Ontario’s Expanded Eligibility for Third Dose of COVID-19 Vaccine

We have had many calls about the expanded list of vulnerable populations who are now eligible for a third dose of COVID-19 vaccine. Below is an excerpt of the new guidance which includes a list of patients who are now eligible as well as the earlier list of eligible patients.

We have bolded the type on the fifth bullet of this list, as it applies to the majority of advanced treatments patients with autoimmune diseases are prescribed. The term ‘antimetabolites’ refers to treatments like methotrexate. The third dose of vaccine can be received as soon as two months after the second dose. Proof of eligibility may differ based on the public health unit where you live. Many are requesting a letter from the specialist prescribing the immunosuppressive treatment, others will take a letter from a family physician or the pharmacist dispensing the medication. Some regions have developed a third dose form for completion by the physician. It is advised you call ahead to be sure you have the documentation required.

Read the Ontario government’s press release here.

Those undergoing active treatment for solid tumors;
Those who are in receipt of chimeric antigen receptor (CAR)-T-cell;
Those with moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome);
Stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome; and
Those 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.

Individuals in these groups can receive their third dose at a recommended interval of eight weeks following their second dose and will be contacted by their health care provider such as their primary care provider, specialist, or their hospital specialty program when they are eligible to receive the vaccine.

Locations and timing for third doses may vary by public health unit and high-risk population based on local planning and considerations, with third doses mainly to be administered at transplant clinics and cancer clinics.

This expanded eligibility supplements the government’s previous decision to offer third doses of the COVID-19 vaccine to select vulnerable populations:

Transplant recipients (including solid organ transplant and hematopoietic stem cell transplants);
Patients with hematological cancers (examples include lymphoma, myeloma, leukemia) on active treatment (chemotherapy, targeted therapies, immunotherapy);
Recipients of an anti-CD20 agent (e.g. rituximab, ocrelizumab, ofatumumab); and
Residents of high-risk congregate settings including long-term care homes, higher-risk licensed retirement homes and First Nations elder care lodges.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

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