Missed Opportunities for Vaccination: It is Time to Catch Up

Advisory Alert

June 17, 2021

*Cette information est seulement disponible en anglais.

To: Local Health Care Providers


Enhanced efforts are required to get patients caught up on their recommended vaccines

COVID-19 disrupted routine wellness visits for many infants, children, adolescents, adults, and seniors over the last year. As a result, there were many missed opportunities for vaccination and individuals may have fallen behind on receiving recommended vaccines. It is time to catch up!

This Advisory Alert outlines key information that can be used to enhance your office immunization practices to safely get patients vaccinated with recommended or required vaccines. Please continue to ensure that COVID-19 public health measures are implemented in your offices to ensure the safety of your patients and your staff.

For individuals of all ages

The Publicly Funded Immunization Schedules for Ontario was updated in January 2021. It is available at:  https://www.health.gov.on.ca/en/pro/programs/immunization/docs/Publicly_Funded_ImmunizationSchedule.pdf.

The updated schedule provides information on:

There are no significant changes to current immunization practices.

To ensure high rates of immunization within our community and to get eligible individuals caught up with recommended vaccines, please take every opportunity to provide all vaccines for which people are eligible (due and overdue for) during their appointments. If possible, identify individuals who have missed doses and contact them to schedule appointments. Please communicate directly to individuals and families the importance of vaccination and getting caught up on any recommended vaccines that were missed.

Given the impact of COVID-19 on public health programming, we are seeking your support in providing vaccinations to all your eligible patients, at every opportunity. While we have continued to offer vaccines throughout the pandemic, the scope of our programming has narrowed as have our opportunities to provide school-based vaccines. This is expected to continue over the coming months as individuals seek their second doses of COVID-19 vaccine and as eligibility for the vaccine expands. Please help us protect our community by doing what you can to get your patients caught up on recommended vaccines.  Below are some considerations for assessing vaccine needs of various cohorts that may present to you for immunization.

For infants

In the coming months RotaTeq® will be replaced by Rotarix®. This is a result of contract changes with the Ministry of Health. We will provide further information as it is received. Please consider completing vaccine series for all eligible infants who received one or more doses of RotaTeq® with this product, in accordance with appropriate intervals. The series must be completed ≤ 32 weeks of age.  Rotarix® vaccine is a two-dose series with first dose to be initiated between 6 weeks and before 15 weeks of age and completed by ≤32 weeks of age1 (24 weeks as per the product monograph). Guidance on those who are affected by product transition will be provided as details are known.

The Meningococcal Conjugate C (Men-C-C) [Menjugate Liquid®/NeisVac-C®] vaccine program is for children born on or after 2003/Sept/01 and greater than 1 year of age; and for those born between 1986 and 1996. This is not to be confused with the school program Men-C-ACYW vaccine requirement.

For children

Catch-up schedule 1 and 2 of the publicly funded schedule outline vaccination recommendations for children starting immunization between 1-6 and 7-17 years respectively.

For children requiring diphtheria, tetanus, pertussis and polio antigens, refer to Table 4 of the schedule for appropriate vaccine product for vaccination, Pediacel® or Adacel®-Polio/Boostrix®-Polio (DTaP-IPV-Hib or Tdap-IPV). Product choice is dependant on age of child at dose, number of previous doses received and intervals between doses.

Vaccines for infants and children are available through your usual ordering practices.

For adolescents

The eligibility for school program vaccines (Menactra®/Nimenrix®, Gardasil®9 and Recombivax HB®/Engerix®-B) were extended until August 31, 2021. Details previously shared with you can be found at: https://www.phsd.ca/professionals/health-professionals/advisory-alerts-health-care-professionals/updated-guidance-for-immunization-services-during-covid-19/

It is anticipated that eligibility will be further extended for these vaccines. Further information will be shared with you as it is received. These vaccines may be ordered for your eligible cohort of students using the special release processes outlined on our vaccine order form, found here: https://www.phsd.ca/professionals/health-professionals/immunizations-ordering. Please note: Menjugate®/NeisVac-C®(Men-C-C) are not substitutes for the Grade 7 Menactra®/Nimenrix® (Men-C-ACYW) vaccine. Menactra®/Nimenrix® vaccine is required for school attendance.

Adolescents requiring vaccination against diphtheria, pertussis, and tetanus should receive a single dose of Adacel® or Boostrix® vaccine (Tdap). This vaccine is available through your normal ordering practices.

For adults

Adults ≥ 18 years of age are eligible for a single dose of Adacel® or Boostrix® vaccine (Tdap), generally given 10 years after the adolescent dose. If the Tdap is required earlier, they are eligible to receive it regardless of the interval since last dose of tetanus-or-diphtheria-containing vaccine. Pregnant women are recommended to have Tdap with each pregnancy, however this is not currently publicly funded beyond the one-lifetime adult dose. Refer to the Canadian Immunization Guide for recommendations on timing of vaccination of pregnant women. Td is given to all adults every 10 years through the lifespan.

For seniors

Shingrix® eligibility has been extended until December 31, 2021 for 70-year olds who are turning 71 in 2020 or 2021. This is expected to also be further extended, with details to be shared with you as they are received. Please continue to identify and vaccinate eligible seniors for protection against Herpes Zoster infection. The vaccine is available through your normal ordering practices.

Reporting of vaccines administered

While not required, reporting of vaccines to public health ensures that vaccination assessments are completed using the most up-to-date information and reduces the need for requesting records from your office. Vaccines may be reported via our confidential fax line 705.677.9616. A reporting form is available on our website. It is the responsibility of the vaccinee or their parent/guardian for minor children, to report that vaccines to public health. Please encourage clients to report vaccines that will not otherwise be reported by your office.

Should you require an immunization record for a client presenting to you for immunization please call 705.522.9200, ext. 458 to speak with a staff member to obtain this information.

Should you have questions please contact the immunization program at 705.522.9200, ext. 458.


Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

NOTE: All Advisory Alerts are found on our website.

This item was last modified on June 21, 2021