Frequently asked questions about COVID-19 vaccination

Last revised on May 20, 2022

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Third (booster) dose and fourth (second booster) dose

What is the difference between a “three-dose primary series” and a “booster dose”?
  • The reason for a booster dose is to restore protection that may have decreased over time to a level that is no longer effective, in people who initially responded well to a “complete vaccine series”  

  • This is different than a third dose which might be added to the standard “primary vaccine series” with the aim of enhancing the immune response and establishing an adequate level of protection for people who did not develop immunity or developed a sub-optimal immune response to a 2-dose primary series. 

  • In short – a primary series for most healthy people remains 2-doses, and for these people, a third (booster) dose is offered to boost the immune system. A third-dose primary series is offered to those who are immunocompromised or vulnerable to ensure they have an adequate immune response and are protected. A fourth (booster) dose is then offered to this population to boost their immune response. 

Why should I get a third (booster) dose of the COVID-19 vaccine?

Third (booster doses) of mRNA COVID-19 vaccines are readily available to strengthen protection against severe illness and complications due to COVID-19.  

There is now evidence of a gradual decrease in vaccine effectiveness over time following the second dose. An Ontario study indicates that vaccine effectiveness decreases following a second dose and increases following a third dose.  

A third, booster dose, of the COVID-19 vaccine will help restore and maintain protection against infection and help reduce your risk of severe illness, complication, or death due to COVID-19. For some, a fourth, second booster dose is now available.

Youth aged 12 to 17 years:  

  • For youth 12 to 17 a third dose or a “booster dose” is now being recommended in Ontario to those who received the second dose of their vaccine more than six months (168 days) ago. 

*Note: Youth must be 12 years old on the day they receive the vaccine. 

Adults 18 years of age and older:  

  • For adults 18 years of age and older, a third dose or a “booster dose” is now being recommended in Ontario to those who received the second dose of their vaccine more than three months (84 days) ago. 

Adults 50 years of age and older: 

  • Adults over 50 are at greater risk for serious illness and complications from COVID-19. There is now evidence that there is a gradual decrease in vaccine effectiveness over time following the second dose.  

  • Getting a third (booster dose) ensures greater protection against serious illness and complications from COVID-19.  

Adults 60 years of age and older, First Nations, Inuit and Metis aged 18 years and over or non-indigenous household members: 

  • Adults 60 and over, First Nations, Inuit and Métis aged 18 years and over or non-indigenous household members can now receive a fourth dose of the COVID-19 vaccine at an interval of 140 days after their third (booster) dose. 

  • The above eligible populations may receive their fourth (second booster) dose at shortened interval of 84 days after their third dose. Eligible recipients should consider their individual risk factors that may increase their susceptibility as well as the level of COVID-19 in the community. Individuals can consult their primary care provider for individual considerations.

  • Fourth (booster doses) of mRNA COVID-19 vaccines are readily available to eligible residents to strengthen protection against severe illness and complications due to COVID-19.

Why should I get a third (booster) dose of the COVID-19, as a pregnant person?

Receiving an mRNA COVID-19 vaccine series is highly recommended for individuals who are pregnant, and studies have shown that it is safe right before and/or while pregnant.  

Getting an mRNA COVID-19 vaccine is an effective way to prevent complications and bad outcomes for parent and baby should you be infected with the virus.   

Pregnant individuals who contract COVID-19 are at an increased risk of severe illness requiring hospital care and admission to the intensive care unit compared to those who are not pregnant.  

The antibodies a pregnant individual makes from the vaccine pass to the baby and help protect the baby after birth. Giving birth too early in pregnancy (preterm birth), having a caesarean delivery and having a baby admitted into a neonatal intensive care unit is more common in pregnant people with severe COVID-19.  

The side effects after receiving an mRNA COVID-19 vaccine in individuals who are pregnant are the same in those who are not pregnant. If you’re feeling unsure about getting your third dose, speak with your health care provider or specialist. They can answer your questions and help you to better understand your individual risks

How and where can I get a third (booster) or fourth (second booster) dose?
  • Now is the time to get your COVID-19 booster and increase your protection against severe illness as the highly transmissible Omicron variant is present in our community. Ottawa Public Heath has plenty of capacity to administer COVID-19 vaccines. 
  • Fourth (second booster) doses are now also available for eligible groups.
  • All Ottawa Public Health community clinics are offering drop-ins to everyone eligible for a booster as well as first and second doses. For more information on how to book an appointment, clinic hours and locations, please visit: OttawaPublicHealth.ca/Covid19Vaccine
Is it safe to mix vaccines for a third (booster) dose and fourth (second booster) dose?
  • An mRNA COVID-19 vaccine, by Comirnaty (Pfizer-BioNtech) and Moderna, can be used for third doses and boosters in individuals 18 years of age and older. This is the recommendation whether you received AstraZeneca/COVISHIELD or an mRNA vaccine previously.
  • While OPH offers both mRNA vaccines in its community clinics, several factors are considered when deciding what brand you will receive. You may not get to choose which mRNA brand you receive based clinical assessment and eligibility factors. Currently, and in accordance with guidance from the National Advisory Committee on Immunization.
Do I need a booster dose if I had COVID-19 recently and have some natural immunity? 
  • Currently, data is limited regarding the immune response provided by prior COVID-19 infection and the length of protection provided. However, there is early evidence that immunity from previous COVID-19 infection without vaccination does not provide the best protection against reinfection with COVID-19. 
  • Developing immunity from infection, sometimes called “natural immunity,” requires exposure to an unpredictable virus with known serious consequences including risk of severe illness and death. Vaccines provide a way for your body to develop its own natural immunity to COVID-19 without the risk of severe disease from COVID-19 infection.    
  • Vaccination is recommended for everyone regardless of previous COVID-19 infection to prevent serious illness and complications from COVID-19.  
  • For adults aged 18 and older, it is recommended to get a third (booster) dose of the COVID-19 vaccine if at least three months (84 days) have passed since their second dose.  
  • For youth 12 to 17, a third (booster) dose is recommended for those who received the second dose of their vaccine more than six months (168 days) ago. 
  • Fourth doses (second boosters) are also recommended to those eligible.
  • Adults 60 and over, First Nations, Inuit and Métis aged 18 years and over or non-indigenous household members can now receive a fourth dose of the COVID-19 vaccine at an interval of 140 days after their third (booster) dose. 
  • The above eligible populations may receive their fourth (second booster) dose at shortened interval of 84 days after their third dose. Eligible recipients should consider their individual risk factors that may increase their susceptibility as well as the level of COVID-19 in the community. Individuals can consult their primary care provider for individual considerations.
Should I delay getting a booster dose?
  • With many vaccinated individuals contracting COVID-19 due to the Omicron and BA.2 variants, it is reasonable to question the need for a booster dose, at this time.
  • Two doses of vaccine are providing protection against severe illness due to the Omicron variant and far fewer individuals in Ontario are needing intensive care because of two-dose vaccination. However, a third, booster dose, is important to improve the immune response which may decrease over time since the last dose. The booster dose will also increase protection against serious illness and complications from COVID-19 including death.
  • Fourth doses (second booster) are also available for eligible groups. A fourth dose will further improve the immune response, providing protection against serious illness and complication from COVID-19.  
How soon can I get my third (booster) dose after a COVID-19 infection or suspected infection?
  • Those who have previously tested positive for COVID-19 should still be vaccinated with a third (booster) dose and people do not need COVID-19 testing prior to vaccination.
  • Both National Advisory Committee on Immunization (NACI) and the Province recommend that individuals needing a booster dose who experienced COVID-19 infection after completing their primary series wait for three months after symptoms started or after testing positive (if no symptoms were experienced) before receiving a booster dose of COVID-19 vaccine; and for youth 12 to 17, provided it has been at least 184 days from completing the primary series
  • For the purposes of COVID-19 vaccination, a previous COVID-19 infection includes individuals who received a positive COVID-19 test result (either a PCR or Rapid Antigen Test) or who was a household contact of a confirmed case and had COVID-19 symptoms.
  • Individuals who have tested positive for COVID-19, or suspect having contracted it, should wait until they have recovered, completed the self-isolation period, and are feeling better before getting vaccinated. This will help to prevent exposing others at a vaccination clinic to the virus. 
  • A third dose may be given earlier than three months (84 days) following infection so as long as 84 days have passed since the last dose of the primary series for individuals 18 years of age and older and 168 days since the last dose of the primary series for individuals 12 to 17 years of age.
  • Informed consent should include that new evidence shows a longer interval between a COVID-19 infection and vaccination is associated with improved antibody response to COVID-19 vaccines.

What information is available about fourth doses (booster)?

Why should I get a fourth (second booster) dose of the COVID-19 vaccine?

There is currently a resurgence of COVID-19 in Ontario and the community. Information from the Ontario Ministry of Health, shows that some people are several months past their third (first booster) dose which may lead to increased vulnerability due to decreased immunity.  

A fourth dose (second booster) can provide additional protection, including against severe disease in certain individuals. According to NACI, preliminary data suggests the safety of a second booster is well tolerated with no additional safety signals in the populations studied such as older adults and long-term care residents.  

In Ontario, individuals aged 60 and over as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 and over are eligible for fourth (second booster) doses.

How soon can I get a fourth dose (second booster) after a COVID-19 infection or suspected infection?

Those who have previously tested positive for COVID-19 should still be vaccinated with a fourth dose and do not need COVID-19 testing prior to vaccination. 

See Who can receive their fourth dose (second booster)? for eligibility criteria.

If you have had a recent COVID-19 infection or suspected infection and meet the eligibility criteria, it is recommended that you wait at least three months after symptoms started or after testing positive for COVID-19 (if no symptoms were experienced) before you receive your fourth dose (second booster) of a COVID-19 vaccine, provided that it has been at least five months since the third dose (first booster). 

For the purposes of COVID-19 vaccination, a previous COVID-19 infection includes individuals who received a positive COVID-19 test result (either a PCR or Rapid Antigen Test) or who were household contacts of a confirmed case and had COVID-19 symptoms. 

Informed consent should include that new evidence shows a longer interval between a COVID-19 infection and vaccination is associated with improved antibody response to COVID-19 vaccines. 

Proof of vaccination regulation

⚠ Ontario moved to its next phase of reopening on March 1, 2022. While the proof of vaccination is now no longer required for most indoor settings, businesses and other settings may choose to continue to require proof of vaccination. Ottawa Public Health will continue to share information to help you make informed decisions regarding activities and personal levels of risk in this changing environment.

What can I show as proof of vaccination and personal identification?

Individuals aged 12 and over, unless otherwise exempted, can provide proof of vaccination and personal identification as follows:

Proof of vaccination

You can provide your enhanced vaccine certificate with a valid QR code.

Personal identification

Businesses or organizations are permitted to voluntarily verify your identification as well as your proof of vaccination, your medical exemption or your proof of participation in a COVID- 19 vaccine trial. Photo ID is not required.

Your ID must include your:

  • name
  • date of birth

Examples of identification that you may use include:

  • birth certificate
  • driver's license
  • government (Ontario or other) issued identification card
  • passport
  • citizenship card
  • permanent resident (PR) card
  • Indian Status Card or Indigenous Membership Card
How do I get a copy of my ‘vaccine receipt’ after I have been vaccinated?

After each dose of the COVID-19 vaccine that you get, you will be able to log into the provincial portal to download and or print an electronic COVID-19 vaccine receipt. The vaccine receipt will be a pdf document with a QR code that can be scanned by businesses using the Verify Ontario App .

You will need the following to log into the provincial portal:

A green photo health (OHIP) card (you will need the numbers from the front and back of the card, expired cards will be accepted)

Your date of birth

Your postal code that is associated with your health card

  • Red and white health card: call the Provincial Vaccine Booking line at 1-833-943-3900. You will be emailed a copy of the vaccine receipt after your request.
  • Individuals who do not have a health card but were immunized in Ontario and need proof of vaccination can call 613-691-5505 and listen to the options.
  • Individuals who do not have access to a computer and printer can drop into any of our Neighbourhood Vaccination Hubs where an OPH staff can help to download and print your vaccination receipt.

Can Ottawa Public Health upload vaccine exemptions documents to the Verify Ontario app, so I can use my QR code to show proof my medical or clinical exemption?

Any person who has a medical exemption to COVID-19 vaccines will need a provincially issued digital QR Code to access certain businesses and settings that voluntarily require proof of vaccination. Medical exemptions to obtain the QR code can only be granted by physicians and nurse practitioners licensed in Ontario. Once proper documentation is received from a physician or nurse practitioner Ottawa Public Health can generate the QR codes.

