Updated Guidance for Routine Immunization Services During COVID-19
Advisory Alert
June 8, 2022
*Cette information est seulement disponible en anglais.
To: Local Health System Partners
FOR IMMEDIATE ATTENTION
Updated program eligibility extensions for select publicly-funded vaccines
The Ministry of Health has recently updated their Guidance for Routine Immunization Services During COVID-19 (PDF) document. The document complements existing Ministry of Health guidance that can be found on the Ministry of Health COVID-19 website. Important changes related to vaccine program eligibility are highlighted below.
Please review the document in its entirety for information on COVID-19 requirements for screening of patients presenting to your office for services and on the infection prevention and control measures (masking, physical distancing, environment and equipment cleaning and disinfection and use of PPE, etc.) that must continue to be implemented within clinical environments to ensure the provision of safe care.
Immunization of individuals missing routine vaccines
As a result of COVID-19, some individuals may have missed opportunities to receive some publicly-funded vaccines that have age or grade-based eligibility. As such, extensions have been provided for impacted cohorts as noted in Tables 1 to 3 below. Please consider these extensions when assessing individuals for eligibility for routine publicly funded vaccines.
General principles
- If a vaccine dose has been delayed, the individual should be immunized at the earliest opportunity. In general, interruption of a vaccine series does not require restarting the series. Refer to the Timing of vaccine administration chapter of the Canadian Immunization Guide (CIG) for information on vaccines that may be impacted by delayed immunization schedules.
- Maximum protection is generally not attained until the complete vaccine series has been administered. For this reason, catch-up schedules (Ministry of Health, PDF) take into consideration the minimum interval between doses so that optimal protection can be achieved within the shortest amount of time while still being effective.
- In the absence of contraindications, all vaccines due or overdue should be administered, using the appropriate product and dose for age, in accordance with the Publicly Funded Immunization Schedules for Ontario (Ministry of Health, PDF) to provide protection as soon as possible and minimize the number of health care visits needed to complete vaccination.
Extension dates for select publicly-funded vaccines
Table 1: School program vaccines
| Vaccine | Current Eligibility | Impacted Cohort | Remains Eligible for Missed Doses Until |
|---|---|---|---|
| Hep B (Recombivax or Engerix) | Grades 7 to 8 | Grade 9 students in the 2020/21, 2021/22, and 2022/23 school years (Born in 2006a, 2007, or 2008) | Aug 31, 2023 (must complete series) |
| HPV-9 (Gardasil 9) | Grades 7 to 12 | Students who graduated in the 2019/20*, 2020/21*, and 2021/22 school years (Born in 2002, 2003, or 2004)b | Aug 31, 2023 (must complete series) |
| Men-C-ACYW135 (Nimenrix) | Grades 7 to 12 and those born in or after 1997 | N/A | Remains eligible until vaccine is received. |
Table 2: High-risk vaccines
| Vaccine | Current Eligibility | Impacted Cohort | Remains Eligible for Missed Doses Until |
|---|---|---|---|
| HPV-9c (Gardasil) | Males 9 to 26 years | Males born in 1993, 1994, 1995, and 1996 | Dec 31, 2023 |
| 4CMenBd (Bexsero) | 2 months to 17 years | Individuals born in 2002, 2003, 2004, and 2005 | Dec 31, 2023 |
| Men-C-ACYW135 (Menactra) (Nimenrix) | 9 months to 55 yearse | Individuals born in 1964f, 1965g, 1966h, and 1967 | Dec 31, 2023 |
*Females only as per publicly-funded program criteria. Males in grade 7 became eligible in 2016. These males were born in 2004.
a Individuals aged 16 years and older require a 3-dose Hep B immunization schedule as per the Canadian Immunization Guide.
b Individuals aged 15 years and older require a 3-dose HPV-9 immunization schedule as per the Canadian Immunization Guide.
c, d Age of the impacted cohorts falls within the Health Canada product monograph age indications for product use
e Ontario publicly funds a single lifetime dose of Men-C-ACYW135 for individuals ≥56 years of age who meet high risk eligibility criteria listed in Table 3: High Risk Vaccine Programs of the Publicly Funded Schedules for Ontario (2020).
f, g, h Under the program extension high risk individuals born in 1964, 1965, and 1966 are eligible for 2 doses of Men-C-ACYW135, since they would have been 55 years of age in 2020, 2021, and 2022, respectively. Administration of two doses in these cohorts aligns with National Advisory Committee on Immunization (NACI) recommendations based on expert opinion to as the product monographs limits age indication to 55 years of age.
Table 3: Adult vaccines
| Vaccine | Current Eligibility | Impacted Cohort | Remains Eligible for Missed Doses Until |
|---|---|---|---|
| HZ (Shingrix) | 65 to 70 years old | Seniors born in 1949, 1950, 1951, and 1952 | Dec 31, 2023 |
Vaccine ordering
Vaccines may be ordered through your usual ordering practices using the Vaccine Order Form (PDF) available on our website (www.phsd.ca).
For further information
Refer to the National Advisory Committee on Immunization for current recommendations on the concomitant administration of COVID-19 and other routine vaccines in children and adults.
Should you have questions regarding eligibility for publicly funded vaccines, to inquire about an immunization record, or for assistance in determining an appropriate catch-up schedule for a patient, please contact the immunization program at 1.705.522.9200, 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
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This item was last modified on June 9, 2022