Intimate partner violence & brain injury

Intimate partner violence (IPV) is physical, emotional, and verbal abuse by a significant other or intimate partner. IPV is a global public health issue, and it can happen to anyone.

According to the World Health Organization, one in three women will experience intimate partner violence in her lifetime. Most may also suffer one or more brain injuries as a result, since IPV often involves blows to the face, head, and neck.  Brain injury in IPV can also happen from a loss of oxygen to the brain caused by strangulation. Often times, these injuries result from repetitive episodes of IPV occurring over many months or years.

While there’s traditionally been a strong focus on sports-related concussion, brain injuries caused by intimate partner violence receive much less attention.

Statistics about intimate partner violence

  • In Canada, every two and a half days, a woman or girl is killed violently, usually by a male partner or family member [1], and each night, more than 6,000 women and children find refuge from gender-based violence in shelters [2]
  • 35-80% of women affected by IPV experience symptoms of traumatic brain injury [3]
  • Up to 92% of IPV incidents involve hits to the head and face, and strangulation [4]
  • Strangulation is one of the most dangerous forms of IPV, increasing the risk of death in following assaults [5]
  • Some victims can die weeks after being strangled because of the underlying brain damage, even if there is no visible injury [6]

Statistical information about intimate partner violence (IPV) as collected and reported by the Government of Canada.

An invisible and underreported issue

Intimate partner violence (IPV) tends to happen behind closed doors, and there may not be signs obvious to people outside the household. Brain injury is often just as invisible, causing lifelong symptoms and challenges, but with no outward signs of disability. Clinicians may also not ask about intimate partner violence in their practice.

IPV is also extremely underreported. This happens for a variety of reasons, including:

  • Shame and stigma associated with IPV;
  • Fear of not being believed;
  • Desire to keep the family together, and;
  • A lack of recognition as to what constitutes abuse, causing victims to think it’s normal

Many women who have experienced a brain injury from IPV aren’t even aware that the challenges they face are related to a brain injury, which makes it much harder to receive a diagnosis or timely treatment. Also, research in Canada and elsewhere has shown that front line service providers lack knowledge and training/awareness about brain injury [7]. It’s a difficult, terrifying situation. Support from friends, family, and local resources can make all the difference, although in some cases, women may lack family support..

Effects of intimate partner violence (IPV) and brain injury

Intimate partner violence (IPV) and brain injury can each cause significant, long-term challenges, but when someone experiences both, the effects may intensify, and become more complex.

IPV is linked to lasting psychological trauma. Emotional disturbances such as complex post-traumatic stress disorder (PTSD), anxiety, and depression are common.

Brain injury survivors can suffer some of the same issues, along with a range of cognitive, physical and behavioural changes.

Effects of brain injury can include:

  • Difficulty communicating
  • Memory problems
  • Reduced judgement and problem-solving skills
  • Shortened attention span and inability to concentrate
  • Inability to initiate tasks or activities
  • Headaches
  • Fatigue

This is a small example of the kinds of effects people with brain injury can experience. And it can further be compounded by the cause of the brain injury (or injuries). In a study of female veterans, results found that women with persistent IPV-related TBI symptoms were nearly 6 times more likely to have probable PTSD compared those with no IPV-related TBI history [8].

Both brain injury and IPV can have an impact on activities of daily living (ADLs), parenting, and court appointments/proceedings. This can be discouraging and scary, particularly for women who are single parents or engaged in custody negotiations. The more survivors; family members and friends; health care workers; and other service providers (such as lawyers and social workers) understand the effects of brain injury, the more appropriate support can be provided.

Unfortunately, survivors of IPV and care providers commonly mistake brain injury symptoms for the emotional distress brought on by the abuse [9]. That’s why research and educational resources on brain injury and IPV are so important.

Increased risk of intimate partner violence (IPV) towards people with disabilities

Overall, women and men with disabilities have a higher risk of abuse, including from intimate partners.

According to Statistics Canada, “Canadians with a disability were more likely to be victimized in their own home, as close to 30% of violent incidents against a person with a disability occurred in their private residence.” [10]

The study dives deeper, indicating that 23% of women with a disability “experienced emotional, financial, physical or sexual violence or abuse committed by a current or former partner” in a 5-year period. This is 2 times higher than the rates of those without a disability. Women with disabilities were also more likely to experience physical violence leading to injury [11].

For individuals who have a disability (brain injury or otherwise), the increased risk of physical violence can lead to further or new injury. This could lead to an even higher risk of violence – and the cycle goes on.

This is yet another indicator that supports for women with brain injury and experiencing IPV are essential.

Assessment by a physician

If you, or someone you know, have been hit on the head, face, or neck, or have been choked or strangled, it is important to access medical care as soon as possible, and request that health care providers look for indications of brain injury. If you are not able to see a medical professional, speak to a social worker, support worker at a shelter or a brain injury support worker.

The earlier a brain injury is diagnosed, the earlier a treatment plan can be put in place. When you do meet with a doctor, it’s important to tell them if you have ever been struck on the head or neck.

