Increased eligibility for two publicly funded vaccines
Advisory Alert
May 5, 2022
*Cette information est seulement disponible en anglais.
To: Local Health System Partners
FOR IMMEDIATE ATTENTION
Important eligibility changes for Tdap and Hepatitis B vaccines
This Advisory Alert is to make you aware of the expansion of the eligibility criteria for Tdap vaccine for pregnant women and hepatitis B vaccine administered as part of the school-based vaccine program. Please consider the benefits of these two important vaccines in the context of providing routine care to your eligible patients.
Tdap in every pregnancy
Effective April 2022, Ontario has expanded its publicly funded Tdap (tetanus, diphtheria, pertussis) immunization program to include a routine dose in every pregnancy for protection against pertussis infection.
Due to high infection susceptibility infants who have not initiated vaccination or completed the primary series of pertussis immunization are at greatest risk for pertussis complications, including hospitalization and death. Immunization in pregnancy is safe and provides protection to infants until they can receive the pertussis vaccine at two months of age.
This change aligns with current evidence as reviewed by the National Advisory Committee on Immunization (NACI) that recommends one dose of pertussis vaccine in every pregnancy, ideally administered between 27 and 32 weeks gestation, and regardless of the interval from the last dose of pertussis-containing vaccine. Tdap may be provided from 13 weeks up to the time of delivery in view of programmatic and unique patient considerations. NACI offers further guidance on the timing of pertussis vaccine during pregnancy in its Advisory Committee Statement Update on immunization in pregnancy with Tdap vaccine – Canada.ca. If offered earlier than 13 weeks gestation, re-immunization is not required.
As part of routine care, please counsel your patients on the benefits of pertussis vaccine during pregnancy for the prevention of pertussis infection in newborn infants and provide routine Tdap vaccine during every pregnancy. A Tdap Fact Sheet (English and French) is included with this Advisory Alert for your use.
Hepatitis B school program expansion
Beginning in the 2022-23 school year the school-based Hepatitis B immunization program currently initiated in Grade 7 and completed in Grade 8, will have the eligibility period expanded until the end of Grade 12. The eligibility expansion will allow students who missed one or both doses of Hepatitis B vaccine in Grade 7 to be vaccinated under the publicly funded program until the end of Grade 12. Hepatitis B vaccine will continue to be offered routinely as a 2-dose series in Grade 7 as part of the school-based program.
Please be reminded that while eligibility for the school program has been expanded, the 2-dose vaccine series (given as 1 mL adult formulation) is for age 11 to 15 years only. Those initiating or completing immunization at age ≥ 16 years will be required to receive the 0.5 mL pediatric vaccine formulation for any doses received on or after age 16. Refer to the table below for further information on dosing and intervals by age. Please encourage those receiving doses to report their vaccines to Public Health Sudbury & Districts.
| Age | Vaccine | mL | Complete seriesa | Interval |
|---|---|---|---|---|
| Routine – No doses received | ||||
| 11 to < 16 years | Hepatitis B (adult) | 1.0 | 2 doses | Dose 1: 0 Dose 2: 4 to 6 months after 1st doseb |
| 16 to < 19 years | Hepatitis B (paediatric) | 0.5 | 3 doses | Dose 1: 0 Dose 2: 1 month after 1st dose Dose 3: 5 months after 2nd dose |
| Catch-up – one dose (hepatitis B 1.0 mL) received 11 to <16 years AND is now 16 years of age or older | ||||
| 16 to < 19 years | Hepatitis B (paediatric) | 0.5 | 2 doses | Dose 2: 1 month after 1st dose Dose 3: 5 months after 2nd dose |
| a All doses need to be administered by the end of Grade 12. b Depending on vaccine used for first dose, see Table 6 in the Publicly Funded Schedules for Ontario |
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Vaccine ordering
Tdap and Hepatitis B vaccines are available to order through your usual ordering practices. The vaccine order form is available on our website at phsd.ca.
For further information please contact the Vaccine Preventable Disease Program at 705.522.9200, ext. 458 or toll-free at 1.866.522.9200.
Sincerely,
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 May 5, 2022