Recommended immunization schedules: Canadian Immunization Guide

For health professionals

Notice

This chapter has not yet been updated with the following statement from the National Advisory Committee on Immunization (NACI):


This CIG chapter has not been updated to contain any information regarding COVID-19 vaccines, refer to the COVID-19 vaccine chapter.

Last partial content update (see Table of Updates): July 2023

Clarifications were made to Table 5 to better align with information provided in Part 4 chapters.

Last complete chapter revision: December 2013

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General recommendations

Administration of vaccines in accordance with the immunization schedules summarized in the following tables will provide optimal protection from vaccine preventable diseases for most individuals. However, modifications of the recommended schedule may be necessary due to missed appointments or illness. In general, interruption of an immunization series does not require restarting the vaccine series, regardless of the interval between doses. Individuals with interrupted immunization schedules should be vaccinated to complete the appropriate schedule for their current age. Refer to Timing of vaccine administration in Part 1 and vaccine-specific chapters in Part 4 for additional information.

Similar, but not identical, vaccines may be available from different manufacturers; therefore, it is useful to review the relevant vaccine-specific chapters in the Canadian Immunization Guide as well as the manufacturer's product leaflet or product monograph before administering a vaccine. Refer to Principles of vaccine interchangeability in Part 1 for information about the interchangeability of similar vaccines from different manufacturers. Product monographs are periodically updated; it is a best practice to consult the information contained within the product monographs available through Health Canada's Drug Product Database.

Table 1: Routine childhood immunization schedule, infants and children (birth to 17 years of age)

Table 1: Routine childhood immunization schedule, infants and children (birth to 17 years of age)
VaccineFootnote * Age
Birth 2 mos 4 mos 6 mos 12 mos 15 mos 18 mos 23 mos 2 years 4 years 5 years 6 years 9 years 12 years 14 years 15 years 16 years 17 years
DTaP-IPV-Hib
or
DTaP-HB-IPV-Hib
- Table 1 - Footnote A
or Table 1 - Footnote B
1st dose
Table 1 - Footnote A
or Table 1 - Footnote B
2nd dose
Table 1 - Footnote A
or Table 1 - Footnote B
3rd dose
Table 1 - Footnote A
or 4th dose
Generally at 18 months of age
- - - - - - - - - -
DTaP-IPV
or
Tdap-IPV
- - - - - - - - - Table 1 - Footnote C - - - - - -
Tdap - - - - - - - - - - - - - - Table 1 - Footnote D -
Rot - Table 1 - Footnote E
2 or 3 doses
Complete series before 8 months
- - - - - - - - - - - - - -
Pneu-C-13 - Table 1 - Footnote F Table 1 - Footnote F - - - - - - - - - - - -
Men-C-C - Table 1 - Footnote [G]
According to P/T schedule
Table 1 - Footnote G
Generally at 12 months
- - - - - - - -
Men-C-C
or
Men-C-ACYW
- - - - - - - - - - - - - Table 1 - Footnote H - - - -
MMR and Var - - - - Table 1 - Footnote I + Table 1 - Footnote J Table 1 - Footnote I + Table 1 - Footnote J - - - - - -
OR
MMRV - - - - Table 1 - Footnote K Table 1 - Footnote K
Generally at 4-6 years
- - - - - -
HB Table 1 - Footnote L
3 doses
- - - - - - - - - - - - -
OR
HB - - - - - - - - - - - - Table 1 - Footnote M
2 or 3 doses
HPV - - - - - - - - - - - - Table 1 - Footnote N
2 or 3 doses
- - -
OR
HPV - - - - - - - - - - - - - - - Table 1 - Footnote O
3 doses
Inf - - - Table 1 - Footnote P
1 or 2 doses
Recommended annually
Table 1 - Footnote P
1 dose
Recommended annually

Table 2: Recommended Immunization Schedule, Children (less than 7 years of age), NOT Previously Immunized as Infants

Table 2: Recommended immunization schedule, children (less than 7 years of age), not previously immunized as Infants
VaccineFootnote * First visit Time after first visit 6-12 mos
after last dose
4 weeks 8 weeks 3 mos 4 mos 6 mos
DTaP-IPV-Hib
or
DTaP-IPV
Footnote A - Footnote A - Footnote A - Footnote A Footnote [B]
Pneu-C-13 Footnote [C] - Footnote [C] - - - -
Men-C-C Footnote D - - - - - -
MMR Footnote E Footnote E - - - - -
Var Footnote F - - Footnote F - - -
OR
MMRV Footnote G - - Footnote G - - -
HB Footnote [H] Footnote [H] - - - Footnote [H] -
Inf Footnote I Footnote I - - - - -

