Recommended immunization schedules: Canadian Immunization Guide

For health professionals

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Last partial content update : April 2025

This chapter has been updated with guidance from the following statements from the National Advisory Committee on Immunization (NACI):

This information is captured in the table of updates.

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
Immunizing AgentTable 1 Footnote * 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
- DTaP-IPV-Hib Table 1 Footnote A
or DTaP-HB-IPV-Hib Table 1 Footnote B
1st dose
DTaP-IPV-Hib Table 1 Footnote A
or DTaP-HB-IPV-Hib Table 1 Footnote B
2nd dose
DTaP-IPV-Hib Table 1 Footnote A
or DTaP-HB-IPV-Hib Table 1 Footnote B
3rd dose
DTaP-IPV-Hib Table 1 Footnote A
or 4th dose
Generally at 18 months of age
- - - - - - - - - -
DTaP-IPV
or
Tdap-IPV
- - - - - - - - - DTaP-IPV
or
Tdap-IPV
- - - - - -
Tdap - - - - - - - - - - - - - - Tdap Table 1 Footnote C -
Rot - 2 or 3 doses
Complete series before 8 months Table 1 Footnote D
- - - - - - - - - - - - - -
Pneu-C-15 or Pneu-C-20 - Pneu-C-15 or Pneu-C-20Table 1 Footnote E Pneu-C-15 or Pneu-C-20Table 1 Footnote E - - - - - - - - - - - -
Men-C-C - Men-C-CTable 1 Footnote F
According to P/T schedule
Men-C-C Table 1 Footnote F
Generally at 12 months
- - - - - - - -
Men-C-C
or
Men-C-ACYW
- - - - - - - - - - - - - Men-C-C
or
Men-C-ACYWTable 1 Footnote G
- - - -
MMR and Var - - - - MMR Table 1 Footnote H + Var Table 1 Footnote I MMRTable 1 Footnote H + Var Table 1 Footnote I - - - - - -
OR
MMRV - - - - MMRVTable 1 Footnote J MMRV
Generally at 4-6 yearsTable 1 Footnote J
- - - - - -
HB HB
3 dosesTable 1 Footnote K
- - - - - - - - - - - - -
OR
HB - - - - - - - - - - - - HB
2 or 3 dosesTable 1 Footnote L
HPV - - - - - - - - - - - - HPV
1 doseTable 1 Footnote M
Inf - - - Inf
1 or 2 doses
Recommended annuallyTable 1 Footnote N
Inf
1 dose
Recommended annuallyTable 1 Footnote N
RSV Ab RSV mAbs
1 doseTable 1 Footnote O
- - - - - - - - - - - - - - -
Table 1 Footnote *

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

Table 1 Return to footnote * referrer

Table 1 Footnote A

Diphtheria toxoid- tetanus toxoid- acellular pertussis- inactivated polio- Haemophilus influenzae type b (DTaP-IPV-Hib). For infants and children beginning primary immunization at 7 months of age and older, the number of doses of Hib vaccine required varies by age.

Table 1 Return to footnote A referrer

Table 1 Footnote B

Diphtheria toxoid- tetanus toxoid- acellular pertussis- hepatitis B- inactivated polio- Haemophilus influenzae type b (DTaP-HB-IPV-Hib). Alternative schedules may be used: DTaP-HB-IPV-Hib at 2, 4 and 12-23 months of age with DTaP-IPV-Hib vaccine at 6 months of age; or DTaP-HB-IPV -Hib at 2, 4 and 6 months of age with DTaP-IPV-Hib vaccine at 12-23 months of age.

Table 1 Return to footnote B referrer

Table 1 Footnote C

Tetanus toxoid- reduced diphtheria toxoid- reduced acellular pertussis (Tdap): 10 years after last dose of DTaP- or Tdap-containing vaccine.

Table 1 Return to footnote C referrer

Table 1 Footnote D

Rotavirus (Rot-5): Rotavirus pentavalent vaccine - 3 doses, 4 to 10 weeks apart; Rotavirus monovalent vaccine - 2 doses, at least 4 weeks apart. Give the first dose starting at 6 weeks and before 15 weeks of age. Administer all doses before 8 months of age.

