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COVID-19 Vaccine

An annual vaccine — free for everyone 6 months and older in Ontario

Quick Summary

COVID-19 Vaccine

An annually updated vaccine that protects against COVID-19, especially severe illness.

Seasonal / annual Publicly funded
Disease Protected Against
COVID-19, the illness caused by the SARS-CoV-2 virus — ranging from mild to, less commonly, severe.
Ontario Timing
An annual program, like the flu vaccine — available each year to everyone 6 months and older. Previously unvaccinated young children may need a short primary series first.
Number of Doses
Usually one updated dose per year for most; young children not previously vaccinated may need more than one dose to start.
Publicly Funded Status
Yes — free for everyone 6 months and older who lives, works, or attends school in Ontario.
Bottom line: Ontario's COVID-19 vaccine program is now annual, like the flu program — the vaccine is updated each year to better match circulating variants, and offered free to everyone 6 months and older. It is not required for school, but it's recommended, especially for those at higher risk of severe illness. The number of doses depends on your child's age and vaccination history.
This guidance changes regularly. COVID-19 vaccine products, formulations, eligibility, and recommendations are updated by season, age, and risk group. Check current Ontario and Canadian guidance, or speak with a healthcare provider or local public health unit, before making decisions.
The Disease

What it protects against

COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus. In children it's often mild, but it can sometimes be more serious, and the vaccine focuses on reducing severe illness.

Aspect What parents might notice How it spreads Why it can be serious How vaccination helps
COVID-19 illness Fever, cough, sore throat, runny nose, tiredness, and sometimes loss of taste or smell, headache, or tummy symptoms. Many children have mild or even no symptoms. Mainly through respiratory droplets and aerosols from coughing, talking, and breathing, especially in close or indoor settings. Most children recover well, but some develop more serious illness, and COVID-19 can occasionally lead to complications. It can also be more serious in children with certain medical conditions. The vaccine reduces the chance of infection and, more importantly, the risk of severe illness and complications.
MIS-C (a rare complication) A rare but serious condition — multisystem inflammatory syndrome in children — that can appear in the weeks after a COVID-19 infection, with fever and inflammation affecting different parts of the body. Follows a COVID-19 infection rather than spreading on its own. MIS-C is uncommon but can be serious and require hospital care. By reducing COVID-19 infections, vaccination is associated with a lower risk of this rare post-infection complication.
The SARS-CoV-2 virus continues to change over time, and protection (from vaccination or past infection) wanes. That's why the vaccine is updated periodically to better match circulating variants, and offered on an annual basis.
Timing & Schedule

Why it's given annually

Why annually? Ontario's COVID-19 program has transitioned to an annual schedule, like the flu program. The virus changes over time and protection wanes, so the vaccine is updated to match circulating variants and offered each year to refresh protection — particularly heading into the respiratory illness season.

How many doses? For most children who have been vaccinated or infected before, one updated dose per year is the usual approach. Young children (6 months to under 5) who have never been vaccinated may need a short primary series of more than one dose to build initial protection. The exact number depends on age and history — a healthcare provider or public health unit can confirm what your child needs.

Higher-risk children and spring doses: Children who are moderately to severely immunocompromised may be recommended to have a dose in spring as well as fall. A healthcare provider can advise if this applies to your child.

Why not for babies under 6 months? The COVID-19 vaccine is authorized from 6 months of age. Younger infants aren't eligible, so protecting those around them — and the parent during pregnancy — is part of how very young babies are indirectly protected.

Can it be given with other vaccines? Yes. The COVID-19 vaccine can be given at the same time as, before, or after other vaccines — including flu and RSV products. If given at the same visit, separate injection sites (or limbs) are used.

