COVID-19 testing and clinical assessment centres

Halton COVID-19 information

Please note Monday’s are too busy to take on drugs representatives. As such, front staff have been instructed to state either to call us back or come back another day of the week.

If you wish to meet the physicians, it is better for you to call our front staff Tuesdays through Thursdays between 9 am and 4 pm, or on Fridays between 9 am and 3 pm.

Please do not come in with pamphlets and additional resources that can be sent via email. Please call us to book and ask staff for an email to forward your information through.

I am also asking you to avoid seeing family physicians outside the FHO, i.e. neighbourhood Walk-Ins and Virtual Clinics. Why?

• The physician you will be seeing in person or virtually has no knowledge of your medical history, and this can impact the quality of care you receive,
• As your family physician I will not receive any information about your appointment from the walk-in physician,
• The walk-in/virtual clinic physician deals only with the very specific symptom you present with. He/she cannot understand that symptom in the context of your medical history

If my office cannot provide you with a same day appointment, you will be seen at our After-Hours Clinic by a physician from our FHO. He/she will send me a note about the encounter with the nature of the concern, the findings, as well as any actions taken such as prescriptions, blood work or other tests.  This communication enables me to keep abreast of your health needs and concerns, providing continuity of care, which is an essential component of quality of care. 

When our After-Hours clinics aren’t available, we recommend you call the nurse staffed Telephone Health Advisory Service. You will be assessed by the nurse who can usually address your concerns. If you do need to see a physician, the nurse will direct you to the appropriate after hours care in your neighbourhood. As your family physician I receive an Encounter Note from the THAS Nurse, again keeping me abreast of your needs/concerns.

Continuity of care has always been at the heart of family practice and I look forward go caring for you in the years to come

COVID-19 Booster Dose for 5-11 years old

Starting Thursday, September 1, 2022, all children 5-11 years of age will be eligible to receive a first booster dose of Pfizer-BioNTech COVID-19 vaccine.

The recommended interval between the booster dose and completion of their primary COVID-19 vaccine series is six months, but can be received at a minimum interval of three months.

• Booster appointments for children aged 5-11 can be booked online at halton.ca/COVIDvaccines, or at eligible pharmacies.

• While all children aged 5-11 years are recommended to get the booster dose, NACI strongly recommends that children who have an underlying medical condition that places them at high risk of severe illness due to COVID-19, including children who are immunocompromised, should be offered a booster dose of the COVID-19 vaccine.

• Medical conditions that may place children at high risk of severe COVID-19 illness include:

o Cardiac or pulmonary disorders

o Diabetes mellitus and/or other metabolic diseases

o Obesity

o Acute or chronic health problems requiring routine medical care

o Multiple (2 or more) long-lasting conditions

o Neurologic or neurodevelopmental conditions

o Renal disease, anemia or hemoglobinopathy

o Cancer

o Down syndrome

o Immunocompromising conditions

Vaccines for ages 6 months to 5 years: Health Canada has approved the Moderna vaccine for kids under 5

On July 14, 2022, Health Canada approved the Moderna vaccine (25 mcg) for children 6
months to 5 years old. In Ontario, starting Thursday, July 28, 2022, parents and
caregivers will be able to book appointments for children aged 6 months to under 5.

July 22, 2022

1) What’s the benefit of vaccination in this age group?
While most children with COVID-19 have mild symptoms, some children get severe disease and
require hospitalization.
• Ontario data show that preschoolers are currently at increased risk of illness requiring
hospitalization than school-aged children.
• For children 6 months to 4 years of age, the average monthly rate of hospitalization due
to COVID-19 increased from 1.4 to 15.9 per 100,000, comparing March 1, 2020 –
December 31, 2021 to January 1, 2022 – March 31, 2022 in 6 Canadian jurisdictions
[source: NACI statement, July 14, page 5].
• Although rare, multi-inflammatory syndrome in children (MIS-C) is a serious condition
associated with COVID-19. See page 5 here.
• Children ≤5 years of age with any comorbidity may have an increased risk for severe
COVID-19 outcomes. Risk factors may include low birth weight, cardiovascular and
respiratory conditions, medications that affect the immune system, among others. See
page 6 here.
Data from older children and teens shows that vaccines lower the risk of complications from
COVID-19, and the 2-dose Moderna vaccine series is expected to have comparable
effectiveness in preventing severe disease in children 6 months to 5 years old.
• The CPS notes trial data showing vaccine efficacy against symptomatic COVID-19
infection, “starting 14 days after dose 2 was 50.6% for children aged 6 to 23 months, and
36.5% for those aged 2 to 5 years.
• Efficacy against severe disease could not be determined because there were no severe
cases in the vaccinated group and only one case (of MIS-C) in the placebo group.”
2) Is there concern for myocarditis in children aged 6 months to under 5?
There were no cases of myocarditis in the clinical trials for the Moderna vaccine and according
to NACI (page 11), data suggests the risk of myocarditis and/or pericarditis in younger children
is lower than that of adolescents or young adults.
For more on vaccine side effects in the trial, see Appendix A of the NACI report.
On July 14, 2022, Health Canada approved the Moderna vaccine (25 mcg) for children 6
months to 5 years old. In Ontario, starting Thursday, July 28, 2022, parents and
caregivers will be able to book appointments for children aged 6 months to under 5.
For every parent, the decision of whether to vaccinate their young child is a personal
one, informed by current knowledge of benefits and risks. The OCFP has compiled
answers to common questions based on statements from NACI and the Canadian
Paediatric Society (CPS).