Table 3: Recommended immunization schedule, children (7 to 17 years of age), not previously immunized

Table 3: Recommended immunization schedule, children (7 to 17 years of age), not previously immunized
VaccineTable 3 Footnote * First visit Time after first visit 6-12 mos after last dose 10 yrs after last dose
4 weeks 8 weeks 3 mos 6 mos
Tdap-IPV
Tdap
Table 3 Footnote A - Table 3 Footnote A   - Table 3 Footnote A Table 3 Footnote B
Men-C-C Table 3 Footnote [C]
7-11 years of age
- - - - - -
OR
Men-C-C
or
Men-C-ACYW
Table 3 Footnote D
12-17 years of age
- - - - - -
MMR Table 3 Footnote E Table 3 Footnote E - - - - -
Var Table 3 Footnote F - - Table 3 Footnote F - - -
OR
MMRV Table 3 Footnote G
7-12 years of age
- - Table 3 Footnote G - - -
HB Table 3 Footnote H Table 3 Footnote [H] - - Table 3 Footnote H - -
HPV Table 3 Footnote I
9-14 years of age
- - - Table 3 Footnote I - -
OR
HPV Table 3 Footnote I
9-14 years of age
3 doses
- -
OR
HPV Table 3 Footnote J
15-17 years of age
3 doses
- -
Inf Table 3 Footnote K
7-8 years of age
Table 3 Footnote K - - - - -
OR
Inf Table 3 Footnote K
9-17 years of age
- - - - - -
Table 3 - Footnote *

For abbreviations and brand names of vaccines refer to Contents of immunizing agents authorized for use in Canada in Part 1.

Return to Table 3 footnote * referrer

Table 3 - Footnote A

Tetanus toxoid- reduced diphtheria toxoid- reduced acellular pertussis- inactivated polio (Tdap-IPV): 2 doses, 8 weeks apart; third dose 6-12 months after second dose.

Return to first Table 3 footnote A referrer

Table 3 - Footnote B

Tetanus toxoid- reduced diphtheria toxoid- reduced acellular pertussis: 10 years after last dose of Tdap-IPV.

Return to Table 3 footnote B referrer

Table 3 - Footnote C

Meningococcal conjugate monovalent: 7-11 years of age - consider 1 dose.

Return to Table 3 footnote C referrer

Table 3 - Footnote D

Meningococcal conjugate monovalent or quadrivalent: 12-17 years of age - 1 dose, even if meningococcal conjugate vaccine received at a younger age. Vaccine chosen depends on local epidemiology and programmatic considerations.

Return to Table 3 footnote D referrer

Table 3 - Footnote E

Measles-mumps-rubella: 2 doses, at least 4 weeks apart.

Return to first Table 3 footnote E referrer

Table 3 - Footnote F

Varicella (chickenpox): 7-12 years of age - 2 doses, at least 3 months apart. 13 years of age and older - 2 doses, at least 6 weeks apart. A minimum interval of 4 weeks between doses may be used if rapid, complete protection is required.

Return to first Table 3 footnote F referrer

Table 3 - Footnote G

Measles-mumps-rubella-varicella: 7-12 years of age - 2 doses, at least 3 months apart. A minimum interval of 4 weeks between doses may be used if rapid, complete protection is required.

Return to first Table 3 footnote G referrer

Table 3 - Footnote H

Hepatitis B: 7-17 years of age - 3 doses, months 0, 1 and 6 (first dose = month 0) with at least 4 weeks between the first and second dose, 2 months between the second and third dose, and 4 months between the first and third dose. 11-15 years of age - two doses; schedule depends on the product used.

Return to first Table 3 footnote H referrer

Table 3 - Footnote I

Human papillomavirus (HPV): Girls, 9-14 years of age - HPV bivalent (HPV2) or HPV nonavalent (HPV9) - months 0 and 6-12 (first dose = month 0). Alternatively, a 3 dose schedule may be used for HPV2 vaccine - months 0, 1 and 6 (first dose = month 0) and for HPV nonavalent (HPV9) vaccine - months 0, 2 and 6 (first dose = month 0). Boys, 9-14 years of age HPV9 - months 0 and 6-12 (first dose = month 0). Alternatively, a 3 dose schedule may be used for HPV9 vaccine - months 0, 2 and 6 (first dose = month 0). For a 2 or 3 dose schedule, the minimum interval between first and last doses is 6 months.