Signs of a recent or more serious injury include:

  • Loss of consciousness
  • Neck pain
  • Seizure
  • Vision changes
  • Weakness or feelings of tingling or burning in the arms or legs [12]

Additional signs of brain injury may include, but are not limited to:

  • Balance problems
  • Headaches
  • Emotional lability
  • Fatigue
  • Memory issues
  • Sleep disturbances
  • Trouble speaking

Treatment of brain injury

Treatment for brain injury and its effects can be challenging not only because it is often misdiagnosed, but individuals who are in temporary shelters or transitional housing may not be able to access the supports and services they need for effective rehabilitation. Rehabilitation is a long-term process that involves regular appointments with various therapists and checkups with physicians.

It’s important for the person’s health and wellbeing that they access appropriate supports and services available to help them with their brain injury recovery. A good place to start is at your local brain injury association.

Support for survivors


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Dystonia is a movement disorder that causes the muscles to contract and spasm involuntarily. The neurological mechanism that makes muscles relax when they are not in use does not function properly. Opposing muscles often contract simultaneously as if they are “competing” for control of a body part. The involuntary muscle contractions force the body into repetitive and often twisting movements as well as awkward, irregular postures.

There are approximately 13 forms of dystonia, and dozens of diseases and conditions include dystonia as a major symptom.

Dystonia may affect a single area of the body or be present throughout multiple muscle groups. Dystonia affects men, women, and children of all ages and backgrounds.

Secondary dystonias are caused by diseases and traumas. Secondary dystonias are much more prevalent than the primary forms (where dystonia is the root health concern). When the dozens of diseases that can cause dystonia such as Parkinson’s, Huntington’s and Multiple Sclerosis are considered, the number of dystonia cases can be propelled into the millions.

Dystonia causes varying degrees of disability and pain, from mild to severe. There is presently no cure, but multiple treatment options exist and scientists around the world are actively researching new therapies.

Dystonia is a chronic disorder, but most dystonia cases do not impact cognition, intelligence, or shorten a person’s life span. The main exception to this is dystonia that occurs as a symptom of another disease or condition that already exists.

Causes of dystonia

Categorizing dystonia by the cause is not a simple task and can easily get complicated because scientists have not yet identified the precise biochemical process in the body that triggers the symptoms. This is often referred to as the “mechanism” of dystonia, and it is suspected that this mechanism is common to all forms of dystonia.

On the other hand, we do know that dystonia can occur as a result of trauma, certain medications, and mutated genes. So, we may say that the mutated DYT1 gene or physical trauma cause dystonia, but these explanations do not address the true origin of the dystonia and what happens inside the body to produce the symptoms.

When describing dystonia by the cause, it may be characterized as primary, secondary, or dystonia-plus.

Diagnosing dystonia

Currently there is no single test to confirm the diagnosis of dystonia. Instead, the diagnosis depends on a physician’s ability to observe symptoms of dystonia and obtain a thorough patient history. Doctors must be able to recognize the physical signs and be familiar with the symptoms. In certain instances, tests may be ordered to rule out other conditions or disorders. The kind of physician who is typically in the best position to diagnose dystonia is a movement disorder neurologist.

The dystonia diagnostic process may include:

  • Patient history
  • Family history
  • Laboratory studies such as blood and urine tests, and analysis of cerebrospinal fluid
  • Electrical recording techniques, such as electromyography (EMG) or electroencephalography (EEG)
  • Genetic testing for specific forms of dystonia
  • Other tests and screenings intended to rule out other conditions or disorders

Dystonia prognosis

Dystonia does not define who you are. People with all forms of dystonia have been able to pursue education, work, remain independent and active, form romantic relationships, build families, and live full lives. Individuals may have to adjust activities and lifestyle to incorporate dystonia, but it must be stressed that having this disorder does not define who you are.

Dystonia includes a wide variety of symptoms and characteristics, and each person with dystonia is unique. At this time, there is no way to predict the prognosis of the disorder. Most cases of primary dystonia (both generalized and focal forms) will usually stabilize within five years of onset. Even when stabilized, symptoms may fluctuate. For example, stressful situations may make symptoms temporarily worse. Currently, no medication or therapy can prevent progression from happening. Prompt diagnosis and treatment can often minimize the impact of symptoms and improve or maintain a person’s ability to function in everyday activities.

Dystonia treatments

Although there is presently no cure for dystonia, multiple treatment options are available. Because every person with dystonia is unique, treatment must be highly customized to the individual. No single strategy will be appropriate for every case.

The treatment options for dystonia generally consists of several approaches:

  • Non-drug therapies
  • Oral medications
  • Physical therapy
  • Voice/speech therapy
  • Botulinum toxin injections
  • Surgery
  • Complementary therapies

The information for this page was written and provided by the Dystonia Medical Research Foundation.

Exercise after brain injury

Many people may be nervous to try exercising after brain injury in case they make their symptoms worse. But when you start slowly, complete your exercises safely and listen to your body, it can have a lot of benefits for your brain health. This is the reason many health professionals make recommendations for physical activity as part of a brain injury recovery plan.

