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

Vaccine Order Request

To help slow the rate of the COVID-19 virus, some Regional services and facilities are temporarily affected. Brampton, Meadowvale, Malton and the Davis Centre are closed until further notice. For more information, please visit our website here.

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: The Vaccine Order Desk staff will be responding to inquiries via email at VMPIOrderRequests@peelregion.ca.

I have confirmed:





Order Information
(*) Mandatory fields
RMP_MS_

Date of Pick-up: Three 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 3 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
Pick one package size:
Menactra® (Men-C-ACYW)
For students in grade 8-12
(age 13 to 18 years)
:
5 doses
or

1 dose
Menjugate® / NeisVac-C® (Men-C)
For students in grade 6 and under
(age 11 and under):
10 doses
MMR® II / Priorix® & diluent (MMR)
For age 12 months and older:
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)
For less than age 2 years or
For adults age 50 years and older who meet high-risk criteria:
10 doses
Pneumococcal Immunization Decision Tool High Risk Patient
Priorix Tetra / ProQuad ® & diluent (MMRV): 10 doses
RotaTeq® (Rotarvirus): 10 doses
Td Adsorbed
(For age 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 todays 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: March 18, 2020

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