Hastings Prince Edward Public Health
Online Bulletin for Health Care Providers

January 18, 2022

From:
Dr. Ethan Toumishey
Acting Medical Officer of Health
Hastings Prince Edward Public Health

In this Issue:

  1. COVID-19 information for HCPs section on HPEPH website updated
  2. New: web submission form for high risk settings to report COVID-19 cases and exposures
  3. COVID-19: interim guidance for schools and child care
  4. COVID-19 long term care updates
  5. Quick reference charts for COVID-19 vaccine eligibility
  6. PAXLOVID authorized by Health Canada
  7. Updated case definition – Coronavirus Disease (COVID-19)
  8. Educational opportunity
  9. New and updated COVID-19 resources

COVID-19 vaccine news & updates

COVID-19 information for HCPs section on HPEPH website updated

COVID-19 resources that are relevant to health care providers can be found on the HPEPH website under COVID-19 Resources for Health Care Providers.

New: web submission form for high risk settings to report COVID-19 cases and exposures

HPEPH has launched a secure web reporting form for the highest risk settings* to report COVID-19 cases and exposures. The completed form is sufficient reporting of COVID-19 in a highest risk setting and an HPEPH communicable disease investigator will follow up with the setting.

*Hospitals and health care settings, including complex continuing care facilities, acute care facilities and paramedic services; Congregate living settings, e.g. long-term care homes, retirement homes, First Nation elder care lodges, group homes, shelters, hospices, temporary foreign worker settings, and correctional institutions; First Nations, Inuit, Métis communities

COVID-19: interim guidance for schools and child care

Ontario schools reopened to in-person learning on January 17, 2022 and will be managing COVID-19 cases as per the Interim Guidance for Schools and Child Care: Omicron Surge. Of note from the new guidance:

  • Take-home PCR self-collection kits will only be used in limited circumstances. These kits are to be provided only to symptomatic elementary/secondary students and education staff who become symptomatic while at school.
  • An individual that is experiencing symptoms and does not have access to a PCR test or rapid antigen test (RAT) is presumed to have COVID-19 based on their symptoms and should isolate as per the guidance in COVID-19 Integrated Testing & Case, Contact and Outbreak Management Interim Guidance: Omicron Surge.
  • Individuals experiencing single symptoms are only required to isolate until the symptom is improving for 24 hours (48 for gastrointestinal symptoms).
  • Where a child, student, or staff member has been advised from a case that they may have been exposed to a positive case of COVID-19 at school, they should monitor for symptoms and seek testing if eligible/available.

 

COVID-19 long term care updates

Stay up-to-date on the guidance for LTCH and RHs using the COVID-19 guidance document for long-term care homes in Ontario.

Important updates:

  • Mandatory third (booster) dose for all staff, students, volunteers and caregivers is required by January 28, 2022 for those who were eligible on or before December 31, 2021.
  • Residents of long-term care homes are eligible for a fourth dose of an mRNA vaccine if at least three months have passed since their third dose.
  • In cases of serious staffing shortage, there is a new risk-based framework to guide homes in navigating return to work scenarios for fully vaccinated staff who are high risk close contacts with someone who is COVID-19 positive or who are COVID-19 positive. The framework outlines testing and isolation requirements for various risk of transmission levels (lowest risk, moderate risk and highest risk).
  • Testing and isolation requirements for admissions and transfers from the community that include testing on day 5 instead of day 7 (isolation remains at least 7 days), and provisions for rapid antigen testing when PCR testing isn’t timely.

Quick reference charts for COVID-19 vaccine eligibility

Below are quick reference charts for COVID-19 vaccine eligibility provided by the Ministry of Health. The HPEPH Eligibility & Interval for Third Dose / Boosters COVID-19 mRNA Vaccine chart, including 4th dose eligibility is also updated regularly.