Please note: You should always consult with your doctor or primary care physician about what exercises are appropriate for you. Not all exercises or exercise programs will be safe or effective for you.

The benefits of exercise after brain injury

Improved mood

Regular exercise that increases the heart rate can cause the release of serotonin and dopamine, which help alleviate feelings of depression [1]. Endorphins from exercises are also associated with improved mood [2].This means that exercise can actually help make you feel happier.

Support for brain healing & function

Studies into the effects of exercise on brain injury survivors have shown that individuals with traumatic brain injury (TBI) who exercised, had fewer cognitive, physical, and emotional symptoms [3]. Additional reviews of existing studies demonstrated that physical exercise also has a positive effect on cognitive functioning [4,5]. This includes thought processing and memory. According to research [6], the physiological factors of exercise that contribute to improvements in cognition include:

  • Increased blood flow to the brain
  • Changes in the brain involved in cognitive behaviour

Support for bodily health & well-being

The main purpose of exercise for the majority of people is to improve their physical health. Different types of exercises can strengthen the heart, lungs, and muscles. It’s an essential building block for a healthy lifestyle.

Exercise comes in many forms – you don’t have to be at the gym to be healthy, and you don’t have to exercise for hours at a time. The health benefits come from being consistently active in your day to day life to the best of your ability. Walking or stretching can be as beneficial as strenuous activities: it’s all dependent on what your body is able to do and what it needs.

The challenges of exercising after a brain injury

After a brain injury, you may face some challenges when it comes to exercise:

  • Changes in physical capacity and mobility
  • A lack of motivation, interest or energy
  • Symptoms such as fatigue and headaches that may impact your abilities
  • A lack of access to appropriate physical rehabilitation, exercise space or appropriate equipment
  • Not enough support

While these definitely are challenges, that does not mean it’s impossible for you to exercise and receive the benefits. It just means that you may have to get creative.

Physical rehabilitation

Physical rehabilitation (physiotherapy) is one of the most common therapies for people of all abilities. It can be helpful for people with brain injury who are experiencing challenges with mobility, strength, balance, and cardiovascular fitness. A physiotherapist will perform an assessment and work directly with you to develop a treatment plan based on your challenges and your goals. The treatment plan will largely consist of exercises or physical motions that will be modified to your needs so that you can replicate them at home. It may be recommended that you continue the exercises at home to the best of your ability either on your own or under someone else’s guidance.

There are both private and public physiotherapy practices, and you may be covered for some of the costs through your provincial/territorial insurance plan, a private insurance plan, or an auto insurance plan (depending on the cause of your injury and type of coverage).

Types of exercises

Aerobic exercise

Aerobic exercise can also be known as cardio: in other words, any type of exercise that strengthens the cardiovascular system (your heart and lungs) [7]. Types of aerobic exercises include walking, running, cycling, or swimming. Aerobic exercises are meant to increase your heart rate, and are done for longer periods of time on a consistent basis.

A 12-week study on the effects of aerobic exercise on depression symptoms in those with traumatic brain injury (TBI) found that participants had higher self-esteem, improved cardiovascular function, and fewer symptoms of depression [8].

Aerobic exercise is often connected to a healthier heart, but it has tremendous effects on body and brain health as well. Check with your doctor to make sure you understand what you are able to do safely for exercise. You may not be able to go for a run, but you could go for a walk.

If you need some extra support for your aerobic exercise, there are assistive mobility devices that may be helpful for you.

Strength & conditioning exercise

For individuals with muscle weakness, strength and conditioning exercises after brain injury can be incredibly beneficial. Types of exercises that can help with strength and conditioning include resistance training, which can include using body weight or using free weights.

The key to strength and endurance training is patience. You don’t want to push yourself too hard or too quickly. Working with a physiotherapist or occupational therapist on a recovery program can be beneficial and help you progress safely.

Range of motion exercise

Range of motion (ROM) exercises can also be called flexibility and mobility exercises. Depending on the physical effects of your injury, you may be experiencing problems with your muscles or joint tightness. The purpose of ROM exercises is to help increase muscle flexibility and joint mobility. With time and patience, these types of exercises can help you move more easily (such as lifting your arms or bending your legs).

Balance exercise

Many individuals struggle with balance after brain injury. Balance is the ability to keep yourself centered.  Specific exercises can help you work on your balance and make you feel steadier as you move through your day.

Remember – any exercise is a gradual process. You may be feeling good one day, and not as great the next. And that is totally normal – the important thing is to take it slow and not get discouraged.

See sources

How to talk about COVID-19 with friends & family

When it comes to COVID-19, we’re not always going to agree with the opinions of others. This is particularly true in the cases of masks, physical distancing, staying home, and the COVID-19 vaccine. In fact, you’ve probably already had some awkward or even hostile conversations on the subject. You may be uncomfortable or even feel unsafe around certain people due to their different views/standards for safety.