3) What are some of the considerations in counselling
parents about vaccinating their child under 5 now?
Parents may decide to vaccinate their child if:
• the child has an underlying health condition and may be at increased risk for more severe
disease
• there is a high prevalence or increasing transmission of COVID-19 in their community
• the child is in regular contact with a lot of people (e.g., attends daycare)
• the child will be in close contact with someone who is immunocompromised
Source: Addendum to Canadian Paediatric Society Position Statement, July 19, 2022
4) How are appointments booked for the paediatric COVID-19 vaccine? Where can
parents/caregivers reach out with questions?
Starting Thursday, July 28, appointments will be available through: 1) the COVID-19 vaccination
portal and the Provincial Vaccine Contact Centre (1-833-943-3900); 2) directly through public
health units using their own booking system; 3) participating primary care providers and
paediatricians; 4) participating pharmacies and Indigenous-led vaccination clinics.
Parents and caregivers with questions are encouraged to speak with their health care provider
or call the Provincial Vaccine Contact Centre (1-833-943-3900) to speak to a health specialist,
or visit COVID-19 Vaccine Consult Service to book a confidential phone appointment with a
SickKids Registered Nurse.
5) What are the recommended dosages and the interval between doses?
Children aged 6 months to under 5 years old will receive the paediatric Moderna COVID-19
vaccine which is a slightly modified, lower dose (half the amount given to children aged 6 to 11),
in a two-dose series at a recommended interval of eight weeks between first and second doses.
For children in this age group who are moderately to severely immunocompromised, the primary
series is three doses and interval between doses may be 4 to 8 weeks.
You can read more about timing of COVID-19 vaccines for young children here.
6) How long after a COVID-19 infection should the first vaccine be given?
NACI suggests waiting 8 weeks after the start of symptoms or a positive COVID-19 test before
starting or continuing a primary vaccine series for children in these age groups. This interval
may be shortened to 4 weeks for children who are moderately to severely
immunocompromised.
7) Can the COVID-19 vaccine be given at the same time as other vaccines to children
6 months to under 5 years old?
NACI does not “routinely” recommend concurrent administration of the vaccine and advises
waiting 14 days between the COVID-19 vaccine and another vaccine for this age group,
acknowledging the importance for children to catch up on routine vaccinations. The CPS
recommends offering the COVID-19 vaccine simultaneously with other required or routine
vaccines, “unless there is assurance that timely administration

For more information, please visit the links below:

https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/summary-updates-canadian-immunization-guide-june-21-2022-covid-19-vaccines.html

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/vaccine/COVID-19_vaccine_third_dose_recommendations.pdf

https://www.toronto.ca/home/covid-19/covid-19-vaccines/covid-19-vaccines-for-infants-children-youth/covid-19-vaccines-for-6-months-to-under-5/

https://www.sickkids.ca/en/care-services/support-services/covid-19-vaccine-consult/

https://www.canada.ca/en/health-canada/news/2022/07/health-canada-authorizes-use-of-moderna-covid-19-vaccine-in-children-6-months-to-5-years-of-age.html

https://dfcm.utoronto.ca/confused-about-covid

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://uwaterloo.ca/pharmacy/sites/ca.pharmacy/files/uploads/files/faq_timing_of_covid-19_vaccines_for_young_children_6mo_and_older_july_14_2022.pdf

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://uwaterloo.ca/pharmacy/sites/ca.pharmacy/files/uploads/files/what_are_the_reasons_to_vaccinate_my_young_child_against_covid-19_1.pdf

NovaVax Nuvaxovid COVID-19 Vaccine Available April 23

• Halton Region Public Health is offering the NovaVax Nuvaxovid COVID-19 vaccine on April 23 and May 7 at the Burlington community clinic at 3450 Harvester Road in Burlington during regular clinic hours (9:30-3:45), by appointment only.
• Future clinics will be offered and patients can visit halton.ca/COVIDvaccines or call 311 for updates. Patients can also email accesshalton@halton.ca or call 311 to have their name added to
  a waitlist to be notified when a clinic date is available. Patients living outside of Halton Region should contact their local health unit for details on how to receive NovaVax.
• NovaVax Nuvaxovid is a protein-based, two dose COVID-19 vaccine for those 18+ who have allergies to any of the components of mRNA vaccines, or to those who have had an allergic
  reaction to a previous dose of mRNA.
• The NovaVax vaccine is a two dose series with a recommended dose interval of 56 days.
• The Pfizer BioNTech Cormirnaty and Moderna Spikevax mRNA vaccines remain the preferred option for preventing COVID-19, however Novavax is more efficacious than previous non-mRNA
  vaccines.
• Fourth/second booster doses are available at Halton Region Community Clinics by appointment only. All other doses of COVID-19 vaccine will continue to be offered by walk-in or by appointment through the online booking system.

Regarding Treatment for COVID-19

• Starting April 11, the following groups are eligible to be tested and assessed for antiviral treatment, such as Paxlovid:
  • 18+ who are immunocompromised (by a health condition or medications)
  • 70+
  • 60+ with fewer than three vaccine doses and
  • 18+ with fewer than three vaccine doses and at least one risk condition (e.g., a chronic medical
    condition).
• Treatment for antivirals must be started within five days of symptoms in most cases.
• Physicians and patients may use the provincial COVID-19 antiviral treatment screener to determine if they are at a higher risk of severe COVID-19 and may benefit from treatments. The
  screener will also refer patients to a nearby clinical assessment centre.
• Starting April 12, eligible individuals with a prescription can access antivirals from a participating pharmacy. A list of pharmacies dispensing COVID-19 treatment (Paxlovid) is available at
  Ontario.ca/antivirals.

ACCESSING COVID-19 TREATMENT

• Individuals can visit the Ontario provincial website to check if they are eligible for COVID-19 treatment and where to access the treatment
• Patients can find an assessment centre near them by visiting the Ontario COVID-19 testing locations and clinical assessment centre webpage

Third Doses for Youth 12-17 Start Feb 17, 2022

Updated Recommendations for Therapeutic Management of Adult Patients with COVID-19:

The Ontario COVID-19 Science Advisory Table has released updated recommendations for therapeutic management of adult patients with COVID-19, that incorporates Paxlovid and Sotrovimab.

Supply of antivirals is limited at this time for outpatient therapy and Ontario is prioritizing these therapeutics to patients who are at a higher risk of sever disease, including:

o Immunocompromised individuals 18+, regardless of vaccine status

o Unvaccinated individuals 60+

o Unvaccinated First Nations, Inuit, and Metis individuals 50+

o Unvaccinated individuals 50+ with one or more risk factors (BMI>30, dialysis or stage 5 kidney disease, diabetes, cerebral palsy, intellectual disability, sickle cell disease, receiving active cancer treatment, solid organ or stem cell transplant recipients.

PAXLOVID

Paxlovid is currently being distributed through 15 sites across Ontario, including CACs.  Each site serves as a “hub” to facilitate access within their region and through other CACs.

