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COVID-19 Vaccine Safety
Learn about the safety of COVID-19 vaccines, including the approved Pfizer-BioNTech and Moderna vaccines, how they work and possible side effects. Overview The coronavirus (COVID-19) vaccine does not cause a coronavirus infection. It helps to build up your immunity to the virus, so your body will fight it off more easily if it affects you. This can reduce your risk of developing coronavirus and make your symptoms milder if you do get it. The effectiveness and immune response of the vaccine is being monitored as the vaccine is rolled out. Vaccination is expected to be an effective way to prevent the spread and reduce the impact of COVID-19. Only vaccines that Health Canada determines to be safe and effective will be approved for use in Canada and available in Ontario. After independent and thorough scientific reviews for safety, efficacy and quality, Health Canada has approved two vaccines for use in Canada: Pfizer-BioNTech – approved on December 9, 2020 Moderna – approved on December 23, 2020 This means the vaccines: were tested on a large number of people through extensive clinical trials have met all the requirements for approval, including safety will be monitored for any adverse reactions that may occur after vaccination and appropriate measures will be taken Both vaccines require two doses for your body to develop adequate immunity. After two doses, they are expected to be 94-95% effective, which will lower how much of the virus can spread in the population, help build herd immunity and stop the pandemic. They were both manufactured in Belgium. Learn more about the vaccines from Health Canada’s website. Vaccine development Creating a new vaccine typically takes years. However, the progress on COVID-19covid 19 vaccines is happening quickly for many reasons, including: being informed by decades of research on other strains of coronavirus prior to COVID-19covid 19, such as Middle East Respiratory Syndrome (MERS) and Sars-CoV (SARS) advances in science and technology international collaboration among scientists, health professionals, researchers, industry and governments increased dedicated funding Before any vaccines are available in Ontario, they: undergo rigorous clinical trials to ensure they are safe and effective are evaluated and authorized for use by Health Canada, using rigorous standards Ontario’s plan to make sure vaccines remain safe for Ontarians includes: securely and safely transporting and storing vaccines at required conditions and temperatures establishing safe clinic spaces to give people immunizations, including providing the required training to those administering vaccines monitoring for any adverse reactions or side effects that may occur after vaccination and taking appropriate measures, including working with the federal government and other provinces and territories Health Canada will continue to monitor all authorized vaccines to ensure they continue to be safe and effective. Read more information on vaccines and vaccine authorization updates from the Government of Canada. Vaccine ingredients and how they work COVID-19 vaccines work by training your body’s immune system to recognize and fight the virus that causes the disease (SARS-CoV-2). To do this, the vaccine uses certain molecules or parts of the virus — called antigens — which trigger an immune response when they are introduced into the body through vaccination. By injecting these antigens into the body, your immune system safely learns to: recognize the antigens produce antibodies to fight the antigens remember the antigens for the future If the virus reappears, your immune system will recognize the antigens and attack them before the disease can develop and cause sickness. In addition to the antigens, vaccines can also include: adjuvants (for example, aluminum salts) – help boost the body’s response to the vaccine antibiotics – prevent contamination during the manufacturing process preservatives and stabilizers – keep the vaccine stable, effective and safe when it’s being made, shipped and stored Vaccine types There are several different types of vaccines being studied to fight COVID-19covid 19. Three key types include: mRNA vaccines mRNA vaccines are a new type of vaccine. mRNA vaccines teach our cells how to make a protein from the virus that will trigger an immune response and create antibodies. These antibodies help us fight the infection if the real virus does enter our body in the future as they recognize this protein. The Pfizer-BioNTech and Moderna vaccines that Health Canada approved for use are both mRNA type vaccines. Viral vector-based vaccines These vaccines use genetically modified viruses (vectors) that are harmless to humans. Once injected into the body, the viral vector contained in the vaccine produces a part of the SARS-CoV-2 virus, such as its spike protein (the part of the virus that binds to our cells and starts the COVID-19 infection). The vector virus is not the virus that causes COVID-19 and doesn't make you sick. It does its job and then goes away. This process triggers an immune response against the spike protein without exposing you to the virus that causes COVID-19. Viral vector-based vaccines have been used to develop: many vaccines for animals an Ebola vaccine approved by a number of international regulators Virus-like particle vaccines Virus-like particles are molecules that mimic viruses but are not infectious. They are very similar to real viral molecules, so introducing them into the body through vaccination triggers an immune response, without any symptoms of the virus they are being vaccinated against. Once the body responds to the virus-like particles, it recognizes the virus and prevents infection in the future, giving people immunity to that particular virus. Virus-like particles have been an effective way of vaccinating against diseases such as: human papillomavirus (HPV) hepatitis B malaria Possible side effects Serious adverse reactions to vaccines are extremely rare. They happen less than one time in a million. Once a vaccine is in use, Canada has a strong vaccine safety monitoring system to alert public health authorities of changing trends or unusual adverse events that were not previously reported. The side effects observed during the clinical trials for the approved vaccines are very similar to other vaccines. They were all mild or moderate and included things like pain at the site of injection, body chills, feeling tired and feeling feverish. The vaccines cannot cause COVID-19. This is because they do not contain the SARS-CoV-2 virus responsible for the disease. However, if you come in contact with the virus just before or after you complete the vaccine series of two doses, you could still develop COVID-19. To date, no serious adverse effects have been identified with the vaccines approved for use. If you do have a severe adverse reaction to a COVID-19 vaccine, you may be eligible for compensation from the federal government. Read Health Canada’s recommendations for people with serious allergies. Approving vaccines in Canada Drugs, including vaccines, are regulated under the Food and Drugs Act and regulations. They must meet the regulatory requirements for safety, efficacy and quality before they can be approved for use and distribution in Canada. The federal government (Health Canada) is responsible for approving vaccines. Before authorizing a vaccine, Health Canada assesses the: scientific and clinical evidence — including results of clinical trials — to determine if a vaccine product is safe, effective and manufactured to the highest quality safety and efficacy of the vaccine to determine that there are no concerns, the vaccine can trigger an adequate immune response to protect against disease and the benefits outweigh the risks the manufacturing process to make sure the manufacturer can carry out the necessary quality controls for the vaccine If there is not enough evidence to support the manufacturer’s safety, effectiveness or quality claims: Health Canada will not authorize the vaccine the product cannot be sold in Canada Find out more about Health Canada’s: vaccine approval process review of COVID-19 vaccines