Return to first Table 3 footnote I referrer

Table 3 - Footnote J

Human papillomavirus: Girls, 15-17 years of age: HPV2 vaccine - months 0, 1 and 6 (first dose = month 0) or HPV9 vaccine - months 0, 2 and 6 (first dose = month 0). Boys, 15-17 years of age: HPV9 vaccine - months 0, 2 and 6 (first dose = month 0). In individuals who received the first dose of an HPV vaccine between 9-14 years of age, a 2 dose schedule can be used with the second dose administered at least 6 months after the first dose.

Return to first Table 3 footnote J referrer

Table 3 - Footnote K

Influenza: children less than 9 years of age - 2 doses, at least 4 weeks apart. Children 9 years of age and older - 1 dose.

Return to Table 3 footnote K referrer

Table 4: Additional recommended immunizations, children (birth to 17 years of age), considered at risk due to underlying medical conditions

Table 4: Additional recommended immunizations, children (birth to 17 years of age), considered at risk due to underlying medical condition
VaccineFootnote * Age
Birth 2 mos 6 mos 12 mos 15 mos 18 mos 23 mos 2 years 3 years 5-8 yrs 9-17 yrs
Hib - - - - - - - - - Footnote A
1 dose
Pneu-P-23 - - - - - - - Footnote B
1 dose + 1 booster dose if at highest risk
Pneu-C-13 - - Footnote C - - - - - Footnote [C]
If not previously received
Men-C-ACYW - Footnote D
2, 3 or 4 doses + additional booster doses
-
4CMenB - Footnote E
2, 3 or 4 doses + additional booster doses
HA - - - Footnote F
2 doses
HB Footnote G
3 or 4 doses
Inf - - Footnote H
1 or 2 doses
Recommended annually
Footnote H
1 dose
Recommended annually

Table 5: Recommended immunization schedule, adults (18 years of age and older), not previously immunized

Table 5: Recommended immunization schedule, adults (18 years of age and older), not previously immunized
VaccineFootnote * First visit Time after First visit 6-12 mos after last dose 10 years after last dose
4 weeks 6 weeks 8 weeks 6 mos
Tdap-IPV
Tdap
Td
IPV
Footnote A - - Footnote A - Footnote A Footnote B
MMR Footnote C - - - - - -
Var Footnote D
18-49 years of age
- Footnote D - - - -
OR
RZV Footnote E
50 years of age and over
- - Footnote E - - -
Pneu-P-23 Footnote F - - - - - -
Men-C-C
or
Men-C-ACYW
Footnote G
18-24 years of age
- - - - - -
HPV Footnote H
3 doses
- -
Inf Footnote I
Annually

Table 6: Recommended immunizations, adults (18 years of age and older), previously immunized

Table 6: Recommended immunizations, adults (18 years of age and older), previously immunized
VaccineFootnote * Age
18-26 years 27-49 years 50-59 years 60 years 65 years and older
Td Footnote A
1 dose every 10 years
Tdap Footnote B
1 dose
Pneu-P-23 - - - - Footnote C
1 dose
RZV - - Footnote D
2 doses
Inf Footnote E
Annually

Table 7: Additional recommended immunizations, adults (18 years of age and older), considered at risk

Table 7: Additional recommended immunizations, adults (18 years of age and older), considered at risk
VaccineFootnote * Age
18 years of age and older
Hib Footnote A
1 dose
IPV Footnote B
1 booster dose
MMR Footnote C
Second dose
Pneu-C-13 Footnote D
1 dose
Pneu-P-23 Footnote E
1 dose + 1 booster dose if at highest risk
Men-C-ACYW Footnote F
2 doses + booster doses
4CMenB Footnote G
2 doses
HA Footnote H
2 doses
HB Footnote I
3 or 4 doses
OR
HAHB Footnote J
3 or 4 doses
Inf Footnote K
Annually
Typh-I Footnote L
1 dose + booster doses if at ongoing risk
OR
Typh-O Footnote L
4 doses + booster doses if at ongoing risk
Rab Footnote M
3 doses + booster doses if required
Var Footnote N
2 doses

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