– Currently ~70 Clinical Assessment Centers (CACs) across Ontario provide assessments, testing, and treatment for COVID-19 and accept referrals from primary care providers or self-referrals.  Patients do not have to be eligible for PCR testing to visit a CAC.  A list of current CACs is available at: COVID-19 testing and clinical assessment centre locations (ontario.ca)

– If a patient cannot travel to a clinical assessment centre associated with one of the 15 sites that distribute Paxlovid, refer them to a local clinical assessment centre. The 15 sites will work with the other clinical assessment centres to provide Paxlovid on an individual basis for eligible patients.

-Sites providing Paxlovid treatment:

o Mississauga Medical Arts – COVID, Cold and Flu Care clinic (5010 Glen Erin Dr., Mississauga). Call 905-288-5900 or visit www.familycovidtest.ca to book an appointment.

o St. Joseph’s Healthcare Hamilton (50 Charlton East, Hamilton). Call 905-522-1155, ext. 32367 or visit www.stjoes.ca/coronavirus/covid-care-clinic to book an appointment. Email: COVIDCareClinic@stjoes.ca o For information on sites in St. Catharines, Toronto or others, please email doctors@halton.ca.

SOTROVIMAB 

Sotrovimab is available at 7 sites (called monoclonal therapy clinics) across the province. Clinic locations and contact information are in the common referral form (see attached). Primary care providers considering sotrovimab should fax or email the referral form to the desired site. · Patients must have a positive COVID-19 test to be referred to receive sotrovimab at a monoclonal therapy clinic. Testing is not provided at the monoclonal therapy clinics.

**If you are pregnant or breastfeeding and have questions regarding the COVID-19 vaccine, please click HERE

Regarding Vaccines for Children 5-11 Years Old

**Updated December 23, 2021 in Bold**

• New appointments for first and second doses of the paediatric COVID-19 vaccine have been added to the online booking system.
• Second doses can be scheduled at least 8 weeks after the first dose.
• First dose COVID-19 vaccination appointments for children 5 to 11 years of age (or turning five in 2021) can now be booked through Halton Region’s online booking system or by calling 311.
• Appointments are available starting Friday, November 26, are dependent on pediatric vaccine supply and will be added to the booking system as supply is confirmed.

LOCATIONS FOR PEDIATRIC COVID-19 VACCINATION

• Child-friendly pediatric clinics
o Burlington (3450 Harvester Road)
o Milton (180 Market Drive)
o Oakville (240 Wyecroft Road)
o Additional pediatric clinics in Halton Hills will be confirmed in coming weeks

• Existing community vaccination clinics
o Burlington (3250 New Street)
o Georgetown (10241 8 Line)
o Milton (1010 Main Street East)
o Oakville (410 Rebecca Street)
• Pharmacies, primary care and pediatric offices who have signed up to offer vaccine

Regarding Booster COVID-19 Vaccine Doses *Updated December 23, 2021 in BOLD*:

**A Message From Halton Regarding: Third dose COVID-19 vaccine appointments for residents 18+

There has been a high volume and demand on our booking system and through our call centre, Access Halton, to book appointments. We continue to add appointments and more appointments will become available if people cancel. If you have an appointment and would like to find an earlier appointment, please continue to check regularly using the “Manage My Appointment” tool that can be found in your confirmation email and on our booking page.

Our clinics are not the only way to get your vaccine. Participating pharmacies, primary care offices and Provincial GOVAXX bus stops are also offering third doses and may have earlier availability. We know that finding an appointment and waiting in line is a challenge, but if you do get a third dose earlier, please cancel your appointment online. This will automatically add the appointment back to our system for someone else to book.

• Starting Monday, December 13, individuals 50+ can book their COVID-19 vaccine booster dose appointment online at halton.ca/COVIDvaccines, at pharmacies across Halton and through primary care offices who are offering the COVID-19 vaccine.
• Halton Region has launched a Third Dose/Booster Calculator online that people can use to help calculate the earliest date they can receive their third dose/booster.
• Dialysis (hemodialysis or peritoneal dialysis) patients have been added to the list of moderately to severely immunocompromised groups already eligible for a third dose of the COVID-19 vaccine. These individuals should speak with their primary care provider/specialist to discuss vaccination and complete a referral form
  before booking their appointment through public health clinics.
• The Province also recommends re-vaccination of post-transplantation for people who receive hematopoietic stem cell transplants (HSCT), hematopoietic cell transplants (HCT) (autologous or allogeneic), and recipients of CAR-T-cell therapy due to the loss of immunity following therapy or transplant. Exact timing of re-vaccination must be done in consultation with the person’s treating healthcare professionals and Public Health is currently developing a process to appropriately coordinate.
• Pharmacists and physician offices are able to administer vaccine to the newest eligible medical conditions.
• Starting December 13, Halton community clinics will resume walk-ins for first and second doses for residents 12+ on days scheduled for 12+ vaccinations (walk-ins will not be accepted on clinic days dedicated for 5 to 11 y.o.). Appointments are still required for paediatric vaccine and for third doses.
• Based on new evidence, NACI recommends Pfizer-BioNTech Comirnaty mRNA vaccine (30 mcg) is preferred in adolescents and young adults 12 to 29 years of age, to further minimize the rare risk of adolescents and young adults experiencing myocarditis/pericarditis after receiving an mRNA vaccine.
• There are new animated videos to share with your younger patients to help prepare them for vaccination:
  How vaccines work and Getting ready for your COVID-19 vaccine

