A bivalent booster dose can be administered as a third, fourth or fifth dose. To receive a bivalent booster, a minimum of three months must have passed since your last dose (i.e., second, third or fourth dose) of COVID-19 vaccine. The recommended interval to receive a bivalent booster dose is six months since your last dose.

As of September 23, 2022, all those 18 years-of-age or older, who have had at least three months pass since their last dose, can receive a bivalent booster dose.

Eligibility will be checked at the time of the appointment. Those who do not meet the eligibility criteria will not receive a vaccine at their scheduled appointment time.

Those aged 5 years-of-age or older can receive a third dose at a recommended interval of 6 months (168 days) or a minimum interval of 3 months (84 days) after their second dose.

• Pregnant individuals – All pregnant individuals in the authorized age group are eligible and recommended to be vaccinated as soon as possible, at any stage in pregnancy, as COVID-19 infection during pregnancy can be severe, and the benefits of vaccination outweigh the risks. These individuals are encouraged to review any concerns with their treating health care provider and/or utilize the Vaccination in Pregnancy & Breastfeeding decision making tool on the MOH website Ministry of Health website.
• Breastfeeding individuals – COVID-19 vaccines can be safely given to breastfeeding individuals and recent data shows that mRNA from vaccines do not transfer into breast milk. Anti-COVID-19 antibodies produced by the breastfeeding person have been shown to transfer through the milk and provide protection to the infant.
  
• Autoimmune condition/immunocompromised due to disease or treatment that are receiving stem cell therapy, CAR-T therapy, chemo, immune checkpoint inhibitors, monoclonal antibodies, and other targeted agents are strongly encourage you to consult with your treating provider regarding timing of vaccination in relation to therapy and/or treatment modification to ensure the impact of the immunosuppressive therapy on vaccine effectiveness is as minimal as possible.
• All other individuals with autoimmune/immunocompromised due to disease and immunocompromised due to treatment – may choose to consult with their treating provider but not required prior to vaccination.
• Severe allergic reaction or anaphylaxis to a previous dose of a COVID-19 vaccine or to any of its components should not receive the COVID-19 vaccine in a general vaccine clinic. An urgent referral to an allergist/immunologist is recommended to assess the method for possible (re)administration of a COVID-19 vaccine.
  
• Immediate allergic reaction to a previous dose of a COVID-19 vaccine or to any of its components –requires evaluation by an allergist/immunologist and documentation of allergist to determine if the vaccine can be safely administered. Documentation of the discussion with the allergist/immunologist must be provided to the clinic and include a vaccination care plan (including what types of parameters the clinic should meet to provide safe vaccination administration, e.g., availability of advanced medical care), details/severity of the previous allergic episode(s), confirm that appropriate counselling on the safe administration of vaccine was provided, and include the date, the clinician’s name, signature and contact information as well as the individual’s name and date of birth.
  
• Severe/immediate allergic reaction to other vaccines or injectable therapies – does not require consultation with an allergist prior to vaccination but client will be asked to wait 30 minutes post vaccination for observation.
• Significant or anaphylactic allergic reactions to other allergens does not require consultation with an allergist prior to vaccination. Client will be asked to wait the typical 15-minute observation time.