As per provincial guidance, true medical exemptions are expected to be infrequent and should be supported by expert consultation. Further information is available for physicians and health care professionals.

What can First Nation, Inuit and Métis community members show as proof of vaccination?

For anyone who got vaccinated at Akausivik and/or for people who chose not to have their personal information entered into the provincial database system (COVAX), you need two things:

  1. A copy of the receipt you received at the time of vaccination. The receipt must include your name, date of vaccination (first and second dose), and vaccine product you received (e.g. Comirnaty/Pfizer-BioNtech). If you lost or misplaced your vaccination receipt, please contact the clinic where you got your vaccine to receive another copy.
  2. Proof of identification. The identification needs to include your name and date of birth but photo ID is not required.  The identification used can be expired.

Identification documents include:

  • Birth certificate
  • Citizenship card
  • Driver’s license
  • Government (Ontario or other) issued identification card, including health card
  • Indian Status Card /Indigenous Membership Card
  • Passport
  • Permanent Resident card

If your personal information is not in COVAX, you will not be able to download a vaccine receipt. You will need to contact the clinic for a copy, as described above.

There is no requirement for you to have your personal information in COVAX, provided that you have the receipt and proof of identification as described above.

How to prepare for vaccination

Take a tour of our COVID-19 vaccination clinic:

For more information on vaccines, please visit the COVID-19 vaccine webpage.

Visit our COVID-19 Vaccination Dashboard for up-to-date information on COVID-19 vaccinations in Ottawa.

Clinics, accessibility and transportation

Am I eligible for in-home vaccination?
  • If you have a health condition or special needs that prevents you from visiting a local clinic, pharmacy, or your primary care provider to receive the COVID-19 vaccine, a team can come to your home to offer vaccination to you and to your caregiver. 
  • Please call 613-691-5505 to request an in-home vaccination. 
  • A nurse will contact you to assess your eligibility and obtain more information to book a date and time. 
If I have symptoms or was told to self-isolate can I still go to my vaccine appointment?

No. If you have COVID-19 symptoms or have been told to self-isolate then you must not go to your vaccination appointment.

Once you are feeling well and out of isolation, you can drop-in to any scheduled clinic with proof of your appointment booking confirmation.  

For more information on scheduled clinic, please visit the COVID-19 vaccine webpage.

Are the vaccine clinic sites accessible?

Yes, they are. The City of Ottawa's Accessibility Design Standards were used to select the sites. These standards include considerations of accessibility under the Building Code. Site visits were done to make sure that:  

  • The doors had operators 

  • Washrooms were accessible 

  • Ramps were installed where needed

  • Accessible parking is available

  • Seating is available for those who cannot stand for long periods

  • There are designated Para Transpo drop off/pickup locations, with an indoor waiting area

  • There is promotion of a scent free environment 

Considerations of wide corridors and turning radius will be maintained during the clinics. Additional disability related supports can be provided when identified at the time of booking appointments. 

Due to limited availability, we are asking for those who can bring their own wheelchairs. Howeverstandard and bariatric wheelchairs are available at all clinic sites. 

Staff will be on hand at the clinics to assist residents who arrive for their vaccinations. Please let staff know what support you require when you arrive. Clients who need assistance will be allowed one support person to accompany them into the vaccination clinic. 

You will be seated while you wait for your vaccine. Bariatric chairs are available at all sites. 

Low sensory, quiet areas are available at all sites. Please let staff know if you require access to this space. 

If you require additional disability-related accommodations, please fill out this COVID-19 Vaccine accessibility assessment form at least 48 hours in advance of your appointment. With less than 48 hours, Ottawa Public Health will strive to meet all accommodation needs, however, may not be able meet all requirements. 

Should you need assistance in completing the accommodation request form, please contact Ottawa Public Health at 613-691-5505.

Take a tour of our COVID-19 vaccination clinic:

Is parking available at the community clinics?

Free parking options are available at each of the community clinic locations

Can I bring a support person with me to my appointment?

Yes, if you need help from a support person, they can attend the appointment with you. Staff will be on hand at the clinics to assist residents who arrive for their vaccinations. To reduce overcrowding at the clinics, we ask that you only bring one support person who is essential to you.

Are communication supports available on site?

Yes. Clinic staff can access interpretation services by telephone if needed. However, clients who wish to bring a support person with them to assist with interpretation at the clinic are welcome to do so. There is a limit of one support person per client.  

Transportation to COVID-19 vaccination clinics and Para Transpo

Residents who are eligible for vaccination are encouraged to make a transportation plan in advance of their appointment. This could include using public transit or asking a friend, family member or caregiver to provide a ride to your designated vaccination clinic.

There are several support services available to assist in getting to and from your appointment:

  • Use the Travel Planner to plan your trip to any of the vaccine clinics located across the city.
  • If you are a Para Transpo user, you can book your ride through the COVID-19 Vaccination Trip Reservation telephone line at 613-842-3600 between the hours of 10 am and 8 pm.
  • If you are a resident age 65 years or older or an adult with disabilities you can request a ride through Ottawa Community Transportation after you have booked your appointment. Ottawa Community Transportation will contact you directly to confirm your transportation.

If you or someone you know requires transportation but do not have online access, please contact 211. A representative will assist in completing the online form on your behalf. Please have your vaccine booking confirmation number available when calling.

  • If you are not eligible for support through Para Transpo or Ottawa Community Transportation, you can request a ride with a volunteer driver through the VaxAide online form, or by calling 613-869-8221.

COVID-19 protocols are in place to ensure the safety of the rider and the driver, and wearing a mask is mandatory.

Take a tour of our COVID-19 vaccination clinic:

How can I support a friend, family member or neighbour with booking their vaccine appointment?

If you are helping someone book their vaccine appointment, there are a few things you will need to do and have available to you. Ideally, and if it can be done safely, the person is with you to clarify information, or answer questions.  

  • Obtain your family member, friend, or neighbours consent to help them book their vaccine appointment as you will be providing that person’s personal health information for a health screening  

  • Visit ottawapublichealth.ca/COVID19Vaccine to check the current criteria for eligibility 

  • If they are eligible, follow the instructions listed and/or call the phone number listed to book an appointment 

  • If booking by phone, tell the booking agent that you are helping another person to book an appointment and have their consent to make an appointment on their behalf  

  • Make note of the date, time and location of the appointment. Give this information to the person you are helping. 

To support someone with booking their vaccine appointment, you will need their:  

  • Date of birth 

  • Address and postal code  

  • Contact information (telephone, email) 

  • Background health information. The booking agent will do a health screening. The person will need to speak to their health care provider to discuss the vaccine before booking if any of the criteria below apply

  • You will be asked if the person: 

  • Has had an allergic reaction to a previous vaccine 

  • Has an autoimmune disease or is immunocompromised 

For residents whose first language is not English or French, a translation service is available. Please tell the booking agent which language you need support in.   

Note: A support person can go with another person to a vaccine appointment, if needed.  

How can I support someone who I am a Power of Attorney (POA) or Proxy for, when I cannot attend a vaccine clinic with them, but they require support to complete their consent? 

If you are a POA, or a proxy for someone who needs support with consent, it is preferred that you attend the clinic with the person being vaccinated.

If you are unable to go with the person to their vaccine appointment, a completed electronic copy of the consent can be brought to the clinic. The consent should be completed, including the complete name of the POA, and their phone number. While an electronic copy is preferred, if this is also not possible, a paper copy can be brought to the clinic.

OPH vaccine clinics are paperless, paper consents are not kept with the clinic.

To find the consent form, please visit the Ministry of Health- COVID-19 Vaccine Consent Form Version 3.0 - March 11, 2021 COVID-19 Vaccine Consent Form (gov.on.ca).

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Youth vaccine information

Can children and youth aged 12 to 17 years consent to receive a COVID-19 vaccine? 
Yes. The Health Care Consent Act, 1996 of Ontario, states that there is no minimum age for consent to health care. Children and youth aged 12 to 17 will be able to consent for themselves at their vaccine appointment. Children or youth will only be given a vaccine if they are able to make the decision and show that they understand what the vaccine is for and why they are getting it. People getting a vaccine should understand:

The individual giving the vaccination and the family must respect the young person’s decision about the vaccine. This means, it is possible your child could refuse the vaccine even if you wish them to have it. OPH recommends that parents and guardians discuss the COVID-19 vaccine with their eligible child(ren) before the vaccine appointment. The COVID-19 vaccine is voluntary.

If a child or youth is unable to consent for themselves, a substitute decision maker such as a parent or guardian, needs to provide consent.

A parent or guardian can attend a vaccine appointment with their child, however it is not required unless the child cannot consent for themselves or needs support. 

Is the COVID-19 vaccine recommended for children and youth aged 12 to 18 years?

Yes. The Comirnaty (Pfizer-BioNtech) COVID-19 vaccine is recommended for youth based on its effectiveness and safety profile. 

The National Advisory Committee on Immunization (NACI) recommends that a complete series with a Comirnaty (Pfizer-BioNtech) COVID-19 vaccine should be offered to those 12 to 18 years who do not have any contraindications to the vaccine.  

According to NACI, clinical trials showed an excellent ability to protect adolescents 12 to 15 years of age against confirmed COVID-19 illness. After 2 doses, it is estimated that the vaccine will protect somewhere between 75% to 100% of those vaccinated in this age group. 

In clinical trials, the Comirnaty (Pfizer-BioNtech) COVID-19 vaccine was well tolerated in adolescents 12 to 15 years of age. Compared to individuals 18 to 55 years of age, adolescents 12 to 15 years of age showed  side effects of headache, chills, and fever more often. Safety and effectiveness will continue to be monitored in clinical trial participants and in those receiving the vaccine through public health programs. NACI closely monitors evidence and updates its guidance as needed.  

It is very important that we continue to follow public health measures (e.g., physical distancing, limiting close contacts, wearing a mask, staying home when sick, and practising hand hygiene) to keep each other safe, whether you have received a vaccination or not. COVID-19 is still in the community. The vaccine does not protect everyone, particularly after only one dose.  

Please, continue to review the COVID-19 vaccine web page for details on booking your child or youth for a COVID-19 vaccine.  

What can I expect at my COVID-19 vaccine appointment?   
Please arrive at the clinic site, no more than 10 minutes before your appointment time. Once you come into the building you will be screened for COVID-19 and asked about your scheduled appointment. Make sure you bring:
  • Your booking confirmation code or email. Check your junk folder if you have trouble finding your email
  • Your Ontario health card, if you have one. If you do not: a letter from your school, medical provider or faith leader with the child’s name, date of birth and address.
  • Your immunization record, if available, to keep track of your COVID-19 vaccine
  • An allergy form, if you have a suspected allergy to a COVID-19 vaccine or any of its ingredients or have had a previous allergic reaction to a vaccine
  • A mask
  • A support person, if needed. This could be your parent, or guardian or someone else that provides support

Check out these resources before your COVID-19 vaccine appointment:

COVID-19 vaccines for youth

Ministry of Health: What you need to know about your COVID-19 vaccine appointment

Youth Kids Health First COVID-19 Vaccines for Ontario Youth  

Take a tour of our COVID-19 vaccination clinic:

What do I need to know about the COVID-19 vaccine? 

Other resources:

What other resources do I need to know about? 
The Link Ottawa- TikTok @thelinkottawa 

The Link Ottawa- Instragram @thelinkottawa 

Am I mandated under the Immunization of School Pupils Act to disclose my child’s COVID-19 vaccination status? If so, should I complete a Statement of Conscience or Religious Belief?

No, you are not currently mandated to disclose your child’s COVID-19 vaccination status or complete a Statement of Conscience or Religious Belief. The Statement of Conscience or Religious Belief applies to mandatory vaccines listed in the Immunization of School Pupils Act. Although the COVID-19 vaccine is highly recommended for those eligible, it is not currently mandated. Your child’s vaccination status may be requested by OPH as part of case and contact management if they have an exposure to determine their isolation requirements. Further guidance from OPH will be provided when contacted.

Other questions

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Eligibility

Can I get vaccinated at the same time as a family member and/or partner?

Individual appointments must be made for each person who is eligible for a vaccine.

How will I be notified when it's my turn to get the vaccine?

Residents of all ages who are not yet eligible for the vaccine are encouraged to follow announcements on the City of Ottawa and Ottawa Public Health websites and social media channels, and from your local news media to learn when they can receive their vaccine. You can also sign up for the City of Ottawa’s COVID-19 vaccination update e-subscription for regular news and updates on the vaccine roll-out.