Which products are used: For the current program, the COVID-19 vaccines are mRNA vaccines — Spikevax (Moderna), authorized from 6 months of age, and Comirnaty (Pfizer-BioNTech), authorized from 5 years of age. For children under 5, Spikevax is the product used. The Novavax (protein-based) vaccine is not available in Ontario for the current program. Products and formulations are updated over time.
Ontario School & Reporting Status

School and reporting status

COVID-19 is not one of the diseases required for school attendance under Ontario's Immunization of School Pupils Act (ISPA). The COVID-19 vaccine is offered free to everyone 6 months and older and is recommended — but it is not on the ISPA list, so it is not required for school entry.

COVID-19 is not an ISPA-designated disease for school attendance, so missing it does not trigger the ISPA suspension process. It remains recommended — particularly for children at higher risk of severe illness — because it reduces the chance of serious outcomes and helps limit spread to more vulnerable people.

Reporting: The COVID-19 vaccine is given in many places — doctors' offices, pharmacies, and public health clinics. Keep a note of each dose. Ontario has indicated COVID-19 vaccine records are viewable through your local public health unit's Immunize Connect Ontario (ICON) portal. Because it's not ISPA-required, it's not tracked for school the way required vaccines are.

Higher-risk children: COVID-19 vaccination is especially encouraged for children who are moderately to severely immunocompromised or have certain medical conditions, who may also be offered a spring dose. A healthcare provider can advise.

Ingredient Transparency

What's in this vaccine

The COVID-19 vaccines used in Ontario are mRNA vaccines: Spikevax® (Moderna, from 6 months) and Comirnaty® (Pfizer-BioNTech, from 5 years). They work by delivering a piece of mRNA — a set of instructions — that prompts cells to briefly make a harmless copy of the virus's "spike" protein, which the immune system learns to recognize. The information below reflects the general categories of ingredients from their Health Canada product monographs.

Ingredient / Component Category Why it's there Plain-English explanation
mRNA (encoding the SARS-CoV-2 spike protein) Active ingredient Provides the instructions the body uses to recognize the virus. A short piece of genetic "message" that tells cells to make a harmless copy of the spike protein, which trains the immune system. The mRNA does not enter the cell's DNA and is broken down by the body soon after — it cannot cause COVID-19 and cannot change your child's genes.
Lipids (including a small amount of specialized lipids) Delivery system Form a tiny protective bubble ("lipid nanoparticle") around the mRNA. Fat-like molecules that surround and protect the fragile mRNA so it can get into cells, then are cleared by the body. This is how the instructions are delivered safely.
Salts and buffers (e.g. sodium and potassium salts, tromethamine or phosphate) Buffers / tonicity agents Keep the vaccine at a stable, body-friendly acidity and concentration. Small amounts of salts that keep the product stable and gentle on the tissues.
Sugar (sucrose) Stabilizer Protects the vaccine, especially during freezing. Ordinary sugar, used to keep the vaccine stable in storage.
Water for injection Base The liquid base of the vaccine. Sterile water making up most of the injection.
What's NOT in it: These vaccines do not contain live virus, the actual SARS-CoV-2 virus, eggs, gelatin, preservatives, antibiotics, aluminum, or any microchip or tracking device. They cannot give your child COVID-19, and the mRNA does not alter DNA. Formulations are updated over time — for the exact contents of the product your child receives, ask your provider or check the product monograph.
Side Effects & Safety

Side effects and safety

Expected / common side effects

  • Soreness, redness, or swelling where the needle was given
  • Tiredness
  • Headache or muscle aches
  • Mild fever or chills
  • Irritability, sleepiness, or reduced appetite (in young children)

Timing and duration: These reactions usually appear within a day or two and typically settle within 1–3 days. They're a sign the immune system is responding.

Home care: A cool compress can ease injection-site soreness. Acetaminophen or ibuprofen may be used as directed for discomfort or fever. People under 19 should not be given ASA (Aspirin) or salicylate-containing products.

When to call a healthcare provider: If a fever is high or persistent, if your child seems unusually unwell, or if you're unsure — it's always reasonable to call.