Understanding How COVID-19 Vaccines Work
To understand how COVID-19 vaccines work, it helps to first look at how our bodies fight illness. The Immune System—The Body’s Defense Against Infection When germs, such as the virus that causes COVID-19, invade our bodies, they attack and multiply. This invasion, called an infection, is what causes illness. Our immune system uses several tools to fight infection. Blood contains red cells, which carry oxygen to tissues and organs, and white or immune cells, which fight infection. Different types of white blood cells fight infection in different ways: Macrophages are white blood cells that swallow up and digest germs and dead or dying cells. The macrophages leave behind parts of the invading germs called antigens. The body identifies antigens as dangerous and stimulates antibodies to attack them. B-lymphocytes are defensive white blood cells. They produce antibodies that attack the pieces of the virus left behind by the macrophages. T-lymphocytes are another type of defensive white blood cell. They attack cells in the body that have already been infected. The first time a person is infected with the virus that causes COVID-19, it can take several days or weeks for their body to make and use all the germ-fighting tools needed to get over the infection. After the infection, the person’s immune system remembers what it learned about how to protect the body against that disease. The body keeps a few T-lymphocytes, called memory cells, that go into action quickly if the body encounters the same virus again. When the familiar antigens are detected, B-lymphocytes produce antibodies to attack them. Experts are still learning how long these memory cells protect a person against the virus that causes COVID-19. How COVID-19 Vaccines Work COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Different types of vaccines work in different ways to offer protection, but with all types of vaccines, the body is left with a supply of “memory” T-lymphocytes as well as B-lymphocytes that will remember how to fight that virus in the future. It typically takes a few weeks for the body to produce T-lymphocytes and B-lymphocytes after vaccination. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection. Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever. These symptoms are normal and are a sign that the body is building immunity. Types of Vaccines Currently, there are three main types of COVID-19 vaccines that are or soon will be undergoing large-scale (Phase 3) clinical trials in the United States. Below is a description of how each type of vaccine prompts our bodies to recognize and protect us from the virus that causes COVID-19. None of these vaccines can give you COVID-19. mRNA vaccines contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build T-lymphocytes and B-lymphocytes that will remember how to fight the virus that causes COVID-19 if we are infected in the future. Protein subunit vaccines include harmless pieces (proteins) of the virus that cause COVID-19 instead of the entire germ. Once vaccinated, our immune system recognizes that the proteins don’t belong in the body and begins making T-lymphocytes and antibodies. If we are ever infected in the future, memory cells will recognize and fight the virus. Vector vaccines contain a weakened version of a live virus—a different virus than the one that causes COVID-19—that has genetic material from the virus that causes COVID-19 inserted in it (this is called a viral vector). Once the viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the virus that causes COVID-19. Using these instructions, our cells make copies of the protein. This prompts our bodies to build T-lymphocytes and B-lymphocytes that will remember how to fight that virus if we are infected in the future. Most COVID-19 Vaccines Require More Than One Shot All but one of the COVID-19 vaccines that are currently in Phase 3 clinical trials in the United States use two shots. The first shot starts building protection. A second shot a few weeks later is needed to get the most protection the vaccine has to offer. One vaccine in Phase 3 clinical trials only needs one shot. The Bottom Line Getting vaccinated is one of many steps you can take to protect yourself and others from COVID-19. Protection from COVID-19 is critically important because for some people, it can cause severe illness or death. Stopping a pandemic requires using all the tools available. Vaccines work with your immune system so your body will be ready to fight the virus if you are exposed. Other steps, like masks and social distancing, help reduce your chance of being exposed to the virus or spreading it to others.
Moderna COVID-19 Vaccine
A vaccine is one of the keys to stopping the spread of COVID-19. The Moderna COVID-19 vaccine was approved for use in Canada on December 23, 2020. Canadians started getting vaccine on January 3rd, 2021. The Moderna COVID-19 vaccine is coming to your community soon. Here are some questions people often ask. Learn the answers and be prepared. What is mRNA? The Moderna vaccine is an mRNA vaccine. This stands for ‘messenger ribonucleic acid’ or ‘messenger RNA’. Messenger RNA is a tiny molecule that carries instructions. Its job is to tell cells how to make proteins. How does the Moderna mRNA vaccine work? “Health Canada describes mRNA vaccines as follows. mRNA vaccines teach your cells how to make a protein that will create an immune response. The vaccines do this without using the live coronavirus that causes COVID-19. After getting the vaccine, your body will start making antibodies. The antibodies made will help fight an infection if COVID-19 enters your body in the future.” Learn more about mRNA vaccines here: Will it change my DNA? No. mRNA from the vaccine never enters the part of your cell where your DNA is. It does not affect or interact with your DNA. Can I get COVID-19 from the vaccine? No. There is no way to catch COVID-19 from this vaccine because it is not made with the virus. It only uses information from the virus. If you are already infected with COVID-19 when you get your vaccine, it cannot protect you from getting sick. I already had COVID-19. Should I still have the vaccine? Talk with your health team first if: you are ill with COVID-19 right now, or you have been very ill with COVID-19 in the past 3 months. Is the Moderna vaccine effective? Yes. In people younger than 65, it is 94.1% effective in preventing moderate and severe cases of COVID-19. The amount of protection for people 65 and older is a little less – 86.4%. You will get 2 doses of the vaccine. The level of protection increases up to two weeks after your second dose. As COVID-19 vaccine is new, we will be learning much more about it. This information is accurate as of January 22, 2021. Can I stop wearing a mask after I get vaccinated? No. You should keep practising all of the public health measures, such as keeping your distance and wearing a mask. The vaccine protects people from getting sick, but we do not know yet if it protects them from getting the virus and spreading it to others. We will know more about this as time goes on. How long will it provide protection for? The vaccine is new, so we do not know how long the protection lasts. We will know more as time goes on. Who can have this vaccine? It is for people 18+ years of age. What about children under 18 years old? The first round of clinical trials did not include children. But studies are taking place now. We expect that the vaccine will be safe for those under 18 and will have more info soon. If I am pregnant or breastfeeding, can I have this vaccine? Yes. We still need to learn more about the vaccine and pregnant or breastfeeding women. But for now, talk over the risks with your health team. Weigh these risks against the risks to you and your baby of getting a severe case of COVID-19. I have allergies. Can I have the vaccine? People with a history of allergies should speak with their doctor or nurse before getting the vaccine. Be prepared to wait up to 30 minutes at the clinic after getting the shot. They will watch you carefully for any problems. How is the vaccine given? You get it with a needle