2026–2027 Respiratory Season Immunization Information for Health Care Professionals

Individuals who are part of the population groups listed below are included in the fall COVID-19 and UIIP program high-risk and priority groups and are eligible for both vaccines, as soon as the vaccines are available:

• People ≥ 65 years of age
• Residents, staff and care providers in long-term care homes and other congregate living settings
• Individuals 6 months of age and older who are moderately to severely immunocompromised (due to specific underlying condition or treatment)
• All pregnant individuals
• All children 6 months to 4 years of age 

·       Individuals 6 months of age and older with the following underlying health conditions:

o   Cardiac or pulmonary disorders

o   Cerebrovascular disease

o   Diabetes mellitus or other metabolic disease

o   Cancer

o   Chronic liver disease

o   Conditions or medication which compromise the immune system

o   Renal disease

o   Anemia or hemoglobinopathy

o   Neurologic or neurodevelopment conditions

o   Class 3 obesity (body mass index of 40 or more)

o   Children and adolescents (6 months to 18 years) undergoing treatment with acetylsalicylic acid for long periods

·       Individuals from First Nations, Métis and Inuit communities, and their non-indigenous household members 

• Members of underserved communities
• Health care workers and first responders
• Individuals whose occupational or recreational activities increase their risk of exposure to avian influenza A viruses

Note: Refer to the Ministry of Health’s COVID-19 Fact Sheet for Health Care Providers  for full list of eligible underlying medical conditions, specific eligibility criteria, vaccine intervals, as well as populations eligible for a spring COVID-19 vaccine dose

Those not eligible as part of high-risk and priority population groups will be eligible for influenza and COVID-19 vaccination starting October 26, 2026. 

Ottawa Public Health (OPH) expects to receive its initial shipments of COVID-19 and influenza vaccines from the Ontario Ministry of Health by the week of September 28^th. As such we will work diligently to distribute as soon as possible to providers for administration to high-risk and priority populations.

Initial vaccine allocations are for hospitals and long-term care homes (LTCHs), for the vaccination of hospital patients and staff, and LTCH residents, staff, and caregivers.

Further supply will be prioritized to retirement homes and other congregate living settings.  Vaccine availability for community health care providers to vaccinate high-risk and priority populations is expected by early to mid-October for both COVID-19 and influenza vaccines. Pharmacies will receive their vaccine shipments through their provincial distributor. Vaccine availability in pharmacies for high-risk and priority populations is expected to closely align with product availability anticipated by mid-October.

Congregate settings and health care providers can begin vaccinating high-risk and priority groups as soon as they receive supply, understanding that they will not be able to reorder vaccines until October 19^th, after the initial supply has reached all settings and health care providers, and the provincial supply is replenished.

Starting mid-October OPH will begin offering COVID-19 and influenza vaccine to specific high-risk individuals through local community clinics and Neighbourhood Health and Wellness Hubs. OPH clinics are for individuals facing significant barriers in accessing vaccines through pharmacies or healthcare providers such as children less than 5 years of age and newcomers without OHIP. Information will be updated as it becomes available on our website.

• Due to the possibility of unanticipated restrictions on the availability of publicly funded influenza vaccines and/or delays in vaccine delivery, it is recommended that health professionals do not book appointments prior to receiving vaccine. 
• Health professionals wishing to conduct large-scale community vaccination clinics are asked to wait until October 26th  to ensure that an adequate supply of vaccine can be ordered based on the available provincial supply.

·       All available influenza vaccines or COVID-19 vaccine may be given at the same time with other vaccines, or at any time before or after, other vaccines, including RSV products for individuals 6 months and older.

·       If given at the same time, separate limbs should be used if possible for the injections. Alternatively, the injections may be administered into the same muscle separated by at least 2.5 cm (1”). Different immunization equipment (needle and syringe) must be used for each vaccine.

Publicly funded influenza vaccines 2026/2027

All products are trivalent inactivated vaccines (TIV) and contain inactivated strains of influenza A (H3N2 and H1N1) and influenza B (Victoria strain), as recommended by the WHO for the Northern hemisphere for the 2026/2027 season.

Important notes: Fluzone® and Fluzone® High-Dose are different products. Fluzone® High-Dose is authorized ONLY for individuals aged 65 years and older.

