Ages and Vaccines

Infants and Toddlers

A child’s immune system is not fully developed at birth. In the first year of life, an infant’s immune system develops. This makes an infant more vulnerable to communicable diseases. This is also why infants need many doses of vaccines in the first year of life, to prime the immune system and develop immunity. Vaccines protect infants and children when they are most vulnerable and work best when children are immunized on time. These strategies have significantly reduced infant mortality rates in Canada and across the world.Table 2.1 is an example of a routine government-funded vaccine schedule in early childhood.

 

Table 2.1: Routine Vaccines During Early Childhood in Ontario

Age Vaccine Vaccine-Preventable Illness
 

2 months

 

 

DTaP-IPV-Hib

 

Diphtheria, Tetanus, Pertussis, Polio, Haemophilus Influenzae type B (Hib)
 

Pneu-C-13

 

 

Pneumococcal

 

 

Rota

 

 

Rotavirus

 

 

4 months

 

 

DTaP-IPV-Hib

 

 

Diphtheria, Tetanus, Pertussis, Polio, Haemophilus Influenzae type B (Hib)

 

 

Pneu-C-13

 

 

Pneumococcal

 

 

Rota

 

 

Rotavirus

 

 

6 months

 

 

DTaP-IPV-Hib

 

 

Diphtheria, Tetanus, Pertussis, Polio, Haemophilus Influenzae type B (Hib)

 

 

Rota

 

 

Rotavirus

 

 

12 months

 

 

 

Men-C-C

 

 

Meningococcal Disease

 

 

MMR

 

Measles, Mumps, Rubella
 

Pneu-C-13

 

 

Pneumococcal

 

 

15 months

 

 

Var

 

 

Varicella (chickenpox)

 

 

18 months

 

 

DTaP-IPV-Hib

 

 

Diphtheria, Tetanus, Pertussis, Polio, Haemophilus Influenzae type B (Hib)

 

 

4-6 years

 

 

MMRV

Tdap-IPV

 

 

Measles, Mumps, Rubella, Varicella (chickenpox), Diphtheria, Tetanus, Pertussis, Polio

 

 

There is variation in how each province and territory approaches vaccine exemptions. In Ontario, for example, under the Ontario Child Care and Early Years Act (2014), children who attend child care centres are required to either be immunized against the diseases listed in Table 2.1 or have a valid exemption. A medical exemption form is completed by a legally qualified medical provider (i.e. physician or nurse practitioner). A parent who has a philosophical or religious objection may complete a different exemption form. In Ontario, exemptions are granted on the grounds that immunizations conflict with the sincerely held convictions of the parents’ religion or conscience or that a legally qualified medical provider gives medical reasons to the child care centre as to why the child should not be immunized (Ontario Child Care and Early Years Act, Reg. 137/15s).

School Age Children

By school entry, students should be up to date with most routine childhood vaccinations. Contagious diseases can spread quickly in a school setting, so it is important to ensure that school aged children are up to date with their immunizations. Table 2.2 is an example of a government-funded vaccine schedule for school-age children.

 

Table 2.2: Vaccine Schedule for School Age Children in Ontario

Age Vaccine Vaccine-Preventable Illness
 

4-6 years

 

 

MMRV

 

 

Measles, Mumps, Rubella, Varicella (chickenpox)

 

 

Tdap-IPV

 

 

Diphtheria, Tetanus, Pertussis, Polio

 

 

Grade 7

 

 

HB

 

 

Hepatitis B (2 or 3 doses)

 

 

HPV9

 

 

Human Papillomavirus (2 doses)

 

 

Men-C-ACYW-135

 

 

Meningococcal Disease

 

 

14-16 years

 

 

Tdap

 

 

Tetanus, Diphtheria, Pertussis

 

 

 

In Ontario, under the Immunization of School Pupils Act (1990), students who attend school are required to provide proof of immunization against the following diseases: diphtheria, tetanus, polio, measles, mumps, rubella, meningococcal disease, pertussis, varicella (children born 2010 or later) or have a valid exemption. Parents need to provide a record of their child’s immunization status to the local Public Health Unit. A medical exemption form is completed by a legally qualified medical provider. A parent who has a philosophical or religious objection must attend a mandatory education session and complete the standardized Ministry approved exemption form.

A list of the routine childhood vaccinations and what they protect against. There are 12 vaccinations listed on the diagram, arranged in 3 rows and 4 columns. Under each vaccination is the list of vaccine-preventable diseases that the vaccines protect against. In order from left to right: DTap-IPV-Hib, Tdap-IPV, Tdap, Rota, MMR, MMRV, VAR, HB or DTAp-HB or DTap-HB-IPV-Hib, M-C-C, Men-C-ACYW-135, Pneu, HPV9.
Image 2.4: Routine childhood vaccinations

Healthy Adults

Vaccinations are not just for children. Vaccines are safe and protect you and those around you from vaccine-preventable diseases. As we get older, the protection we had from previous vaccinations can decrease for some diseases. Getting another dose, known as a booster, can increase our immunity to provide the best protection. Some adults may have missed one or more of their vaccines when they were a child. They may need to catch up and get these vaccines now. There are also diseases that are more common in adults—even healthy adults—such as shingles. This is why additional vaccines are needed as we get older.

Many Canadian adults are not up to date with their vaccines. Healthcare providers can assess what is needed to be fully protected. The following table is an example based on the Ontario provincial immunization schedule. Table 2.3 is an example of recommended vaccines for health adults.

 

Table 2.3: Ontario Vaccine Schedule for Healthy Adults

Vaccine Vaccine-Preventable Illness Considerations
 

Td or Tdap

 

 

Tetanus, Diphtheria (pertussis)

 

 

  • Every 10 years (booster)
  • One dose Tdap as an adult

 

 

HZ

 

 

Herpes Zoster (shingles)

 

 

  • 65 years
  • One dose of a live-attenuated vaccine is publicly funded in Ontario (65-70 years of age).
  • The National Advisory Committee on Immunization (NACI) recommends recombinant subunit vaccine (2 doses) for people >50 years of age due to greater efficacy.

 

 

Inf

 

 

Influenza

 

 

Annually

 

 

Pneu-P-23

 

 

Pneumococcal

 

 

65 years

 

 

HA

 

 

Hepatitis A

 

 

Not publicly funded for healthy adults (2 doses)

 

 

HB

 

 

Hepatitis B

 

 

Not publicly funded for healthy adults (3 doses)

 

 

HPV9

 

 

Human Papillomavirus (HPV)

 

 

Not publicly funded for healthy adults (3 doses)

 

 

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Vaccine Practice for Health Professionals: 1st Canadian Edition by Oona St-Amant, Jennifer Lapum, Vinita Dubey, Karen Beckermann, Che-Sheu Huang, Carly Weeks, Kate Leslie, and Kim English is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, except where otherwise noted.

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