Many children have few or no side effects, and that does not mean the vaccine didn't work.

Rare but important

  • Severe allergic reaction (anaphylaxis) — reported rarely after vaccination in general; exact frequency varies by source.
  • Myocarditis or pericarditis (inflammation of the heart muscle or its lining) — a rare effect seen mostly in adolescent and young adult males, more often after a second dose. Cases are usually mild and resolve with rest and care; the risk of heart inflammation from COVID-19 infection itself is higher.

About the heart-inflammation signal: This is uncommon, generally mild, and most cases recover well. Worth knowing the signs in the days after vaccination, especially in teens: chest pain, shortness of breath, or a fluttering/pounding/racing heartbeat. If these occur, seek medical care. Notably, COVID-19 infection itself carries a higher risk of heart inflammation than the vaccine does.

What clinics do to reduce risk: Clinics ask about allergy history, are equipped with epinephrine and trained staff, and recommend a brief observation period after the injection.

Observation period: Staying nearby for about 15 minutes after vaccination is recommended, as severe allergic reactions — though rare — typically occur shortly after.

Get urgent help now if your child has:

  • Trouble breathing
  • Swelling of the lips, tongue, throat, or face
  • Widespread hives together with breathing difficulty
  • Chest pain, or a fluttering, pounding, or racing heartbeat (especially in teens, in the days after the dose)
  • Severe weakness, limpness, or unresponsiveness
  • A seizure
  • A high or persistent fever, especially in a young infant
  • Any symptom that feels serious or is rapidly getting worse

If any of these occur, go to the nearest emergency department or call 911. Otherwise, contact a healthcare provider and let them know what happened — this information also helps with vaccine safety monitoring.

Before the Appointment

Who should pause or speak with a healthcare provider first

Speak with a healthcare provider before this vaccine if:

  • Your child has had a serious allergic reaction to a previous dose of a COVID-19 vaccine, or to any component (such as PEG, found in the lipid component)
  • Your child developed myocarditis or pericarditis (heart inflammation) after a previous dose — this needs individual review
  • Your child has a moderate or severe acute illness (it's generally fine to wait until they feel better)
  • Your child has a complex medical condition or is immunocompromised — not a reason to avoid it, but the schedule may differ, so a provider can advise

These usually do NOT require delaying this vaccine:

  • A mild cold or other minor illness without fever
  • Currently breastfeeding
  • A stable, ongoing chronic health condition (often a reason it's more strongly recommended)
  • Currently taking antibiotics for an unrelated condition
  • A previous COVID-19 infection (vaccination is still recommended; timing can be discussed with a provider)
Common Questions

Questions parents often ask

The virus keeps changing, and protection (from vaccination or past infection) fades over time. An updated annual dose better matches circulating variants and refreshes protection — the same idea as the yearly flu vaccine. Ontario's program is now annual for this reason.
No. The mRNA delivers a temporary "message" that cells use to make a harmless piece of the virus for the immune system to learn from. It doesn't enter the part of the cell where DNA is kept, and the body breaks it down soon after. It cannot alter your child's genes, and it cannot cause COVID-19.
Myocarditis/pericarditis (heart inflammation) is a rare effect, seen mostly in adolescent and young adult males, more often after a second dose. Cases are usually mild and recover with rest. Importantly, the risk of heart inflammation from COVID-19 infection is higher than from the vaccine. Watch for chest pain, shortness of breath, or a racing/fluttering heartbeat in the days after a dose, and seek care if they occur.
Vaccination is still recommended, since protection from infection fades and the virus changes. The timing after a recent infection can be discussed with a provider (often a few months later). Hybrid protection — from both infection and vaccination — tends to be stronger than either alone.
Generally, no. A mild cold without fever is usually not a reason to delay. If your child has a fever or seems more unwell, it's reasonable to mention this to the clinic — they can advise whether to proceed or reschedule.
A mild fever after a previous dose is common and is not usually a reason to avoid future doses. Let the clinic know about the previous reaction — they can advise on any precautions, such as giving acetaminophen proactively, and will watch for any pattern.
Through participating family doctors, nurse practitioners, public health clinics, and many pharmacies (for eligible ages). For young children (6 months to under 5), some public health units offer dedicated clinics by appointment. It's free for everyone 6 months and older in Ontario. See the Resources page for help finding a location.
Doses received elsewhere generally count toward your child's history. Ontario guidance allows people vaccinated outside Canada with products not approved by Health Canada to get a dose of the updated vaccine, usually if enough time has passed since the last dose. Bring any records to a provider or public health unit, who can advise on what's needed next.
Parents and caregivers are generally responsible for reporting vaccines to their local public health unit — healthcare providers do not always do this automatically. Many areas use Immunization Connect Ontario (ICON) for this. See the Resources page for links.
Mild soreness, redness, fussiness, or a low fever for a day or two are common and expected. Review the "Get urgent help now" list above — if any of those signs occur, seek urgent care. Otherwise, contact a healthcare provider with any concerns.
What the Evidence Shows

