Vaccines for Under 5, Second Boosters, Monkeypox

July 25, 2022

Dear members,

As many of you saw in a recent memo issued by the Chief Medical Officer of Health on July 21, there is increasing international community transmission of two sub-variants of the Omicron variant of concern of COVID-19, BA.4 and BA.5. In Ontario, recent data indicates that an increasing proportion of cases are due to these sub-variants, and the BA.5 variant is now the dominant sub-variant in the province. With these trends of increasing transmission, and with the recognition that flu season is quickly also approaching, just a reminder that you can still access PPE and RATs through the provincial stockpile. Oxygen saturation monitors are also available to order for those teams currently, or will be, participating in the COVID@Home program.

Vaccinating Children Under Age 5
As you know, Health Canada has approved the Moderna vaccine for children between the ages of 6 months and 5 years, stating there were no safety signals from the trial and that it will look to “more data from ongoing studies and real-world use to ensure the benefits of the vaccine continue to outweigh any risks.” NACI issued these recommendations to advise on its use.
The Ontario government announced on July 21 that appointments for the paediatric COVID-19 vaccine for children aged six months to under five years will be available starting Thursday, July 28, 2022. EN FR. It is anticipated with this age group that the majority of these vaccines will be delivered in primary care or paediatrician offices. If you have not yet done so or have not heard about the distribution of the paediatric vaccines, please contact your public health unit or the COVID-19 delegated vaccine lead.
You may also expect that parents and caregivers will come to you with their questions over the following weeks and months. To support providers in these conversations, please see:

**To help the ministry with their planning on where children under 5 are or will be receiving vaccines, please take a moment and complete this short survey that should take no more than 2 minutes. We thank you very much in advance as your answers will be helpful in determining how widespread the vaccines will be given.

Second Boosters (or 4th Shot)
On July 20, the government announced that it would be expanding eligibility for the 4th shot (2nd booster) of the COVID-19 vaccine to everyone aged 18 to 59. Here are some resources you may find helpful:

Teams are also being asked to continue to encourage eligible patients to get their third dose if they haven’t already done so. Evidence shows vaccine effectiveness remains high six months after the third dose in otherwise healthy patients.
Finally, teams are also getting questions about monkeypox, especially now that the WHO has declared it a global health emergency. The Ministry of Health and Public Health Ontario are posting tools to assist providers with learning more about the disease, such as fact sheets, Q&As, and other resources. Dr. Allan Grill was also on CTV News to provide an overview of monkeypox, including what you need to know and how to protect yourself. If you have any questions about monkeypox in your community or how to access vaccination, please contact your PHU.

You may have also heard that the Ontario Government announced the extension of the 3-day COVID sick days to March 31, 2023. Though this does not go far enough in ensuring permanent sick days, it is a start - please see here for an ebulletin on the COVID sick days and what you need to know from Maria McDonald of McDonald HR Law.

We hope you are all getting some much-deserved rest this summer and spending time with your loved ones. If you need any assistance or have questions, please contact us any time.

Yours in good health,
The AFHTO Team