• Starting November 6, the following vulnerable populations will be eligible for a booster dose of the COVID-19 vaccine, if at least six months have passed since their last dose:
  o Individuals aged 70 and over (born in 1951 or earlier);
  o Health care workers and any staff member working in-person in a health care organization, including workers not providing direct patient care but frequently in the patient environment;
  o Designated essential caregivers in congregate settings (including long-term care home and retirement home staff and designated caregivers);
  o Individuals who received a complete series of a viral vector vaccine (two doses of the AstraZeneca vaccine or one dose of the Janssen vaccine); and
  o First Nation, Inuit and Metis adults and their non-Indigenous household members.
• COVID-19 vaccine can be administered at the same time as influenza and other vaccines.
• Appointments will be required for all first, second and third doses and walk-ins will no longer be offered at Halton Region Community COVID-19 vaccination clinics after Friday, November 5.
• Starting Saturday, November 6, eligible individuals can book appointments at a Halton Region Community COVID-19 Vaccination Clinic at halton.ca/covidvaccines. Clinics are located at FirstOntario Arts Centre (Milton), YMCA (Oakville), Gary Allan Learning Centre (Burlington) and Gellert Community Centre (Halton Hills).
• COVID-19 vaccine is also available at more than 100 pharmacies across Halton Region, participating physician offices and pop-up clinics.
• People are reminded that those who have received two doses of COVID-19 vaccine still have excellent protection against the virus. There is currently no evidence of widespread waning of protection against severe disease in the general Canadian population who have been fully vaccinated.
• However, lower vaccine effectiveness against severe disease has been identified mainly in residents in long-term care homes, with some evidence of decreased effectiveness in elderly adults, particularly those 80 years of age and over.

• NACI has announced interim guidance on booster COVID-19 vaccine doses. Halton Region Public Health is expecting further direction next week on provincial implementation. Third doses
  for these populations is not available at Public Health Clinics at this time.
• People are reminded that those who are fully vaccinated against COVID-19 still have excellent protection against the virus. There is currently no evidence of widespread waning of protection
  against severe disease in the general Canadian population who have been fully vaccinated.
• However, lower vaccine effectiveness against severe disease has been identified mainly in residents in long-term care homes, with some evidence of decreased effectiveness in elderly
  adults, particularly those 80 years of age and over.
• NACI strongly recommends the following populations should be offered a booster dose of an mRNA COVID-19 vaccine at least 6 months after completing their primary series:
  • Adults 80+ and those living in long-term care or other congregate settings that provide care for seniors.
• NACI also recommends the following populations may be offered a booster dose of an mRNA COVID-19 vaccine at least 6 months after completing their primary series:
  • Adults 70-79 years of age;
  • People who received two doses of the AstraZeneca Vaxzevria vaccine or one dose of the Janssen vaccine;
  • Adults in or from First Nations, Inuit and Metis communities; and
  • Adults who are frontline healthcare workers who have direct in-person contact with patients and who were vaccinated with a very short interval.

**New Information Regarding School Based Immunizations**

To support Lakeshore Medical Group’s capacity for providing flu vaccinations, Halton Region Public Health is hosting community clinics to provide immunizations traditionally provided in school.

• Please book an appointment at a community clinic
• Patients will receive a consultation at their appointment and will be offered all school-based vaccines they are eligible to receive.

While community clinics for school-based vaccines are running (until mid-November), Public Health will NOT be accepting or releasing special order requests for school-based vaccines to Lakeshore Medical Group.

• Community clinics will be held on a short-term basis for eligible students born in 2002-2009 by appointment only at four clinics (note: some locations may close earlier than others):

• Please go to halton.ca/immunize to book an appointment at a Public Health clinic.
• The following outlines school-based vaccine eligibility at community clinics:

*remain eligible for missed doses until August 31, 2022. Series must be completed by this date.

**REGARDING 3RD DOSE – NEW INFORMATION AS OF SEPTEMBER 20TH FROM HALTON REGION PUBLIC HEALTH:

QUICK FACTS

• Ontario has expanded eligibility for third doses of the COVID-19 vaccine to additional groups at highest risk
  of serious illness from the virus. The physician referral form for third doses will be updated today and can
  receive their third dose at a Community Clinic as of September 18, 2021. Third doses can also be received
  at participating pharmacies and primary care clinics.
• Eligible people can receive their third dose at a recommended interval of eight weeks following their
  second dose (minimum 28 days), but should discuss the best timing with their specialist.
• Ontario’s COVID-19 Guidance for Individuals Vaccinated outside of Ontario/Canada has been updated to
  allow one additional dose of an mRNA vaccine to people who received either a complete or incomplete
  dose of a COVID-19 vaccine not authorized for use by Health Canada.
• Physicians can sign up their practices now to provide COVID-19 vaccines, even if they don’t wish to
  vaccinate immediately. This will avoid delay when you choose to start vaccinating once public health clinics
  are closed and more eligibility is announced. Email doctors@halton.ca to start the onboarding process.

ELIGIBLE POPULATIONS FOR THIRD DOSE OF COVID-19 VACCINE

• Those undergoing active treatment for solid tumors;
• Those who are in receipt of chimeric antigen receptor (CAR)-T-cell therapy;
• Those with moderate/severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich
  syndrome);
• Stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome;
• Those undergoing active treatment with the following categories of immunosuppressive therapies: anti-B
  cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic
  corticosteroids, alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other
  biologic agents that are significantly immunosuppressive;
• Transplant recipients (including solid organ transplant and hematopoietic stem cell transplants);
• Patients with hematological cancers (examples include lymphoma, myeloma, leukemia) on active treatment
  (chemotherapy, targeted therapies, immunotherapy);
• Recipients of an anti-CD20 agent (e.g. rituximab, ocrelizumab, ofatumumab); and
• Additionally, Halton Region’s mobile teams are providing third doses to residents of long-term care and
  high-risk retirement homes. The Province has identified the settings and not all retirement homes are
  eligible at this time.

VACCINE ELIGIBILITY FOR THOSE WHO RECEIVED COVID-19 VACCINE NOT AUTHORIZED BY
HEALTH CANADA

• The province has updated guidance for Individuals who have received a complete one or two-dose series
  of a COVID-19 vaccine that is not authorized for use by Health Canada. These individuals should now be
  offered one additional dose of an mRNA vaccine.
  • Minimum interval between preceding dose and additional dose should be 28 days.
  • If the individual has already received three doses of a non-Health Canada authorized COVID-19
    vaccine at the appropriate interval, no additional doses should be offered at this time
• Individuals who have proof of immunization and have received an incomplete series of a non-Health
  Canada authorized vaccine, should receive one additional dose of an mRNA vaccine.
  • Minimum interval between preceding dose and additional dose should be 28 days.
• Residents who received COVID-19 vaccine outside of the Province can report this to Halton Region
  Public Health by going online and selecting the “Report an Out of Province Vaccination” tab.

