Long Term Care Homes & Retirement Homes Immunization Tool Kit


Ottawa Public Health has created this virtual toolkit to support community partners in implementation and/or continuation of seasonal 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 

Long-term care homes and retirement homes are critical partners in the management of seasonal respiratory illness. Residents of these institutions are vulnerable to severe complications from COVID-19, Influenza & RSV. 

Infection control practices and vaccinations in these institutions are important to protect residents, staff and their caregivers.

General eligibility to administer COVID-19, Influenza & RSV vaccines: 

  • Must be a Long-Term Care Home or Registered Retirement Home in Ottawa

  • Must have a designated vaccine fridge that meets the Ministry of Health vaccine storage and handling guidelines and has 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: Ensure your home is eligible to administer vaccines

Retirement Homes:

If an organization already receives publicly funded vaccine(s) other than publicly funded influenza vaccine (excluding COVID-19 vaccine) they do not need to apply to the Universal Influenza Immunization Program (UIIP). 

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). 

After receiving a pass on the current year’s vaccine fridge inspection, continue with the onboarding process in step 2. If you have not yet completed an inspection, contact Ottawa Public Health’s Vaccine Distribution Centre at vaccine@ottawa.ca requesting a vaccine fridge inspection. 

Long-Term Care Homes:

Long-Term Care Homes do not need to apply to participate in the Universal Influenza Immunization Program(UIIP). 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). 

After receiving a pass on the current year’s vaccine fridge inspection, continue with the onboarding process, step 2. If you have not yet completed an inspection, contact Ottawa Public Health’s Vaccine Distribution Centre at vaccine@ottawa.ca requesting a vaccine fridge inspection. 

Step 2: For COVID-19 administration only: complete LOA and receive COVaxON Training; if you are only administering influenza vaccines, 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 vaccine@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 Training and Technical Support 

The OntarioMD (OMD) offers COVaxON Training and user management support. For more information about OntarioMD COVaxON training, please contact:  

OMD Support Team

Phone: 416-623-1248

Toll Free: 1-866-744-8668

Email: support@ontariomd.com

 

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


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 recordingslearning modulesjob 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: Ensure authorizing mechanism is available for Epinephrine, Influenza vaccine and/ or COVID-19 vaccine administration for nursing staff.

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

Medical Directive Templates: 

If your organization has an authorizing health professional who would like a template to assist them in the creation of their own medical directive, please email immunization@ottawa.ca. 

Step 4: Immunizer training on vaccine administration, vaccine products and their preparation

If your organization is interested in copies of Ottawa Public Health’s immunization competency modules for external providers please 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 

Other Learning Resources:  

Management of Adverse Events 

Vaccine Administration Practices: Canadian Immunization Guide

The Education Program for Immunization Competencies (EPIC): Canadian Paediatric Society

COVID-19 vaccine products: 

Prior to administration ensure familiarity with the Ontario Ministry of Health’s COVID-19 Vaccine Guidance which provides important guidance for health care providers administering COVID-19 vaccine including eligibility and summaries of vaccine product formulations. 

Additional Information Sources 

Health Canada Resources 

Vaccine Product Monographs for currently available COVID-19 vaccines:  

These monographs include information on:  

  • Storage, handling and preparation of vaccine 

  • Administration guidelines including dosing, routes etc. 

  • Contraindication, side effects and warnings 

 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 2023-2024

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)

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

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

**Thimerosal-free QIVs in pre-filled syringe format Fluzone® Quadrivalent 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.

For individual-level decision making, NACI in Canada states that when available, high-dose is recommended over standard-dose inactivated influenza vaccine, given the burden of influenza A(H3N2) disease and the good evidence of better protection compared to standard-dose in adults 65 years of age and older.

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 insufficient evidence to make a preferential recommendation between QIV-HD and TIV-adj. There is good evidence of QIV-HD providing better protection compared to QIV standard dose.
  • In considering use of TIV-adj and QIV standard dose, given the increased burden of disease associated with influenza A(H3N2) in older adults, better protection against influenza A(H3N2) afforded by the TIV-adj may be more important, especially in those with multiple co-morbid conditions and compromised health status.

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 2023-2024.

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: Organize and set clinic dates

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. 

Step 6: Order vaccine and supplies
  • COVID-19 vaccines: complete the Covid-Related Vaccine Order Form; Please allow 3 - 5 business days for processing your order.

  • 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

Following the launch of the 2023-2024 UIIP campaign: Vaccine ordering forms will be available on ottawapublichealth.ca/hcp.

Vaccine Distribution Centre Contact Information

Should you require support with vaccine supply:

  • Email:
    • vaccine@ottawa.ca
  • Phone:
    • COVID-19 vaccine - 613-580-3000
    • Influenza vaccine - 613-580-6744 (choose options 1, 8 then 3)
Step 7: Immunization clinic day reminders
  • Ensure staff login into COVaxON prior to the clinic to ensure 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.
  • Have consent forms (if using) available and completed by resident or (power of attorney, if applicable) prior to administration.
  • Record immunizations given for COVID-19 in COVaxON
  • Report immunizations given for COVID-19 in Daily Tally Sheet

Influenza can be recorded and documented as per your facilities policy.