What we know about the COVID-19 vaccine

Fact COVID-19 vaccines were developed quickly, but the mRNA technology behind them had been studied for many years beforehand, and the vaccines went through the standard clinical-trial phases and regulatory review.
Concern A common worry is that these vaccines were "rushed" and therefore can't be as safe as others.
Evidence The speed came from factors like prior mRNA research, large global investment, overlapping (not skipped) trial phases, and running manufacturing in parallel — not from cutting safety corners. The vaccines were tested in large trials and reviewed by Health Canada, and have since been given billions of times worldwide with extensive ongoing safety monitoring. Rare effects like myocarditis were identified through that monitoring and are well characterized.
Takeaway "Fast" did not mean "unsafe" — the process compressed timelines without skipping the safety steps, and monitoring has continued ever since.
Fact COVID-19 is usually milder in children than adults, but it can still cause serious illness and rare complications like MIS-C, and the vaccine reduces these risks.
Concern Because COVID-19 is often mild in kids, some parents question whether the vaccine is worth it for a healthy child.
Evidence Most children do recover well, which is reassuring. But a minority become seriously ill or develop complications, and these can be hard to predict. Vaccination lowers the chance of severe illness and the rare post-infection condition MIS-C, and reduces spread to more vulnerable household members. For children at higher risk due to medical conditions, the case for vaccination is stronger still.
Takeaway The vaccine's main value is reducing the risk of the less-common-but-serious outcomes, and protecting others — a personal decision a provider can help you weigh for your child.
Ontario Next Steps

What to do next

Where to get it

Participating family doctors, nurse practitioners, public health clinics, and many pharmacies. Some public health units run clinics for children 6 months to under 5. Free for everyone 6 months and older.

When to get it

Each year when the updated vaccine is offered (typically fall). Higher-risk children may also be offered a spring dose.

What to bring / mention

Your child's vaccination history, any history of severe allergy or of heart inflammation after a previous dose, and whether your young child has been vaccinated before (which affects dose number).

If never vaccinated

Young children (6 months to under 5) not previously vaccinated may need a short primary series. A provider can confirm how many doses.

Pair with other vaccines

Can be given at the same visit as flu, RSV, or routine vaccines, at separate sites — convenient for one trip.

Keep a record

Note each dose. Records are viewable through your public health unit's ICON portal. See the Resources page.

Sources

Where this information comes from

This page is based on:

Last reviewed: June 2026  ·  Next review due: December 2026
Schedules, products, and eligibility can change. Always confirm current details with your healthcare provider, your local public health unit, or official Ontario sources.

Please note: This is an independent website. It is not affiliated with, endorsed by, or operated by the Government of Ontario, the Ministry of Health, or any public health unit. The information here is for general education only and is not medical advice — always consult a licensed healthcare provider about your or your child's immunizations.