Prescribing Paxlovid, Fourth Doses and Additional Resources

April 13, 2022

Dear Members,

As COVID-19 hospitalizations and cases continue to rise across the province, the reality of this sixth wave of the pandemic is taking hold with this highly transmissible BA.2 sub-variant of Omicron. Ontario approved fourth doses of the COVID-19 vaccine for those eligible and has now made it possible for physicians and Nurse Practitioners to prescribe Paxlovid that can be dispensed in community pharmacies. As we head into what will be a difficult spring, please see below for some additional resources and updates you may find helpful.

Prescribing Paxlovid
An individual with a valid prescription for Paxlovid is eligible to receive publicly funded Paxlovid if they live, work, or study in Ontario or are here for an extended stay. They also need to meet the applicable clinical criteria outlined in the Ontario Health Guidance for providers on access to COVID-19 antiviral treatment.

An individual is not required to have a valid Ontario health card or be an Ontario Drug Benefit Program recipient to receive publicly funded Paxlovid. Community pharmacies across the province are still onboarding to dispense Paxlovid and you can find which locations already have the antivirals on the Ministry site. Paxlovid is also available at all provincial Clinical Assessment Centres.

Below are some resources you may find helpful:

In their President’s Message yesterday, the Ontario College of Family Physicians highlighted key details to keep in mind with the rollout of Paxlovid prescribing, including additional clinical tools that would be helpful in determining patient eligibility for the antivirals.

Rolling out fourth doses of COVID-19 vaccines
On April 7th, the Ministry expanded eligibility for fourth doses (second booster dose) of the COVID-19 vaccine to include individuals aged 60 years and over as well as First Nation, Inuit and Métis individuals and their non-Indigenous household members aged 18 and over. Additional considerations include:

  • A fourth dose should be offered to those who received their third dose (first booster dose) five months (140 days) prior. The minimum interval for the fourth dose (second booster dose) is three months (84 days).
  • To maximize the immune response of the vaccine after a COVID-19 infection, it is recommended that individuals wait three months (84 days) after they tested positive, or their symptoms started.
  • At this time, it is not recommended to administer a fifth dose (second booster dose) to immunocompromised people.

As a reminder, if  you would like to administer vaccines in your clinic so please connect with your PHU operational lead for information if you haven’t yet done so.

IPAC Strategies To Ensure A Safe Environment In Primary Care Clinics

The Primary Care Collaborative has partnered with Public Health Ontario to provide an infection prevention and control (IPAC) information webinar to those working in clinical office settings. In this webinar, practical IPAC strategies for ensuring a safe environment for patients, clinicians, and staff will be reviewed and evidence-based resources will be introduced to support the ongoing development of a complete IPAC program for this practice setting. Such an IPAC program will be responsive to current concerns related to the COVID-19 pandemic, as well as routine infection risks in the clinical office environment.
Date & Time: Thursday April 14, 2022 12:00 p.m. to 1:00 p.m.
Speaker: Dr. Jeya Nadarajah, IPAC Physician, Science and Public Health, Public Health Ontario

Please register here.

COVID-19 Community of Practice: All About Paxlovid
The next OCFP/UofT DFCM CoP will be all about Paxlovid.
Date & Time: Friday, April 22, 2022 from 7:55 a.m. to 9:15 a.m.
Speakers: Dr. Sohal Goyal, Family Physician, West Mississauga Medical, Dr. Kelly Grindrod, Pharmacist and Associate Professor, University of Waterloo School of Pharmacy and Dr. Andrew Morris, Medical Director, Antimicrobial Stewardship Program, Sinai Health System/University Health Network.

Please register here.

Ontario Health Primary Care and COVID-19 Support CoP
Ontario Health has a monthly series that will run every second Wednesday April to December. Its objectives are:

  • Provide updates on new guidance and initiatives affecting primary care.
  • View presentations and ask questions related to COVID-19 response and recovery initiatives within primary care.
  • Learn from and connect with your peers.

Please register here.

Alliance for Healthier Communities
On April 5, 2022, the Alliance held a webinar on COVID-19 and indoor air quality - how community spaces can reduce transmission using ventilation, filtration, and ultra-violet disinfection. Click here to access the recording.

New and Updated Resources

Last week, the Ontario government announced the launching of a suite of supports for Ukrainian families arriving under the Canada-Ukraine Authorization for Emergency Travel. The supports available include Ontario Health Insurance Plan (OHIP) coverage. Please find the news release here and additional information on coming to Ontario from Ukraine here.

The Ministry has developed the guidance document Ukrainians Fleeing War: Early Assessment Considerations for Primary Care Providers. This document is intended to support primary health care providers in their early assessments and care of individuals arriving in Ontario who have been displaced due to the war in Ukraine.

There is a lot going on and we know you are exhausted. Heading into these ongoing waves is a constant reminder that this virus has no timetable around an end date, and we need to continue to remain vigilant to reduce its spread. Once again thank you for all you are doing to keep your patients and the community safe. If you need any assistance or have any questions, please do not hesitate to contact us. Stay safe.
Yours in Good Health,
The AFHTO Team