**REGARDING 2ND DOSE – NEW INFORMATION AS OF JUNE 18TH – FROM THE HALTON WEBSITE:

**New as of April 16, 2021)** Regarding: Attestation (exemption) forms to confirm vaccine eligibility not required.

The Ministry of Health has communicated to all 34 public health units that attestation forms and doctors’ notes are not required to confirm vaccine eligibility. This is in response to OMA advocating to the government that attestation forms and doctors’ notes to confirm eligibility (for example, to confirm eligible health condition) are a barrier to vaccination and an inappropriate use of health- care resources.

Only individuals who belong to groups listed below must complete an exception form (PDF file) with their primary health care provider prior to booking a vaccine appointment at Halton Healthcare.

Highest-Risk health conditions include:

– Organ transplant recipients

– Hematopoietic stem cell transplant recipients

– Haematological malignancy diagnosed <1 year

High-Risk health conditions include:

– Other treatments causing immunosuppression (e.g., chemotherapy, immunity- weakening medications)

Individuals who have an autoimmune condition or immunodeficiency condition and are receiving any of the following treatments must speak with their health care provider before getting the COVID-19 vaccine:

– stem cell therapy

– CAR-T therapy

– chemotherapy

– immune checkpoint inhibitors

– monoclonal antibodies (e.g., rituximab) and other targeted agents (e.g., CD4/6 inhibitors, PARP  inhibitors etc.)

For the most up to date information regarding COVID-19 vaccines in the Halton Region, please click the following link: Halton – COVID-19 Vaccines

WE DO NOT HAVE THE COVID-19 VACCINE IN THE OFFICE, WE CANNOT ADVISE PATIENTS ON WHICH VACCINE TO OBTAIN. WE RECOMMEND YOU OBTAIN THE FIRST VACCINE YOU ARE ELIGIBLE FOR. REFER TO THE HALTON PUBLIC HEALTH WEBSITE FOR DAILY UPDATES.

**If you are pregnant or breastfeeding and have questions regarding the COVID-19 vaccine, please click HERE

Who is eligible for a shortened dose interval?

On May 28, the Province announced plans to further accelerate second dose appointments(external link), starting with individuals 80+. Information on when additional groups will be eligible to reschedule second dose appointments, as directed by the Province(external link), will be announced as vaccine supplies are confirmed. Thank you for your patience as we work to implement this direction.

Based on provincial direction, the following groups are currently eligible to receive their second dose as early(external link) as 28 days after they received their first dose:

• Halton residents 80 years of age and older
• highest-priority health care workers(external link) (refer to “All health care workers who live or work in Halton and cannot work from home” above for more details)
• all Indigenous Peoples (and household members)
• designated essential caregivers of those living in seniors congregate settings
• individuals with the following health conditions or treatments (your physician must complete a medical exemptions form(PDF file), or sign a letter indicating that you have one of the conditions listed and are eligible for a shortened interval):
  • Solid organ transplant recipients
  • Hematopoietic stem cell transplant recipients
  • Malignant hematologic disorders receiving active treatment (examples: chemotherapy, targeted therapies, immunotherapy), excluding individuals receiving solely hormonal therapy or radiation therapy
  • Malignant non-hematologic solid tumors receiving active treatment (examples: chemotherapy, targeted therapies, immunotherapy), excluding individuals receiving solely receiving solely hormonal therapy or radiation therapy
  • Individuals undergoing hemodialysis or peritoneal dialysis
  • Individuals receiving treatment with an anti-CD20 agent (examples: rituximab, ocrelizumab, ofatumumab)
• If you already received your first dose and have a second dose appointment booked 16 weeks after the first dose, if eligible for a shortened interval you can reschedule your second dose appointment to a shorter interval through our online booking system (subject to appointment availability and vaccine supply). You may be able to book your second dose appointment through a participating pharmacy(external link), but should call ahead to confirm availability and eligibility.
• If you are eligible for a shortened dose but received your first dose as part of a group receiving their second dose at a 16 week interval (for example, you are a paramedic and received your first dose as a Group 1- Essential Worker) you will need to reschedule your second dose appointment under a different eligibility group. This feature is not yet available, but is coming soon.

How to reschedule an appointment

To reschedule your second dose appointment online, you will require the email address that you used when you first booked your appointments. If you did not provide an email address at that time, please call 311 and someone will assist you.

  Reschedule your second dose appointment now
Use the latest version of Chrome, Safari, Firefox or Microsoft Edge (windows 10 only)

1. Select the Reschedule your second dose appointment button above. This will open the Vaccine Appointment View/Reschedule/Cancel tool.
2. Enter either:
   1. the 7-digit confirmation number you received when booking your appointment and your date of birth; or
   2. your date of birth, last name and postal code.
3. Select the Next button. This will display the details of your active appointments, such as location, date, time and confirmation numbers.
4. Scroll down to the Reschedule or cancel your appointments section, and click the Send me an invitation to reschedule or cancel my appointments button. This will send an email to the email address originally used to book your appointments. If you did not provide an email to schedule your appointments, please call 311 and provide an email to include with your appointment.
5. Go to the email mailbox originally used to book the appointments. You should have received a message from Halton Region Public Health.
6. Select the Manage my appointments button in the email. This will open the Manage Appointments screen giving you the option to select a new appointment date and time.
7. Select the Reschedule Now button. Your new appointment is now booked and your previous appointment will be cancelled. Note: Your new appointment will not be booked until you select a new appointment date and time and click on the Reschedule Now button.
8. You will receive an email confirming your new appointments.

Please note: Your existing appointment will not be cancelled until you select a new appointment location, date and time and then select the Finish button.

Parents of children aged 12-17 please click here to view a letter from the MOH detailing how to get your child vaccinated with both doses by August 2021

Clinics are by appointment only (please no walk-ins) and must be booked online through Halton Region’s
booking system at halton.ca/COVID19vaccines or by phone through 311 if assistance is required. Please do not
call clinic locations directly; bookings can only be made through Halton Region. Residents are reminded that parking is free at Oakville Trafalgar Memorial Hospital and Joseph Brant Hospital for those with scheduled appointments at these clinics

**Important Information Regarding the AstraZeneca Vaccine** Halton Region Public Health is NOT part of the provincial AstraZeneca pilot for primary care or pharmacies.