Who is currently eligible for the COVID-19 vaccine?

Who can receive their first and second dose?

  • Everyone aged five years or older at the time of their appointment is currently eligible to receive a COVID-19 vaccine.
  • The Pfizer-BioNTech, Moderna and AstraZeneca/COVISHIELD vaccines require two doses. All residents are encouraged to get vaccinated as soon as they can, and to receive further doses as soon as they are eligible to ensure maximum protection against COVID-19.
How can individuals access the Novavax (Nuvaxovid) COVID-19 vaccine?

You cannot book through the provincial portal. Booking will be through your local public health unit. Use this online form to register for a Novavax COVID-19 vaccine.

Visit our frequently asked questions about COVID-19 vaccination web page to learn more about the Novavax (Nuvaxovid) COVID-19 vaccine.

Who can receive their third dose?

Vaccination and practising public health measures like masking, avoiding gatherings, and staying home when sick, remain our strongest defense against COVID-19.

OPH recommends a third dose of COVID-19 vaccine for those who are eligible. Patients can be directed to our frequently asked questions about COVID-19 vaccination page

Third dose eligibility 

  • Third doses of an mRNA COVID-19 vaccine (Pfizer or Moderna) are recommended in Ontario for youth aged 12 to 17 if at least 168 days (approximately six months) have passed since their second dose.
    • Individuals must be at least 12 years old on the day they receive the vaccine.
  • Third doses of an approved COVID-19 vaccine are recommended in Ontario for individuals aged 18 and over (born in 2003 or earlier) if at least 84 days (approximately three months) have passed since they have received their second dose (or one dose of the Janssen vaccine.

Eligible residents can now drop-in to any Ottawa Public Health community clinic to receive their third dose of the COVID-19 vaccine. Residents may also book an appointment at a community clinic through the Provincial COVID-19 Vaccination Portal or by calling the Provincial Vaccine Contact Centre at 1-833-943-3900. 

Please ensure the minimum time interval has passed between second and third doses .

Three-dose primary series for individuals who are immunocompromised

Some individuals who are immunocompromised can get a third dose of the COVID-19 vaccine eight weeks after their second dose as part of an extended primary series. Note that in some cases the interval may be shortened as advised by your health care provider or specialist.

Eligibility:

  • a transplant recipient (including solid organ transplant and hematopoietic stem cell transplants)
  • receiving stable, active treatment (chemotherapy, targeted therapies, immunotherapy) for a malignant hematologic disorder or solid tumor
  • in receipt of chimeric antigen receptor (CAR)-T-cell
  • an individual with moderate or severe primary immunodeficiency (for example, DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome
  • undergoing active treatment with the following categories of immunosuppressive therapies: anti-B cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids, alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive or are taking specific immunosuppressant medications
  • receiving dialysis (hemodialysis or peritoneal dialysis)

The third dose of vaccine will be given at least two months (eight weeks) after the second dose. Please note both Moderna and Comirnaty (Pfizer-BionTech) vaccines will be offered. Drop-in vaccinations are available for third doses at any community clinic in Ottawa during their hours of operation.

Ottawa residents who meet these criteria must present one of the following to receive their third dose:

  • A letter from their specialist or hospital program; or
  • Current prescription package, label or pharmacy receipt of an immunosuppressant medication listed by the Ontario government. The prescription must clearly label: patient name, name of medication, date of dispensing, and name of prescribing doctor.

Residents of Long-Term Care Homes (LTCH), Retirement Homes (RH), Elder Care Lodges, and elderly living in other congregate settings will also be offered a third dose, or in some cases a fourth dose. Ottawa Public Health is working with these groups directly to offer a third dose or fourth dose to residents in those settings 

Who can receive their fourth dose?

It is recommended that individuals aged 60 and over book a fourth (second booster) dose appointment at least 140 days (5 months) after their third (booster) dose. First Nation, Inuit and Métis individuals and their household members aged 18 and over are also eligible.

This aligns with the National Advisory Committee of Canada (NACI) recommendations that a longer interval between doses has shown to result in a better immune response and somewhat better vaccine effectiveness than shorter intervals. Longer time between doses gives more time for decreasing protection but may also result in a better response after the next dose.

It is recommended that individuals who wish to receive the fourth (second booster) dose between 84 days (3 months) and 140 days (5 months) consult their health care provider for individual recommendations and to assess personal risk of the benefits of receiving vaccination earlier due to the high levels of COVID-19 currently present in our community.

To book an appointment at the shorter interval individuals must call the Provincial booking line at 1-833-943-3900, between 8 a.m. and 8 p.m.

Individuals who meet the eligibility criteria can book their fourth dose appointment through the COVID-19 vaccination portal, by calling the Provincial Vaccine Contact Centre at 1-833-943-3900 or check local pharmacies to find locations that provide the booster dose. Residents are encouraged to make an appointment as drop-in availability will be limited at community vaccine clinics. Some primary care physicians are also providing booster doses. 

You can also get a fourth dose of an mRNA vaccine three months (84 days) after your third dose if you are a resident of a:

  • long-term care home
  • retirement homes
  • elder care lodge
  • other congregate setting that provide assisted-living and health services

Public health units will work with the homes who will offer fourth doses on-site within your home or make arrangements for a visit from a mobile clinic.

Some individuals who are immunocompromised can get a fourth dose (booster) three months (84 days) after completion of the three-dose primary series.

Who can receive their fifth dose?

A second booster corresponds to a 5th dose among individuals that have a recommended 3-dose primary series (e.g. moderately to severely immunocompromised individuals).  

Moderately to severely immunocompromised individuals who received a 3-dose primary series are eligible for a second booster dose if they fall into one of the groups listed:  

  • Individuals 60 years of age and older who received their first booster five months (140 days) ago. Individuals may receive a second booster (5th dose) at a minimum interval of 3 months (84 days) after their first booster dose*.  

  • First Nation, Inuit and Metis Adults and their non-indigenous household members, 18 years of age and older may be offered a second booster dose (5th dose). The second booster may be offered five months (140 days) after the first booster at the discretion of the health care provider. The minimum interval for the second booster is 3 months (84 days) after the first booster dose* 

  • Residents of long-term care homes, retirement homes, elder care lodges and older adults living in other congregate settings(60 years of age and older). A second booster (5th dose) of an mRNA vaccine is recommended for those in this group that received their first booster at least 3 months (84 days) ago.  

*As per the Ontario Ministry of Health, the longer 5-month interval is recommended as it is likely to result in a better immune response, higher vaccine effectiveness and longer duration of protection. Individuals should discuss what interval is best for them with their health care provider considering individual risk factors for exposure and risk of severe disease from SARS-CoV2 infection. 

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Novavax (Nuvaxovid) COVID-19 vaccine

What is the Novavax Covid-19 vaccine?

The Novavax Nuvaxovid COVID-19 vaccine is a 2-dose recombinant protein subunit vaccine. It was authorized for use in adults 18 years of age and older by Health Canada February 17, 2022. 

The National Advisory Committee on Immunization (NACI) recommends an interval of eight weeks between dose one and dose two.  

NACI preferentially recommends that a complete series with an mRNA COVID-19 vaccine should be offered to individuals in the authorized age group without contraindications to the vaccine. 

NACI recommends that an authorized recombinant protein subunit COVID-19 vaccine (Novavax Nuvaxovid) may be offered to individuals in the authorized age group without contraindications to the vaccine who are not able or willing to receive an mRNA COVID-19 vaccine.  

Novavax Nuvaxovid may be used in a mixed primary series (after one or two doses of mRNA vaccine) or as a booster dose (third or fourth dose) for individuals not able to receive an mRNA vaccine due to contraindications, or who choose not to receive an mRNA vaccine.

What is a recombinant protein subunit vaccine?

A recombinant protein subunit vaccine is a type of vaccine that uses harmless and purified proteins of the virus to trigger an immune response in the body. The immune response means our body will recognize and fight the virus if ever exposed. Some protein subunit vaccines, such as Novavax, also have adjuvants. An adjuvant is a substance that is added to the vaccine to help create a stronger and longer lasting immune response. 

These types of vaccines cannot cause COVID-19. They only use small, purified pieces of proteins to trigger the immune response, and do not contain the virus itself.  

Protein subunit vaccines are already used for other vaccine preventable diseases, such as the Hepatitis B vaccine.   

Eligibility for the Novavax COVID-19 Vaccine

The mRNA vaccines remain the recommended vaccine to offer to eligible individuals. Those 18 years of age or older can receive the Novavax COVID-19 vaccine if they meet the following criteria: 

  • Are 18 years of age or older 
  • Live, work, or attend school in Ottawa 
  • Do NOT have a confirmed allergy to any of the vaccine components or its container (the vial stopper is bromobutyl rubber which is latex free). Please see Health Canada for a full list of vaccine ingredients.   
  • Not able to receive an mRNA vaccine due to contraindications, or would prefer not to receive an mRNA vaccine

Please see the Vaccination of specific populations FAQ for more information on the NACI recommendations for specific populations.

How can I get the Novavax COVID-19 Vaccine?

You cannot book through the provincial portal. Booking will be through your local public health unit. Use this online form to register for a Novavax COVID-19 vaccine.

Effectiveness

Clinical trials showed that beginning one week after the second dose, Novavax Nuvaxovid® COVID-19 vaccine was: 

  • 90% effective in protecting trial participants aged 18 and above against COVID-19 

Data is not available on vaccine efficacy/effectiveness specifically against the Delta or Omicron variant, although there is limited immunogenicity data for these variants from the clinical trial on booster doses. For more information see NACI Recommendations on the use of Novavax Nuvaxovid COVID-19 vaccine.

Common side effects of the Novavax COVID-19 vaccine

It is common to have temporary side effects after getting vaccinated.  

At the injection site:  

  • Redness, soreness, swelling  

General symptoms:  

  • Chills 
  • Fatigue 
  • Joint pain 
  • Headache 
  • Mild fever  
  • Muscle aches 
  • Nausea and vomiting  
What information is there regarding Myocarditis and or pericarditis following vaccination?

The clinical trial data shows that there have been mild cases of myocarditis and or pericarditis reported after receiving the Novavax Nuvaxovid COVID-19 vaccine. According to the National Advisory Committee on Immunization (NACI), it is unclear whether these cases are indicative of a safety signal. Post-market safety surveillance, which is routinely done, is required to determine whether this is an adverse event of interest associated with Novavax Nuvaxovid. 

For more information see NACI Recommendations on the use of Novavax Nuvaxovid COVID-19 vaccine. 

Vaccination of specific populations

Please see the  NACI Recommendations on the use of Novavax Nuvaxovid COVID-19 vaccine. 

According to NACI, the safety and efficacy of Novavax Nuvaxovid have not been established in the following populations: 

  • Individuals previously infected with SARS-CoV-2; 
  • Individuals who are immunocompromised due to disease or treatment; 
  • Individuals who are pregnant or breastfeeding; 
  • Individuals who have an autoimmune condition. 

Informed consent should include discussion that there is currently limited evidence on the use of the Novavax Nuvaxovid in these populations, while there is evidence on the safety profile and effectiveness of mRNA COVID-19 vaccines in these populations based on real world use with large numbers of individuals.  

NACI will continue to monitor the evidence and update recommendations as needed.

Are there any contraindications or special precautions for the Novavax vaccine?

At the time of approval, there are no known serious warnings or precautions associated with the Novavax Nuvaxovid COVID-19 vaccine. 

Allergy to ingredients in a vaccine or its container is considered a contraindication. A potential allergen found in the Novavax vaccine is polysorbate 80. This is found in several medical preparations like vitamin oils, tablets, anticancer agents, and also in cosmetic products. For a full list of ingredients please see Novavax Nuvaxovid COVID-19 vaccine

Booster use

NACI recommends that a booster dose of a recombinant protein subunit COVID-19 vaccine (Novavax Nuvaxovid) may be offered 6 months after completion of a primary COVID-19 vaccine series (dose 1 and dose 2) to adults without contraindications to the vaccine who are not able or willing to receive an mRNA COVID-19 vaccine.  

The Novavax Nuvaxovid COVID-19 vaccine may be offered as a booster dose to people who are not able or not willing to receive an mRNA vaccine, regardless of which COVID-19 vaccines were received in the primary series.  

