Health Professionals Update - Vol. 18, No. 5

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

In this issue:

• RSV prevention program ordering reminders: Abrysvo and Beyfortus
• Meningococcal immunization: Hajj and Umrah requirements in Saudi Arabia
• Considerations for returning travelers with possible travel-related illness, including invasive meningococcal disease and reporting requirements

Key messages:

• RSV vaccine Abrysvo and Beyfortus are available to order.
• Proof of quadrivalent meningococcal vaccination is required for Hajj/Umrah entry to Saudi Arabia.
• Men-C-ACYW is not publicly funded in Ontario for travel purposes.
• Ensure that eligible patients are current with their routine immunizations prior to travel.
• When assessing a patient with a possible travel-related illness, including invasive meningococcal disease, consider both their symptoms and travel-related risk factors.
• Diseases of public health significance must be reported to Peel Public Health.

RSV prevention program ordering reminders: Abrysvo and Beyfortus

Peel Public Health has remaining supply of the RSV vaccine (Abrysvo) available. Health care providers can order the Abrysvo vaccine through the Health Professional’s Portal for eligible pregnant individuals and high-risk older adult patients.

Peel Public Health Beyfortus clinics have ended. To support administration to eligible infants, Beyfortus can be ordered for your clinic:

• For infants <5 kg: Request the Beyfortus 50 mg product by emailing vmpiorderrequests@peelregion.ca  Please include the practice name, number of practitioners, and required doses.
• For infants >5 kg: Order Beyfortus 100 mg product through the Health Professional’s Portal.

Please order as per the RSV prevention program eligibility criteria. If you have any questions, contact VMPIOrderRequests@peelregion.ca.

Meningococcal immunization: Hajj and Umrah requirements in Saudi Arabia

The annual Hajj pilgrimage to Mecca, Saudi Arabia, is among the largest mass gatherings in the world. This year, Hajj is expected to take place between June 4 to 9, 2025. Umrah is also a pilgrimage that can be undertaken at any time of the year and is likely to be more crowded during the month of Ramadan from February 28 to March 29, 2025. 

Quadrivalent meningococcal vaccination (Men-C-ACYW or Men-P-ACYW) is required for pilgrims to the Hajj or Umrah in Mecca. Hajj or Umrah visas cannot be issued without a valid proof of vaccination. Only Men-C-ACYW (Nimenrix, Menactra and Menveo) is currently distributed in Canada. Men-C-ACYW must have been administered within the last 5 years and at least 10 days prior to arrival.

Travel advice and advisories for Saudi Arabia, which includes vaccine entry requirements, is available on the Government of Canada website.

Men-C-ACYW eligibility

The following individuals are eligible for publicly funded Men-C-ACYW:

• Children in grades 7-12 who did not receive a dose as part of the school vaccination program.
• Adults born in or after 1997 who did not receive a dose as part of the school vaccination program. Primary care providers may order vaccine for eligible adults on the Health Professionals Portal.
• Individuals eligible under the high-risk meningococcal program.

NOTE: Men-C-ACYW is not publicly funded in Ontario for the purpose of travel.

Healthcare providers can use this opportunity to ensure that eligible patients are current with their routine immunizations (measles, mumps, rubella, tetanus, diphtheria, pertussis, polio and varicella) prior to travel as per the Publicly Funded Immunization Schedules for Ontario.

Considerations for returning travelers with possible travel-related illness, including invasive meningococcal disease and reporting requirements

Mass gatherings may increase the risk of transmission of various communicable diseases, such as invasive meningococcal disease, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), influenza, COVID-19 and measles.  When assessing a patient with a possible travel-related illness, approach the differential diagnosis by incorporating both the patient presentation and risk factors related to travel (e.g., destination, travel duration, and exposures). Details about the timing of illness, vaccinations, travel history, exposures, and any existing health conditions can help make a more accurate diagnosis.

Invasive meningococcal disease can develop 2 to 10 days after being infected with the bacteria (usually after 3 to 4 days). The two most common presentations are meningococcal meningitis and meningococcal sepsis or meningococcemia. More details can be found on the Public Health Agency of Canada (PHAC) website.

Additional information related to returning travelers can be found in the CDC Yellow Book.

Reporting requirements

Diseases of public health significance, including suspect or confirmed cases of invasive meningococcal disease, must be reported to Peel Public Health by phone at 905-799-7700, 1-888-919-7800 (toll-free) or send lab results by fax to 289-801-0257.

Contact us

The Health Professionals Update (HPU) is distributed to physician offices in Peel region via fax or email. Share this update with other health professionals in your clinic.  

More information: 

• Review past HPUs
• Subscribe to HPU emails 
• For questions about this update, email healthprofessionals@peelregion.ca