Phase Two to Vaccinate Groups Based on Age and Risk
Vaccine administration will focus on age as the most significant predictor of death or hospitalization from COVID-19, and on risk, with some adjustments for COVID-19 hot spots, specific health conditions, congregate care settings, essential caregivers and workers who cannot work from home.
During Phase Two, the following groups will be eligible for vaccination:
- Older adults, between 60-75-79 years of age;
- Individuals with specific health conditions and some primary caregivers;
- People who live and work in congregate settings and some primary caregivers;
- People who live in hot spots with high rates of death, hospitalizations and transmission; and,
- Certain workers who cannot work from home.
Ontario is expecting to vaccinate these groups from April to July 2021, depending on availability of vaccines from the federal government. The rollout plan was developed in partnership with the COVID-19 Vaccine Distribution Task Force and in alignment with the Ethical Framework for COVID-19 Vaccine Distribution to ensure that vaccines are distributed fairly and consistently to each group.
Who is Eligible in Phase Two?
Health conditions
Individuals with the health conditions listed below will be vaccinated in order of risk, with the highest-risk individuals being vaccinated first, followed by high-risk and at-risk individuals. Patients with these specific health conditions are at increased risk of serious illness and death regardless of age.
Highest-risk (442,000 people):
- Organ transplant recipients
- Hematopoietic stem cell transplant recipients
- People with neurological diseases in which respiratory function may be compromised (e.g., motor neuron disease, myasthenia gravis, multiple sclerosis)
- Haematological malignancy diagnosed less than 1 year ago
- Kidney disease eGFR< 30
High-risk (292,000 people):
- Obesity (BMI > 40)
- Other treatments causing immunosuppression (e.g., chemotherapy, immunity-weakening medications)
- Intellectual or developmental disabilities (e.g., Down Syndrome)
At-risk (2.2 million people):
- Immune deficiencies / autoimmune disorders
- Stroke / cerebrovascular disease
- Dementia
- Diabetes
- Liver disease
- All other cancers
- Respiratory diseases
- Spleen problems
- Heart disease
- Hypertension with end organ damage
- Diagnosis of mental disorder
- Substance use disorders
- Thalassemia
- Pregnancy
- Immunocompromising health conditions
- Other disabilities requiring direct support care in the community
Congregate settings
Congregate settings are among the most significant sources of cases, hospitalizations and deaths linked to COVID-19 outbreaks in Ontario. At-risk staff, essential caregivers and residents from the following congregate settings are eligible for vaccination during Phase Two (158,000):
- Supportive housing
- Developmental services / intervenor and supported independent living (SIL)
- Emergency homeless shelters
- Other homeless populations not in shelters
- Mental health and addictions congregate settings
- Homes for special care Violence Against Women (VAW) shelters and Anti-Human Trafficking (AHT) residents
- Children’s residential facilities
- Youth justice facilities
- Indigenous healing and wellness
- Provincial and demonstration schools
- Farm workers who live in congregate settings, including Temporary foreign workers
- Bail beds and Indigenous bail beds
- Adult correctional facilities
Caregivers in select congregate care settings will be vaccinated as part of the vaccine rollout in congregate settings, including:
- Developmental services
- Mental health and addictions congregate settings
- Homes for special care
- Children’s residential facilities
- Indigenous healing and wellness
Essential caregivers
These are primary caregivers to those with highest-risk health conditions; i.e., organ transplant recipients, hematopoietic stem cell transplant recipients, neurological diseases in which respiratory function may be compromised, haematological malignancy diagnosed less than 1 year ago, kidney disease eGFR< 30 (400,000).
Hot spots
Over 20 per cent of community-based deaths in Ontario have occurred in just 10 per cent of areas referred to as hot spots, where COVID-19 rates are highest. To target historic and ongoing areas with high rates of death, hospitalization and transmission, the following public health units will receive additional doses (up to 920,000):
- Durham Region Health Department
- Halton Region Public Health
- City of Hamilton Public Health Services
- Niagara Region Public Health
- Ottawa Public Health
- Peel Public Health
- Simcoe-Muskoka District Health Unit
- Region of Waterloo Public Health and Emergency Services
- Wellington-Dufferin Guelph Public Health
- Windsor-Essex County Health Unit
- York Region Public Health
- Toronto Public Health
- Southwestern Public Health
Public health units will use their local knowledge and expertise to distribute vaccines to their hotspots, as well as provincial data and information from the COVID-19 Science Advisory Science Table.
Workers who cannot work from home
Workers who cannot work from home in the sectors listed below will be vaccinated in two groups. Within each group, all workers listed will be eligible for vaccination at the same time:
First group of workers unable to work remotely (730,000 people):
- Elementary / secondary school staff and bus drivers that transport students
- Workers responding to critical events (e.g., police, fire, compliance, funeral, special constables)
- Child care workers
- Licensed foster care workers
- Food manufacturing workers
- Agriculture and farm workers
Remaining workers unable to work remotely (1.4 million people):
- High-risk and critical retail workers (grocery and pharmacies)
- Remaining manufacturing workers
- Social workers (including youth justice)
- Courts and justice system workers (including probation and parole)
- Lower-risk retail workers (wholesalers, general goods)
- Transportation, warehousing and distribution
- Energy, telecom (data and voice), water and wastewater management
- Financial services
- Waste management
- Mining, oil and gas workers