This recommendation is off-label, as the Novavax Nuvaxovid COVID-19 vaccine is not currently authorized for use by Health Canada as a booster dose in Canada. Informed consent should include a discussion about what is known and unknown about the benefits and potential risks of the use of the Novavax Nuvaxovid vaccine as a booster dose, including the off-label status of this recommendation. 

For more information see NACI Recommendations on the use of Novavax Nuvaxovid COVID-19 vaccine. 

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Vaccines received outside of Canada, Ontario or Ottawa, or through a Federal program

If I received one or more doses of a COVID-19 vaccine in one city in Ontario, can I receive my next dose in a different city in Ontario?

Yes. If you received one or more doses of a COVID-19 vaccine in one part of Ontario, you will be able to get your next dose in another city or town, if needed.

When you are registering for your next dose in the Provincial booking system, use the postal code of the address you will be at during the time of your appointment.

For example, if you received your first dose in Ottawa, but will be moving to Toronto for school in the fall when you are due for your second dose, use your new address when booking your dose.

I have received one or more doses of a COVID-19 vaccine while in a different province or country. What should I do?

If you have received one or more doses of a COVID-19 vaccine outside of the Province of Ontario, you may provide your proof of immunization to Ottawa Public Health. Complete the COVID-19 Out of Province Dose Documentation form to notify Ottawa Public Health of your out of province dose administration, and upload the documentation you have received.

Do not use this form to submit medical exemption information.

This form is to be completed by City of Ottawa residents only.

If you live outside of Ottawa, but within Ontario, contact your local public health unit to submit proof of your out of province vaccination.

If you are visiting Ottawa, you do not need to complete this form. If you are visiting from outside of Canada, please consult the Government of Canada's entry requirements.

I received one or two doses of a COVID-19 vaccine not approved for use in Canada, while outside of the country. Am I eligible to receive any other doses?

If you received one or two doses of a COVID-19 vaccine series outside of Canada, that is not currently approved for use in Canada, you are eligible to receive an additional dose of a COVID-19 vaccine. You are also eligible to receive a booster dose three months (84 days) after your additional dose if you are 18 years of age and older or six months (168 days) after your additional dose if you are 12 years of age and older. Please visit a COVID-19 vaccination clinic to receive your COVID-19 vaccine that is approved for use in Canada. You may also be eligible to receive a second booster which is recommended five months (140 days) after your first booster. For more information and to determine if you are eligible for a second booster, see Who Can Receive their Fourth Dose? 

If you reside in Ottawa, please Complete the COVID-19 Out of Province Dose Documentation form to notify Ottawa Public Health of your out of province dose administration, and upload the documentation you have received.

I received three doses of a COVID-19 vaccine not approved for use in Canada, while outside of the country. Am I eligible to receive any other doses?

If you received three doses of a COVID-19 vaccine series outside of Canada, that is not currently approved for use in Canada, you are eligible to receive a booster dose. You can receive the booster dose three months (84 days) after your last dose if you are 18 years of age and older or 6 months (168 days) after your last dose if you are 12 years of age and older. Please visit a COVID-19 vaccination clinic to receive your COVID-19 vaccine that is approved for use in Canada.

You are also eligible to receive a second booster if you meet the eligibility criteria which is recommended 5 months (140 days) after your first booster. For more information, see Who Can Receive their Fourth Dose?

I received one or more doses of a COVID-19 vaccine through a Federal program while in the province of Ontario (for example military, global affairs or embassy vaccination clinic). How do I ensure my vaccination is recorded in Ontario?

If you have received one or more doses of a COVID-19 vaccine through a Federal program while in the province of Ontario, (for example global affairs or embassy vaccination clinics) you may complete the Ontario COVID-19 Vaccine Form for Federal Programs.

Regular Force Canadian Armed Forces members do not require their vaccinations to be recorded in Ontario. The Canadian Armed Forces proof of vaccination is recognized as valid proof of vaccination in Ontario and no further action is required.

Do not use this form to submit medical exemption information.

What can I expect once I submit my proof of vaccination form?

You will receive an automatic confirmation email once you submit the Out-of-Province or Federal Documentation Form.

Once your submission is reviewed and approved by Ottawa Public Health you will receive an email with instructions on how to access your provincial vaccine receipt.

If your submission is not approved, you will receive an email from Ottawa Public Health with further instructions to re-submit with corrections and/or omissions.

I’m visiting Ontario, do I need to submit my proof of vaccination to be uploaded into the provincial system?

If you are visiting Ontario, please visit ontario.ca/covid19 for more information on what types of proof of vaccination you need.

If you are visiting from outside of Canada, please consult the Government of Canada's entry requirements.

The Out-of-province documentation form is to be completed by City of Ottawa residents only.

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Booking and cancelling vaccine appointments

How do I book an appointment if I do not have an Ontario health card or have a red and white card?

If you have confirmed that you are eligible to receive a vaccine but have a red and white Ontario health card, please call the Province of Ontario’s Provincial Vaccine Booking Line at 1-833-943-3900 (TTY 1-866-797-0007) to book your appointment. This line is available 8 am to 8 pm, 7 days a week. Information is available in more than 300 languages.

If you do not have a valid health card but are eligible for a vaccine, please call Ottawa Public Health at 613-691-5505 to book an appointment.

What do I do if when I enter my postal code into the provincial booking system to book an appointment at a community clinic, I receive an error?
If you do not have one or live in a recently built neighbourhood, the Province of Ontario has directed clients to use the postal code of a shelter, library, or other community space in your area. 

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Mixing or interchanging vaccines

Do all doses in a COVID-19 vaccine series need to be the same COVID-19 vaccine?

The National Advisory Committee on Immunization (NACI) has released  recommendations on the interchangeability of COVID-19 vaccines used in Canada as well as guidance on booster doses. This means that you could receive different vaccines for your doses.

NACI recommends that:

  • If you received AstraZeneca/COVISHEILD as your first dose: you may receive either AstraZeneca/COVISHEILD vaccine or an mRNA vaccine, such as Comirnaty (Pfizer-BioNtech) or Moderna, for your second dose, unless contraindicated. However, an mRNA vaccine product is preferred.
  • If you received an mRNA vaccine as your first dose: you should be offered the same mRNA vaccine for your second dose. If the same mRNA vaccine is not available or unknown, another mRNA vaccine can be considered interchangeable and should be offered to complete the vaccine series.
  • An authorized mRNA COVID-19 vaccine, Comirnaty (Pfizer-BioNtech) and Moderna vaccines can be used for third doses and boosters in individuals 18 years of age and older. This is the recommendation whether you received AstraZeneca/ COVISHEILD or an mRNA vaccine previously. A booster dose of an authorized viral vector vaccine should only be considered when other authorized COVID-19 vaccines are contraindicated or inaccessible.

Whether you get the same vaccine or different vaccines for your doses (also called a “mixed schedule”), both are considered valid options. Both schedules will count as a full series. Consider talking to a healthcare professional for help in understanding information related to each vaccine, to help with informed decision-making on vaccination.

Something to note is that there is a possibility of increased short-term side effects with a mixed COVID-19 vaccine schedule. Common short-term side effects include headache, fatigue, muscle aches, joint pain and generally feeling ill. These side effects are temporary and should resolve on their own within 48 hours after vaccination.

If symptoms last or develop more than 48 hours after vaccination, or if symptoms continue or worsen for more than 48 hours after the first symptom(s) appeared, and you may have been exposed to COVID-19 in the previous 14 days, you should self-isolate and go for COVID-19 testing. If at any time symptoms are severe, seek medical assessment right away.

In regard to the booster/additional dose, NACI has outlined certain populations for which a specific product and/or doses may be preferred. See NACI’s Guidance on booster COVID-19 vaccine doses in Canada for additional rationale and considerations.

For more information on mixed vaccine schedules, please review NACI’s Interchangeability of Authorized COVID-19 Vaccines.

For information on how to book your vaccination appointment, please see COVID-19 vaccine information.

What about getting a third dose of the COVID-19 vaccine and my flu vaccine?

This year with the presence of COVID-19 circulating in the community, it is especially important for high risks groups to get the flu vaccine to reduce the potential risk of having COVID-19 and influenza at the same time.

The National Advisory Committee on Immunization (NACI) now recommends that COVID-19 vaccines may be given at the same time as, or before or after other vaccines. This includes live, non-live, adjuvanted, and non-adjuvanted vaccines. There are no specific safety concerns when routine vaccines are given at the same time or within days of each other. Please note that there could be stronger, temporary side effects when a COVID-19 vaccine and another vaccine are given at the same time or within days of each other.

NACI was previously recommending that COVID-19 vaccines be given at least 28 days before and 14 days after other vaccines. However, after reviewing the evidence available on COVID-19 vaccines and the data and experience of giving other routine vaccines at the same time or within days of each other, NACI has since changed their recommendation.

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Vaccine effectiveness

 What is the optimal interval between the first and second dose for 2-dose COVID-19 vaccines?

The optimal interval between the first and second dose of an mRNA COVID-19 vaccine is eight weeks. 

  • More data has become available that suggests that protection can be improved upon when the interval between the first and second dose are extended beyond the original manufacturer’s recommended interval (e.g., 21 days between first and second dose of a Comirnaty/Pfizer-BioNtech COVID-19 vaccine; 28 days between first and second doses of a Moderna Spikevax COVID-19 vaccine for children aged 6-11).  
  • As per NACI, there is emerging safety data that suggest that a longer interval between dose one and two may reduce the risk of myocarditis/pericarditis after the second dose of an mRNA COVID-19 vaccine.
  • As per NACI, an eight week interval helps balance optimal protection while simultaneously minimizing the time at risk of infection due to having protection from only one dose.  
  • Individuals may choose to speak with their primary care provider about what interval is best for them considering the local transmission of COVID-19 and the degree of individual risk of exposure.  
  • The authorized interval may still be used with informed parental consent.
    • You can get your child’s second dose of Pfizer-BioNTech 10 mcg 21 days after their first by providing informed consent at one of our clinics or by calling the province at 1-833-943-3900.
    • You can get your child’s second dose of a Moderna Spikevax 50 mcg ( if they are 6 to 11 years of age) 28 days after their first by providing informed consent at one of our clinics and upon request
  • Interruption of a vaccine series resulting in a greater interval between doses than recommended does not require re-starting the series. 

References

National Advisory Committee on Immunization (2021). Recommendations on the use of COVID-19 vaccines.

(March 17, 2022) NACI statement: Recommendations on the use of Moderna Spikevax COVID-19 vaccine in children 6 to 11 years of age

Ministry of Health (2021). COVID-19 Vaccine Administration, Version 2.0.

What vaccines are approved in Canada?

There are four COVID-19 vaccines currently approved for use in Canada

All four vaccines are safe and effective against symptomatic COVID-19 infection and protect you from severe COVID-19 illness and hospitalization. COVID-19 vaccines work best when immunizing those at highest risk of severe illness first, which helps protect each other and helps prevent hospitals from being overwhelmed from COVID-19 cases.

No vaccine is perfect, and there is a chance that you may still get COVID-19 after being vaccinated. Vaccines take time to work, and vaccine effectiveness against novel variants is still being investigated. It is very important to continue following public health measures such as physical distancing, wearing a mask, minimizing contact with people outside of your household, washing your hands often, and staying home if you are sick. Healthcare and other staff must still wear personal protective equipment (PPE) even after they have been vaccinated.

What does % efficacy or % effectiveness mean in a vaccine?

Vaccine efficacy is a representation of how well a vaccine will work at preventing illness caused by a particular virus.   In clinical trials, vaccine efficacy (VE) or effectiveness is interpreted as the proportionate reduction in disease among the vaccinated group. A VE of 50% indicates a 50% reduction in disease occurrence among the vaccinated group, or a 50% reduction from the number of cases you would expect if they have not been vaccinated. In a group of 100 vaccinated people, on average, only 50 people instead of all 100 people would get ill if all 100 were exposed to the virus.

It is important to note that all of the COVID-19 vaccines currently approved are effective at reducing the risk of serious illness, hospitalization, and death, and will help control the spread of COVID-19 in the community. A 50% reduction in disease occurrence could still play an important role in ending an epidemic. 

How do viral vector-based vaccine’s work?

The AstraZeneca and Janssen COVID-19 vaccines are non-replicating viral vector-based vaccines. 

Viral vector-based vaccines use a virus, which has been modified to be harmless, as a delivery system to build your immunity. When injected into the body, these COVID-19 vaccines produce a surface protein from the SARS-CoV-2 virus, specifically the SARS-CoV-2 spike protein. The spike protein does not make you sick -- it helps your body develop a strong immune response without exposing you to the virus that causes COVID-19. Many people around the world have safely received viral vector vaccines for COVID-19.

