Health Professionals Update – Vol. 19, No. 24
From:
Dr. Nicholas Brandon, MD, MA, MSc, CCFP, FRCPC
Associate Medical Officer of Health
In this issue
Ontario meningococcal vaccine program updates
Key messages
- Ontario will transition to Men-C-ACYW vaccines (MenQuadfi, Nimenrix, Menveo) for the routine childhood immunization program.
- Continue administering existing Men-C-C vaccine inventory for eligible 12-month and catch-up doses until supplies are exhausted or expired.
- Publicly funded age groups for the high-risk Men-C-ACYW program have been revised to better align with authorized age indications of product monographs.
Ontario meningococcal vaccine program updates
Routine childhood immunization program
Men-C-C vaccines (NeisVac-C and Menjugate) will no longer be available in Canada. As a result, Ontario is transitioning to Men-C-ACYW vaccines (MenQuadfi, Nimenrix, MENVEO) for the routine meningococcal dose at 12 months of age.
While this change will provide broader protection against meningococcal serogroups A, C, Y, and W, it is not being driven by changes in disease epidemiology or an increased risk of meningococcal disease in Ontario.
To support responsible use of publicly funded vaccines and ensure a stable vaccine supply, health care providers should continue administering existing Men-C-C vaccine inventory for eligible 12-month and catch-up doses until supplies are exhausted or expired. Appropriate use of current inventory will help prevent vaccine wastage and reduce the risk of supply disruptions during the transition.
Peel Public Health expects its supply of Men-C-C vaccine to be depleted in September at which point only Men C-ACYW vaccine will be available for ordering through the Health Professionals Vaccine Ordering Portal.
Key points
- Continue administering available Men-C-C vaccine stock (NeisVac-C and Menjugate) for routine 12-month and catch-up doses until depleted or expired.
- Do not return Men-C-C vaccine prior to expiry.
- Transition to the use of Men-C-ACYW for those 12 months of age, or as required for catch-up, once your Men-C-C inventory is depleted.
- Children who previously received a Men-C-C vaccine at 12 months of age or older do not require revaccination.
- The publicly funded Grade 7 meningococcal immunization program will continue to provide a routine Men-C-ACYW vaccine dose.
High-risk Men-C-ACYW program
Effective immediately, the publicly funded age groups for the high-risk Men-C-ACYW program have been revised to better align with authorized age indications of product monographs. The updated National Advisory Committee on Immunization (NACI) guidance, published as a Rapid Response, offers enhanced clarity on vaccine schedules and product options for infants and children under 2 years of age.
High-risk eligibility criteria for publicly funded doses
- Acquired complement deficiencies (e.g., receiving eculizumab)
- Asplenia (functional or anatomic)
- Cochlear implant recipients (pre and post implant)
- Complement, properdin, factor D or primary antibody deficiencies
- HIV
- High-risk contacts – determined by Peel Public Health
- Outbreaks – determined by Peel Public Health
The table should be used in place of Table 15 in the Publicly Funded Immunization Schedules for Ontario for high-risk infants and children aged 6 weeks to 23 months.
Recommended Men-C-ACYW vaccine schedules for high-risk infants and children 2 years and younger
| Age at first dose | Recommended vaccine schedules by age | |
|---|---|---|
| Routine schedule | Schedule for individuals at high risk of IMD | |
| 6 weeks to 6 months | Not applicable | 2 doses + 1 booster dose at 12 to 23 months of age |
| 7 to 11 months | Not applicable | 1 dose + 1 booster dose at 12 to 23 months of age |
| 12 to 23 months | 1 dose | 1 dose (if previously immunized) 2 doses (if previously unimmunized) |
Recommended intervals are 8 weeks or more between doses, with a minimum of 4 weeks between doses if accelerated immunization is needed.
The dosing schedules for high-risk infants and children may differ from authorized product monographs. As per the Ministry Qs and As document, these recommendations reflect NACI guidance and may include off-label use. It is in a health care provider’s sole discretion whether to apply a dosing schedule off-label.
For additional information related to the meningococcal publicly funded immunization program please refer to the Qs and As for Health Care Providers: Meningococcal Vaccine Transition found at Vaccine resources for professionals | ontario.ca
To order meningococcal vaccines under the high-risk program, please fill out the meningococcal vaccine requisition form and fax to 905-565-9874.
Contact us
The Health Professionals Update (HPU) is distributed to physician offices in Peel region via email. Share this update with other health professionals in your clinic.
More information:
For questions about this update, email healthprofessionals@peelregion.ca.