in your upper arm. If you started with Moderna vaccine, the second dose must also be Moderna vaccine. You will get 2 doses, about 28 days apart. What are the common side effects? Common side effects include pain or tenderness and redness in your arm where you got the needle. Less common side effects include tiredness, headache, body pain, chills, nausea, vomiting, and a low fever. You may also get swelling in your armpit on the side where you got your needle. Side effects can happen after either dose but may be more after the second dose. This is because the vaccine has already geared up the immune system to build protection. All of these common side effects go away on their own in a day or so. They mean that your immune system is working. If your side effects are more severe than this, see your community health nurse right away. Serious side effects are rare. As COVID-19 vaccine is new, we will be learning much more about it. This information is accurate as of January 22, 2021. After I have the vaccine, can I return to ‘normal’ life? Even after getting the vaccine, we must all keep following the public health measures. The vaccine protects people from getting sick, but we do not know yet if it protects them from getting the virus and spreading it to others. It will take time for enough people to be vaccinated for the virus to stop spreading. And we do not know yet how long the vaccine lasts before we need to get another shot. References
Public Health Alert – COVID-19 Variants of Concern
Dear Chief and Health Director: Public Health Alert – COVID-19 Variants of Concern As you are aware, COVID-19 Variants of Concern (VOCs) are circulating within Ontario. We are writing to you today to provide updated information and public health recommendations regarding COVID-19 VOCs. At least one of these variants, B.1.1.7 (the “UK variant”) is thought to be 30-50% more transmissible than those already established in Canada and there is some evidence that it can cause more severe illness, resulting in more hospitalizations and deaths. This variant can spread very quickly from people who do not know they have it (asymptomatic people) and can cause a rapid increase in cases in a short period of time. In January 2021, an outbreak of B.1.1.7 in a Barrie, Ontario, long-term care facility saw almost every resident of the facility infected. More recently, this variant was detected during the week of February 8, 2021 in St. John’s, Newfoundland, resulting in a lockdown and closure of workplaces, schools, and non-essential businesses to control the spread of this variant. Given this evolving situation, we are making the following recommendations: Remain aware of VOC detection in your area/region by visiting your local public health unit website(s). Continue to prepare should a VOC be detected by alerting residents and preparing to support an immediate lockdown and stay-at-home order for the community. A stay-at-home order could be 14 days or longer depending on the variant’s spread in a community. Strongly consider the following public health measures should a VOC be detected in a community and if there is any uncertainty about spread outside of an immediate household: Immediate lockdown of community. Stay-at-home order in the community. Closure of non-essential businesses, workplaces, and schools/childcare facilities. Daily communication from Chief and Council to residents updating them on the situation. These public health measures will help limit the spread of infection to community members and allow time for thorough case and contact management, testing of persons at risk of having been exposed, and determination of the extent of possible spread in the community. Social Gatherings As First Nations communities in Ontario, Manitoba, Saskatchewan and Alberta have experienced, social gatherings have been a major source of transmission of COVID-19. In order to avoid this risk, we are continuing to advise that people not gather in other people’s homes, or in places with people they do not live with. Every gathering can quickly contribute to the spread of the virus and lead to many cases that can overwhelm a community. Continue to Follow Public Health Measures COVID-19 vaccine distribution is underway in Ontario, however, we must take action now to prevent the spread of the virus and keep communities safe. Please continue to advise your residents to practice public health measures to prevent the spread of COVID-19: DO NOT VISIT OTHER PEOPLE’S HOMES Any gatherings/celebrations should only include members of an immediate household Wash hands often and practice good hygiene Cover your cough or sneeze IF YOU HAVE ANY SYMPTOMS get tested immediately and stay away from others as much as possible Self-isolate until you have your test results and are notified by your provider about next steps Wear a well-fitting 3-ply mask and practice physical distancing of 2-metres when out of your home to get essential supplies, groceries, medications, etc. This advice is to supplement, not replace, the advice of your local public health authorities. Thank you for all of your efforts in protecting your communities, Dr. Maurica Maher Regional Public Health Physician First Nations and Inuit Health Branch, Ontario Region
What you should know about the COVID-19 vaccines
With Health Canada approval of some COVID-19 vaccines, we know that many people have questions about the vaccines and what this means for them. Here are answers to some of the commonly asked questions to help you make an informed decision about getting the COVID-19 vaccine. About COVID-19 vaccines How do the COVID-19 vaccines work? Vaccines tell your body how to make a harmless protein found in the virus and start building antibodies that know how to fight the real virus if you come in contact with it. How well does the vaccine work, can I still get COVID-19? The Pfizer-BioNTech and Moderna vaccines are given in two doses using a needle in your upper arm. The same vaccine is used for your first and second dose. The Pfizer-BioNTech and Moderna vaccines are expected to be 94-95% effective after two doses. Do I still need to wear a mask after I’ve been vaccinated? Yes. Studies are still underway to determine the effectiveness of the vaccine in preventing asymptomatic infection and reducing the transmission of COVID-19. For now, and until scientific experts say it’s safe to stop, it is important to continue to follow the advice of public health officials including maintaining a physical distance of two metres from people outside of your household, wearing a mask, practicing proper hand hygiene and limiting non-essential travel. These measures will help keep you, your loved ones and your community safe. How long will the vaccine last? Do I need to get it each year? Studies are still underway to determine how long the vaccine will provide immunity. The government will keep the public informed as new data becomes available. Is there a microchip in the vaccine? No. How is the COVID-19 vaccine different from the flu vaccine? The COVID-19 vaccine and the flu vaccine are very different and cannot be directly compared. They target different viruses: the flu vaccine has to combat several influenza viruses which mutate, while the COVID-19 vaccine targets just one virus, SARS-CoV-2. What if I don’t take the second dose of the Pfizer or Moderna vaccines? It is important to receive both doses. Protection offered by the first dose is lower than what is achieved after the second dose. The vaccines are 94-95% effective after two doses. What ingredients are in the Pfizer-BioNTech vaccine? Non-medical ingredients in the vaccine include: ALC-0315 = (4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate) ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide 1,2-distearoyl-sn-glycero-3-phosphocholine Cholesterol dibasic sodium phosphate dihydrate monobasic potassium phosphate potassium chloride sodium chloride sucrose water for injection See the Ontario Ministry of Health’s Information Sheet on Pfizer-BioNTech and Moderna COVID-19 Vaccines for further information. What ingredients are in the Moderna vaccine? Non-medical ingredients in the Moderna COVID-19 vaccine include: 1, 2-distearoyl-sn-glycero-3-phosphocholine (DSPC) acetic acid cholesterol lipid SM-102 PEG2000 DMG 1,2-dimyristoyl-rac-glycerol, methoxy-polyethyleneglycol sodium acetate sucrose tromethamine tromethamine hydrochloride water for injection See the Ontario Ministry of Health’s Information Sheet on Pfizer-BioNTech and Moderna COVID-19 Vaccines for further information. COVID-19 vaccine safety Are COVID-19 vaccines safe? Yes. Only vaccines that Health Canada has approved and determined are safe and effective will be administered in Ontario. Health Canada has one of the most rigorous scientific review systems in the world. Health Canada only approves a vaccine if it is safe, it works, it meets manufacturing standards, and the benefits of being vaccinated outweigh the risks. What was the approval process for the vaccine? Canada’s best independent scientists thoroughly reviewed all the data before approving the vaccines as safe and effective for Canadians. All safety steps were followed in approving these vaccines. The development of the COVID-19 vaccines progressed quickly for several reasons including: reduced time delays in the vaccine approval process, quick adaptation of existing research programs, international collaboration among scientists and governments, increased dedicated funding and quick recruitment of clinical trial participants. View the Ministry of Health’s summary of the COVID-19 Vaccine Approval Process and Safety for further information. Should I be worried about a vaccine that was developed so quickly? No. Only vaccines that Health Canada has approved and determined are safe and effective will be administered in Ontario. These vaccines were developed faster than before because of the never-before-seen levels of collaboration and funding invested in this effort around the world. The technology behind the vaccines has been around for more than 10 years and have already been used in animal models for influenza, zika virus, rabies virus, cytomegalovirus (CMV) and others. Because this advanced technology already existed, scientists were able to work quickly. Can the vaccine give me COVID-19? No, the COVID-19 vaccine cannot give you COVID-19 or any other infectious disease. None of the Health Canada-approved vaccines so far are live vaccines, meaning that they do not contain the virus that causes COVID-19. It is important to remember that it typically takes a few weeks for the human body to build immunity after vaccination. That means it is possible for a person to become infected with the virus that causes COVID-19 just before or just after vaccination. This is because the vaccine has not had enough time to provide protection. Even if you receive the vaccine, please continue to follow the public health measures to keep you, your loved ones and your community safe. Will I experience side effects? Similar to medications and other vaccines, the COVID-19 vaccines can cause side effects. The most common side effects include soreness at the injection site on your arm, a bit of tiredness, chills and/or a mild headache as the vaccine starts to work. During the clinical trials, the most frequent side effects were mild and resolved within a few days after vaccination. These types of side effects are expected and simply indicate the vaccine is working to produce protection. As with any medicines and vaccines, allergic reactions are rare but can occur after receiving a vaccine. Symptoms of an allergic reaction include hives (bumps on the skin that are often very itchy), swelling of your face, tongue or throat, or difficulty breathing. Most serious reactions will occur shortly after injection, and clinic staff are prepared to manage an allergic reaction should it occur. If you are concerned about any reactions you experience after receiving the vaccine, contact your health care provider. You can also contact your local public health unit to ask questions or to report an adverse reaction. Serious side effects after receiving the vaccine are rare. However, should you develop any of the following reactions within three days of receiving the vaccine, seek medical attention right away or call 911: hives swelling of the face or mouth trouble breathing very pale colour and serious drowsiness high fever (over 40°C) convulsions or seizures other serious symptoms (e.g., “pins and needles” or numbness) What are the longer-term side effects of this vaccine? Ongoing studies on the Pfizer-BioNTech and Moderna vaccines indicate no serious side effects found to date. People who have received the vaccine in studies continue to be monitored for any longer-term side effects. For more information on adverse events following immunization (AEFIs) or to report an AEFI visit Public Heath Ontario’s vaccine safety web page. Are side effects from the second dose worse than the first dose? Side effects are more likely to occur after your second dose of the vaccine. Since side effects are the result of your immune system building protection, once your immune system has been primed with the first dose then there is a much stronger immune response to the second dose (this is a good thing!). Has anyone died from taking a COVID-19 vaccine? No one is known to have died as a direct result of the COVID-19 vaccine. Nearly two million people have died globally from COVID-19. Should I get a COVID-19 vaccine? Why should I get a COVID-19 vaccine? A vaccine is the only foreseeable way to end the COVID-19 pandemic. The pandemic will not end until the majority of Canadians are vaccinated. You can protect yourself, your loved ones, and your community by getting vaccinated. While the vaccine will protect each of us individually, the primary goal of a vaccine program is to immunize the majority of the population so that COVID-19 can no longer spread. The percentage of people that need to be vaccinated depends on how infectious the disease is and how effective the vaccine is at preventing spread of the disease. The sooner a majority of Ontarians are vaccinated, the sooner our lives can return to normal. I’m not high risk. COVID-19 isn’t that bad. I don’t need a vaccine. Globally, nearly two million people have died of COVID-19 in less than a year. COVID-19 does not discriminate, and anyone can become sick from the virus. Even if a healthy person does not die of COVID-19 infection, they may have long-term complications that impact their ability to experience normal life, such as shortness of breath, fatigue, headaches, muscle/joint pain, cognitive impairment, cough and loss of taste and/or smell. Even if you are not high-risk, there are other individuals in your community who may be high-risk and immunocompromised, which means their immune systems are not strong enough to receive a vaccine. When a majority of the community is vaccinated, this protects individuals who are immunocompromised because it reduces the chances that a virus can spread throughout the community and infect that immunocompromised individual who could not receive the vaccine. I think I should wait and see what happens to others The sooner a majority of Ontarians are vaccinated, the sooner our lives can return to normal. We need a majority of Ontarians to be vaccinated to end the pandemic. We are working to distribute the vaccine to every corner of the province as soon as we receive sufficient supply. To ensure that everyone who wants to be vaccinated can be vaccinated safely and quickly, it is important that people who have access the vaccine are vaccinated the first time it is offered to them. What if I’m pregnant or trying to get pregnant? People who are pregnant may be able to get the COVID-19 vaccine. People who were pregnant were excluded from the Phase III trials for the Pfizer BioNTech and Moderna COVID-19 vaccines. Therefore, there is limited data on the safety of the vaccines during pregnancy. Pregnant individuals in the authorized age group may choose to receive the vaccine after counselling and informed consent that includes: a review of the risks and benefits of the vaccine a review of the potential risks/consequences of a COVID-19 infection in pregnancy a review of the risk of acquiring a COVID-19 infection in pregnancy an acknowledgment of the insufficiency of evidence for the use of current COVID-19 vaccines