Here are some tips for communicating about COVID-19.

Speak respectfully

Recognize that many people are scared, frustrated, and/or tired of COVID-19. Even if you feel this way, it’s important to speak to others with respect. You may completely disagree with a friend or family member, but you shouldn’t call them names, belittle, or dismiss them. This will only create more angry feelings and arguments.

Helpful phrases you can use in conversation

Some examples of phrases you can use when discussing COVID-19 with others include:

  • “I’m following the recommendations of my local health authority.”
  • “It’s a frustrating situation, but I’m making the decision that I feel is best for me and/or my household.”
  • “I disagree with you, but I respect your opinion.”
  • “For the health and mental well-being of myself, I’ll be [say what action you will be taking here].”
  • “Since I’m [or someone in your household] at a higher risk for catching COVID-19, I would feel the most comfortable having a virtual call.”

If you are having trouble keeping the conversation respectful, the best course of action would be to change the subject (“With respect, I don’t feel that I can talk about this right now”) or remove yourself from the situation.

Don’t judge others

We are all trying to do the best we can. Yes, there will be some people who don’t treat the pandemic as seriously as you. There may also be people who treat it more seriously than you. You are fully entitled to disagree with someone, but judging them or criticizing them isn’t going to be helpful.

If you do want to talk to someone about their views on COVID, refer back to the first tip (speak respectfully). It may also help to have some information from the World Health Organization (WHO) and your local health authority to which you can refer.

If you are uncomfortable with another person’s views and safety measures and they are not respectful of your views, you may have to make the decision to not see or speak to them for a while. While this is challenging, you need to keep your own physical and mental health a priority.

Don’t dismiss the distress or frustration of others

We often want to try and make people feel better. While our intentions are good, saying things like “at least you’re better off than other people” or “everything will be okay”, or even “you’ll get through it” can actually make a person feel more upset. They may experience shame for feeling bad, or feel like they can’t express themselves without being told to “look on the bright side.” You may be experiencing the same things.

Instead, say phrases like, “I know this is hard, and I’m scared too.” Empathy is important, and many times in situations like these, people just want to feel seen/understood.

If you want to learn more, here is an article on this kind of interaction (called “dismissive positivity) from Psychology Today.

Suggest alternative ways to communicate

Many of us are missing people in our lives, and we’re not getting to see them in person anymore. It’s incredibly tough. While it’s not the same, there are alternate ways to stay in touch for now. This can include video calls, texting, email, phone calls, or even traditional letters.

COVID-19 vaccines & accessibility

The following presentation is about making an accessibility plan for COVID-19 vaccines in Canada. Navigate the presentation by click the arrows at the bottom of the slides. You can also make the presentation full screen by clicking the icon in the bottom right-hand corner.

You can also watch a narrated version of the presentation:

Frequently Asked Questions

Here are some of the most commonly asked questions about the COVID-19 vaccine in Canada.


How does COVID-19 affect individuals with brain injury?
Due to the ever-changing nature of the COVID-19 virus and the lack of peer-reviewed research on COVID-19 specific to those with brain injury, we cannot report how this virus affects individuals with existing acquired brain injuries. We follow the guidelines and recommendation provided by both the World Health Organization and the Public Health Agency of Canada. We encourage everyone who can to consider COVID-19 vaccination and continue to practice physical distancing, washing hands regularly, wearing masks, and following your local guidelines.

The COVID-19 vaccines

How do the vaccines work?
The vaccines provide the information your cells need to recognize and learn how to fight COVID-19.
What’s an mRNA vaccine?
An mRNA vaccine is a vaccine that includes compounds that help teach your cells how to recognize and fight COVID-19. Learn more about mRNA vaccines in this article.
Are the current COVID-19 vaccines effective against the variants?
Research shows that the current vaccines are effective against variants of COVID-19. This is because they include a broad range of antibodies that can identify components in the variants. Learn more on the World Health Organization website
How effective are the COVID-19 vaccines?
The first dose is 90% effective after 14 days. The second dose increases that effectiveness to 95%.
What does “% effectiveness” mean?
The protection vaccines provide is measured in percentages. This means that a vaccine with 80% effectiveness provides 80% protection against its disease.
How does Canada test the vaccines?
The COVID-19 vaccine was developed thanks to decades of research and development of vaccines. Health Canada has an independent drug authorization process that relies on medical and scientific evidence.

More information about Health Canada’s COVID-19 vaccine authorization process

What are the ingredients in COVID-19 vaccines?
Each COVID-19 vaccine has its own formula. You can find the ingredients for the three main COVID-19 vaccines available in Canada here.

What if I am allergic to ingredients in one or more of the COVID-19 vaccines?
If you are allergic to one or more ingredients in the COVID-19 vaccines, you should speak with a doctor about your options.