Table 1 Return to footnote D referrer

Table 1 Footnote E

Pneumococcal conjugate 15 or 20-valent (Pneu-C-15 or Pneu-C-20): infants without medical or environmental risk factors for invasive pneumococcal disease (IPD) beginning primary immunization at 2 to less than 7 months of age: 3 or 4 dose schedule. For a 3 dose schedule : 2, 4 months of age, followed by a booster dose at 12 to 15 months of age. For a 4 dose schedule: minimum of 8 weeks interval between doses beginning at 2 months of age, followed by a booster dose at 12 to 15 months of age. Infants without medical or environmental risk factors for IPD beginning primary immunization at 7 to less than 12 months of age: 2 doses, at least 8 weeks apart followed by a booster dose at 12 to 15 months of age, at least 8 weeks after the second dose.
Children without medical or environmental risk factors for IPD who have received age-appropriate pneumococcal vaccination with Pneu-C-13 vaccine do not need an additional dose of Pneu-C-15 or Pneu-C-20.

Table 1 Return to footnote E referrer

Table 1 Footnote F

Monovalent conjugate meningococcal(Men-C-C): children 12-48 months of age: 1 dose routinely provided at 12 months of age, regardless of any doses given during the first year of life. Immunization may be considered for unimmunized children 5-11 years of age.

Table 1 Return to footnote F referrer

Table 1 Footnote G

Monovalent conjugate meningococcal (Men-C-C) or quadrivalent conjugate meningococcal (Men-C-ACYW): early adolescence (around 12 years of age) - 1 dose, even if conjugate meningococcal vaccine received at a younger age. Vaccine chosen depends on local epidemiology and programmatic considerations.

Table 1 Return to footnote G referrer

Table 1 Footnote H

Measles-mumps-rubella (MMR): first dose at 12-15 months of age; second dose at 18 months of age or anytime thereafter, but should be given no later than around school entry.

Table 1 Return to footnote H referrer

Table 1 Footnote I

Varicella (chickenpox) (Var): first dose at 12-15 months of age; second dose at 18 months of age or anytime thereafter, but should be given no later than around school entry.

Table 1 Return to footnote I referrer

Table 1 Footnote J

Measles-mumps-rubella-varicella (MMRV): first dose at 12-15 months of age; second dose at 18 months of age or anytime thereafter, but should be given no later than around school entry.

Table 1 Return to footnote J referrer

Table 1 Footnote K

Hepatitis B (HB): months 0, 1 and 6 (first dose = month 0) with at least 4 weeks between the first and second dose, at least 2 months between the second and third dose, and at least 4 months between the first and third dose. Alternatively, can be administered as DTaP-HB-IPV-Hib vaccine, with first dose at 2 months of age.

Table 1 Return to footnote K referrer

Table 1 Footnote L

Hepatitis B (HB): 9-17 years of age - months 0, 1 and 6 (first dose = month 0) with at least 4 weeks between the first and second dose, at least 2 months between the second and third dose, and at least 4 months between the first and third dose. 11-15 years of age - 2 doses; schedule depends on the product used.

Table 1 Return to footnote L referrer

Table 1 Footnote M

Human papillomavirus (HPV): Individuals 9 to 17 years of age, unless immunocompromised, should receive one dose of HPV nonavalent (9vHPV) vaccine. A 2-dose schedule may be considered on an individual basis for individuals 9 to 17 years of age in discussion with their health care provider. For a 2-dose schedule, doses should be administered at least 24 weeks apart - months 0 and 6 (first dose = month 0).

Table 1 Return to footnote M referrer

Table 1 Footnote N

Influenza (Inf): recommended annually for anyone 6 months of age and older without contraindications. Children 6 months-less than 9 years of age, receiving influenza vaccine for the first time - 2 doses, at least 4 weeks apart. Children 6 months-8 years of age, previously immunized with influenza vaccine and children 9 years of age and older - 1 dose.

