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Fourth vaccine available to some people

So you’ve had your three COVID-19 vaccinations.  Now, if you meet a long list of health conditions from the Porcupine Health Unit, you can get your fourth jab.

Here are the criteria:

  • Individuals receiving dialysis (hemodialysis or peritoneal dialysis)
  • Individuals receiving active treatment (e.g., chemotherapy, targeted therapies, immunotherapy) for solid tumour or hematologic malignancies
  • Recipients of solid-organ transplant and taking immunosuppressive therapy
  • Recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Individuals with moderate to severe primary immunodeficiency (e.g.,DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Individuals with stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome
  • Individuals receiving active treatment with the following categories of immunosuppressive therapies: anti-B cell therapies2 (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids (refer to the Canadian Immunization Guide for suggested definition of high dose steroids), alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive (see list on

Individuals must provide a referral form: (from their treating provider) or present with a medication bottle for applicable medication in order to confirm eligibility. Eligible individuals can receive their fourth/booster dose once at least three months or 84 days have passed since getting their third dose. The best time to receive the booster should be discussed with their treating provider.

Either Moderna or Pfizer vaccines can be used as a booster dose (regardless of what vaccines have been received in the past). Note that there is a supply shortage of Pfizer vaccine in Ontario. We are following provincial direction and the ONLY vaccine available to adults aged 30 years and older is MODERNA. Adult Pfizer will be available for individuals aged 18-29. Eligible individuals are strongly encouraged to book an appointment for their booster. Walk-ins will only be accepted if there is time available. Appointments can be booked online at or by calling the health unit at 1-800-461-1818.

-Source: Porcupine Health Unit, January 17, 2022

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