COVID-19 vaccination process

Who is eligible for a vaccine?
Canadians aged 12 and up are eligible for vaccines, though age ranges depend on the type of vaccine.
Is the vaccine safe for children, pregnant women, and people with other health conditions?
Children under the age of 12 are not currently able to get a COVID-19 vaccine. Pregnant women and individuals with other health conditions should consult with a doctor before getting the vaccine.
How does the vaccination process work?
A vaccine is administered in two doses over the course of several weeks. It is given through a needle in the arm, and is a relatively quick process. After the needle, there is a 15-20 minute waiting period where doctors can monitor for any side effects.
When can I get the vaccine?
As of July 2021, the majority of Canadians 12 years of age and older are eligible for the first dose of vaccine. The second dose is made available based upon the date of your first dose.
What does it cost to get vaccinated?
It is free for you to get a vaccine.
What are the benefits of getting vaccinated?
Vaccines for COVID-19 are protecting Canadians from serious COVID-19 illnesses, and allowing families to reunite, businesses to open up, and other activities to resume.
Can I get the vaccine if I’m sick with COVID-19?
You are not eligible to get the vaccine if you currently have COVID-19. The general recommendation is that the COVID-19 vaccine is safe for those who are not contagious.
If I have already had COVID-19 and recovered, do I still need the COVID-19 vaccine?
A person who has had COVID-19 should still get the COVID-19 vaccine. This is because researchers do not know how much protection antibodies left by the disease provide. The vaccine provides extra protection.
Can I choose which COVID-19 vaccine to get?
In most circumstances, you are not able to pick which vaccine you receive, as it depends on what doses are available at the clinics or pharmacy.

If you are allergic to one or more of the vaccines, you should speak with a doctor or your local health authority about finding an appropriate solution.

How long does the COVID-19 vaccine last?
We’re not yet sure how long protection from the COVID-19 vaccine will last. But vaccine experts are working hard to find an answer. What they do know is that the vaccine is effective, and will offer much higher protection against the disease.
Why do I need two doses of vaccine?
The mRNA vaccines Pfizer-BioNTech and Moderna, and the AstraZeneca vaccine are given in two doses in order to provide the highest level of protection.
Can I get a different vaccine for my second dose?
Yes, you can get a different vaccine for your second dose. Both Pfizer and Moderna are the same type of vaccine, and work well together to provide highly effective protection.

Second doses are typically determined based on the available supply of vaccines.

Can I get the COVID-19 vaccine if I’ve gotten a different kind of vaccine?
If you have had a vaccine for a different health condition within the 2 weeks before your appointment, you will not be able to get the vaccine. Check with a doctor if you aren’t sure of your eligibility.
Can I get COVID-19 from the vaccine?
You cannot get COVID-19 from the vaccine itself. According to experts from Vancouver Coastal Health, if you were exposed to the virus before you got either dose of the vaccine, you may be at risk of getting COVID-19. It also takes 2 weeks for each dose of the vaccine to come into full effect, which means that within those 2 weeks, you may still be at risk of getting sick.
Will COVID-19 vaccine interact with my medication or treatments?
The COVID-19 vaccine is safe for the majority of people taking medication or with medical conditions. However, health authorities are recommending that people who are pregnant; have an autoimmune condition; are taking medication that suppresses the immune system; or have a pre-existing health condition should consult with their doctor before getting the vaccine.
What are the side effects of COVID-19 vaccines?
Common side effects of the different kinds of COVID-19 vaccines include:

  • Pain at the injection site
  • Headaches
  • Fatigue
  • Muscle or joint pain
  • Fever or chills

These side effects are commonly short-term. For more information about COVID-19 vaccine symptoms, Ottawa Public Health has a helpful chart.

What do I do if I experience side effects?
If you have some common side effects, they commonly disappear after a few days, and require no medical treatment.

If you are experiencing any side effects or have any concerns, you should speak with a doctor.

For any emergency medical situations, you should call 911 or go to the emergency room.

Do I need to continue wearing a mask and physical distancing after my vaccine?
While the vaccine is highly effective, as the pandemic is still going on, it is recommended in many provinces and territories to continue physical distancing and wearing a mask.

For more specific information, check with your local or provincial/territorial health authority.

Can I travel when I have the vaccine?
Travel within Canada is allowed, but each province and territory has requirements for travelers. For example, this could include periods of self-isolation depending on your vaccine status.

International travel is also subject to restrictions.

Will I receive a vaccine/immunization record?
You will receive a record of your vaccination. Each province and territory has its own appointment booking system, and how you receive your record of vaccination will change.
Are there alternative formats for immunization records?
Immunization records are commonly provided digitally, with the ability for them to be printed.
I got my first dose in a different province/territory. How do I get my second dose?
Many provinces/territories are using out-of-province forms or web-based portals to help track immunization. Each province and territory has its own vaccine appointment booking system. As such, you will have to visit the booking site to find the specific process.
How do I decide if getting the vaccine is the right choice?
The decision to get a vaccine is an important one. The vaccine can help protect individuals and their families from the effects of COVID-19, prevent serious long-term effects from the illness, and enable Canada’s reopening. It also is making it possible for families and friends to reconnect in person.

While the decision may be easy for some, it is important to take your time and talk to health professionals if you have any questions.