How do mRNA vaccines work?

American Sign Language - How do mRNA vaccines work?

These types of COVID-19 vaccines use messenger RNA (mRNA). mRNA provide instructions to the cells in our bodies to make a viral protein from the coronavirus called a “spike protein”. The mRNA provides the instructions that allows the cell to make the spike protein, and then the immune system is activated to recognize the spike protein as being different from the body’s own proteins which initiates an immune response. The mRNA is then degraded by normal cellular mechanisms and the spike proteins are destroyed by the immune system. mRNA vaccines are just one of the different types of vaccines currently used to prevent COVID-19 disease caused by the SARS-CoV-2 virus. COVID-19 vaccination along with public health measures will offer the best protection from COVID-19.

How is the COVID-19 vaccine different from the influenza (flu) vaccine?

The COVID-19 and influenza vaccines are separate products. The COVID-19 vaccine will not protect you against influenza. The seasonal influenza vaccine changes every flu season. When you receive your annual flu vaccine, you are protected only from the specific influenza strains that are circulating for that given season that are covered by the vaccine.

The flu vaccine won’t protect you against COVID-19.

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Pregnancy and COVID-19 Vaccines

Pregnancy and COVID-19 Vaccine factsheet - Provincial Council for Maternal and Child Health (PCMCH)

I am pregnant. Should I get the COVID-19 Vaccine?

COVID-19 vaccination (including booster dose) is strongly recommended during pregnancy. Getting vaccinated, as soon as possible, is the safest choice to protect yourself and your baby from the known risks of COVID-19 infection.

The National Advisory Committee on Immunization (NACI) recommends you get a complete series with an mRNA COVID-19 vaccine if you're pregnant or breastfeeding. Getting the COVID-19 vaccine can prevent serious illness, hospitalization, and complications from COVID-19 infection.

In Ontario, all pregnant individuals are eligible and prioritized to be vaccinated as soon as possible, at any stage of pregnancy. The same applies to receiving a booster dose three months after their last dose.

What are the benefits of COVID-19 vaccination for you and your baby?

COVID-19 vaccines are very effective in protecting you from severe illness.

  • Getting the vaccine can help prevent complications or bad outcomes for parent and baby. Like everyone else, most pregnant people have mild COVID-19. However, pregnant people are at an increased risk of severe illness requiring hospital care and admission to the intensive care unit compared to those who are not pregnant.
  • Giving birth too early in pregnancy (preterm birth), having a caesarean delivery and having a baby admitted into a neonatal intensive care unit is more common in pregnant people with severe COVID-19.

There is growing evidence about the safety of COVID-19 vaccines in pregnancy.

  • The mRNA vaccines are effective at reducing the risk of a COVID-19 vaccine infection caused by any variant of the virus (e.g. Omicron) similarly in both pregnant and non-pregnant people. These vaccines do not contain live virus.
  • Booster doses decrease the chance of having a symptomatic COVID-19 infection, the severity of the COVID-19 illness and the chance of being hospitalized for COVID-19.
  • Antibodies created by the COVID-19 vaccine can offer protection to your baby and are passed through the placenta and/or in your breastmilk.

The mRNA COVID-19 vaccines and booster doses are safe in pregnancy.

  • Several studies with large numbers of pregnant people have shown that vaccination immediately before and/or during any time in pregnancy has no impact on pregnancy outcomes.
    • No increased risk of miscarriage, preterm birth, stillbirth, growth restriction, high blood pressure during pregnancy, medical complications of pregnancy or death.
What are the risks of getting the COVID-19 vaccine?

Pregnant and breastfeeding individuals who receive the mRNA (Comirnaty/Pfizer-BioNtech or Moderna) vaccines experience the same side effects of vaccination as non-pregnant individuals.

Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy, has been growing from real-world use. The data shows that mRNA COVID-19 vaccines are safe for people who are pregnant or breastfeeding. No safety concerns were identified in a study of more than 35,000 pregnant people who received an mRNA COVID-19 vaccine within 30 days of conception.

The mRNA COVID-19 vaccines:

  • Do not contain any live virus.
  • Do not contain any mercury, aluminum, formaldehyde, or substances harmful to you and/or your baby.
  • Do not contain any human and/or animal blood or by-product(s).
  • Cannot be measures in your bloodstream; thus, the baby is not exposed to the vaccine.

Anyone getting the vaccine may have some side effects.

  • Common side effects after receiving the COVID-19 vaccine are pain at the injection site, fatigue, headache, and muscle pain. This is caused by the immune system’s normal response to the vaccine. These side effects are generally not serious and go away on their own.
  • In more than 35,000 pregnant and/or breastfeeding people who were monitored at the time of COVID-19 vaccination, less than 10% of pregnant people experience a fever.
    • Talk to your doctor or midwife if you develop a fever, or any side effects that worry you or that last more than 3 days, so they can give you advice. A high fever that lasts too long during the first three months of pregnancy (first trimester) may increase the risk of miscarriage or abnormalities to the baby.
  • As with any vaccine, allergic reactions, including anaphylaxis, are rare but can occur. Talk to your health care provider if you have allergies to medications.
 What do the experts recommend?

The National Advisory Committee on Immunization (NACI) strongly recommends that a complete vaccine series with an mRNA COVID-19 vaccine should be offered to people in the authorized age group who are pregnant or breastfeeding. Booster doses are also recommended for pregnant or breastfeeding people.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends that all individuals who are pregnant or those trying to become pregnant should receive all COVID-19 vaccination doses, including the booster dose, when eligible.

Speak to your health care provider about getting the COVID-19 vaccine when pregnant or breastfeeding. If you decide to get the COVID-19 vaccine and need another vaccine around the same time, your health care provider will help you determine the appropriate time between different vaccines. 

What else should I think about to help me decide?

Make sure you understand as much as you can about COVID-19, vaccines, and boosters. Ask a trusted source, such as your obstetrician, midwife, family doctor or nurse, any questions. 

The risk of COVID-19 is higher if:

  • The dominant variant circulating (i.e., Omicron) is more easily passed from person-to-person.
  • You live in a community with a lot of COVID-19 cases
  • You have regular contact with people outside your home
  • You live in a crowded housing situation
  • You, or another member of your household, work in a high-risk environment (for example, you are a front-line essential worker or a healthcare worker)

The risk of developing severe illness from COVID-19 in pregnancy is higher if:

  • You have medical problems such as pre-pregnancy diabetes, pre-pregnancy high blood pressure, a compromised immune system, kidney disease, liver disease, heart disease, or asthma
  • You are overweight
  • You smoke
  • You are 35 years of age or older
  • You are in the last three months (third trimester) of your pregnancy

It’s safer to get vaccinated (and boosted) as soon as possible, especially if you are at an even higher risk of getting COVID-19 and developing severe illness. The known risks of severe illness from COVID-19 are greater than the known risks of the vaccine.

If you choose to wait, you need to know that without the vaccine, you are at higher risk of severe illness from COVID-19.

What if I get pregnant after getting the vaccine?

If you are pregnant or become pregnant soon after getting the first or second dose of the vaccine, you should complete the full series and receive your booster dose.

Several studies show that prior to and in the first trimester, there is no impact of COVID-19 vaccination on the risk of miscarriage or any adverse pregnancy outcome.

What if I am planning a pregnancy?

There is no evidence to suggest that COVID-19 vaccines have any effect on your fertility or chances of becoming pregnant. Fertility treatment is not a medical reason that prevents you from getting vaccinated. 

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Reasons to get vaccinated

Why should I get vaccinated with COVID-19 vaccine?

Vaccination is one of the most effective ways to prevent the spread and reduce the impact of infectious diseases, whether it is the seasonal flu (influenza) or childhood infections such as chickenpox (varicella). Safe and effective vaccines for COVID-19 are now available to protect us against COVID-19. While many people infected with COVID-19 experience only mild illness, others may get a severe illness or even die. There is no way to know how COVID-19 will affect you, even if you are not at increased risk of severe complications. 

The COVID-19 vaccine has been shown to:

  • Help protect you by creating an antibody response without having to experience the illness of COVID-19, reducing your risk of getting COVID-19.
  • Reduce your risk of severe illness or death if you do get COVID-19.
  • Reduce your risk of spreading the virus that causes COVID-19 to others.

Also, the more people are vaccinated in the community, the less the risk of the virus replicating, mutating, and possibly coming more resistant to vaccines.

Why I am choosing the vaccine

Why I am choosing the vaccine videos are available in French, Arabic, Mandarin, and Somali. 

What percentage of the population needs to get vaccinated to achieve “community immunity”?

Community immunity is reached when enough people have protection against a disease, which makes it unlikely that a virus or bacteria can spread and cause more infections. This protection can be either from a previous infection or vaccination. As a result,  the whole population within the community is protected. But those who are not protected because they have never had the disease, did not get vaccinated or the vaccine was not as effective for them can still get sick. This is why it is not a good idea to rely on community immunity to protect yourself instead of getting vaccinated.

The percentage of people who need to have protection to reach community immunity varies by disease. 

Some estimates for COVID-19 suggest it may be near 60 to 70%. However, community immunity calculations may not be reliable in the context of COVID-19 because of many unknowns. The effectiveness of COVID-19 vaccines in preventing asymptomatic infection remains unknown right now. For this reason, community immunity calculations will only give an estimated target for vaccination programs.

Until the effects of the COVID-19 vaccines have been fully studied, it is best to not assume that vaccinations will protect others. We must continue to protect ourselves and others by:

  • wearing a mask
  • practicing physical distancing
  • practicing hand hygiene
  • staying home and getting tested when sick

These measures will help to continue to stop the spread of COVID-19. 

For more information on COVID-19 vaccines, visit: OttawaPublicHealth.ca/COVID19Vaccine

How do I decide if vaccination is the right choice for me and my family?

Feeling worried or hesitant is completely normal when something is new. Vaccination is a personal choice, and one that most Canadians agree is an important part of maintaining good health and for disease prevention.

Why I am choosing the vaccine

Why I am choosing the vaccine videos are available in French, Arabic, Mandarin, and Somali. 

How do I talk to a friend, family member, colleague or employee who is unsure about getting the COVID-19 vaccine?

Check out our guide below for some great tips to help your loved ones and the people you live or work with feel more confident in taking the COVID-19 vaccine. 

HOW TO TALK VACCINES! Tips to increase vaccine confidence and address vaccine hesitancy (PDF - 1,369 KB)

Need more information? Having questions about the vaccine is totally normal. Learn more at our frequently asked questions about COVID-19 vaccines

Will the current COVID-19 vaccines protect against new variants of COVID-19?

The evidence we have now suggests that current vaccines may be effective or partially effective against one or more variants. But more data is still needed. Vaccine makers are looking into how vaccines can be changed to keep them effective against new variants.

Non-variant SARS-CoV2 continues to cause severe illness. This is preventable through vaccination

Is it worth taking the vaccines when the COVID variants are becoming more of a concern? 
Yes. Non-variant SARS-CoV2 continues to be present in our community and causes severe illness. This is preventable through vaccination.

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Myths

Can the mRNA vaccine alter a person’s DNA?
No. mRNA is not able to alter or modify a person’s genetic makeup (DNA). The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which is where our DNA are kept. This means the mRNA does not affect or interact with our DNA in any way. Instead, COVID-19 vaccines that use mRNA work with the body’s natural defenses to safely develop protection (immunity) to disease.
Can the COVID-19 vaccine cause a COVID-19 infection?

No. None of the COVID-19 vaccines currently approved for use in Canada use the live virus that causes COVID-19. There are several different types of vaccines in development. The goal of each of the vaccines is to teach the immune system how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever. These symptoms are normal and are a sign of the immune response to vaccine.

It usually takes the body a few weeks to build immunity after receiving a vaccine. It is possible that someone could become infected with the COVID-19 virus before or just after getting the vaccine and get sick. This happens because the vaccine has not had enough time to provide protection in the body. Learn more about COVID-19.

How do I know if the vaccine is halal?

Many companies are making vaccines and the COVID-19 vaccines that are approved in Canada are from Comirnaty (Pfizer-BioNtech), Moderna, AstraZeneca and Janssen do not contain gelatin or pork products.

Vaccines that may become available later may include gelatin or pork products and as more information becomes available for these, consult with religious leaders about which specific vaccines are recommended. It is important to know there are approved vaccines in Canada that do not contain gelatin or pork products.

