Vaccine Information for Physicians

Temperature logs are submitted electronically through the online order form. Public Health will only accept scanned PDFs or photos (jpg format) of temperature logs (PDF file). Please note that the submission must be for one full month leading up to the order date

Vaccine orders submitted after 4 p.m. on the Wednesday prior to a scheduled delivery date will be processed and delivered for the next scheduled bi-weekly delivery date.

Please note: If you have missed the delivery and will need the vaccines more urgently (e.g. high risk vaccines, post exposure prophylaxis), please call 311 or email accesshalton@halton.ca.

Each municipality will receive bi-weekly vaccine deliveries. Routine, special, COVID-19 and high risk vaccines must be ordered online by 4 p.m. on the Wednesday prior to scheduled delivery dates. Refer to Vaccine Distribution for bi-weekly delivery schedule.

Vaccine orders submitted after 4 p.m. on the Wednesday prior to a scheduled delivery date will be processed and delivered for the next scheduled bi-weekly delivery date.

Please note: If vaccines are needed urgently (e.g. high risk vaccines, post exposure prophylaxis), please call 311 or email accesshalton@halton.ca.

Vaccine Storage and Handling Guidelines (external PDF) require that health care providers storing publicly funded vaccines meet specific requirements, including appropriately monitored refrigeration and cold chain maintenance. If bi-weekly delivery of vaccine orders will cause issues related to appropriate storage and inventory practices, please contact accesshalton@halton.ca to discuss options.

Vaccines will be delivered on your scheduled delivery date listed on Halton Region Public Health vaccine delivery schedule. Vaccines will be delivered between 9 a.m. and 4 p.m. by Critical Path Courier. We are unable to provide a specific time for each office as the courier plans their route based on the number of deliveries in the area and what the most efficient route is.

Please ensure there is a staff member to receive the vaccines between 9 a.m. and 4 p.m. If there is no staff member present to receive the delivery, vaccines will be returned to Halton Regional Centre (HRC) and will be delivered again on your next scheduled bi-weekly delivery date. Pick-ups at HRC are not permitted at this time.

Vaccine orders that are unable to be delivered on the scheduled delivery date will be returned to Halton Regional Centre and will be sent on your next scheduled delivery date. If you need to cancel your scheduled vaccine delivery, please call 311 or email accesshalton@halton.ca for options.

Halton Region is currently using a vaccine courier service as a temporary measure to reduce traffic at Halton Regional Centre (HRC) during construction. As construction is completed at HRC, healthcare providers can either choose to continue receiving vaccines couriered to their offices for a nominal fee, or pick up vaccines at HRC at 1151 Bronte Road in Oakville during specific days and times.

Halton Region Public Health will continue to pay for all vaccine deliveries until construction at the Halton Regional Centre is complete and the Vaccine Depot is able to offer vaccine pick-up options again.

Using a courier to receive vaccines is a convenient option for many healthcare professionals that saves staff time and expenses while protecting the integrity of the vaccines and the cold chain process. Critical Path (the vaccine courier service) uses temperature controlled vans, which helps to ensure that cold chain is maintained during transportation. Many clinics prefer couriered vaccines due to staff time and the associated costs of pick up.

Using a courier to receive vaccines is a convenient option for many healthcare professionals that saves staff time and expenses while protecting the integrity of the vaccines and the cold chain process. Critical Path (the vaccine courier service) uses temperature controlled vans, which helps to ensure that cold chain is maintained during transportation. Many clinics prefer couriered vaccines due to staff time and the associated costs of pick up.

The cost to use the vaccine courier is approximately $35 per delivery. All facilities in Halton are charged the same rate.

Public Health will continue to pay for the flu auto shipments, which are made at the beginning of the flu season, while clinics will pay for the delivery of vaccines they order.

Facilities that would like to continue receiving their vaccines through Critical Path will need to complete an Account Activation Form (PDF file) and send to ar@criticalpath.ca. You will be asked to provide credit card information for billing. If there is information on the Account Activation Form that you would prefer to provide over the phone rather than email (e.g. credit card information), please write “call for information” in the form field. Critical Path will contact you to collect this information over the phone.

If you have questions about the Account Activation form or the account set up process, please contact Critical Path at ar@criticalpath.ca or 905-212- 8333.

Only facilities that have an account with a courier service will be able to select courier as an option from the Online Vaccine Ordering form.

If you have an existing arrangement with a courier service, you can continue to use it or you can transition to Halton Region’s courier service by establishing an account with Critical Path (PDF file).

Halton Region Public Health is strongly encouraging offices to use Critical Path for vaccine deliveries because vaccines are transported in temperature controlled vehicles. This helps to ensure that vaccines are safe and that proper cold chain is maintained during transport.

Each holding point code must order vaccines for their own facility. To avoid cold chain issues and to preserve the integrity of the vaccines, each holding point code is able to order enough vaccine for their individual clinic to last approximately one month. Ordering more than a one-month supply of vaccine can contribute to vaccine wastage in the case of power disruptions.