Dear patients

We know you are hoping to get your COVID-19 vaccine as soon as possible and are seeking the latest information. Here is what we know now (March 12, 2021).

AstraZeneca Vaccine **updates in BOLD as of April 6th, 2021**
We have not received the AstraZeneca COVID vaccine in our clinic.  The Astra Zeneca vaccine is being offered only to people aged 55 and over as of the day of vaccination. Do not get this vaccine if you are under 55 years of age. It is available in pharmacies and some family doctors’ offices in certain health regions. We will let you know as soon as possible when the vaccine becomes available to us. Please do not call us to try to book an appointment or to enquire as to whether we have received the vaccine or not. We need to keep our phone lines free for patients with immediate medical needs.

Vaccines for patients over 80 (born in 1941 or earlier):
If you are 80 or older and do not live in a care home, your local public health unit will have details about vaccinations in your area.

Provincial online system
Eligible residents can now register for appointments starting on March 17.

For more information about COVID vaccines visit the Ministry of Health website: https://covid-19.ontario.ca/covid-19-vaccines-ontario

Please be assured that we will let you know if we have any vaccine and if you are eligible to receive it from us. Please take the first vaccine offered to you.

Regards

Lakeshore Medical Group

Halton Vaccination Locations:

LOCATION OF IMMUNIZATION CLINIC FOR OAKVILLE:   St. Volodymyr Cultural Centre, 1280 Dundas Street West, Oakville

LOCATION OF IMMUNIZATION CLINIC FOR BURLINGTON: Compass Point Bible Church, 1500 Kerns Road, Burlington

LOCATION OF IMMUNIZATION CLINIC FOR MILTON: FirstOntario Arts Centre Milton, 1010 Main Street East, Milton

LOCATION OF IMMUNIZATION CLINIC FOR GEORGETOWN: Gellert Community Centre, 10241 Eighth Line, Georgetown

Peel Vaccination Locations:

LOCATION OF IMMUNIZATION CLINIC FOR MISSISUAGUA: 7120 Hurontario Street, Mississauga

LOCATION OF IMMUNIZATION CLINIC FOR BRAMPTON: 10 Peel Centre Drive, Brampton

**Please Note** 

Additional community clinics in Brampton, Caledon and Mississauga will be launched between February and April. Locations include:

• Caledon East Community Complex, 6215 Old Church Road, Caledon East
• Save Max Sports Centre (formerly Brampton Soccer Centre), 1495 Sandalwood Parkway East, Brampton
• Chris Gibson Arena, Brampton
• International Centre, Mississauga
• Paramount Fine Foods Centre, Sportsplex C – C Gate 1, 5600 Rose Cherry Place, Mississauga
• Trillium Health Partners – University of Toronto (Mississauga) Recreation, Athletics and Wellness Centre Clinic

For more up-to-date information regarding which clinics have been opened, please click HERE

Answering Patient Questions about COVID-19 Vaccines

January 11, 2021

 Dear Patients,

2020 has brought such fear and changes to the way we live our lives. But as 2021 dawns, there is hope – vaccines are on their way.

As you all know, the first vaccines are being given to higher-risk people and healthcare workers. But we look forward to when you all will have access to the vaccine. We do not yet know the place or the timing and we will communicate this when we do.

Some questions have arisen that we wanted to answer at this stage – please see below, and you can find more detail here.

• Appropriate steps taken – The vaccines were developed was so fast because it was a top priority for everyone in the field and billions of dollars from governments and companies around the world were spent on getting it developed. The scientific world cooperated in ways they had not before. The bureaucratic process was super-fast because of the importance of getting this
• New technology – mRNA has been used for cancer treatments for upwards of 30 years, but this is the first vaccine using the There are two vaccines made this way (Pfizer and Moderna) and another one (Oxford) that is coming later is made with an older technology (like the effective Ebola vaccine). More information is available here.
• Effectiveness – In clinical studies, very few people got COVID-19 within 12 days of getting the first dose of the Pfizer This result is similar to the Moderna vaccine, which is the other COVID-19 vaccine now approved for use in Canada.
• Allergies – People with allergies to any of the ingredients in the vaccine should not receive We will discuss any serious allergies or other health conditions you may have before you receive the vaccine.
• Pregnancy and children less than 16 years old – None of the vaccine trials included these populations, so at this time the vaccine is not recommended routinely for these groups

Pregnancy and children less than 16 years old (continued)

For pregnant or breastfeeding individuals who are at high risk of infection and/or morbidity from COVID-19, the various national societies for obstetricians have stated that “the documented risk of not getting the COVID-19 vaccine outweighs the theorized and undescribed risk of being vaccinated during pregnancy or while breastfeeding and vaccination should be offered.”

*****

Our office has remained accessible to you, by phone, by video or in person as it was deemed necessary. We thank you for your understanding as we help you in your health in these different ways.

Thank you all for what you have done to keep yourselves, your loved ones, and your communities safe. Thank you to those frontline workers who have faced fears and yet continued to provide the services that we have needed to function.

We look forward to when the vaccine allows us to return to a life that is more connected. In the meantime –

Wear a mask, keep your distance, wash your hands. AND be calm, be safe, be kind.

Warmly,

The Physicians and Staff of Lakeshore Medical Group

TO OUR PATIENTS AT LAKESHORE MEDICAL GROUP:

– Please be advised that if you are not physically in the province of Ontario at the time of their virtual, or phone appointment, our physicians cannot provide medical care according to the policies set out by the OCFP and CPSO. Medicolegally our physicians’ practicing licenses are for Ontario only.

Updated Mask Guidelines/Requirements:

As of March 21, masking will continue to be required in select settings such as public transit, long-term care homes, retirement homes, and other health care settings (i.e. Medical Clinics), shelters, jails and congregate care and living settings, including homes for individuals with developmental disabilities.

In addition to the settings above, masks will also be required in the following circumstances:

• Individuals who test positive for COVID-19 are required to wear a mask until day 10 following a positive test result or the onset of symptoms (whichever occurred first).
• Close contacts and household contacts of individuals with COVID-19 are required to wear a mask for 10 days after exposure.
• Individuals who have recently traveled outside of Canada, have to wear a mask for 14 days upon return.