Table 1 Return to footnote N referrer

Table 1 Footnote O

Respiratory syncytial virus monoclonal antibodies (RSV Ab): Nirsevimab is recommended for neonates and infants, entering or during their first RSV season. Ideally, RSV Ab are administered just before the RSV season begins (typically fall through spring) or within the first weeks of life for those born during the RSV season.

Table 1 Return to footnote O referrer

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
DTaP-HB-IPV-HibFootnote C Footnote D - Footnote D - Footnote D - Footnote D
Pneu-C-15 or 20 Footnote E - Footnote E - - - -
Men-C-C Footnote F - - - - - -
MMR Footnote G Footnote G - - - - -
Var Footnote H - - Footnote H - - -
OR
MMRV Footnote I - - Footnote I - - -
HB Footnote I Footnote I - - - Footnote I -
Inf Footnote K Footnote K - - - - -

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
9-17 years of age
- - - - - -
Inf Table 3 Footnote J
7-8 years of age
Table 3 Footnote J - - - - -
OR
Inf Table 3 Footnote J
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 to 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 (Tdap): 10 years after last dose of Tdap-IPV.

Return to Table 3 footnote B referrer

Table 3 - Footnote C

Monovalent conjugate meningococcal (Men-C-C): 7 to 11 years of age - consider 1 dose.

Return to Table 3 footnote C referrer

Table 3 - Footnote D

Monovalent conjugate meningococcal (Men-C-C) or quadrivalent conjugate meningococcal (Men-C-ACYW): 12 to 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 (MMR): 2 doses, at least 4 weeks apart.

Return to first Table 3 footnote E referrer

Table 3 - Footnote F

Varicella (chickenpox) (Var): 7 to 12 years of age - 2 doses, at least 3 months apart. 13 years of age and older - 2 doses, 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 (MMRV): 7 to 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 (HB): 7 to 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 to 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): Individuals 9 to 17 years of age, unless immunocompromised, should receive one dose of HPV nonavalent (HPV9) vaccine. A 2-dose schedule may be considered on an individual basis for individuals 9 to 17 years of age in discussion with their health care provider. For a 2-dose schedule, doses should be administered at least 24 weeks apart - months 0 and 6 (first dose = month 0).

Return to first Table 3 footnote I referrer

Table 3 - Footnote J

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 first Table 3 footnote J 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
Immunizing AgentFootnote * 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-C-20 - 3 dosesFootnote B 1 doseFootnote B 1 doseFootnote B
If not previously received
Men-C-ACYW - Footnote C
2, 3 or 4 doses + additional booster doses
-
4CMenB - Footnote D
2, 3 or 4 doses + additional booster doses
OR
MenB-fHBP - - - - - - - - -

-

Footnote D
10-17 years of age
3 doses
HA - - - Footnote E
2 doses
HB Footnote F
3 or 4 doses
Inf - - Footnote G
1 or 2 doses
annually
Footnote G
1 dose
annually
RSV Ab Footnote H

First RSV season
1 dose
OR
4 to 5 doses

Footnote H

Second RSV season
1 dose
OR
4 to 5 doses

- - - - -

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 to 49 years of age
- Footnote D - - - -
OR
RZV Footnote E
50 years of age and older
- - Footnote E - - -
Pneu-C-20 65 years of age and older Footnote F - - - - - -
Men-C-C
or
Men-C-ACYW
Footnote G
18 to 24 years of age
- - - - - -
HPV Footnote H - -
Inf Footnote I
Annually
RSV Footnote J
75 years of age and older
- - - - - -

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-C-20 - - - - 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-20 Footnote D
1 dose
Men-C-ACYW Footnote E
2 doses + booster doses
4CMenB Footnote F
2 doses
OR
MenB-fHBP

Footnote F
3 doses

HA Footnote G
2 doses
HB Footnote H
3 or 4 doses
OR
HAHB Footnote I
3 or 4 doses
Inf Footnote J
Annually
SMV Footnote K
2 doses
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
RSV Footnote O
1 dose

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