Steps to accessing RSV vaccines:

Step 1: Ensure your home is eligible for the High-Risk Older Adults RSV Vaccine Program

The publicly funded vaccine program for individuals 60 years and older is open to residents living in long-term care homes (LTCHs), including Elder Care Lodges and residents of retirement homes (RHs) licensed to provide dementia care services. 

Retirement Homes licensed to provide dementia care services:

To administer publicly funded RSV 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). 

After receiving a pass on the current year’s vaccine fridge inspection, continue with step 2. If you have not yet completed an inspection, contact Ottawa Public Health’s Vaccine Distribution Centre at vaccine@ottawa.ca requesting a vaccine fridge inspection.

Long-Term Care Homes:

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). 

After receiving a pass on the current year’s vaccine fridge inspection, continue with step 2. If you have not yet completed an inspection, contact Ottawa Public Health’s Vaccine Distribution Centre at vaccine@ottawa.ca requesting a vaccine fridge inspection. 

Step 2: Ensure authorizing mechanism is available for Epinephrine, and RSV vaccine administration for nursing staff.

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

Medical Directive Templates: 

If your organization has an authorizing health professional who would like a sample directive to assist them in the creation of their own medical directive, please email immunization@ottawa.ca
Step 3: Immunizer training on vaccine administration, vaccine products and their preparation

If your organization is interested in copies of Ottawa Public Health’s immunization competency modules for external providers please 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 
  • High Risk Older Adults RSV Vaccine Program Module

RSV vaccine products: 

Other Learning Resources: 
 
Management of Adverse Events 

Vaccine Administration Practices: Canadian Immunization Guide

The Education Program for Immunization Competencies (EPIC): Canadian Paediatric Society

Step 4: Organize and set clinic dates

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. 

Passive screening posters for patients and visitors

Hand Hygiene poster

Creating clinic posters and directional signage may be helpful for patients, caregivers and families to access your clinic

Utilize your established consent processes for vaccine administration;

RSV Fact Sheet for Vaccine Recipients.
Step 5: Order vaccine

RSV vaccine through the High-Risk Older Adult RSV Vaccine Program can be ordered starting November 7th by eligible LTCHS & RHs by completing the RSV Vaccine Order Form

Should you require support with vaccine supply:

Email:

vaccine@ottawa.ca

Phone:

613-580-6744 (choose options 1, 8 then 3)

Step 6: Immunization clinic documentation
RSV vaccine can be recorded and documented as per your facilities policy.

RSV Vaccine Consent Form Sample


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 Guidance, 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?

Please visit Ontario’s website on COVID-19 vaccines for the latest guidelines.

Our residence does not have registered staff to administer COVID-19 or Influenza immunizations, what are our options?
  • Seek immunization from residents’ regular health care provider.
  • Contact local pharmacies to inquire if they can provide immunizations to your residents, whether in the pharmacy or they may offer the option of hosting a clinic in your residence. 

Some known options for pharmacies are:

  • Valley Health Pharmacy
  • Shoppers Drugmart on Dalhousie
  • Half Moon Bay Pharmacy

Visit https://www.ontario.ca/vaccine-locations for a full list of pharmacies offering COVID-19; list of participating pharmacies for influenza will be posted on our website following the launch of the 2023-2024 UIIP campaign.

Note: currently due to legislative limitation pharmacists are unable to host in-house immunizations for influenza in Long-Term Care Homes Facilities.

  • Posters to direct residents to local pharmacies
  • Direct residents to an Ottawa Public Health Clinic
  • Consider organizing a clinic with available nursing agencies
    • GEM Health Care Services
    • Lifemark Workplace Health and Wellness
    • ParaMed Inc.
    • Access Healthcare Services Inc.
Can Ottawa Public Health (OPH) visit my organization for this training support and/or to help administer vaccines?
  • Unfortunately, OPH doesn’t have the capacity to provide in-person immunization support to LTCH and RH. We are shifting back to pre-pandemic operations and staffing capacity. 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.
  • By providing this online resource you can continue to access needed information to offer seasonal immunizations in your organization. OPH will provide external support to organizations to ensure vaccine supply and access to up-to-date COVID-19 & Influenza immunization information to support your organization to build and maintain capacity to deliver immunizations directly or in collaboration with community partners.
  • For 2023-2024 season OPH is contacting eligible retirement homes as identified by the Province, and will be supporting for roll-out of the new High-Risk Older Adults RSV Vaccine Program in these settings.

Can pharmacy professionals administer the RSV vaccine under the publicly funded program? Can RNs and RPNs administer the RSV vaccine?

At this time, pharmacy professionals (pharmacists, registered pharmacy students, interns, and pharmacy technicians) are not authorized to administer the RSV vaccine; expansion to pharmacy professionals is​ pending approval of regulatory amendments. 

 

Currently, under an authorizing mechanism like directives and direct orders, RNs and RPNs may administer the RSV vaccine under the publicly-funded program.

If your organization has an authorizing health professional who would like a sample directive to assist them in the creation of their own medical directive, please email immunization@ottawa.ca

Can we transport vaccines between our multiple sites?

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