Older Adults:

• The trivalent inactivated high-dose (TIV-HD) vaccine, Fluzone® High-Dose,  and trivalent inactivated adjuvanted (TIV-adj) vaccine, Fluad® , should be offered, when available, over standard dose TIV influenza vaccines for adults ≥65 years of age. There is no preferential recommendation for the use of TIV-HD versus TIV-adj vaccine for this age group.
• If these products are not available, do not delay vaccination. The most important thing is for older adults to be vaccinated. Any of the available age-appropriate influenza vaccines should be used.

• Memo form the Ministry: COVID-19 Vaccine Program and Universal Influenza Immunization Program (UIIP) – 2026/2027
• Health Care Provider Fact Sheet: UIIP 6 months – 64 years
• Health Care Provider Fact Sheet: UIIP 65+ years
• Ottawa Public Health's Influenza for Health Care Professionals
• Ontario Ministry of Health Universal Influenza Immunization Program Page

Two mRNA COVID-19 vaccines, Moderna Spikevax® and Pfizer Comirnaty ® mRNA and one protein subunit COVID-19 vaccine (Nuvaxovid) are available in Ontario for the 2026/2027 program:

• Moderna Spikevax: for those ≥ 6 months of age
• Pfizer-BioNTech Comirnaty: for those ≥ 12 years of age
• Nuvaxovid: for those ≥ 12 years of age

The updated COVID-19 vaccines target the XFG variant and are expected to offer additional protection against infection and severe COVID-19 disease. Not all vaccine brands and/or formats will be available at all times or at all locations. All publicly funded COVID-19 vaccines are equivalent and provide the same protection against COVID-19 disease. Health care providers should use the vaccine (according to the products’ age indications) that is available unless the patient has a contraindication toward a specific vaccine.

COVID-19 immunization schedule:

• Previously vaccinated individuals:
  • Should receive a fall dose when eligible, with a minimal interval of 3 months from their previous dose.
  • A minimum of 3 months from test-confirmed infection to COVID-19 vaccination may be considered.
• Previously unvaccinated individuals:
  • XFG containing COVID-19 vaccine can be used to initiate the series

Please refer to the Ministry of Health, Health Care Provider Fact Sheet: COVID-19 Vaccine  for detailed COVID-19 vaccine recommendations based on vaccine history and immune status of the individual.

• Memo from Ministry of Health: COVID-19 Vaccine Program and Universal Influenza Immunization Program (UIIP) – 2026/2027
•  Health Care Provider Fact Sheet: COVID-19
•  Ottawa Public Health's COVID-19 for Health Care Professionals webpage
• Ontario Ministry of Health COVID-19 Vaccine Program Page

As communicated earlier this year, the Older Adult RSV Vaccine Prevention Program is available year-round for eligible individuals. A single dose of RSV vaccine can be given to eligible older adults at any time during the year. If an individual has previously received a dose of RSV vaccine, they do not need to receive another dose this season, as booster doses are not currently recommended at this time.

Older Adult High Risk RSV Vaccine Prevention program eligibility:

• All individuals 75 years of age and older
• Individuals 60 to 74 years of age who are also:
• Residents of long-term care homes, Elder Care Lodges, or retirement homes including similar settings (e.g., co-located facilities)
• Patients in hospital receiving alternate level of care (ALC) including similar settings (for example, complex continuing care, hospital transitional programs)
• Individuals on home oxygen or requiring chronic oxygen therapy, regardless of residence
• Patients with glomerulonephritis (GN) who are moderately to severely immunocompromised
• Patients receiving hemodialysis or peritoneal dialysis
• Recipients of solid organ or hematopoietic stem cell transplants within the past two years or with ongoing immunosuppression
• Individuals experiencing homelessness
• Individuals who identify as First Nations, Inuit, or Métis

Eligible Ontario residents can access publicly funded RSV vaccine through their primary care provider or in the setting in which they are eligible. RSV vaccination is not available through pharmacies. OPH will support residents with barriers to access through select OPH clinics. More information will be available on our website.

Both Arexvy and Abrysvo^TM are Health Canada approved RSV vaccines that are indicated for the prevention of lower respiratory tract disease (LRTD) caused by RSV in those 60 years of age and older. RSV vaccine may be co-administered with other routine and seasonal immunizations for older adults.

Depending on vaccine supply and availability, healthcare providers may receive either product in their vaccine order.