in the pregnant population If after this counselling by their treating provider the pregnant individual feels the potential benefits of vaccination outweigh the potential harms, they should be able to access the vaccine. Individuals planning on becoming pregnant should speak with their primary care provider. For additional information, consult the Society of Obstetricians and Gynaecologists of Canada Statement on COVID-19 Vaccination in Pregnancy. What if I’m breastfeeding? Breastfeeding individuals may be able to get the COVID-19 vaccine. Breastfeeding individuals were excluded from the Phase III trials for the Pfizer BioNTech and Moderna COVID-19 vaccines. Therefore, there is no data on the safety of the vaccines in lactating individuals or the effects of mRNA vaccines on the breastfed infant or on milk production. For any individuals who are breastfeeding, the COVID-19 vaccine should be offered after counselling and informed consent that includes recognizing the insufficiency of evidence for the use of COVID-19 vaccine in the breastfeeding population. For additional information, consult the Society of Obstetricians and Gynaecologists of Canada Statement on COVID-19 Vaccination in Pregnancy. When can my kids get the vaccine? So far, a vaccine has not been approved for children. Research is underway to determine when those under the authorized ages can receive the vaccine. Can my employer force me to take the vaccine? The vaccine is not mandatory in Ontario. If I don’t take it now, will I get a chance later? Or will I be placed at the end of the line? Our goal is to ensure that everybody across Ontario who is eligible and who wants the vaccine can get it. The sooner the majority of Ontarians are vaccinated, the sooner our lives can return to normal. The pandemic will not be under control until the majority of Canadians are vaccinated. To ensure we can vaccinate everyone who wants to be vaccinated as safely and as quickly as possible, it is important that people who have access to the vaccine are vaccinated the first time it is offered to them. What if I’m behind on my regular immunization schedule? Can I still get it? Yes. We also encourage those who are behind on their immunizations to contact their health care provider to get up to date. Why am I not in a priority group? As recommended by the COVID-19 Vaccine Distribution Task Force and aligned with the National Advisory Committee on Immunization, the province has adopted an approach for identifying the next groups to receive the vaccination as early as March 2021. As part of phase one, we are vaccinating the most vulnerable populations first, who have higher risk outcomes from contracting the virus and are at a higher risk of being exposed to and spreading the virus. As Ontario gets more vaccine supply, the program will further expand to include additional groups. You can find more details about Ontario’s COVID-19 vaccination program, including the various phases of the program at Ontario’s COVID-19 vaccine web page.
COVID-19 Variant of Concern: Case, Contact and Outbreak Management Interim Guidance
Version 1.0 – February 9, 2021 This guidance document provides basic information only. It is not intended to provide medical advice, diagnosis or treatment or legal advice. In the event of any conflict between this guidance document and any orders or directives issued by the Minister of Health or the Chief Medical Officer of Health (CMOH), the order or directive prevails. Please check the Ministry of Health (MOH) COVID-19 website regularly for updates to this document, mental health resources, and other information, Please check the Directives, Memorandums and Other Resources page regularly for the most up to date directives. Download the full PDF here:
Ontario Extending Stay-at-Home Order across Most of the Province to Save Lives
Public Health Units to Gradually Return to the COVID-19 Response Framework TORONTO — In consultation with the Chief Medical Officer of Health, the government is moving to a regional approach and maintaining the shutdown in the majority of the public health regions in Ontario, including the Stay-at-Home order and all existing public health and workplace safety measures. When it is safe to do so, the province will gradually transition each region from the shutdown measures to a revised and strengthened COVID-19 Response Framework: Keeping Ontario Safe and Open (the "Framework"). Details were provided today by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, Solicitor General Sylvia Jones, and Dr. David Williams, Chief Medical Officer of Health. "Our number one priority will always be protecting the health and safety of all individuals, families and workers across the province," said Premier Ford. "But we must also consider the severe impact COVID-19 is having on our businesses. That's why we have been listening to business owners, and we are strengthening and adjusting the Framework to allow more businesses to safely reopen and get people back to work." To support the province's economic recovery, the government has updated the Framework to allow for a safer approach to retail. Limited in-person shopping in Grey-Lockdown zones will be permitted with public health and safety measures, such as limiting capacity to 25 percent in most retail settings. In addition, public health and safety measures in retail settings will be strengthened for other levels of the Framework. Individuals will also be required to wear a face-covering and maintain physical distance when indoors in a business, with limited exceptions. Other measures include a requirement for individuals to wear a face-covering when attending an organized public event or gathering (where permitted) if they are within two metres distance of another individual who is not part of their household (both indoor and outdoor). All other requirements for gatherings and organized public events would be maintained. Based on the improving local trends of key indicators, including lower transmission of COVID-19, improving hospital capacity, and available public health capacity to conduct rapid case and contact management, the following three regions will be moving back to the Framework at the Green-Prevent level on Wednesday, February 10, 2021, at 12:01 a.m. and will no longer be subject to the Stay-at-Home order: Hastings Prince Edward Public Health; Kingston, Frontenac and Lennox & Addington Public Health; and Renfrew County and District Health Unit. Due to the fact that public health trends are improving in some regions faster than others, the current Stay-at-Home order will be amended and individual orders making it applicable to each public health region will be made except for the three above. It is proposed that the Stay-at-Home order will continue to apply to 28 public health regions until Tuesday, February 16, 2021. For Toronto, Peel and York regions, it is proposed that the Stay-at-Home order will continue to apply until Monday, February 22, 2021. Final decisions will be subject to review of the trends in public health indicators at that time. "While we have seen some progress in our fight against COVID-19, the situation in our hospitals remains precarious and the new variants pose a considerable threat to all of us," said Minister Elliott. "As we cautiously and gradually transition out of the provincewide shutdown, we have developed an emergency brake system giving us the flexibility to contain community spread quickly in a specific region, providing an extra layer of protection." Recognizing the risk posed by new variants to the province's pandemic response, Ontario is introducing an "emergency brake" to allow for immediate action if a public health unit region experiences rapid acceleration in COVID-19 transmission or if its health care system risks becoming overwhelmed. If this occurs, the Chief Medical Officer of Health, in consultation with the local medical officer of health, may advise immediately moving a region into Grey-Lockdown to interrupt transmission. "While we are seeing our numbers trend in the right direction, our situation remains precarious as the variants of concern remain a serious risk," said Dr. Williams. "This is not a re-opening or a 'return to