Is it true that the COVID-19 vaccines contain elements from a human fetus?

No. Many researchers use what are called ‘cell lines’ to develop vaccines. Cell lines are cultures of human or animal cells that can be grown in a lab for long periods of time. Most cells will eventually stop dividing and die, but some cell lines, called immortal cell lines, never stop dividing. These cell lines are especially useful for vaccine work. The viral-vector vaccines currently approved for use in Canada were produced using cell lines from human embryos that were electively aborted many years ago*. Scientists used these cell lines to grow the harmless virus needed to create an immune response against COVID-19. Cell lines from elective abortions are called fetal cell lines. Fetal cell lines have been used in medicine for years. Many of the vaccines that are widely used today were developed using fetal cell lines. These include some of the vaccines used to prevent rubella, hepatitis A and chickenpox. Although human cell cultures may have been used in the process of developing these vaccines, the vaccines do not contain any human cells or tissue.

Each of the COVID-19 vaccines being used in Canada have been approved and are safe and effective.

*The viral vector vaccines (AstraZeneca and Janssen) used fetal cell lines in the production of the final vaccine product. The mRNA vaccines (Comirnaty/Pfizer-BioNtech and Moderna), used fetal cell lines in the research phase but not in the production:

  • AstraZeneca uses the HEK-293 cell line for the development, testing and production of the vaccine.
  • Janssen (J&J) uses PER.c6 cell line for the development, testing and production of the vaccine. This cell line was developed from retinal cells of an 18-week-old fetus aborted in 1985.
  • Comirnaty (Pfizer-BioNtech) was developed using genetic sequencing on computers without fetal cells. The HEK-293 abortion-related cell line was used in research related to the vaccine. It was not used for testing or the ongoing production.
  • Moderna does not need aborted fetal cell lines for production. But, aborted fetal cell line was used in both development and testing in the initial stage.

Can someone who has been vaccinated ‘shed the virus’ and put others at risk?

No. Viral shedding occurs after an individual gets infected by a viable (living) virus.

Vaccinated people do not shed any virus because the vaccines do not contain whole, living viruses. The vaccines also do not cause whole viruses to be created. The current vaccines approved for use in Canada do not contain live SARS-CoV-2 virus.

There are two classes of approved COVID-19 vaccines in Canada: mRNA vaccines, and viral vector-based vaccines.

mRNA vaccines

Both mRNA vaccines approved for use in Canada ( Comirnaty/Pfizer-BioNtech and Moderna) use synthetic mRNA. Synthetic mRNA is made to contain instructions for the spike protein found on the coronavirus. Once given to someone, the mRNA is delivered to the vaccinated person’s cells. The cell uses this to make copies of this spike protein, not whole viruses, which allow the body’s immune system to recognize and fight the coronavirus.

Viral vector-based vaccines

The COVID-19 viral vector-based vaccines (AstraZeneca and Janssen) use a harmless, weakened adenovirus as a vector (a shell). When the vaccine is made, DNA coding for the SARS-CoV-2 spike protein is put into this adenoviral vector (or shell). The vector acts as a delivery system to bring the SARS-CoV-2 spike protein code to human cells. The vector (not SARS-CoV-2) will enter a cell in the body to deliver the instructions. Then the instructions from inside the vector use the cell’s machinery to produce the spike protein and bring it to the surface of the cell. A vaccinated person’s immune system will recognize that the protein doesn’t belong there and train the body’s immune system to attack the coronavirus in the future. However, the spike protein doesn’t infect the recipient with SARS-CoV-2. It cannot cause the infection because it is not a whole virus.

Both mRNA COVID-19 and viral vector-based vaccines cannot cause infection with SARS-CoV-2, and therefore cannot cause viral shedding of SARS-CoV-2.


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Public health measures

If I am vaccinated with a COVID-19 vaccine do I still have to isolate and seek testing if I have COVID-19 symptoms?

Vaccination against COVID-19 will help protect you against COVID-19 infection and severe outcomes. Some people will experience common side effects after receiving a dose of COVID-19 vaccine, such as: 

  • Pain, redness, swelling in the arm you got the shot 

  • Headache   

  • Fatigue

  • Muscle ache 

  • Joint pain

  • Transient chills or mild fever

  • Nausea 

These are normal side effects that occur with many types of vaccines. Side effects usually appear (and go away) in the first 24-48 hours after vaccination (a sore arm can last a bit longer) and do not require individuals to self-isolate or go for testing, although they may interfere with your ability to carry out your daily activities. Because some symptoms of COVID-19 resemble some side effects of vaccination, Ottawa Public Health recommends you self-isolate or go for testing if: 

  • Symptoms last, worsen, or develop more than 48 hours after vaccination (for example, an ongoing fever) 

  • You have new and worsening respiratory symptoms such as coughing, shortness of breath, or loss of taste or smell 

  • Symptoms started before COVID-19 vaccination 

  • The symptomatic individual has had close contact with a case of COVID-19 in the past 10 days 

  • Symptoms are judged by a health care provider to be severe and/or not in keeping with a COVID-19 vaccination reaction   

Ottawa Public Health recommends that Ottawa residents use the following screening tools to help them make decisions about whether they need to self-isolate or go for testing:  

Ottawa Public Health continues to recommend that anyone with symptoms of COVID-19 consult with a health care provider if they have questions or concerns. 

Once a person is vaccinated with the series of two doses of the COVID-19 vaccine, can they stop following public health measures like wearing a mask, physical distancing and self-isolating when they become sick?

No. While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue practicing public health measures to help stop the spread of COVID-19. That means covering your mouth and nose with a mask, washing hands often and never touching your eyes, nose or mouth with unwashed hands, staying at least two metres (six feet) away from others and self-isolating when sick.  

Health care and other staff must still wear personal protective equipment (PPE) when working, even after they have been vaccinated. 

COVID-19 vaccination along with public health measures will offer the best protection from the spread of COVID-19. Experts need to understand more about the protection that COVID-19 vaccines provide before deciding to change the recommendations everyone should take to slow the spread of the virus that causes COVID-19. Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision. 

Now that I am up to date and received all recommended COVID-19 vaccine doses, including any booster dose(s), am I able to have more contact with others, like my family and friends? (can I go see my grandchildren, gather with friends etc.?)

Please refer to Ottawa Public Health’s Be Social Wise webpage for specific guidance on gathering with your loved ones.   

Why would I want to get the COVID-19 vaccine if we are still required to follow public health measures even after vaccination?

The main reason to get vaccinated is to protect your own health. Vaccines add a valuable layer of protection against COVID-19 infection which can lead to severe illness and death. More people vaccinated means fewer COVID-19 infections in the community. This is important in helping to reduce the burden on the health care system. This would mean less people in the hospital, less patients in ICU and more capacity for hospitals to resume surgeries and treatments. 

At this timewe do know that getting the vaccine prevents people from getting seriously ill from COVID-19, but that they could still pass it on to others. What we have learned from other vaccines is when more people are vaccinated and immunethis should eventually mean a higher likelihood of indirect protectioto those who are not immune to the disease.  

How long can we expect public health measures to be in place after COVID-19 vaccination in the community?

It is not known at this time. As we know public health measures such as mask wearing, physical distancing and hand washing help to limit the spread of COVID-19. Individual public health measures  will be strongly recommended for as long as they are needed. Measures in place at businesses and schools could be lifted over time depending on levels of community transmission.

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Travelling

Mask requirements when returning from international travel

A reminder that under current federal travel requirements, upon return from international travel, individuals that are exempt from quarantine, AND that are not fully vaccinated must wear a mask at all times when in public spaces (including schools and child care), for their first 14 days in Canada. Fully vaccinated returning international travelers are no longer required to mask in public settings for 14 days after arrival to Canada.

Important: The travel guidelines are set by the federal government and are continuously changing. Please check for current federal information at the link above and direct any questions to the federal COVID-19 information line at 1-833-784-4391 or phac.covid19.aspc@canada.ca

What are the requirements regarding proof of vaccination to enter Canada?

For information on requirements for entering Canada, please visit the Government of Canada website.

Can I travel after being vaccinated with a full series of a COVID-19 vaccine? What If I have a mixed dose schedule?

It is important to assess your own personal risk factors for travel. It is also important to be aware of the COVID-19 situation occurring at your travel location. Please check with the country you are travelling to for vaccine, testing, isolation and other public health recommendations. 

If you have a mixed dose series, please know that you are well protected from a COVID-19 infection. Mixed dose schedules continue to be safe and effective. With regards to travel and other countries, it is important to check with the country you are travelling to for their requirements.

For more on Canada’s travel measures see:

COVID-19: Travel, testing, quarantine and borders

COVID-19: Your safety and security outside Canada

COVID-19 vaccinated travellers entering Canada

Another helpful resource from The Government of Canada is the Travel Advice and Advisories.

Information for travel outside of Canada

Information for travel outside of Canada 

Returning from International Travel? 

All travelers entering Canada must follow federal quarantine requirements including isolation and testing, unless exempt. Refer to the Federal Quarantine Requirements to determine if you are required to isolate. 

Travelling Outside of Canada? 

Ottawa Public Health currently does not provide clearance letters for travel. Please contact your primary care provider or visit a travel clinic. 

Ottawa Public Health does not provide recommendations regarding international travel. Please look into the guidelines of the country you are travelling to. 

For previous PCR test results, contact the clinic or testing centre in which you received testing or access the Province of Ontario’s website. Visit our testing page for more information on accessing your test result. 

Looking for pre-travel clearance? Visit our testing page for more information. 

Learn more about COVID-19 testing for the purpose of pre-travel clearance

Private testing options for international and domestic travellers

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Safety

I am concerned about reports of myocarditis or pericarditis following the COVID-19 vaccine. What information is there?

Myocarditis is an inflammation of the heart muscle. Pericarditis is an inflammation of the lining around the heart. Symptoms can include: 

  • chest pain 

  • shortness of breath 

  • heart palpitations (fluttering or pounding of the heart) 

There have been reports of myocarditis and/or pericarditis after immunization with mRNA COVID-19 vaccines in Canada and internationally. Cases of myocarditis and/or pericarditis occur more often in people under 30 years of age, more often in males than in females, and more often after a second dose of an mRNA vaccine than after a first dose. The risk of myocarditis/ pericarditis is rare, and events usually occur within a week after vaccination and mostly have been mild with a quick recovery.  

According to the National Advisory Committee on Immunization (NACI):  

For people aged 12 to 29 years receiving an mRNA COVID-19 vaccine primary series: 

  • The use of Comirnaty/Pfizer-BioNtech (30 mcg dose) is preferred to Moderna Spikevax (100 mcg dose) to start or continue the mRNA primary vaccine series. 

  • The second dose of mRNA vaccine should be provided 8 weeks after the first dose as a longer interval between doses is associated with higher vaccine effectiveness and potentially lower risk of myocarditis/pericarditis. 

NACI further states that the known risks of COVID-19 illness (including complications like myocarditis/pericarditis) outweigh the potential harms of having an adverse reaction following mRNA vaccination, including the rare risk of myocarditis or pericarditis which despite hospitalization, is relatively mild and resolves quickly in most individuals. 

Those who are aged 12 to 29 years, who have already received the Moderna vaccine, do not need to be concerned, as the risk of myocarditis/ pericarditis is rare.  

People aged 30 years or older can receive either mRNA vaccines (Comirnaty/Pfizer-BioNtech or Moderna) to start or continue the mRNA vaccine series given that this age group has a lower risk of vaccine-associated myocarditis/pericarditis. 

The majority of reported cases have been mild with individuals recovering quickly, normally with anti-inflammatory medication. 

Get medical attention immediately if you develop any of the following symptoms: 

  • chest pain 

  • shortness of breath 

  • feelings of having a fast-beating, fluttering or pounding heart 

Report any adverse events after immunization to your healthcare provider. 

For more information, please visit the Third (booster) dose Frequently Asked Questions.

Can getting a COVID-19 vaccine affect menstruation or fertility?

It is not clear if the COVID-19 vaccine can affect your periods. But getting sick with COVID-19 can affect your periods. There was a  study done in Wuhan, China (Chen et al., 2020). It showed that one fifth of patients with confirmed COVID-19 had temporary changes in:

  • the length of their menstrual cycle; and
  • the amount of their bleeding.

Fertility, the ability to get pregnant, is not affected by vaccines. During the years that someone could get pregnant, precaution should be taken with certain live virus vaccines. This is because of theoretical risk to the fetus, not because fertility could be affected. An example of a live virus vaccine is the measles vaccine. 

