Recommended Immunization Schedules in Ontario

This document is for reference only. Please consult your physician.

Below are three Ontario Infant Immunization Schedules proposed by Dr. Ross Pennie, Professor of Pediatrics at McMaster University, that include the 3 new vaccines not included in the government-funded immunization program for infants in Ontario. The Halton Health Unit agrees with these options, and they all fit within the NACI guidelines on immunization of infants in Canada.

Before reading please note:

Menjugate: Meningococcus C conjugate vaccine, Merck. Recommended for all children and youth. Only one dose is required for people over one year of age at the time of the first dose.

Prevnar: 7-valen Pneumococcus conjugate vaccine, Wyeth Ayerst. Children 2 to 5 years of age should receive one dose of Prevnar (not necessary if already completed a Prevnar series as an infant). Because infants are at the greatest risk of pneumococcal meningitis, it is unwise to defer the first dose of Prevnar until after the second birthday.


> Table 1


The basic schedule


> Table 2


The deluxe schedule


> Table 3


The ultimate schedule


> Table 4


The schedule for infants already near or past their first birthday



Age 4 to 6 years:


1. Varivax (one dose only) if they have not ever had chicken pox or the vaccine
2. Booster of MMR
3. Booster of Quadracel
4. Menjugate one dose if they have not already had it
5. Prevnar not necessary for healthy children who have reached their fifth birthday. Between age 2 and 5 years, only one dose is needed.


Children between 6 and teenagerhood:


1. Varivax (two doses separated by 4 to 8 weeks) if they have not ever had chicken pox or the vaccine
2. Menjugate one dose if they have not already had it
3. Prevnar not necessary unless have sickle cell disease, asplenia, recurrent aspiration pneumonia, or tracheostomy


Teenagers and young adults:


1. Varivax (two dose separated by 4 to 8 weeks) if they have not ever had chicken pox or the vaccine
2. Menjugate one dose if they have not already had it
3. Adacel (Tetanus + diptheria + acellular pertussis) at age 14 to 17 yr [acellular pertussis a new addition]
4. Prevnar not necessary; may be considered if they have sickle cell disease or asplenia






























































Varivax: Chicken pox (varicella) vaccine, Merck. Recommended for children and adults who have had neither chicken pox disease nor Varivax vaccine. Two doses of Varivax are required if the first dose is given past the 13th birthday.

Adacel: Tetanus + Diptheria + Acellular pertussis vaccine, Aventis. Recommended for teenagers and perhaps adults, recognizing that pertussis is fairly common beyond infancy and can cause significant morbidity in children, teens, and adults/

Table 1:

Infants Beginning Series in Early Infancy

Age

Vaccine

2 months cPDT Polio + Act-HIB
4 months cPDT Polio + Act-HIB
6 months cPDT Polio + Act-HIB
Shortly after 1 year MMR
18 months cPDT Polio + Act-HIB
4-6 years cPDT Polio, MMR
14-16 years Td Polio


Table 2: The minimum that can now be considered acceptable.

This includes protection for most infants under one year of ages against invasive pneumococcal infection and is mindful of the total number of injections and the cost of the vaccines that are not government-funded. Protection against meningococcus C starts at age 12 mo. (Total of 6 visits, 11 shots, 6 doses of vaccines not paid for by government plan in Ontario.)

Age

Vaccine Administered

2 months Pentacel + Prevnar
4 months Pentacel + Prevnar
6 months Pentacel + Prevnar
12 months Menjugate + Prevnar
13 or 14 months MMR + Varivax
18 months Pentacel
14-16 years Adacel

Babies getting Hepatitis B vaccine because their mother or father is a carrier would get Hepatitis B vaccine within the first week of life, then at age 1 mo. and 7 mo. (to avoid three shots at ages 6 mo.)



Table 3: The ultimate schedule, for families wishing to give the best protection for very young infants, using the maximum number of vaccine doses.

It includes protection for most infants under one year of age against invasive pneumococcal and meningococcus C infection. (Total of 8 visits, 12 shots, 7 doses of vaccines not paid for by government plan in Ontario.)

Age

Vaccine Administered

2 months Pentacel + Prevnar
4 months Pentacel + Prevnar
5 months Menjugate
6 months Pentacel + Prevnar
7 months Menjugate
12 months Prevnar
13 months MMR + Varivax
18 months Pentacel
14-16 years Adacel

Babies getting Hepatitis B vaccine because their mother or father is a carrier would get Hepatitis B vaccine within the first week of life, then at age 1 mo. and 7 mo. (to avoid three shots at ages 6 mo.)



Table 4: For infants and toddlers already near or past their first birthday at the time when the new vaccines are being considered.

This schedule leaves infants under one year of age vulnerable to invasive pneumococcal infection, and is therefore not the preferred option for very young infants. (Total of 7 visits, 9 shots, 4 doses of vaccines not paid for by government plan in Ontario.)

Age

Vaccine Administered

2 months Pentacel
4 months Pentacel
6 months Pentacel
12 months Menjugate + Prevnar
13 months MMR + Varivax
14 months Prevnar
14-16 years Adacel

Babies getting Hepatitis B vaccine because their mother or father is a carrier would get Hepatitis B vaccine within the first week of life, then at age 1 mo. and 7 mo. (to avoid three shots at ages 6 mo.)

Valid HTML 4.01 Transitional Valid CSS