Resources for health care professionals

• Older Adult High-Risk Respiratory Syncytial Virus (RSV) Vaccine Program Fact Sheet - Health Care Providers
• Letter from the Office of the Chief Medical Officer of Health re Ontario’s RSV prevention programming for the 2026-2027 season

Adverse Event Reporting

• Abrysvo^TM and Arexvy adverse event reports can be reported using the Adverse Event Following Immunization Form.

Resources for patients

• Ministry of Health’s RSV prevention program page for the general public: ontario.ca/rsv
• Ottawa Public Health’s RSV website: ottawapublichealth.ca/rsv
  

Immunization of eligible infants, high-risk children, and pregnant patients can begin on October 1^st, 2026.

a) Monoclonal Antibody (mAb) for Infants and High-risk Children

Starting October 1^st, eligible infants or high-risk children can receive publicly funded doses of Beyfortus® (Nirsevimab) monoclonal antibody (mAb):

Eligibility includes Ontario residents who meet one of the following criteria:

• Infant program
  • Infants born April 1, 2026 or after and who are less than 8 months of age
    
• High-risk children program:
  • Children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season due to specific health conditions, following a discussion with a healthcare provider:
    •  Chronic lung disease (CLD), including bronchopulmonary dysplasia (BPD), defined by need for ongoing respiratory support and supplemental oxygen therapy at 36 weeks postmenstrual age (gestational age at birth plus chronological age) or discharged home, if earlier.
      • Note: Children who were < 12 months of age and approved for coverage in the previous RSV season for chronic lung disease and bronchopulmonary dysplasia remain eligible.
  • Hemodynamically significant cyanotic or acyanotic congenital heart disease (CHD) defined as infants requiring corrective surgery or are on cardiac medication for congestive heart failure or diagnosed with moderate to severe pulmonary hypertension.
  • Severe immunodeficiency
  • Down syndrome/Trisomy 21
  • Cystic fibrosis with recurrent pulmonary exacerbations requiring hospitalization, deteriorating pulmonary function and/or severe growth delay
  • Neuromuscular disease impairing clearing of respiratory secretions
  • Severe congenital airway anomalies impairing the clearing of respiratory secretions

b) Abrysvo^TM vaccination for pregnant people

Vaccination for pregnant people with Abrysvo^TM, to provide their infant with passive immunity through maternal antibodies, can help to protect infants against RSV.

Abrysvo^TM is not to be administered to infants. This vaccine is only approved for those 18 and older. Please be extra cautious in separating these products to avoid a medication error. Eligibility is for pregnant individuals at 28-36 weeks pregnant who are Ontario residents and will deliver during RSV season, following a discussion with a health care provider.

While RSVpreF (Abrysvo®) is authorized by Health Canada for use in pregnant persons between 32 and 36 weeks gestation, the National Advisory Committee on Immunization (NACI) recommends that RSVpreF may be administered between 28 and 36 weeks gestation. This recommendation is supported by available safety and efficacy data, supports broader access and opportunities for immunization, and aligns with recommendations by the World Health Organization. Administration before 32 weeks gestation is considered off-label and is subject to the clinical judgment of the health care provider.

Important notes:

• Administration of both the vaccine and a monoclonal antibody is NOT recommended except under the following specific circumstances:
  • All premature infants (<37 weeks gestational age)
  • Infants who meet any of the above high-risk criteria
  • OPH will support families with infants with barriers to access through select OPH clinics and information will be available on our website.
  • Infants born less than 14 days after administration of Abrysvo^TM in pregnancy OR
  • Infants at increased risk of severe RSV disease
    • All premature infants (<37 weeks gestational age)
    • Infants who meet any of the above high-risk criteria
    • OPH will support families with infants with barriers to access through select OPH clinics and information will be available on our website.

RSV prevention program information can be found on the Ministry of Health’s website; information for the 2026-2027 season to be posted on their website shortly.

Resources for Health Care Professionals

• Infant and High-risk Children Respiratory Syncytial Virus (RSV) Prevention Program Factsheet for Health Care Providers
• Letter from the Office of the Chief Medical Officer of Health re Ontario’s RSV prevention programming for the 2026-2027 season

Adverse Event Reporting

• Beyfortus® is a monoclonal antibody, as such, reports of suspected side effects should be submitted through the Health Canada Side Effect Reporting Form
• Abrysvo^TM and Arexvy adverse event reports can be reported using the Adverse Event Following Immunization Form.

Resources for Patients

• Ministry of Health’s RSV prevention program page for the general public: ontario.ca/rsv
• Ottawa Public Health’s RSV website: ottawapublichealth.ca/rsv