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Health Professionals Update - January 24, 2025; Vol. 18, No. 2

From: 
Monica Hau, MD, MSc, CCFP, FRCPC 
Associate Medical Officer of Health

In this issue:

  • Immunization of School Pupils Act (ISPA): Orders of Suspension
  • School vaccination program
  • Update: Beyfortus® 50 mg doses available to order

Key messages:

  • Peel Public Health is sending Orders of Suspension to students in Kindergarten to Grade 2 who have not provided updated immunization records. 
  • Due to increased demand, maintain a one-month supply of routine childhood vaccines.
  • Primary care providers can order Beyfortus® 50 mg by email.

Immunization of School Pupils Act (ISPA) - Orders of Suspension

From January to April, Peel Public Health is sending Orders of Suspension to Kindergarten to Grade 2 students who have not submitted updated immunization records.

If a student has an Order of Suspension, follow these steps:

  1. Check the student’s immunization records:
    • If the vaccine(s) are already given, provide the parent/guardian with the vaccine date, product, and lot number.
    • If not, administer the vaccine(s).
  2. Remind parents to report the child’s immunizations online or by calling 905-799-7700 or 1-888-919-7800 (toll-free).

NOTE: Vaccines received outside Ontario are valid if there is written proof of vaccination at ages and intervals matching Ontario’s immunization schedule. Records must be in English or translated by the: health professional, patient, or patient’s relative.

ISPA vaccine indications for students in Junior Kindergarten to Grade 2

The antigens, minimum ages and dose spacing required under ISPA align with the Publicly Funded Immunization Schedules for Ontario. Information on recommended vs. minimum intervals starts on page 9.

Meningococcal Conjugate C
Students up to 11 years old require 1 dose of Men-C-C vaccine:

  • Routinely given on or after their 1st birthday.

MMR
Students require two doses of MMR vaccine:

  • 1st dose, routinely given on or after the 1st birthday.
  • 2nd dose, routinely given as MMRV at 4-6 years of age.

Varicella
Students born on or after January 1, 2010, require two doses of varicella vaccine:

  • 1st dose routinely given at 15 months.
  • 2nd dose routinely given as MMRV at 4-6 years of age.

Students with a history of varicella infection can:

  • Submit a medical exemption with documentation from a healthcare provider or serology results.
  • Receive two doses of the varicella vaccine.

Children who had varicella before 12 months require two doses of vaccine due to the higher risk of reinfection. Parents can contact 905-799-7700 or 1-888-919-7800 (toll free) for information on medical exemptions.

DTaP-IPV-Hib and Tdap-IPV
Students require 4 or 5 doses, depending on age and when doses were given:

  • Routinely given at 2,4,6 and 18 months (DTaP-IPV-Hib) and at 4-6 years (Tdap-IPV).

Reminder: Ensure the appropriate vaccine is administered towards series completion, especially for children under 7, who may need higher diphtheria and pertussis content to meet ISPA requirements.

Preparing for suspension notices - ordering routine childhood vaccines

Increased demand for routine childhood vaccines is expected until the end of the school year. Please maintain a one-month supply and place orders as needed.


School vaccination program

Vaccination efforts for Human Papillomavirus (HPV), Hepatitis B (HB), and Meningococcal (Men-C-ACYW) vaccines are ongoing for students in grades 7-8 in school and catch-up clinics available for grades 9-12. For more details, visit the School Vaccination Program website.

Primary care providers can order Men-C-ACYW for students in grades 7-12 who missed the vaccine. Men-C-ACYW vaccine is required for school attendance unless exempt.

HPV and HB vaccines may be ordered for students with special circumstances (e.g., previous adverse reactions, complex medical history, or students residing in surrounding jurisdictions).  Students should not pay out of pocket for publicly funded vaccines.

For HPV and HB vaccine special order requests, contact 905-799-7700 or 1-888-919-7800 (toll-free).

Update: Beyfortus® 50 mg doses available to order

Since November, all infants born during the 2024/25 RSV season in Peel hospitals have been offered Beyfortus® before discharge. Some infants under 5 kg, born at home or whose parents did not consent at birth may request it from their primary care provider.

To reduce waste and ensure availability of the 50 mg formulation for newborns, email vmpiorderrequests@peelregion.ca to request the Beyfortus® 50 mg formulation and include practice name, number of practitioners, and required doses.  The 100 mg formulation for eligible infants and young children over 5 kg can be ordered on the Health Professionals Portal.

Additional information related to Beyfortus® eligibility: Respiratory Syncytial Virus (RSV) prevention programs.

Contact us

The Health Professionals Update is distributed to physician offices in Peel region via fax or email. Share this update with other health professionals in your clinic. If you have any questions about this update contact us at healthprofessionals@peelregion.ca. To sign up for these updates or to switch from fax to email, complete this form.