Document is current

Article History

Received: 15 March 2025

Accepted: 26 January 2026

First Online: 6 February 2026

Declarations

:

: The use of the data in this project is authorized under section 45 of Ontario’s Personal Health Information Protection Act (PHIPA) and does not require review by a Research Ethics Board. The provincial government of Ontario provides a universal, publicly funded, single-payer health insurance system to residents. Under Ontario’s health information privacy law allows us to use the healthcare and demographic databases held at ICES without consent. This project’s. data access and use were authorized under section 45 of Ontario’s Personal Health Information Protection Act, which does not require Research Ethics Board approval.

: Not applicable.

: Public Health Ontario provided access to vaccination data from COVaxON, case-level data from the Public Health Case and Contact Management System (CCM), COVID-19 laboratory data, and assistance with data interpretation. The staff of Ontario’s public health units were responsible for COVID-19 case and contact management and data collection within the CCM. IQVIA Solutions Canada Inc. permitted the use of its Drug Information File. The CIRN provided networking support. We thank the Ontario residents, without whom this research would be impossible.

: The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources. No endorsement by ICES, the MOH, the MLTC, the OHDP, or their partners; the Province of Ontario; the CIHI; or OH is intended or should be inferred.

: The authors declare no competing interests.