normal' and we must continue to limit close contact to our immediate households and stay at home except for essential reasons. By continuing to follow all public health and workplace safety measures, we can continue to reduce the number of new cases and the strain on our health system." In addition, the provincial emergency declared under s 7.0.1 of the Emergency Management and Civil Protection Act (EMPCA) will be allowed to terminate at the end of February 9, 2021. While the provincewide Stay-at-Home order will cease to apply in some regions as of February 10, 2021, everyone is strongly advised to continue to stay at home, avoid social gatherings, minimize travel between areas with different rules, and limit close contacts to their household. Employers in all industries should continue to make every effort to allow employees to work from home. Enforcement of residential evictions will remain paused in the public health unit regions where the provincial Stay-at-Home order remains in effect. This will ensure people are not forced to leave their homes. In regions where the Stay-at-Home order is lifted, the regular process for residential eviction enforcement will resume. Orders currently in force under the EMCPA have been extended to February 23, 2021 and will be extended further if necessary. O.Reg.55/21 (Compliance Orders for Retirement Homes) is currently in effect until February 19, 2021. "While the declaration of emergency will be ending, the risks posed by COVID-19 and the new variants remain serious concerns," said Solicitor General Jones. "That's why extending the stay-at-home orders for most of the province is necessary to protect our communities, our most vulnerable populations, and stop the spread of COVID-19. We continue to urge all Ontarians to follow public health guidelines and stay home, stay safe, and save lives." The Chief Medical Officer of Health will continue to consult with public health and other experts, review data, and provide advice to the government on the appropriate and effective measures that are needed to protect the health of Ontarians. Municipalities and local medical officers of health may have additional restrictions or targeted requirements in their region. Read more:
COVID-19 vaccines and Indigenous peoples
The Government of Canada is working to secure safe and effective vaccines to prevent COVID-19. This is key to stopping the spread of COVID-19 and resuming normal life. Some members of First Nations, Inuit and Métis communities will be able to get vaccinated in the first stage of vaccinations Now that 2 COVID-19 vaccines have been approved by Health Canada and are becoming available, at-risk groups will be prioritized to receive the vaccines first as they roll out. This is because there will be a limited supply at the beginning. Some Indigenous communities or members of those communities will be identified as being at increased risk. They will be among the first groups to receive the vaccines. The vaccines will be free. Learn about at-risk groups. Latest Moderna COVID-19 vaccine: what you should know Pfizer-BioNTech COID-19 vaccine: what you should know Canada's COVID-19 Immunization Plan Vaccines are safe and will protect you, your family and your community Vaccination is a personal choice. Public health experts agree it helps prevent serious disease. Vaccines are safe. They protect you and those around you from preventable diseases. National Indigenous organizations, some national Indigenous health organizations and Indigenous leaders have been involved in planning for COVID-19 vaccine distribution to Indigenous communities. Learn about the approval process for new vaccines. Why vaccinate against COVID-19 By getting a COVID-19 vaccine, you will be protected and will help prevent the spread of the virus to those who may be more likely to contract it, such as: Elders and older adults residents and staff of long-term care homes people with certain medical conditions where infection could cause severe illness and death Indigenous Services Canada encourages all First Nations, Inuit and Métis to receive the vaccine to protect themselves, their families and communities. Learn more here:
COVID-19 Vaccine Clinic Operations Planning Checklist
This guidance provides basic information only. It is not intended to take the place of medical advice, diagnosis or treatment. Please check the Ministry of Health (MOH) COVID-19 website regularly for updates to this document. Highlights of changes Added Moderna COVID-19 Product Monograph (page 1) Hyperlinks updated throughout including PHAC links and the Ontario AEFI form This document is to support local planning as well as the successful operationalization of COVID-19 vaccination clinics in Ontario for all Ontarians, including considerations for vulnerable populations. Read full document here:
Business Recovery Financing
IAPO is offering Business Recovery Financing (BRF) to eligible First Nations businesses affected by COVID-19. Funding is provided through the Indigenous Economic Development Fund by the Ministry of Indigenous Affairs. The Business Recovery Financing provides eligible businesses with up to $50,000 in funding (50% financing, 50% grants). This program has a funding deadline of March 31, 2021. You can find more information about the program here, as well as find the application here. ] For any questions or comments, please contact IAPO at 1-800-363-0329 or email .
Federal Economic Statement Issued November 30, 2020: Impacts on First Nations Social Policy
Executive Summary: The Fall Economic Statement outlines program and financial supports pertaining to First Nations Social policy, with interactions and overlap through other various other fields/sectors/disciplines. Most notably, funding and policy has been indicated regarding: Indigenous ELCC: $70 million spread over 5 years, beginning in 2021-22, with $15 million ongoing to sustain the existing federal Indigenous Early Learning and Child Care Secretariat, and to help build Indigenous governance capacity and support Indigenous participation in the development of a Canada-wide system Support for Indigenous and Northern Communities: $380 million additionally in 2020-21 for the Indigenous Community Support Fund. Also, $112 million for First Nations to support a safe return to schools on reserve and $206.1 million to support a safe restart in Indigenous communities, including adapting community infrastructure and other supports for safe restart in Indigenous post-secondary education institutions. Anti-Racism Initiatives: $50 million for 2 years, beginning in 2021-22 to expand Canadian Heritage’s programs, Community Support, Multiculturalism and Anti-Racism Initiatives Program; and Anti-Racism Action Program. MMIWG Inquiry Response and National Action Plan: $781.5 million in funding over 5 years starting in 2021–22, and $106.3 million ongoing to combat systemic discrimination against Indigenous peoples and expand efforts to combat violence against Indigenous women, girls and LGBTQ and two-spirit people. Issue On November 30, 2020, the federal government announced an Economic Statement and released an associated 237-page document with details of Covid-19 recovery both on an individual and community health basis, as well as on an economic and social one. Included within the plan are a number of planning, policy, and funding, supports. There are a number of specific initiatives for First Nations and Indigenous policies and programs across Canada. Additionally, some policies and programs targeted to First Nations were included as a subsection within broader public policy initiatives. Read full analysis here:
Ontario Declares Second Provincial Emergency to Address COVID-19 Crisis and Save Lives
