COVID-19 Vaccine Eligibility

Get your booster dose as soon as you can
The COVID-19 vaccine is safe and effective and will continue to protect us against COVID-19. To learn who is eligible, and for which doses, please review the latest COVID-19 vaccine eligibility from the information below. Please note: the Middlesex-London Health Unit follows the Ontario Ministry of Health’s guidance on who is eligible for the COVID-19 vaccine in Ontario.

First Booster Dose (Third Dose)

A third dose (first booster) will help protect you from more severe outcomes from COVID-19 and its variants. All Ontarians are strongly encouraged to get their booster dose as soon as possible to keep up to date with their COVID-19 vaccines.

Youth (12 to 17 years of age)

• If you’re between the ages of 12 and 17, you can receive your third dose (first booster) at an interval of at least six months (24 weeks) after your second dose. You must be at least 12 years old at the time of your appointment.

Adults (18 years of age or older)

• If you’re 18 years of age or older, you can receive your third dose (first booster) at an interval of five months (20 weeks) to as early as three months (12 weeks) after your second dose.

Children (5 to 11 years of age)

• Booster doses are not currently available for children 5 to 11 years old.

First Nations, Inuit and Métis adults and youth, including non-Indigenous household members (12 years of age and older)

• First Nations, Inuit and Métis individuals 12 years of age and older, including non-Indigenous household members, can receive a third dose (first booster) at an interval of 5 months (20 weeks) to as early as 3 months (12 weeks) after a second dose.

Booster doses are strongly recommended for adults 18 years of age and older

The National Advisory Committee on Immunization (NACI) strongly recommends that adults 18 years of age and older and youth between the ages of 12 and 17 who are at high risk of severe outcomes from COVID-19 receive a booster dose of COVID-19 vaccine. Learn more →

The Middlesex-London Health Unit continues to recommend that everyone receives all recommended doses of COVID-19 vaccine. This includes a booster dose for those 12 years of age and older and a second booster (fourth dose) for the eligible groups below.

Second Booster Dose (Fourth Dose)

You can receive a fourth dose (second booster) at a recommended interval of five months (20 weeks) after your third dose (first booster) or at a minimum of three months (12 weeks) after your third dose (first booster) if you are:

• 60 years of age or older
  or
• First Nation, Inuit and Métis individuals 18 years of age or older or a non-Indigenous household member 18 years of age or older

Special populations
The groups below can receive a fourth dose (second booster) at an interval of at least three months (12 weeks) after a third dose (first booster). Please bring your proof of address and your health card or another piece of identification to the appointment.

• Residents of Long-Term Care Homes, Retirement Homes, Elder Care Lodges, and older adults living in other congregate settings (e.g. assisted-living facilities, chronic care hospitals, naturally occurring congregate retirement settings/congregate senior's apartment buildings (50 years of age or older), older adults living in congregate settings for people with developmental disabilities, mental health and addictions issues, etc.).

Immunocompromised individuals (three-dose primary series and booster doses)

Some individuals who are immunocompromised are eligible for a three-dose primary series, which means that three doses of COVID-19 vaccine are received to complete an initial vaccination series. This is because underlying health conditions could put these individuals at high risk of severe illness due to COVID-19. A three-dose primary series enhances the immune response and establishes an adequate level of protection against COVID-19. If you are five years of age or older and have a health condition listed below, you are eligible for a three-dose primary series.

List of health conditions:

• Individuals receiving dialysis (hemodialysis or peritoneal dialysis)
• Individuals receiving active treatment (e.g., chemotherapy, targeted therapies, immunotherapy) for solid tumour or hematologic malignancies
• Recipients of solid-organ transplant and taking immunosuppressive therapy
• Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
• Individuals with moderate to severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
• Individuals with HIV with prior AIDS defining illness or prior CD4 count ≤ 200/mm3 or prior CD4 fraction ≤ 15% or (in children 5-11 years) perinatally acquired HIV infection
• Individuals receiving 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 (see the full list here under Table 1).

If you believe you are eligible for a three-dose primary series and recommended booster doses, please contact your health care provider. When receiving your COVID-19 vaccine, please bring a completed patient referral form from your health care provider or a relevant prescription or pill bottle.

First Booster Dose (fourth dose in a three-dose primary series)
Eligible immunocompromised individuals 12 years of age or older can receive a fourth dose (first booster) after their third dose.

• 12 to 17 years old can get a fourth dose (first booster) six months (168 days) after completion of the three-dose primary series.
• 18 years and over can get a fourth dose (first booster) three months (84 days) after completion of the three-dose primary series.

Second Booster Dose (fifth dose in a three-dose primary series)
Eligible immunocompromised individuals can receive a fifth dose (second booster) five months (140 days) after their fourth dose (first booster) or at a minimum of three months (84 days) after their fourth dose (first booster) if they are also:

• 60 years of age and older
  or
• First Nations, Inuit, & Métis individuals and their non-Indigenous household members who are immunocompromised and are 18 years of age or older

Re-vaccination with a new COVID-19 vaccine primary series
The following individuals are eligible for a new COVID-19 vaccine primary series.

• Post-transplantation individuals who received hematopoietic stem cell transplants (HSCT), hematopoietic cell transplants (HCT) (autologous or allogeneic), and recipients of CAR-T-cell therapy, due to the loss of immunity following therapy or transplant.

First and second doses

Anyone five years of age or older is eligible to receive the COVID-19 vaccine.

Timelines for receiving your second dose of the COVID-19 vaccine

The Ontario Ministry of Health recommends an interval of eight weeks (56 days) between first and second doses instead of the minimum required for Pfizer-BioNTech Comirnaty (21 days) and Moderna Spikevax (28 days). There is emerging evidence that longer intervals between the first and second doses of COVID-19 vaccines result in more robust and durable immune response and higher vaccine effectiveness.

Vaccines can be safely mixed

The mRNA vaccines (Moderna and Pfizer) are interchangeable for those who are 18 years of age or older. Pfizer and Moderna are essentially different brands of the same vaccine and you will have the same protection against COVID-19 regardless of what you get for your first or second dose.

The interchangeability of mRNA vaccines has been supported by experts at both the Public Health Agency of Canada and the National Advisory Committee on Immunization. Interchangeability means that you can receive either the Pfizer or Moderna mRNA vaccine as your second dose, regardless of the type of vaccine you received for your first dose. Learn more →

Nuvaxovid (Novavax) COVID-19 vaccine

The Health Unit is receiving a limited supply of the Novavax Nuvaxovid COVID-19 vaccine. If you are interested in receiving the vaccine, please call 1-226-289-3560 to be added to the waitlist. We will contact you when vaccine is available for you.