Halton Region Public Health is also reminding residents that wearing a mask continues to be an effective public health measure for reducing the spread of COVID-19 and to be kind to those who choose to continue wearing a mask to protect themselves and others.

“There is still risk of transmission in Halton and we need to be mindful that the risk of infection and severe disease is greater for some individuals than others, including those who are immunocompromised or have underlying health conditions, and older adults,” said Dr. Hamidah Meghani, Halton Region’s Medical Officer of Health. “Some individuals may choose to keep wearing masks in places where they are not required, and others, such as those who are close contacts of COVID-19 cases, will be required to wear masks for a period of time. Businesses and organizations may also continue to require or encourage mask use based on the risk in their workplaces and to their patrons. I encourage all Halton residents to continue to be kind and respectful to everyone, regardless of their decision to wear a mask or not.”

We still require all patients coming into the office to wear a mask regardless of vaccination status.

Updated Covid-19 Exposure Guidelines  

If you have symptoms of COVID-19, assume that you may have the virus and may be contagious.

You must isolate:
-for at least five days if you are fully vaccinated or are under 12 years of age
-for at least 10 days if you are over the age of 12 and not fully vaccinated, are immunocompromised , or live in a highest risk setting

If you LIVE WITH someone who has symptoms or has tested positive for COVID-19, you DO NOT need to isolate if one of the following applies to you:

1.you have previously tested positive in the last 90 days and do not have symptoms
2. you are over 18 years old and have received a COVID-19 booster dose
3.you are under 18 years old and are fully vaccinated

Instead, for 10 days after exposure:
-self-monitor for symptoms
-wear a mask and avoid activities where mask removal would be necessary
-do not visit anyone who is at higher risk of illness, such as seniors, or any highest risk settings (unless you previously tested positive in past 90 days)
If you do not meet any of the criteria above, you must isolate while the person with symptoms/positive test result isolates (or for 10 days if you are immunocompromised).
____________________________________________________________________________________

If you’ve been exposed to someone from another  household with symptoms of COVID-19 or a positive test result

You are required to:
1.self-monitor for symptoms for 10 days after your last exposure
2.wear a mask, avoid activities where mask removal is necessary (such as dining out, high contact sports) and follow all other public health measures if leaving home
3.do not visit any highest-risk settings (such as long-term care or retirement homes) or people who may be at higher risk of illness (such as seniors) for 10 days after your last exposure

***Please be advised of  Public Health Guidelines and Lakeshore Medical Group’s updated face coverings/mask Policy as of December 21, 2021

If you’re booked for an in person appointment and are planning to come into the clinic, please be advised that: cloth masks/ scarves/ bandanas, neck gaiters etc will not be permitted for use in our clinic. We require ALL patients regardless of vaccination status, to wear a well fitted surgical/medical grade mask before entering the clinic**

***For Those Experiencing COVID or Flu Like Illness*** Please see below for details on the COVID, Cold and Flu Care Clinics available in our communities:

For Patients With Questions About COVID-19, Please Read The Following:

As Omicron sweeps through communities across Ontario, Canada and beyond, patients are grappling with a large amount of confusing information and new uncertainties about COVID.
To cut through the confusion, family doctors have come together to help patients and the public make sense of the current COVID rules and realities. The ‘Confused about COVID? Family doctors answer your questions’ series offers patients and the public trustworthy advice about protecting their health and how family doctors can help.

https://dfcm.utoronto.ca/confused-about-covid

An Update from Public Health Regarding Testing and Contact Tracing Guidelines (Updated Jan 6, 2022)

PCR testing for COVID-19 is now only available to certain groups, including hospitalized patients, healthcare workers, and residents or staff of long-term care/retirement homes. As a result of limited testing availability, anyone with COVID-19 symptoms should be assumed to have COVID-19, must self-isolate for minimum of 5 days, and not seek testing. Household members of someone symptomatic with COVID-19 symptoms or a positive case (PCR or Rapid Antigen Test) must also isolate for 5 days while the case or symptomatic individual is isolating. Current guidance for case and contact management continues to advise that patients who test positive for COVID-19 or are symptomatic with COVID-19 symptoms must inform their close contacts. Public Health will continue to perform case and contact management in high risk settings (long term care homes, retirement residences, hospitals, congregate settings and First Nations communities). Schools and daycares are not classified as high risk settings for case and contact management purposes. Currently only test-confirmed cases in high risk settings (outlined above) need to be reported to Public Health. Please do not call to report positive PCR or RAT tests.

*Please Note* Our Receptionists are now working in the office, however, you may still receive calls from a blocked number when remote staff, or your family physician attempts to call you. Please be sure your phone is set to accept blocked numbers.

We understand the fear and frustration that the COVID-19 pandemic has caused and we have been working hard to ensure that we continue to deliver high quality medical care while taking into account the health and safety of our patients, physicians and staff. 

We are reducing all non-essential visits and services and replacing them with virtual visits (i.e. telephone and video communication). Non-essential visits include periodic health assessments (i.e. physicals), routine pap tests and minor ailments. We are recommending that you still continue with routine childhood immunizations as there will be dedicated times to book these appointments. With this in mind, we ask that you DO NOT come into the clinic without an appointment. THIS INCLUDES NURSE AND LAB VISITS! If you feel you need to see your doctor or the nurse for any reason, please read the list of frequently asked questions below prior to contacting the office for an appointment. 

**IMPORTANT NOTICE ABOUT NURSE VISITS** We are no longer accepting walk-in visits to see the nurse. If you wish to see the nurse, you must call and speak with the nurse directly to book an appointment as needed. 

**IMPORTANT NOTICE ABOUT LAB VISITS** We are no longer accepting walk-in visits to the lab. If you have seen your doctor in our office (suite 502), or have spoken with your doctor directly over the phone or through video chat, and they have asked you to come in ON THE SAME DAY for blood work, urine testing, or an EKG, you will be asked to knock loudly on the lab door to identify yourself. The door will be locked and Diana will let you in. If you are coming to the lab for any other reason (i.e. a standing order for bloodwork, bloodwork ordered by a specialist for an upcoming appointment, etc.,) you must call 905-845-4511 ext. 224 to be screened for COVID-19 and to be given an appointment.