Province Issues Stay-at-Home Order and Introduces Enhanced Enforcement Measures to Reduce Mobility TORONTO — In response to a doubling in COVID-19 cases over the past two weeks, the real and looming threat of the collapse of the province's hospital system and alarming risks posed to long-term care homes as a result of high COVID-19 transmission rates, the Ontario government, in consultation with the Chief Medical Officer of Health and other health experts, is immediately declaring a second provincial emergency under s 7.0.1 (1) of the Emergency Management and Civil Protection Act (EMPCA). Details were provided today by Premier Doug Ford, Christine Elliott, Deputy Premier and Minister of Health, Solicitor General Sylvia Jones, Dr. David Williams, Chief Medical Officer of Health, and Dr. Adalsteinn (Steini) Brown, Co-Chair of the Ontario COVID-19 Science Advisory Table. "The latest modelling data shows that Ontario is in a crisis and, with the current trends, our hospital ICUs will be overwhelmed in a few short weeks with unthinkable consequences," said Premier Ford. "That's why we are taking urgent and decisive action, which includes declaring a provincial emergency and imposing a stay-at-home-order. We need people to only go out only for essential trips to pick up groceries or go to medical appointments. By doing the right thing and staying home, you can stay safe and save lives." Effective Thursday, January 14, 2021 at 12:01 a.m., the government is issuing a stay-at-home order requiring everyone to remain at home with exceptions for permitted purposes or activities, such as going to the grocery store or pharmacy, accessing health care services, for exercise or for work where the work cannot be done remotely. This order and other new and existing public health restrictions are aimed at limiting people's mobility and reducing the number of daily contacts with those outside an immediate household. In addition to limiting outings for these purposes, all businesses must ensure that any employee who can work from home, does work from home. These new public health measures will help stop the spread of COVID-19 by reducing concerning levels of mobility as the province continues its vaccine rollout and ramps up to mass vaccination when the federal government is able to provide the necessary supply to do so. Additional Public Health Restrictions Since the implementation of the Provincewide Shutdown over two weeks ago, the latest modelling trends in key public health indicators have continued to worsen, forecasting an overwhelming of the health system unless drastic action is taken. Escalating case counts have led to increasing hospitalization rates and intensive care unit (ICU) occupancy which has resulted in cancellations of scheduled surgeries and procedures. Provincial modelling shows growth in COVID-19 cases has accelerated, leading to increased hospitalization rates and ICU occupancy. ICU occupancy by COVID-19 patients is now over 400 beds and is projected to be as high as 1,000 beds by early February which has the potential to overwhelm Ontario's hospitals. The number of COVID-19-related deaths continues to rise and is expected to double from 50 to 100 deaths per day between now and the end of February. Notably, data shows that mobility and contacts between people have not decreased with the current restrictions. A new variant of COVID-19 emerged in November. If community transmission of this variant occurs, Ontario could experience much higher case counts, ICU occupancy and mortality. In response to the alarming and exceptional circumstances at hand, and to further interrupt the deadly trend of transmission in Ontario communities, hospitals, and long-term care homes, the following additional public health measures will take effect January 13, 2021 at 12:01 a.m.: Outdoor organized public gatherings and social gatherings are further restricted to a limit of five people with limited exceptions. This is consistent with the rules during the lockdown during the first wave of COVID-19 in spring 2020 and will allow individuals and families to enjoy time outdoors safely. Individuals are required to wear a mask or face covering in the indoor areas of businesses or organizations that are open. Wearing a mask or face covering is now recommended outdoors when you can't physically distance more than two metres. All non-essential retail stores, including hardware stores, alcohol retailers, and those offering curbside pickup or delivery, must open no earlier than 7 a.m. and close no later than 8 p.m. The restricted hours of operation do not apply to stores that primarily sell food, pharmacies, gas stations, convenience stores, and restaurants for takeout or delivery. Non-essential construction is further restricted, including below-grade construction, exempting survey. These measures will come into effect between Tuesday January 12, 2021 and Thursday, January 14, 2021, including the provincial declaration of emergency under the EMCPA, orders under that Act, and amendments to regulations under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020. "Despite our best efforts, COVID-19 is continuing to spread in our communities, our hospitals, our long-term care homes, and our workplaces. We are continuing to see concerning trends across the province, including a tragic number of deaths," said Christine Elliott, Deputy Premier and Minister of Health. "We have made great strides in vaccinating tens of thousands of Ontarians, and we can't let these efforts go to waste. Urgent action is required to break this deadly trend of transmission, ensure people stay home, and save lives." To help quickly identify and isolate cases of COVID-19 in workplaces and service providers permitted to remain open such as long-term care homes and schools, the province will provide up to 300,000 COVID-19 tests per week to support key sectors such as manufacturing, warehousing, supply chain and food processing, as well as additional tests for schools and long-term care homes. This volume of rapid tests would support antigen screening for up to 150,000 workers per week over the next 4-5 months in Ontario's most critical workplaces. The province is expecting to receive 12 million Panbio tests from the federal government over the next several months and continues to pursue opportunities to purchase additional rapid tests. "The trends in key public health indicators are continuing to deteriorate, and further action is urgently required to save lives," said Dr. David Williams, Chief Medical Officer of Health. "By strictly adhering to all public health and workplace safety measures, we can reduce the transmission of COVID-19 and keep our loved ones and our communities safe. It will take the collective efforts of us all to defeat this virus." To support the stay-at-home order, the enforcement of residential evictions will be suspended until ordered otherwise by the court. Tribunals Ontario will not issue any new eviction orders until further notice. Sheriff's offices have been asked to postpone any scheduled enforcement of eviction orders. The government knows that in order to keep Ontarians safe, it is important that they are not forced to leave their homes during the new state of emergency. Ontario is exploring all options available to put a temporary residential evictions moratorium in place, and will have more to say in the coming days. The additional public health restrictions introduced expand on the existing measures put in place to keep Ontarians safe and healthy. On January 7, the government extended the shutdown for Northern Ontario to at least January 23, 2021 to align with the rest of the province. These time-limited measures will be evaluated after 14 days to determine if any restrictions need to be extended or lifted. New Enforcement Measures The province will provide authority to all provincial offences officers, including the Ontario Provincial Police, local police forces, bylaw officers, and provincial workplace inspectors to issue tickets to individuals who do not comply with the stay-at-home-order, or those not wearing a mask or face covering indoors in places open to the public, subject to limited exceptions, as well as retail operators and companies who do not enforce requirements under orders under the Reopening Ontario (A Flexible Response to COVID-19) Act (ROA) or EMPCA. Those who decide not to abide by orders will be subject to a set fine and/or prosecution under both the ROA and EMCPA as applicable. In addition, all provincial offences officers will have the authority to temporarily close a premise and disperse individuals who are in contravention of gathering limits an order and will be able to disperse people who are