The COVID-19 vaccines in use are not live virus vaccines. There is no biological reason to believe that the current COVID-19 vaccines would impact someone’s fertility. The U.S. has safety data of over 35,000 pregnant women who received COVID-19 vaccine. This data has not identified any safety concerns with getting an mRNA vaccine within 30 days of conception. NACI has recommended that you do not need to avoid pregnancy after vaccination with an mRNA vaccine. 

Male fertility: millions of men worldwide have received the COVID-19 vaccines. There is no evidence to date that shows that getting a COVID-19 vaccine could lead to fertility loss. We do know that all vaccines, including the COVID-19 vaccines, can cause a brief fever in some people. Significant fever from any cause (e.g., if you get the flu) may have a temporary impact on sperm count and quality. But, this effect is only temporary. Some studies have shown that if you get COVID-19, it may affect the quality of your sperm. It is unclear how long this effect lasts.  

I am concerned about reports of Bell’s Palsy following the COVID-19 vaccine. What information is there?

Very rare reports of Bell’s Palsy (typically temporary weakness or paralysis on one side of the face) have been reported in Canada and internationally after vaccination with the Comirnaty (Pfizer-BioNtech) and Moderna COVID-19 vaccines. 

Bell’s Palsy is an episode of facial muscle weakness or paralysis that comes on quickly. Symptoms are usually temporary and improve after a few weeks. It is thought to be the result of swelling and inflammation of the nerve that controls muscles on one side of your face.  

Get medical attention if you experience any of the following symptoms after vaccination: 

  • uncoordinated movement of the muscles that control facial expressions, such as smiling, squinting, blinking or closing the eyelid 
  • loss of feeling in the face 
  • headache 
  • eyes watering
  • drooling 
  • loss of taste on the front two-thirds of the tongue 
  • very sensitive to sound in one ear 
  • unable to close an eye on one side of the face 

Report any adverse events after immunization to your healthcare professional. 

Health Canada reassures Canadians that COVID-19 vaccines continue to be safe and effective at protecting them against COVID-19.  The benefits of COVID-19 vaccines continue to outweigh any potential risks, as scientific evidence shows that they reduce deaths and hospitalizations due to COVID-19. 

Is it true that the COVID-19 vaccine only stops someone from having COVID-19 symptoms, but they could still pass the virus to others without knowing (asymptomatic transmission)?  

Studies of COVID-19 vaccines have shown that they are very effective at preventing people from becoming sick with COVID-19. However, right now we do not have enough information to show us how likely it is that someone who has been given a COVID-19 vaccine can develop an asymptomatic (no symptoms) COVID-19 infection and pass it to others.  

While there is early evidence suggesting that the vaccine may also reduce COVID-19 transmission, NACI is recommending that everyone continue to practice public health measures (e.g. wearing a face mask and physical distancing) regardless of whether or not they received a COVID-19 vaccine. More information on the vaccines ability to reduce COVID-19 transmission is expected in the near future.  

This means the vaccines will protect those who receive it from getting sick, but it is possible that someone who has been vaccinated could still carry the virus pass the virus on to othersalthough it would likely be at a much lower rate.  

How was Health Canada able to approve the COVID-19 vaccine so quickly – did they lower their safety standard for vaccines?

The reason the COVID-19 vaccine was approved quickly is not because safety standards have changed, it’s because Health Canada shortened the administrative and organizational process of vaccine authorization. The safety requirements in clinical trials for the COVID-19 vaccine were just as strict as the regular process for any other vaccine.

Can people who have already tested positive for COVID-19 get a COVID-19 vaccine?

Yes. According to the NACI Updated guidance on COVID-19 vaccination timing for individuals previously infected with SARS-CoV-2, those who have previously tested positive for COVID-19 should still be vaccinated and people do not need COVID-19 testing prior to vaccination.

For individuals five years and older with a previous COVID-19 infection, it is suggested that they can receive the vaccine eight weeks after symptoms began, or after positive test result (if no symptoms). 

This interval applies to an infection before a first dose of the COVID-19 vaccine, as well an infection that may occur between doses. If someone experiences a COVID-19 infection before their second dose, they should wait eight weeks after symptoms began, or after the positive rest result (if no symptoms).

New evidence shows that a longer interval between a COVID-19 infection and vaccination is associated with improved antibody responses to COVID-19 vaccines. 

There is no information that suggests that antibodies from a recent COVID-19 infection would interfere with vaccine efficacy.  

Vaccination continues to be very important, as people who have had previous COVID-19 infections may remain at risk for Omicron infection. The risk of reinfection with Omicron is higher than risk of reinfection with previous variants.

If young children cannot get COVID-19 vaccines yet, how can we protect them from COVID-19?

Vaccines add an extra layer of protection. Most vaccines decrease the circulation and transmission of the diseases against which they provide immunity. However, we still need more real-life data about how the COVID-19 vaccines will impact transmission of COVID-19. For now, it is very important that we continue to follow public health measures to keep each other safe.

All vaccines are reviewed by Health Canada and the National Advisory Committee on Immunization (NACI). They determine who the vaccines are safe and effective for. The Comirnaty (Pfizer-BioNtech) vaccine is currently approved for individuals born in 2016 or earlier.

Due to lack of evidence, children born before 2016 are not currently eligible for the COVID-19 vaccines. There are vaccine companies that are now studying the vaccine in younger age groups. Health Canada and NACI will review new evidence on vaccine safety and effectiveness. They will use the emerging evidence to update their recommendations.

Is it safe to take the vaccines if someone does not know that they have COVID-19? For example, if they are asymptomatic?  

Yes, it is safe to take the vaccine as long as you are feeling well on the day you are to have your vaccine. You do not need a COVID test in order to get the vaccine. However, it is still important to screen yourself before being vaccinated. Public health measures are in place at clinics to keep you and others safe. Please wear a mask, distance yourself from others and stay home if you or anyone in your household is ill. 

Is it safe for seniors or other high risk groups to go to public vaccination clinics?

Yes. Measures are being taken at vaccine clinics to make sure that the public is safe. It is important that if you are going to get vaccinated, that you screen yourself for COVID-19 first. If you or anyone in your household is not well, or has symptoms of COVID-19, you must stay home.

Vaccine clinics are set up to be as safe as possible. The setup of each clinic will allow for physical distancing.  There will also be a limit on the number of people in a space at one time. Everyone is required to wear a mask while attending a clinic. Staff giving the vaccine will also be wearing Personal Protective Equipment (PPE).

Please note that after getting your vaccine, you will need to stay and sit in the clinic for at least 15 minutes. If you need support during your clinic visit, you can bring a support person with you. 

What are the signs and symptoms of Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT)?
Vaccine-Induced Immune Thrombotic Thrombocytopenia is rare. In the reported cases, the symptoms developed 4 to 20 days after getting the AstraZeneca Vaccine. If you develop any of the symptoms below following COVID-19 vaccination, seek immediate medical attention.

Symptoms include:

  • Shortness of breath
  • Chest pain
  • Leg swelling
  • Persistent abdominal pain
  • Neurological symptoms including sudden onset of severe or persistent worsening headaches or blurred vision
  • Skin bruising (other than at the site of vaccination) or petechiae
It is also important to remember that there are temporary minor symptoms which are common after all vaccinations which include: headache, fever or pain at the injection site. 

Can I still get a vaccine at a clinic if I have a history of fainting when getting a needle?

Yes. Please let your immunizer at the clinic know that you have a history of fainting during or after getting a vaccine. You will be accommodated by being given your vaccine lying down on a mat. There is an area of the clinic that Is screened off for privacy.

Fainting after a vaccine is not an adverse reaction and can happen to people for different reasons including stress or anxiety.

Please note: the FAQ above refers to fainting only, not a more a severe allergic reaction, such as anaphylaxis. Please be sure to tell your immunization provider if have a history or fainting or a history of severe allergic reactions following vaccination.

What do I do if I or someone I support has a needle phobia or fear but would still like to get a COVID-19 vaccine at a clinic?

If you or someone you are supporting has a needle fear, phobia or anxiety, community clinic staff can support. 

To accommodate individuals with severe needle phobia, please fill out the COVID-19 Vaccine accessibility assessment form

  1. A clinic nurse or OPH representatives will call the client and/or their contact person to introduce themselves The clinic nurse will explain the vaccination process step-by-step - from the time they enter the clinic to when they leave 

  2. The nurse can offer a private room or isolated space for the vaccination. If necessary, we can also arrange for a place for the client to lie down during the vaccination. Also, an accompanying family member/friend and/or things like stuffed animals are allowed throughout the appointment. 
  3. Lastly, the nurse will ask the client/their contact if there are specific steps we might take which could help with the client’s anxiety
  4. Accommodation requests can be made by completing the COVID-19 Vaccine accessibility assessment form

Some resources that might be helpful include  

Is it possible to experience post-COVID-19 (also known as long COVID) health conditions? 

You never know how COVID-19 will affect your health after the acute illness has passed. Most people with COVID-19 get better in a few weeks. Some take longer to recover or have problems during recovery. 

Anyone can experience post-COVID-19 health conditions (also referred to as long COVID, long-haul COVID, post-acute COVID-19, long-term effects of COVID, or chronic COVID). This includes people who did not have symptoms while they had COVID-19. Every person is different. 

Anyone can experience post-COVID-19 health conditions (also referred to as long COVID, long-haul COVID, post-acute COVID-19, long-term effects of COVID, or chronic COVID). This includes people who did not have symptoms while they had COVID-19. Every person is different.  

Preventing post-COVID conditions / ‘long-COVID’:  

According to the Centers for Disease Control and Prevention (CDC), the best way to prevent post-COVID conditions is to protect yourself and others from being infected. For those who are eligible, getting vaccinated against COVID-19 can help prevent infection and protect against severe illness. The CDC also states that research shows those who are vaccinated and become infected with COVID-19 are less likely to report post-COVID conditions compared to those who are not vaccinated.

Symptoms of post-COVID-19 health conditions can be new or ongoing and last weeks or months following a COVID-19 infection. Some of these symptoms can include:

  • Difficulty breathing or shortness of breath
  • Tiredness or fatigue
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Cough
  • Chest or stomach pain
  • Headache 

Post-COVID-19 health conditions appear to be less common in children and adolescents. Symptoms in children and adolescents are similar to those experienced by adults. 

The causes and treatments for each person who has longer-term health problems will be different. The long-term effects of COVID-19 infection are still being studied. Have a discussion with your health care provider about your personal situation if you are having problems during your recovery. 

For more information on post-COVID-19 health conditions, please visit:

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Allergies, side effects and medical conditions

Can people with severe allergies to a component of the COVID-19 vaccine receive the vaccine?

No. People with a history of severe allergic reaction to a component of the COVID-19 vaccine should not receive the vaccine. 

If you have a known severe allergic reaction to a component in one of either the Moderna or Comirnaty (Pfizer-BioNtech) vaccines and can’t interchange your second dose, you will be able to receive the appropriate vaccine at our community and pop-up clinics.

Visit the Health Canada web page to learn who should not received the  Comirnaty (Pfizer-BioNtech)-BioNTechModernaAstraZeneca and Janssen COVID-19 vaccines.

What are the side effects of the COVID-19 vaccines?

American Sign Language - What are the side effects of the COVID-19 vaccines?

The most frequent side effects are injection site pain, fatigue and headache. Some people who got the vaccine in trials also reported muscle pain, chills, joint pain and fever. These symptoms were usually mild or moderate and went away within a few days. These are all expected reactions to vaccines because of the immune response. They are very similar to those reported following the seasonal influenza vaccination.

You can find more information on the side effects for each vaccine here: Comirnaty (Pfizer-BioNtech)ModernaAstraZeneca or Janssen.

This document is not in an accessible format

If a person develops an adverse reaction, what should be done?

No serious safety concerns have been causally linked to COVID-19 vaccines approved in Canada.

If someone experiences an adverse event following immunization, they should report it to a healthcare professional (e.g., family doctor).

An adverse event following immunization (AEFI) is an unwanted or unexpected health effect that happens after someone receives a vaccine, which may or may not be caused by the vaccine.

Public health surveillance of AEFIs is important for timely detection of rare vaccine safety issues. For more information visit the OPH page on AEFI reporting.

Expected side effects for each vaccine product are listed on the vaccine product monograph; common side effects could be found under ‘Side effects and risks’.

Healthcare professionals should complete the Adverse Events Following Immunization (AEFI) Form and send it to the local public health unit.

