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Dec 2020

COVID-19 Vaccines

Introduction

On December 9, 2020, Health Canada authorized the first COVID-19 vaccine for use in Canada.

This resource guides family physicians and primary care nurse practitioners through the latest information about vaccines in Ontario. It covers prioritization, availability and rollout, point-of-care guidance, details about the Pfizer-BioNTech and Moderna mRNA vaccines, and more. 

Additional information will be included as it becomes available.

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COVID-19: Vaccines

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About the tool

Update (December 23, 2020): Health Canada approved the Moderna COVID-19 Vaccine for use in Canada. We have updated the resource accordingly.

After a thorough and rigorous review of the evidence to ensure the vaccine meets the standards of safety, quality and efficacy for authorization in Canada, Health Canada authorized the first COVID-19 vaccine for use in Canada, the Pfizer-BioNTech mRNA vaccine.

This resource was developed to guide primary care providers through the latest information about COVID-19 vaccines in Ontario. It covers prioritization, availability and rollout, point-of-care guidance, details about the Pfizer-BioNTech and Moderna mRNA vaccines, patient questions about vaccines, and more. 

Due to the nature of the topic, updates will be added as new information emerges.

Key messages

  • Primary care providers can be confident. Standards of safety, efficacy and quality have not been compromised to expedite the approval of COVID-19 vaccines.
  • Health Canada oversight of COVID-19 vaccines will not stop at approval. Health Canada will monitor the vaccines' safety and effectiveness now and into the future.
  • Research into the value of mRNA for vaccinations has been progressing for over ten years. Though the new vaccines are the first mRNA vaccines approved for use in humans, mRNA has been successfully used in cancer treatments.

The COVID-19: Vaccines Resource is part of the COVID-19 Resource Centre. This resource was developed by the Centre for Effective Practice with support from the Ontario College of Family Physicians, Nurse Practitioners’ Association of Ontario, Association of Family Health Teams of Ontario, Ontario Medical Association, Registered Nurses’ Association of Ontario,  Ontario College of Pharmacists, Section of General and Family Physicians of Ontario, Department of Family Medicine at McMaster University and the School of Pharmacy at the University of Waterloo, using a rapidly-modified version of the CEP’s integrated knowledge translation approach. It is one of several clinical resources developed as part of the Knowledge Translation in Primary Care Initiative. Funded by the Ontario Ministry of Health, this initiative supports primary care providers with the development of a series of clinical tools and health information resources.

CEP's COVID-19 evidence inclusion/exclusion criteria

CEP’s standard inclusion criteria for evidence is Clinical Practice Guidelines (CPGs) and systematic reviews that pass an AGREE/AMSTAR quality assessment, published within the previous five years from search date. By their nature, systematic reviews are more likely to convey the strength of evidence than individual studies, and high-quality CPGs provide a more comprehensive picture of a clinical area or question than individual studies.

However, due to the rapidly developing COVID-19 information landscape and the incidence of individual studies being reported in the news and shared on social media on a daily basis, CEP will include certain single studies in our COVID-19 Resource Centre, in order to keep Ontario primary care physicians and nurse practitioners informed about the evolving evidence. Our dedication to providing the highest-quality evidence available has not changed but given the pace of research on COVID-19, it is not feasible for us to critically review individual studies. We have set the following inclusion/exclusion criteria to enable readers to understand what research will and will not be incorporated into the resource.

Inclusion

  • Peer-reviewed individual studies, when their inclusion will not confuse or mislead primary care providers about what constitutes validated, evidence-based care. Contextual information about study limitations will be provided for all Emerging Evidence sections.
  • Systematic reviews and rapid guidelines that pass AGREE/AMSTAR criteria.

Exclusion

  • Non-peer-reviewed studies. This includes preprints, original manuscripts, blogs of academic journals, and Letters to the Editor in many academic journals. Once preprint articles and manuscripts are peer-reviewed they will be eligible for inclusion.

For more information on the hierarchy of evidence and study limitations, see The Centre for Evidence-Based Medicine.

Clinical lead

  • Noah Ivers

    MD, CCFP, PHD - SCIENTIST AND EVALUATOR, WOMEN'S COLLEGE HOSPITAL

    Dr. Noah Ivers is a family physician at Women's College Hospital, scientist at Women’s College Research Institute, and innovation fellow at the Women's College Institute for Health System Solutions. He is also an Associate Professor in the Department of Family and Community Medicine and at the Institute for Health Policy, Management and Evaluation at the University of Toronto. He holds a Canada Research Chair in the Implementation of Evidence Based Practice. Noah's research focuses on the use of data to drive evidence-based, patient-centred improvements in healthcare. He has conducted multiple pragmatic randomized trials, systematic reviews, and qualitative work on health services and quality improvement interventions.

Clinical experts

Clinical expertise and input was provided by:

  • Alykhan Abdulla, MD, CCFP, FCFP, DIPSPORTMED, CTH, CCPE, MCPL, ICD.d
  • Cora Constantinescu, BSc, MD, FRCPC
  • Kelly Grindrod, BScPharm, PharmD, MSc
  • Nancy Lum-Wilson, R.Ph., B.Sc.Phm., MBA

Thank you

Thank you to everyone who supported the development of these resources!


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