Do I need a third dose of the vaccine?
Some provinces/territories are beginning to offer a third dose of eligible COVID-19 vaccines to select groups of people who are most at risk of serious illness. This is to offer as much protection as possible for those who may have immune system complications.

If you are not sure whether a third dose is appropriate for you, speak with your doctor.

What is a vaccine passport, and why are some provinces/territories considering them?
A vaccine passport is another term for a certificate or document that proves someone’s vaccination status. In the case of COVID-19, it would show the number of COVID-19 doses a person has. Canada is working on a national COVID-19 vaccine passport that Canadians can use for international travel – but it is up to each province and territory to decide if they are going to use vaccine passports for use within the province/territory.

COVID-19 vaccine appointments

Are the vaccine sites accessible?
Each vaccine clinic is different, and as such will meet different accessibility needs. If possible, ask about accessibility and identify your own needs when you make the appointment.

For more information about accessibility, consult with your health authority.

How do I help someone book their vaccine or provide consent if I am their caregiver?
In order to provide consent on behalf of someone else, you need to be legally recognized as their proxy. Some health authorities, such as Ottawa Public Health, have COVID-19 consent forms or allow caregivers to accompany the patient to their appointments. You will need to confirm with your own health authority on the process.
Am I allowed to go with someone to their appointment if they need support?
While this may be entirely dependent on individual clinics, in general people are allowed to bring someone to their appointment – or to ask for additional assistance. You should check with your clinic location to ensure this is allowed.
I’m not able to leave my home – can I still get the vaccine?
This depends on the capabilities of your local health authority immunization program. To find out if you are in an area that offers home vaccinations, visit the website or call your city or province’s health authority.
Can I bring a caregiver with me when I get vaccinated?
The policy for bringing someone with you to an appointment depends on each health authority. The majority of immunization plans include making sure that those who need a caregiver or extra assistance are able to have it at their appointments. To confirm that you are able to bring someone to your appointment at a clinic or pharmacy, check with your health authority.
What should I bring to my appointment?
You should bring confirmation of your appointment (this could be a code or a document), your health card or photo identification, and a mask.

It is recommended to wear short sleeves so it is easy for the vaccine to be administered. After your vaccine, there is a 15-minute waiting period so that you can be monitored. Some people like to bring a book or headphones to listen to music during this time.

Do the needles hurt?
With most needles, the person receiving the shot will feel a small pinch. If you have any questions about needles, these should be referred to a doctor.
What happens if I miss my vaccine appointment?
If you miss your vaccine appointment, you will need to reschedule it through your province or territory’s booking system.


National personal protective measures

Along with the COVID-19 immunization program, Canadian provinces and territories have protective measures in place. When these personal protective measures are followed correctly and used together, these measures can help keep yourself and others safe.

While the safety measures differ depending on where you live, here are the most common personal protective measures you can take to reduce your risk of contracting COVID-19.


To reduce the spread of COVID-19, Canada has put an immunization program in place to make COVID-19 vaccines free to anyone who chooses to receive them. These vaccines are administered through provincial/territorial programs, and help protect against COVID-19 and slow the spread of the virus.

Wear a mask

When your area has a mask mandate in effect, everyone who can must wear a face mask in public indoor settings or any place where physical distancing is a challenge. When interacting with members of your immediate household, you do not have to wear a mask unless you or a member of your household are in quarantine or isolation. The mask mandate may differ for specific people, situations, and areas. You can check with your local public health authority for specific mask rules in your area.
Wearing a face mask helps slow the spread of COVID-19 and can protect others around you. The virus can spread through respiratory droplets, which are droplets that are released when we talk, sneeze, cough, shout, and sing. When a person is infected with COVID-19, their respiratory droplets can infect other people if these droplets land on their mouths or noses, or if they are inhaled.

A mask acts as a barrier that can help stop respiratory droplets from spreading near other people. Masks work best when they are well-fitted and cover both your nose and mouth.

Wash your hands

Washing hands regularly helps stop the spread of COVID-19 and other germs. Germs can spread when you:

  • Touch your face with unwashed hands
  • Touch a contaminated surface or object with your hands
  • Blow your nose, cough, or sneeze into your hands
  • Prepare or eat food with unwashed hands

Adapted from the Centre for Disease Control hand-washing information

Washing your hands can help eliminate these germs, which helps reduce the risk of you and other people from getting sick.

To wash your hands:

  1. Wet hands with running water
  2. Apply soap
  3. While your hands are out of the water, rub them together to cover all surfaces of your hands (including palms, back of hands, under nails, between fingers) for at least 20 seconds
  4. Rinse your hands well with running water
  5. Dry hands using a clean towel
  6. Turn off the tap using a towel

Adapted from the Government of Canada’s Reduce the spread of COVID-19: Wash your hands infographic

If soap and water aren’t available, use an alcohol-based hand sanitizer to clean your hands. Rub the hand sanitizer all over the palms, backs and between the fingers on your hands until dry.

