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Influenza, Rabies, STIs, TB, other
public health > health professionals > vaccine order request 2016

Vaccine Order Request

You must provide an email address for online orders so that we can send you a confirmation email for receipt of your order.

NEW THIS SEASON: To process your orders more efficiently, the Vaccine Order Desk staff will respond to inquiries via email or voicemail only. Please email any questions to VMPIOrderRequests@peelregion.ca.
We will respond within two business days.

I have confirmed:





Order Information
(*) Mandatory fields
RMP_MS_

Date of Pick-up: Five Business days after order is received.
(For exceptions, see Delivery or Pick-up Preference section)














Yes No

Ext.



* Delivery or Pick-up Preference
Orders must be submitted 5 business days prior to delivery

Please choose a pick-up location:






Type of Refrigerator

Please indicate the number of refrigerators approved for storage of vaccine:



* Please order no more than a ONE month supply of vaccines

Note: If you are not ordering the vaccine, Current Stock is not required.

Vaccines
For more information about vaccines, visit Ontario's Publicly Funded Immunization Schedules
Vaccine
must be ordered
in increments of:
Current Stock
(# of doses)
# of Doses
Required
Hib: 1 dose
Adacel® / Boostrix® (Tdap): 5 doses
Adacel® Polio / Boostrix® Polio (TdapIPV): 10 doses
IMOVAX® - Inactivated Polio (IPV): 1 dose
Menjugate® / NeisVac-C® (Men-C)
≥12 months of age (up to grade 6):
10 doses
Menactra® (Men-C-ACYW)
≥12 years of age (must be in grades 8-12)
*Only for students
that missed it in grade 7
:
5 doses
1 dose
MMR® II / Priorix® & diluent (MMR)
≥12 months (for school attendance):
10 doses
Pediacel® (DTaP-IPV Hib): 5 doses
Pneumovax® 23 (Pneu PS): 10 doses
Pneumococcal Immunization Decision Tool – High Risk Patient
Prevnar® 13 (Pneumococcal Conjugate)
< 2 years and /or
High Risk Adults > 50 years:
10 doses
Pneumococcal Immunization Decision Tool – High Risk Patient
Priorix Tetra ™ / ProQuad ® & diluent (MMRV): 10 doses
RotaTeq® (Rotarvirus): 10 doses
Td Adsorbed (for 7 years and over): 5 doses
Tubersol® - TB Mantoux: 10 doses
Varivax® III / Varilrix® & diluent(Varicella): 10 doses
Do you have a booked appointment for a clients between 65 - 70 years of age?
Yes    No
The maximum quantity is 10 doses. Administer to patients who are between 65 - 70 years of age only.
Zostavax® (HZV) 1 dose
Vaccine Related Supplies


Quantity:
Quantity:
Quantity:

* Thermometers are no longer available for order through the Region of Peel.
Click here to view a sample list of recommended products.

If you have been advised to submit your vaccine refrigerator temperature logs with your vaccine order, please note the following:

  • Submit your logs the same day as your order.
  • Send logs from the date of your last order to today’s date.
  • Orders missing temperature logs will not be processed.

Send by email or fax at:
ZZG-VMPIOrderRequests@peelregion.ca.
905-565-9874


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Revised: November 12, 2019

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