The Letter of Agreement signed is for the clinic and not specific to the clinician. If the clinic location changes the LOA should be updated to reflect the new address. If you, as the clinician, relocates to a new clinic, then the new clinic should have an LOA i.e. the agreement follows the organization not the individual. Please contact covaxon@ottawa.ca to notify of this location change, so your COVAxON account can be updated accordingly.

What storage is needed for the various vaccines? 
Please see the Ontario Ministry of Health’s COVID-19: General COVID-19: Vaccine Storage and Handling Guidance for information related to the COVID-19 vaccines.
Please see the Ontario Ministry of Health’s Influenza: Vaccine Storage and Handling Guidelines for information related to Influenza vaccines.

Where can I access COVID-19 vaccine medical exemption information?
Statement of Medical Exemption – COVID-19 Vaccine

Additional Resources

Patient Resources

 

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