Social/physical distance

Please note: The terms social distancing and physical distancing have been used interchangeably during the COVID-19 pandemic, but we will be using physical distancing.

Physical distancing means keeping distance from one another and limiting activities outside of our households. Depending on the recommendations of your local public health authority, physical distancing may be maintaining at least a 1 or 2-metre distance (about 6 feet) between yourself and others.

The purpose of physical distancing is to prevent the spread of COVID-19 by limiting contact with people as much as possible. You don’t need to physically distance yourself from people in your immediate household unless they are in quarantine or isolation.

Clean and disinfect surfaces and objects

Although it is not certain that COVID-19 spreads through contact surfaces and objects, the Government of Canada recommends cleaning and disinfecting surfaces or objects people come in contact with frequently, which are the most likely to become contaminated with germs. For example, door handles or light switches. If there are traces of COVID-19 on these surfaces or objects, cleaning and disinfecting them can help deactivate the virus so it is no longer infectious.

Avoid non-essential travel outside of Canada

Travelling outside of Canada may put you at greater risk of getting COVID-19. Other countries may have lower vaccination rates or safety protocols that are different from those in your area, like no mask mandate. This could result in COVID-19 spreading more easily.

Additionally, travelling outside of Canada means that there is a higher chance you could come into contact with variants of COVID-19 that are not common in your area. These variants may be able to spread more easily or be more resistant to known vaccines. For these reasons, non-essential travel should be avoided.

When you are ready to travel, it is important to research the requirements for the area. This may include a check in form or proof of vaccination. As the world starts opening up again, these requirements may change.

Cover your mouth and nose when sneezing or coughing

When coughing or sneezing, ensure that you do it into a tissue or the bend of your arm rather than into your hand or into the air. When coughs and sneezes are covered properly, there is less of a chance for the germs coming in contact with someone else. If you do use a tissue, make sure you dispose of it as soon as you can in a waste container. Afterwards, ensure that you wash your hands or sanitize.

Keep fresh air circulating when you are indoors

An outdoor setting is always better when interacting with other people during the pandemic. If you are with others indoors,  it’s best to have good ventilation to reduce the spread of COVID-19. Good ventilation exchanges indoor air for outdoor air. If a room feels crowded, stuffy, or smelly, the room is not well-ventilated. To increase ventilation, you can open windows and doors, or if possible run a central air system such as an air conditioner or heat pump.

Information on COVID-19 safety & health protocols by province/territory

You can find information on safety protocols based on your province/territory from the list below.

How do vaccines work?

Vaccines are used in health care to help protect people from diseases. As Canada continues its immunization plan for COVID-19, you may have some questions about how vaccines work.

How vaccines fight against viruses

When the COVID-19 virus enters your body, it triggers your immune system. Your body’s immune system is a set of mechanisms that are designed to fight off invaders, like viruses. Often the sickness you feel is your body at work fighting off the disease. Once your body’s immune system has fought off a virus, it remembers that particular virus and knows how to find and destroy it before it causes the disease again. This is called immunity.

A vaccine protects against disease by helping your immune system create antigens – these are parts of organisms designed specifically to fight a virus/disease., helping the immune system prepare a good response before the actual disease is present.

The current COVID-19 vaccines fall into two types [1].

mRNA vaccines

mRNA vaccines provide instructions to your cells for how to make a coronavirus protein antigen. Once your cells have made the coronavirus protein, this protein will trigger a response from your immune system that will help to protect you against COVID-19.

Think of it like building a piece of furniture from a kit. The company provides you with the instructions and the materials you need to build the furniture. An mRNA vaccine works the same way.

Pfizer and Moderna brand COVID-19 vaccines are examples of mRNA vaccines. If you would like to see a visual representation of how an mRNA vaccine works, view this infographic from the University of Waterloo | School of Pharmacy.

You can also watch this Health Canada video on mRNA vaccines.

Viral vector vaccines

Viral vector vaccines supply ready-to-use antigens to produce coronavirus proteins in your body without causing disease. Just like mRNA vaccines, these antigens will trigger a response from your immune system.

Remember, antigens fight disease: pathogens carry the disease.

No matter what kind of vaccine you get, it gives you a much higher level of protection from life-threatening disease than having no vaccine.

Why do I need two doses?

The COVID-19 vaccine is administered in two doses, several weeks apart. By doing this, your cells can form a long memory. They’ll recognize and fight the COVID-19 pathogens for a long time [2].

Vaccines don’t just protect you – they protect your loved ones

The more people who get vaccinated, the harder it is for the COVID-19 disease to infect your community. Think of it like a protective wall – the disease can’t get through.

There are some people who unfortunately can’t get vaccinated because of health conditions or allergies. But your vaccination can protect them, because it means the disease most likely won’t be passed on by you.

And if everyone in that person’s life gets vaccinated, they have a much higher chance of not getting the disease.

More information on COVID-19 vaccines

We have more resources on COVID-19 vaccines, including how to access them and answers to frequently asked questions.