New Online Reporting Option for AEFIs

We are pleased to announce an online portal for submitting AEFI reporting securely in PDF format: https://secureforms.ottawapublichealth.ca/vaccines/AEFI-Submission-EN

This provides an another option, in addition to reporting by fax to: 613-580-9660

If I receive the COVID-19 vaccine and experience symptoms afterwards that are similar to COVID-19, do I need to self-isolate/get tested?

Common Symptoms after COVID-19 Vaccination

Individuals who receive a COVID-19 vaccination may experience post-vaccine side effects.  These side effects may produce symptoms that are also symptoms of COVID-19, such as:   

  • Headache  
  • Fatigue 
  • Muscle ache  
  • Joint pain 

If an individual is newly experiencing any of the above symptom(s) within 48 hours of receiving a vaccine, they do not need to isolate if the symptoms are mild (i.e., not affecting usual activities) and the person has had no known exposure to COVID-19.

An individual should self-isolate and seek testing (if eligible) if:

  • Symptom(s) last or develop more than 48 hours after vaccination  
  • Symptom(s) persist or worsen for more than 48 hours after the first symptom onset  
  • Symptoms begin to affect the individual’s ability to do their usual activities   
  • Symptoms are judged by a health care provider to be severe and/or not in keeping with a COVID-19 vaccination reaction, OR,
  • You have been identified as a high-risk contact of a positive case

Other Symptoms of COVID-19 Vaccination

After immunization, individuals and their household members should self-isolate (and consider testing, if available) if they have any of the following symptoms:   

  • Fever (temperature of 37.8°C/100.0°F or greater) and/or chills (see below) OR
  • Cough OR
  • Shortness of breath OR
  • Decreased or loss of taste or smell OR

Two or more of:

  • Runny nose/congested nose
  • Sore throat
  • Digestive issues like nausea/vomiting, diarrhea, stomach pain 

Fever (temperature of 37.8°C/100.0°F or greater) can be a common side effect of vaccination even without infection. If an individual has a fever of less than 39.0⁰C after vaccination, they (and their household members) can stop self-isolating 24 hours after the fever resolves if all of the following criteria are met:

  • The fever only started after receiving the vaccine
  • The timing of the fever starts within 24hr of receiving the vaccine and resolves within 48hr of receiving the vaccine
  • The fever resolves within 24hr of starting without the use of fever-reducing medications
  • The only other symptom(s), if any, are the mild and common post-vaccine side effects such as headache, fatigue, muscle aches, and joint pain

If the fever is 39.0⁰C or higher, or any of the criteria above are not met, the individual must self-isolate and consider testing (if available).

Ottawa Public Health continues to recommend that anyone with symptom(s) of COVID-19 consult with a health care provider if they have questions or concerns.

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Precautions

Can I get the COVID-19 vaccine if I recently got another vaccine or if I am due for another vaccine?

The National Advisory Committee on Immunization (NACI) was previously recommending that COVID-19 vaccines be given at least 28 days before and 14 days after other vaccines. However, after reviewing the evidence available on COVID-19 vaccines and the data and experience of giving other routine vaccines at the same time or within days of each other, NACI has changed their recommendation.  NACI now recommends that COVID-19 vaccines may be given at the same time as, or before or after other vaccines. This includes live, non-live, adjuvanted, and non-adjuvanted vaccines. There are no specific safety concerns when routine vaccines are given at the same time or within days of each other. Please note that there could be stronger, temporary side effects when a COVID-19 vaccine and another vaccine are given at the same time or within days of each other.

What should I consider before receiving the vaccine? 

  • Wait to get vaccinated if you have a fever or are sick with COVID-19 symptoms. This will help avoid confusing symptoms from other illnesses with vaccine-related adverse events. It also helps to decrease COVID-19 transmission at an immunization clinic
  • Are you on long-term anticoagulation therapy? National Advisory Committee on Immunization (NACI) recommendations support that most people can be safely immunized without stopping their anticoagulation (blood thinner) therapy
  • If you have a bleeding disorder, NACI recommends that you make sure it is well managed before immunization

Can I get vaccinated if I am immunocompromised and or have an autoimmune condition?

NACI recommends that a complete COVID-19 vaccine series with an mRNA COVID-19 vaccine should be offered to those in the approved age group. This includes those who are immunosuppressed due to illness or treatment or who have an autoimmune condition. 

If an mRNA vaccine is contraindicated, another approved COVID-19 vaccine should be offered. The mRNA COVID-19 vaccines approved for use in Canada are the Moderna and Comirnaty (Pfizer-BioNtech) vaccines.   

It is possible that those who are immunocompromised may have a decreased immune response to the COVID-19 vaccines.  

Can the medications I take interfere with the effectiveness of the vaccines? Can they cause other side effects after vaccination?

 Most medications and medical conditions are not expected to interfere with the effectiveness of the vaccines.

You should talk to your health care provider if you:

  • have an autoimmune condition;
  • are receiving immunosuppressing therapies; and
  • have other specific medical conditions.

Your health care provider may have recommendations about the timing of your COVID-19 vaccine in relation to:

  • other vaccines, or
  • treatment for autoimmune or immunocompromising conditions.

Before being vaccinated you will be asked some screening questions. You can find these questions here: COVID-19 Vaccine Screening and Consent Form.

Health care providers can find more information here:

The NACI recommendations are updated as new information becomes available. They have sections with information on:

Have the vaccines been tested on people with a variety of rare conditions?

People who are immunosuppressed may have been excluded from clinical trials for COVID-19 vaccines. People with rare conditions may not be adequately represented in clinical trials for COVID-19 vaccines.

In general, non-live vaccines can be given to individuals who are immunosuppressed.  No safety issues  of concern have been noted to date in the worldwide use of these vaccine products. The vaccines have been tested on thousands of diverse people in many countries before being approved. This is in order to have a good cross-section of society.

Vaccine manufacturing companies report information from clinical trials. This information includes medical conditions of the people who participated. You can view information from clinical COVID-19 vaccine trials. This is a database of privately and publicly funded clinical studies done around the world.

If you have a medical condition, please talk to your health care provider for things to consider. 

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Janssen (Johnson & Johnson) COVID-19 vaccine

What is the Janssen COVID-19 Vaccine?
The Janssen (Johnson & Johnson) COVID-19 Vaccine, also sometimes called, “the J&J Vaccine”, is a single dose, viral vector-based vaccine. This type of vaccine takes another virus, called an adenovirus that is weakened so it cannot grow; it teaches your body how to fight against the COVID-19 virus. The vaccine teaches your immune system to recognize and fight against the COVID-19 virus, which helps to prevent illness if you come into contact with the virus.
 How can I get Janssen (Johnson & Johnson) COVID-19 vaccine?

You cannot book through the provincial portal. Booking will be through your local public health unit. Use this online form to register for a Janssen (Johnson & Johnson) COVID-19 vaccine.

 What is the difference between a viral vector and mRNA vaccine?

Viral vector-based vaccines use a virus, which has been modified to be harmless, as a delivery system to build your immunity. When injected into the body, these COVID-19 vaccines produce a surface protein from the SARS-CoV-2 virus, specifically the SARS-CoV-2 spike protein. The spike protein does not make you sick -- it helps your body develop a strong immune response without exposing you to the virus that causes COVID-19.

Messenger RNA (mRNA) vaccines provide instructions to the cells in our bodies to make a viral protein from the coronavirus called a “spike protein”. The mRNA provides instructions that allows the cell to make the spike protein, and then the immune system is activated to recognize the spike protein as being different from the body’s own proteins which initiates an immune response. The mRNA is then degraded by normal cellular mechanisms and the spike proteins are destroyed by the immune system. mRNA vaccines are just one of the different types of vaccines currently used to prevent COVID-19 disease caused by the SARS-CoV-2 virus. COVID-19 vaccination along with public health measures will offer the best protection from COVID-19.

 Efficacy of the Janssen (Johnson & Johnson) COVID-19
Clinical trials showed that beginning two weeks after the single dose, the Janssen COVID-19 vaccine was 66% effective in protecting trial participants against COVID-19. After 28 days of a single dose, it was found to have an efficacy 85.4% against severe/critical disease.
 Eligibility of the Janssen (Johnson & Johnson) COVID-19

The mRNA vaccines remain the recommended vaccines to offer to eligible individuals. Those 18 years of age or older can receive the Janssen as their COVID-19 vaccine if they meet any of the following criteria:

  • Have not had any doses of a COVID-19 Vaccine, because of a known allergy to one or more of the components of a mRNA COVID-19 Vaccine.
  • Have not received any COVID-19 vaccine and declines an mRNA vaccine (i.e., is looking for an alternative to the mRNA vaccine).
  • Have had a serious Adverse Event Following Immunization (AEFI) after a dose of mRNA COVID-19 vaccine and have been advised by an appropriate Physician or Nurse Practitioner to receive a non mRNA COVID-19 vaccine for future doses.

Please note that individuals who received AstraZeneca as their first dose of COVID-19 vaccine, and do not have a contraindication to receiving an mRNA COVID-19 vaccine are not eligible to receive the Janssen vaccine and should receive an mRNA COVID-19 vaccine.

 Are there any contraindications or special precautions for the viral vector COVID-19 vaccines?
The Janssen COVID-19 vaccine is contraindicated in individuals:
  • Who are younger than 18 years of age
  • Who have experienced major venous and/or arterial thrombosis with thrombocytopenia following vaccination with any vaccine
  • Who have a history of capillary leak syndrome (CLS)
  • Who have experienced a previous cerebral venous sinus thrombosis (CVST) with thrombocytopenia
  • Who have experienced heparin-induced thrombocytopenia (HIT)
  • Actively receiving monoclonal antibody therapy OR convalescent plasma therapy for the treatment or prevention of COVID-19
    • Vaccine should not be administered while actively receiving therapy
Allergies
Individuals who have had a severe, immediate (≤ 4h following vaccination) allergic reaction or anaphylaxis to a previous dose of a COVID-19 vaccine or to any of its components or its container should seek evaluation by an allergist/immunologist. Such an assessment is required to assess the method for possible administration of a COVID-19 vaccine.
 Common side effects of the Janssen (Johnson & Johnson) COVID-19 vaccine
  • Headache
  • Nausea
  • Muscle Pain
  • Pain at injection site
  • Fatigue
  • Fever
 If I am feeling unwell after my vaccine, when should I call my health care provider?
If you experience a high fever (over 40°C or 104°F), or side effects that are worrying you or do not seem to be going away after a few days, contact your health care provider or seek medical attention. Go to the nearest emergency department or call 911 if you have hives, swelling of the face, throat or mouth, trouble breathing within four hours following your vaccine. Also seek medical attention if you experience altered levels of consciousness/serious drowsiness, seizures/convulsions, and “pins and needles”/numbness.

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Other questions

What can I do now and how can I help?

Thank you for your interest in volunteering with Ottawa Public Health’s Community Clinic. Currently, Ottawa Public Health is not in need of volunteer support at the community clinics. For any inquiries related to volunteering at the community clinics, please contact: OPHVolunteerResources@ottawa.ca

If you wish to support local community organizations during the current situation, please visit Volunteer Ottawa or the Champlain Community Support Network webpage.

Help us reach #CommunityImmunity by receiving two doses of any COVID-19 vaccine. Protecting yourself and others from COVID-19 and more transmissible variants is a two-step process

As an increasing number of residents in the City of Ottawa and surrounding areas are continuing to get vaccinated, it is essential that we all continue to do our part to reduce transmission of COVID-19 in the community. Please continue to maintain a distance from those outside your household, wear a mask when you can’t maintain distance, wash your hands, and stay home when you’re feeling sick. Continue to follow local and provincial guidance. 

To keep up to date with the latest information including things you can do to reduce virus spread, follow Ottawa Public Health on Twitter, Facebook and Instagram. You can also subscribe to the City of Ottawa’s weekly roundup of information regarding the City’s response to the COVID-19 pandemic, and follow Ottawa Public Health’s YouTube channel and Community Immunity website.  

What mental health resources are available to those feeling anxious about vaccine availability?

The COVID-19 situation can be very stressful. It is OK to not be OK.

If you are in crisis, please contact the Mental Health Crisis Line (24 hours a day/7 days a week) at 613-722-6914 or if outside Ottawa toll-free at 1-866-996-0991.

Please visit Ottawa Public Health’s Mental Health and COVID-19 page for an extensive list of resources, including a printable version of a Mental Health and COVID-19 Resource List. 

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