COVID-19 vaccine general eligibility by age and third dose

Population Eligibility Vaccine Types *Third Dose Eligibility
Under 5

Not eligible
5-11

Age-based (based on birth date)
  • Pediatric Pfizer primary series only
  • Only for individuals who are immunocompromised (completion of primary series)
12-17 Age-based (based on birth date)
  • Adult Pfizer preferential recommendation
  • Moderna is permitted with informed consent
  • Note: For an 11 year old turning 12 who received their first dose as pediatric Pfizer, the primary series may be finished with the pediatric Pfizer dose.
  • Only for 12-17 year olds who are:
    • immunocompromoised (completion of primary series)
    • 16 and 17 year old HCWs and FNIM
18-29 Age-based (based on birth date)
  • Adult Pfizer preferential recommendation
  • Moderna permitted with informed consent
  • All individuals eligible
30-69 Age-based (based on birth date)
  • Any mRNA vaccine (Pfizer and Moderna)
  • All individuals eligible
70+ Age-based (based on birth date)
  • Any mRNA vaccine (Pfizer and Moderna)
  • All individuals eligible
Post-infection administration - The patient must be asymptomatic and no longer under active investigation. For more information, please see page 12 of COVID-19 Vaccine Administration Guidelines.

Vaccine options and dosing for third doses

Either Moderna or Pfizer vaccines may be used as a third or booster dose (regardless of which COVID-19 vaccine was used in the primary series). There is a preferential recommendation for Pfizer for 12-29 year olds.

Eligibility

Recommended 3rd/Booster Dose
  • Residents of long-term care homes, retirement homes or seniors in other congregate living settings, adults 70 years of age and older (based on birth date), and all eligible immunocompromised individuals.
  • Either Moderna or Pfizer-BioNTech (30mcg) may be considered.
  • If Moderna vaccine is being used as the booster product, a 100 mcg dose may be preferred, based on clinical discretion.
  • For all other populations in whom booster doses are recommended that have not been specified above.
  • Either Moderna (50 mcg) or Pfizer-BioNTech (30 mcg) are suitable products as a booster dose.

A booster dose of a viral vector vaccine (Janssen, AstraZeneca Vaxzevria) can be considered when an mRNA vaccine is contraindicated, inaccessible, or if the individual does not want an mRNA vaccine booster.

Note: the Ontario Immunization Advisory Committee (OIAC) continues to support the NACI recommended interval of at least eight weeks between the first and second dose of the pediatric COVID-19 vaccine among children 5-11 years of age.

PAXLOVID authorized by Health Canada

On January 17, 2022, PAXLOVID (nirmatrelvir and ritonavir) was authorized by Health Canada to treat adults with mild to moderate COVID-19 who are at high risk of progressing to serious disease. According to Health Canada, “PAXLOVIDTM is the first COVID-19 therapy that can be taken at home. The drug is intended for use as soon as possible after diagnosis of COVID-19 and within five days of the start of symptoms”.

Updated case definition – Coronavirus Disease (COVID-19)

The case definition for COVID-19 was updated on January 17, 2021. The case definitions include probable case, confirmed case, laboratory-based case of reinfection and time-based case of reinfection.

Educational opportunity

ECHO Ontario Child and Youth Mental Health Next Cycle begins February 3, 2022.

ECHO is an innovative, technology-enabled collaborative learning program where primary care providers and mental health clinicians work together through videoconferencing to discover new ways to care more effectively for children and adolescents with mental health problems.

  • Winter 2022 cycle will consist of 60-minute weekly ECHO Sessions.
  • These virtual education sessions are offered at no cost to participants.
  • Earn up to 24 certified Mainpro+® credits!

New and updated COVID-19 resources

Vaccine information

COVID-19 guidance

Current information on COVID-19 specifically for health care providers can be found at hpePublicHealth.ca, Ontario Ministry of Health and at publichealthontario.ca.

Back to Summary

Contact Information: 

To give us your comments: hart.sara@hpeph.ca

To report communicable diseases:613-966-5500 x349

To report AEFI or DOPHS: Online / Fax: 613-966-1813 or CDCFAX1@hpeph.ca

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