[1] How do vaccines work? | The World Health Organization
[2] How do vaccines work? | The World Health Organization

Booking a COVID-19 vaccination appointment

If you are ready to book a COVID-19 vaccine appointment (first or second dose), you will need to do so through your province or territory’s online booking system. Many of the systems have both online and phone booking options.

Who is eligible for a COVID-19 vaccine?

Most Canadians over the age of 12 are eligible for a vaccine, which are offered free of charge. If a person is allergic to any of the ingredients in a COVID-19 vaccine, displaying symptoms of COVID-19, or otherwise immuno-compromised, they should first speak with a doctor about the vaccines.

Booking an appointment by province/territory

Each province/territory has its own online booking system for people to register for first and second dose COVID-19 vaccine appointments. We have organized these online platforms by province/territory, and included any accessibility information that may be available.

If you have questions about a specific booking system, please use the province or territory’s contact information.


British Columbia


New Brunswick

Newfoundland and Labrador

Northwest Territories

Nova Scotia

In-home appointments are available. Find out more on their website.



Information is available in other languages.

Prince Edward Island




Refer all questions to your doctor

If you have any questions about the COVID-19 vaccine, speak with your doctor or another member of your medical team.

COVID-19 & COVID-19 vaccines

The coronavirus disease (COVID-19) has been something that the world has lived with since 2020. It has affected the health of millions of people, and unfortunately led to hundreds of thousands of deaths. It has also caused families and friends to be separated for long periods of times, disrupted local businesses, and created backlogs in the medical system. This has resulted in a loss of access to rehabilitation and support services for some people, including those in the brain injury community.

Canada has a COVID-19 immunization program in place to provide vaccines to anyone over the age of 12 who want them. Millions of doses have been administered, which has helped provinces and territories welcome visitors, expand business capacity, and aided the load on the medical system.

Understanding the COVID-19 disease and the vaccines is an important part of understanding how both impact daily life.

Effects of COVID-19

Symptoms of COVID-19 are varied, but there are a few that are more common [1]. These include:

  • Cough
  • Shortness of breath
  • Fever
  • Chills
  • Body aches
  • Fatigue
  • Loss of smell or taste
  • Headache
  • Stomach pain
  • Vomiting

While many people fully recover, there are a percentage of patients who experience the symptoms long-term. These symptoms can also negatively impact pre-existing health conditions.

In studies of patients with COVID-19, there have been several different long-term effects on organs as well [2], including:

  • Damage to the heart muscle
  • Damage to the lungs through an associated form or pneumonia
  • Neurological effects

COVID-19 is still a relatively new disease, and as such, a lot of the long-term effects are still unknown. That’s one of the reasons safety measures around the world were so extensive, and why many are still in effect.

The impact of COVID-19 on Canadians

COVID-19 has had more than health effects. Due to the nature of the disease and the safety measures in place, daily life has changed on a global scale. This includes:

  • Restrictions on the number of people in spaces
  • A shift to online services and appointments, leading to a reliance on digital devices and the Internet
  • Delay in medical procedures, appointments, and rehabilitation
  • Loss of income for local businesses, leading to economic uncertainty
  • Increased isolation
  • Increase in mental health challenges
  • Increase accessibility challenges (particularly online) that has created more barriers for the disability community

It will be years before the full health and societal impacts of COVID-19 are known. Many individuals will be coping with the results of their own pandemic experiences for a long time as well.

Information about the COVID-19 vaccine

While COVID-19 is still very much a part of daily life, the introduction of COVID-19 vaccines has made it possible for Canada to combat the disease and give people the opportunity to move back to in-person activities, seeing family and friends, and once again accessing supports and services that may have been unavailable at the height of the pandemic.

Health Canada has thoroughly tested and approved the COVID-19 vaccines that are currently in use in Canada. Only vaccines that have proven to be safe, effective and of high quality are authorized for use [3].

The COVID-19 vaccines in Canada do not contain any form of the COVID-19 disease, so can’t pass the disease onto you.

The vaccine is provided in two doses to give you the highest level of protection possible. The more people who have the vaccine, the more activities can be re-introduced.

What are the side effects of the COVID-19 vaccine?

As with any vaccine, there are some side effects. These can include [4]:

  • Fever
  • Fatigue
  • Headache
  • Pain at the injection site

These side effects are short-term, and are a natural response to vaccines.

What’s in the COVID-19 vaccine?

Since there are different COVID-19 vaccines, they may have different ingredients. The Government of Canada has the medical ingredients for each of the authorized vaccines listed on their website.

Some individuals have allergies to certain medical ingredients, and as such may not be able to get certain vaccinations. Always consult a doctor if you are uncertain or need a second opinion on the vaccines.

The vaccine is the strongest tool against COVID-19

The COVID-19 is making it possible for families to come together, rehabilitation services to start up again, and other aspects of daily living to resume. It’s helping protect members of the community against a devastating illness.

If you are looking for more information about vaccines, or have any questions about the vaccination process, reach out to your doctor or a member of your medical team.

More information on COVID-19 vaccines

See sources