gathering, regardless whether a premise has been closed or remains open such as a park. "Strong, new measures will be enforced to stop the spread of COVID-19," said Solicitor General Sylvia Jones. "We are taking extraordinary action to provide law enforcement officers with the tools and support they need to protect the health and wellbeing of Ontarians." Schools and Child Care Centres Based on the advice of the Chief Medical Officer of Health, schools in the following public health units (PHUs) will not return to in-person instruction until February 10, 2021: Windsor-Essex Peel Region Toronto York Hamilton By January 20, 2021, the Chief Medical Officer of Health will advise the Ministry of Education on which public health units (PHUs) will be permitted to resume in-person instruction, based on the most up-to-date data and modelling. Before- and after-school programs can be offered when in-person instruction resumes. Schools in northern PHUs will continue to remain open. To continue to keep students, staff and communities safe, the following new health and safety measures will be put in place for in-person learning: Masking for Grade 1-3 and requirements for mask wearing outdoors; Enhanced screening protocols; and Expanded targeted testing. The government will also implement new health and safety measures in Ontario child care settings, such as enhanced screening to align with school requirements, voluntary participation in targeted testing and additional infection prevention and control measures to align with schools. These enhancements are in addition to the existing health and safety measures already being implemented in child care settings across the province. Child care centres for non-school aged children will remain open, and emergency child care for school-aged children will end in approved PHU regions on January 22, 2021 as these elementary schools return to in-person learning. During this extended period of online learning, in areas where in-person elementary learning is suspended, emergency child care will continue for eligible families in regions subject to school closures, as identified by the Chief Medical Officer of Health. "At the heart of our continued efforts to protect against the spread of COVID-19 in our communities is a firm commitment to return kids to school safely," said Education Minister Stephen Lecce. "Protecting our students, staff and their families is our top priority, and these additional measures build on our comprehensive plan to reopen schools and keep young children in child care safe." Workplace Safety The Ministry of Labour, Training and Skills Development is taking additional steps to protect workers with the launch of the "Stay Safe All Day" campaign, focusing workplace inspections in areas of high transmission, including break rooms, and providing new educational materials to employers to promote safe behaviour before, during and after work. Evidence gathered from COVID-19 related workplace inspections to date shows the vast majority of employers and workers are following COVID-19 safety requirements when working. However, when in a break room, a vehicle or not on the clock, there is a tendency to forget about the importance of wearing masks, maintaining physical distance and hand hygiene. As part of the "Stay Safe All Day" campaign, inspectors will use a data-driven approach to focus on workplaces with reported COVID-19 outbreaks, manufacturing businesses, warehouses, distribution centres, food processing operations, construction projects and publicly accessible workplaces deemed essential, such as grocery stores. The Ministry is also using a new data-sharing program, in conjunction with the Ministry of Long-Term Care and the Retirement Regulatory Authority, to focus onsite inspections of long-term-care homes and retirement homes. "We know the majority of businesses are operating safely and responsibly to protect their workers and customers. But as COVID-19 cases continue to rise, we all need to step up and take additional measures to stop the spread," said Monte McNaughton, Minister of Labour, Training and Skills Development. "This includes increasing our inspections to look at everything workers do both while on the job and throughout the workday." In the unfortunate event that an employee becomes infected with COVID-19, they may be entitled to federally funded paid sick leave of up to $500 a week for two weeks. Workers can also access Canada's Recovery Caregiver Benefit of up to $500 per week for up to 26 weeks if they are unable to work because they must care for their child under 12 years old or a family member who needs supervised care. Over the summer, the government enacted a new regulatory amendment that put non-unionized employees on Infectious Disease Emergency Leave during the COVID-19 outbreak any time their hours of work are temporarily reduced by their employer due to COVID-19, ensuring businesses aren't forced to terminate employees after their ESA temporary layoff periods have expired. As part of the Safe Restart Agreement, the federal government is funding a temporary income support program that allows workers to take up to 10 days of leave related to COVID-19, preventing the risk of further spread in the workplace and allowing workers to focus on their health. Quick Facts The Government of Ontario declared its first provincial emergency in response to COVID-19 on March 17, 2020 which remained in effect until July 24, 2020 when the ROA came into force. An emergency declaration pursuant to s. 7.0.1 is terminated 14 days after being made and may be extended for up to a further 14 days by the Lieutenant Governor in Council. Thereafter, extensions require approval of the Legislature, which can extend the declared provincial emergency for additional periods of up to 28 days. Orders made during the declaration of emergency pursuant s. 7.0.2 (4) will automatically terminate after 14 days unless they are extended for additional periods of up to 14 days, while orders pursuant to s. 7.1 can be for a period of up to 90 days and renewed for additional periods of up to 90 days. The orders currently in force under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020 (ROA) remain in effect until January 20, 2021. Under the ROA, orders can be extended for up to 30 days at a time, and the government must continue to report on all order extensions to the Select Committee on Emergency Management Oversight. A full list of emergency orders under the EMPCA as well as orders under the ROA can be found on the e-Laws website and at Ontario.ca/alert. As of January 10, 2021, there have been 215,782 reported COVID-19 cases and 4,983 related deaths in Ontario. Ontario has implemented the largest immunization plan in its history and to date, a total of over 130,000 doses have been administered provincewide. Building on the efforts of the targeted testing in Phase 1, the Ministry of Education and the Ministry of Health will work together with Ontario Health, PHUs and school boards to expand access to COVID-19 testing. Additional Resources Ontario Continues to Support Employers and Workers during COVID-19 Enhancing Public Health and Workplace Safety Measures in the Provincewide Shutdown Visit Ontario’s COVID-19 vaccine web page to view the latest provincial data and information on COVID-19 vaccines. Visit Ontario’s website to learn more about how the province continues to protect the people of Ontario from COVID-19. If you have questions about what will be open or impacts to your business or employment, call the Stop the Spread Business Information Line at 1-888-444-3659. Get tested if you have symptoms compatible with COVID-19, or if you have been advised of exposure by your local public health unit or through the COVID Alert App. Visit Ontario.ca/covidtest to find the nearest testing location. To find the right supports, visit COVID-19: Support for People, which has information about the many available and free mental health services and supports. To stay safe, you can download the COVID Alert App free from the Apple and Google Play app stores. COVID-19: Reopening Schools COVID-19 school and child care screening Operational Guidance: COVID-19 Management in Schools document.