If your office has an account with a vaccine courier, when you place your vaccine order you will have the option to choose whether you would like to pick up your vaccine order at 1151 Bronte Road or have it delivered to your office by the vaccine courier. If you would like your order delivered by vaccine courier, you should select this from the online ordering form and your order will be delivered on your scheduled delivery day. If you would prefer to pick-up your order, you will need to select this option on the online ordering system and select a pick-up time.

Halton Region Public Health is not currently offering vaccine pickups due to construction at the Halton Regional Building in Oakville. Vaccine pickups will resume when construction is complete.

An exact date for when vaccine pickups will resume will be communicated to health care providers once construction is closer to completion.

When vaccine pickups resume, healthcare providers will be able to choose to pick up vaccines at 1151 Bronte Road in Oakville during specific days and times. Offices that would like to pick up their vaccine order must indicate this when placing their vaccine order.

When vaccine pickups resume, vaccine deliveries will no longer be paid for by Halton Region Public Health. Offices that do not have an account with a vaccine courier will be required to pick up their vaccine orders.

Offices that choose to pick up vaccines from 1151 Bronte Road will need to choose an appointment window. Vaccine pickups without an appointment or outside of these pre-determined pick-up times will not be permitted.

The option to pick up vaccine at Joseph Brant, Georgetown, or Milton District hospitals, is no longer available. Vaccines must be picked up from the Halton Regional Centre at 1151 Bronte Road in Oakville.

If you choose to pick up your vaccines from 1151 Bronte Road, please:

• make sure you are available to pick up your vaccines during one of the appointment time slots;
• ensure that your hard-sided insulated container is between +2.0○C and +8.0○C;
• closely follow the most recent Insulated Container section in the Vaccine Storage and Handling Guidelines (external PDF) to avoid being unable to collect your vaccines;
• ensure your hard-sided insulated container has a maximum-minimum thermometer and that you follow the Insulated Containers requirements in the Vaccine Storage and Handling Guidelines (external PDF)
• use refrigerated water blankets to ensure vaccine safety when preparing and packing an insulated container; and
• ensure that your hard-sided cooler is large enough to store your entire vaccine order. Packaging for many vaccines has changed since the start of the pandemic with pre-filled syringes becoming more common. Since pre-filled syringes take up more physical space, your vaccine order may not fit in a single hard-sided cooler.

If the Public Health Pharmacy team determines that you are not prepared to safely transport your vaccine order, you will have to return at a later date once you are able to fulfill the vaccine cold chain requirements.

Eligibility criteria has been extended for select age groups that may have missed an opportunity to receive school-based vaccines due to the COVID-19 pandemic.

Learn who is currently eligible for school-based vaccines.

At this time, Public Health is unable to release school-based vaccines to physicians in bulk. All school-based vaccines released from Public Health are required to be associated with an eligible student. This information needs to be reported back to the Ministry of Health. In addition, Public Health must complete an immunization record assessment on the Provincial Immunization Database (Panorama) for each student prior to release of vaccines.

Released school-based vaccines are assigned to be administered only to the student it was approved for. There are situations where a student is no longer eligible, has received the vaccine elsewhere or has refused the vaccine. This school-based vaccine will have to be re-allocated within your practice.

If you have a student in your practice, whom you believe is eligible to receive a re-allocated school-based vaccine; Public Health (311) must be contacted first. Public Health will ensure a complete record and eligibility assessment is done and prior to re-allocating the vaccine.

This step must be done for all possible re-allocations as all school-based vaccines are required to be associated with an eligible student—this information is reported back to the Ministry of Health.

Similarly, when placing a new special order for school-based vaccines, please review your inventory first to determine if there is a dose available to be re-allocated. Public Health (311) must be contacted prior to administering dose.

As of April 1, Tdap (tetanus, diphtheria, and pertussis) is now publicly funded and may be routinely offered to pregnant people.

The National Advisory Committee on Immunization strongly recommends Tdap vaccination during every pregnancy (external link), regardless of previous Tdap vaccination history to protect the infant from pertussis.

Infants less than 2 months of age are at the greatest risk of severe pertussis infection and hospitalization. Vaccination in pregnancy is safe and effective at preventing neonatal infection.

Immunization should ideally be offered at 27-32 weeks of gestation, which is supported by the strongest safety and effectiveness data. Immunization between 13 and 26 weeks of gestation may also be considered in some situations (for example, pregnancies with an increased risk of pre-term delivery).

Ontario has transitioned from the pentavalent rotavirus vaccine RotaTeq® (Rot-5) to the monovalent rotavirus vaccine, Rotarix® (Rot-1) in the infant rotavirus immunization program.

It is recommended that Rotarix® (Rot-1) be administered between 2 months to 15 weeks of age. If the first dose is administered after 15 weeks of age, the series should be completed with a minimum of four weeks between doses. All doses should be completed on or before 25 weeks of age.

