Question

Response

A patient presented with an Adverse Event Following Immunization (AEFI) What is the reporting process?

Complete an AEFI form and fax it to York Region Community and Health Services at 905-895-6066 for follow up.

A parent is concerned about Pertussis in the Pediacel vaccine. Can we order a vaccine without Pertussis in it?

We currently do not have single antigen vaccines. Pediacel is produced as a 5 in 1 vaccine to promote optimal multi-antigen protection. Use this visit as an opportunity to provide education around the safety and efficacy of vaccines including the Pertussis component. Reassure the parent that current vaccine formulations are safe and effective. AEFIs are rarely observed.

A parent refuses to immunize their children. What is the process for exemption?

There are two types of exemptions for immunizations. One is an exemption for medical reasons and the other is for reason of conscience or religious belief. The form must be completed and submitted to York Region Community and Health Services to be kept on file. For more information, view Exemption Forms.

Can I order Menactra vaccine to have on-hand in my practice?

No. Menactra is publicly funded for grade seven students through the school program and is also indicated for individuals meeting high risk eligibility criteria. For more information, review Meningococcal High Risk Vaccine.

If a grade seven student missed their dose of Hepatitis B or Menactra, are they still eligible to receive a free dose?

Yes. If a student missed their grade seven dose, they can attend a Community Immunization Clinic to receive their immunization free of charge. For more information, visit Community Immunization Clinics.

How do I complete the immunization for a patient who has had a dose of Twinrix and/or monovalent Hepatitis A and/or Hepatitis B?

For a patient to be completely immunized for Hepatitis A and Hepatitis B, they require:

To discuss interchangeability options for these vaccines, please contact a Vaccine Preventable Disease (VPD) nurse to discuss each situation on a case-by-case basis. You may call 1-877-794-1880 and select option 9.

I have just administered an expired vaccine to my patient. How should I proceed?

Vaccine manufacturer's state: A vaccine that is given past its expiry date is not considered a valid dose. Repeat the immunization with vaccine that has not expired as soon as possible. If the expired dose is a live vaccine, wait at least four weeks to repeat the dose.

A patient requires several vaccines to catch up with their immunization schedule. What is the interval between vaccines?

It is safe to administer multiple vaccines at one visit using separate needles and syringes given in different sites. If you are administering two live vaccines they should be given on the same day. If you are unable to give them on the same day, wait at least four weeks to administer the second live vaccine.

An adult patient's serology shows positive immunity for measles but not for mumps. They have already received one dose of MMR. What is the recommendation?

A two dose series is recommended for measles, mumps and rubella - give the patient a booster of MMR. Serology should be done six weeks after immunization. Results often show a negative mumps titre when others are positive.

I have new patients who have emigrated from another country. It can be confusing to determine what immunizations they require in Ontario. Who can I contact to discuss updating their immunizations?

Contact a VPD nurse at 1-877-794-1880 option 9 to review your patients' immunization record and recommend what vaccination is required to bring them up to date.