**IMPORTANT NOTICE ABOUT COVID RELATED DOCTOR’S NOTES** Please note that symptomatic individuals requesting Doctor’s notes to return to school, or employment, or for those who wish to forego testing for COVID-19 generally cannot be honored as per advice and guidelines from Halton Public Health, the Ontario Medical Association and the Ministry of Health.

We all need to take COVID-19 very seriously. Although we currently do not have many case fatalities in Canada, we are at risk of getting to the point of a health care crisis. We ask you to do your part to help “flatten the curve” so that we can protect our most vulnerable populations and keep our hospital beds available for those who need them the most. 

REMEMBER THAT WE ALL HAVE A RESPONSIBILITY TO ENSURE PUBLIC HEALTH AND SAFETY! 

For the most up-to-date information regarding COVID-19, please visit the Halton Public Health Website https://www.halton.ca/For-Residents/Immunizations-Preventable-Disease/Diseases-Infections/New-Coronavirus

COVID-19 self-assessment

If you think you have coronavirus (COVID-19) symptoms or have been in close contact with someone who has it, click HERE to use the self-assessment to help determine how to seek further care.

For further information, please read below for answers to frequently asked questions:

1) Who should be tested for COVID-19?

As the supply for nasopharyngeal swabs is limited, COVID-19 testing is reserved for those at high risk of severe illness or transmitting to someone vulnerable. 

From Halton Public Health Website:

Halton Region Public Health and health care partners continue to focus on those most at risk of COVID-19. Our current priority is to hear from the following people who have symptoms (e.g., fever, new cough, difficulty breathing, etc.):

• those aged 60 and over;
• those with pre-existing medical conditions;
• those who have been in contact with a confirmed case of COVID-19.
• those living or working in a health-care or long-term care setting or institution; or
• First Nation community members living on-reserve.
• Anyone else directed by Halton Region Public Health

If you have symptoms AND meet one of the criteria above you may be tested for COVID-19. Residents must have an appointment to attend an Assessment Centre.

Residents of Oakville, Milton or Halton Hills can book an appointment at a Halton Healthcare Assessment Centre by calling 905-203-7963. Residents of Burlington can call 905-632-3737 ext 6550 to book an appointment at the Joseph Brant Hospital COVID Assessment Clinic.

*Appointments are necessary to attend an Assessment Centre in Halton.

Individuals without symptoms are NOT being tested at this time.

Individuals with mild symptoms that do not meet the criteria above are asked to self-isolate for 14 days, or until they have been symptom-free for 24 hours, whichever is longer. You do not need to contact Public Health.

If you have SEVERE symptoms, please call 9-1-1 immediately.

2) What are the current symptoms?

The following symptoms have been listed in the screening questions provided by the Ministry of Health (Last updated Apr 22, 2020):

• Fever
• New onset or worsening chronic cough
• Shortness of breath
• Difficulty breathing

In addition, the following secondary symptoms has also been listed:

• Sore throat
• Runny nose or sneezing
• Nasal congestion
• Hoarse voice
• Difficulty swallowing
• Decrease or loss of sense of smell
• Chills
• Headaches
• Unexplained fatigue/malaise
• Diarrhea
• Abdominal pain
• Nausea/vomiting

3) What do I do if I have symptoms but do not qualify for testing?

From Halton Public Health Website: Individuals with mild symptoms that do not meet the criteria listed in FAQ 1 are asked to self-isolate for 14 days, or until they have been symptom-free for 24 hours, whichever is longer. You do not need to contact Public Health.

If you have SEVERE symptoms, please call 9-1-1 immediately.

3) How do I protect myself and my family from getting ill?

Practice social distancing. This means avoiding non-essential exposures to other people, especially those over the age of 60 or immunocompromised. 

Sanitize your hands frequently either with alcohol-based sanitizer or hand washing with soap and water x 20 seconds.

Avoid touching your face at all costs. 

4) What do I do if I travelled out of province or outside of Canada in the last 14 days?

Returning travellers from outside of Canada (including the United States of America) should self-isolate for 14 days from the day of return.

• If they develop symptoms within 14 days, they should stay at home and avoid close contact with others, including others at home, until 24 hours after symptoms have resolved or 14 days after returning from travel, whichever is longer.
• people with mild symptoms DO NOT require testing.

5) How do I access medical care during this period?

Lakeshore Medical Group Physicians will continue to be available to patients. However, all elective appointments such as physicals will be postponed for at least 1 month. We will try to substitute all in-person visits for virtual visits (telephone calls or video conferencing when feasible). We will be delaying the ordering of any non-urgent tests and referrals for at least one month.

Please do not walk-in or come to the office if you are symptomatic or have travelled in the past 14 days as we are running very low on personal protective equipment like masks. Contact the office instead at 905-845-4551 for further directions. If it is after hours, please contact TELEHEALTH at +1 866-797-0000. If you need to see a physician after 5pm call 905-815-9177.

For any questions regarding symptoms, testing criteria, and when to stay home if you do have symptoms, please refer to FAQ 1, 2 & 3 prior to contacting the office.

6) What about the After Hours Clinic?

Please do not attend the After Hours Clinic for routine prescriptions and assessments and contact your regular physician as they may be able to assess you by a virtual visit.

If you are having respiratory symptoms, please refer to the comments above in FAQ 1, 2 & 3.

If you have had travel history in the past 14 days, please do not come to the After Hours Clinic and contact your regular physician.

7) Do I need a sick note for work if I have symptoms?

No. 

8) Where can I read more about COVID-19?

https://www.ontario.ca/page/2019-novel-coronavirus

https://www.halton.ca/For-Residents/Immunizations-Preventable-Disease/Diseases-Infections/New-Coronavirus

https://www.publichealthontario.ca/en/diseases-and-conditions/infectious-diseases/respiratory-diseases/novel-coronavirus

https://www.ontariofamilyphysicians.ca/tools-resources/timely-trending/novel-coronavirus-2019-ncov/ocfp-coronavirus-infographic-4-final.pdf

WE APPRECIATE YOUR COOPERATION DURING THIS TIME. 

– LAKESHORE MEDICAL GROUP PHYSICIANS