If the second dose of Rotarix® (Rot-1) is unable to be completed on or before 25 weeks of age, the second dose can be administered up to 32 weeks of age. This extended eligibility interval will still be publicly funded, however this interval is not routinely recommended.

Timing of vaccine administration: Canadian Immunization Guide (external link).

As of September 2022, all students in grades 7 to end of grade 12 will be eligible for the publicly funded Hepatitis B vaccine.

*Individuals aged 16 years to less than 19 years require a 3-dose Hep B 0.5 mL (pediatric) immunization schedule as per the Canadian Immunization Guide (external link).

Individuals who have not completed the HB series prior to age 16 must follow Table 7: Publicly Funded Immunization Schedule (external PDF) recommended intervals for remaining doses using the HB pediatric (0.5 mL) formulation.

For those impacted by the COVID-19 pandemic, refer to the Guidance for Routine & Catch-up Immunization Services, Ministry of Health (external PDF) for information on extended eligibility.

HPV-9 vaccine eligibility starts in grade 7 and extends to the end of grade 12 for all students, regardless of gender, as per the updated Publicly Funded Immunization Schedule.

For those impacted by the COVID-19 pandemic, refer to the Guidance for Routine & Catch-up Immunization Services, Ministry of Health (external PDF) for information on extended eligibility.

*Individuals aged 15 years and older require a 3-dose HPV-9 immunization schedule as per the Canadian Immunization Guide (external link).

Currently, 65-70 year olds are able to receive publicly funded Shingrix®. Seniors born in 1949, 1950, 1951, and 1952 now remain eligible to complete the 2-dose series by December 31, 2023, as per the Guidance for Routine & Catch-up Immunization Services, Ministry of Health (external PDF).

Currently, males 9 to 26 years of age who meet the high-risk criteria (Table 3: Publicly Funded Immunization Schedule (external PDF)) are eligible for 2-3 doses of Gardasil 9®.

Males born in 1993, 1994, 1995, or 1996 now remain eligible to complete the 3-dose series by December 31, 2023, as per the Guidance for Routine & Catch-up Immunization Services, Ministry of Health (external PDF). Age of the impacted cohorts falls within the Health Canada product monograph age indications for product use.

Currently 2 months to 17 year olds who meet the high-risk criteria (Table 3: Publicly Funded Immunization Schedule (external PDF)) are eligible for 2-4 doses of Bexsero®.

Individuals born in 2002, 2003, 2004, or 2005 now remain eligible to complete the 2-dose series by December 31, 2023, as per the Guidance for Routine & Catch-up Immunization Services, Ministry of Health (external PDF). Age of the impacted cohorts falls within the Health Canada product monograph age indications for product use.

Currently, 9 months to 55 year olds who meet the high-risk criteria (Table 3: Publicly Funded Immunization Schedule (external PDF)) are eligible for 2-4 doses.

Individuals born in 1964, 1965, 1966, and 1967 now remain eligible to complete the 2-4 dose series by December 31, 2023, as per the Guidance for Routine & Catch-up Immunization Services, Ministry of Health (external PDF).

The province publicly funds a single lifetime dose of Men-C-ACYW135 for individual’s ≥56 years of age who meet high-risk eligibility criteria listed in Table 3: Publicly Funded Immunization Schedule (external PDF). These individuals may not be included in the age indication listed on the product monograph for the particular publicly funded vaccine. Therefore, administration of these vaccines is off-label and clinical judgment is advised.

Eligible physician practices must submit a completed Readiness Checklist (PDF file) and signed Memorandum of Understanding (PDF file) to pharmacists@halton.ca to enroll in the COVID-19 vaccine program.

Note:

• If practicing in association, in a cost sharing arrangement or as individuals, all physicians must sign the MOU.
• If practicing through a corporation or partnership, one physician can sign the MOU on behalf of the corporation or partnership.

The Health Department will contact your practice directly to confirm eligibility and proceed with the onboarding process.

All staff who will be using COVax must complete COVaxON OntarioMD Training for Primary Care Practices (external link).

All staff who will be involved with COVID-19 vaccine at the physician practice must attend Halton Region’s COVID-19 Vaccine Online Onboarding Session.

• 1 hour sessions will be offered over zoom on various dates and times. The first session will be held on Tuesday October 26th, 5 - 6 p.m.
• For upcoming session dates and times, please email pharmacists@halton.ca.

Once all required clinic staff have completed the OntarioMD COVax training and Halton Online Onboarding session, the Health Department will proceed with setting up COVax accounts and provide all necessary resources.

Physician practices will be notified by the Health Department when they can begin ordering COVID-19 vaccine. Orders for COVID-19 vaccine must be submitted online using the Vaccine Order Form.

• COVID-19 vaccines are delivered to primary care on Thursdays.
• Orders must be submitted by 4:00pm on Friday to receive vaccine the following Thursday.
• A minimum of one week (5 consecutive days) of vaccine fridge temps must be submitted with the vaccine order.

Note: COVID-19 vaccines cannot be ordered until Steps 1-4 have been completed.