What vaccines are mandatory for adults and children in Canada?
The vaccination system in Canada is based on a provincial-territorial model: the federal National Advisory Committee on Immunization (NACI) provides recommendations, but each province and territory independently determines schedules, funding, and requirements.
1. General principles
- No single federal law: Immunizations are regulated by provincial programs.
- NACI recommendations: The main guide for local programs.
- Free of charge: Routine vaccines are funded by the government in all provinces for target age groups.
2. Childhood immunization schedule (0–17 years)
| Age | Vaccines |
|---|---|
| Birth | Hepatitis B (in some provinces) |
| 2 months | DTaP-IPV-Hib or DTaP-HB-IPV-Hib, Pneumococcal, Meningococcal (C), Rotavirus |
| 4 months | DTaP-IPV-Hib or DTaP-HB-IPV-Hib, Pneumococcal, Rotavirus |
| 6 months | DTaP-IPV-Hib or DTaP-HB-IPV-Hib, Influenza (annually) |
| 12–15 months | MMR (measles/mumps/rubella), Varicella, Meningococcal |
| 18 months | DTaP-IPV-Hib (4th dose) |
| 4–6 years | DTaP-IPV or Tdap-IPV, MMR (2nd dose), Chickenpox (2nd dose) |
| 9 years | HPV (1st dose) |
| 14–16 years | Tdap (tetanus/diphtheria/pertussis) |
Explanation:
- DTaP-IPV-Hib: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b
- DTaP-HB-IPV-Hib: previous + hepatitis B
- MMR: measles, mumps, rubella
- HPV: human papillomavirus
3. Mandatory requirements for school attendance
Only three provinces have legislative requirements:
- Ontario – Diphtheria, tetanus, pertussis, polio, measles/mumps/rubella, meningococcal, chickenpox
- New Brunswick
– Diphtheria, tetanus, polio, measles/mumps/rubella
3. Manitoba
– Mandatory measles vaccination (during outbreaks, unvaccinated individuals must stay at home)
Exemptions:
-
Medical contraindications
-
Religious/personal beliefs
-
(In Ontario, participation in an immunization education session is required)
4. Recommended vaccines for adults (18+ years)
| Vaccine | Recommendations |
|---|---|
| Td (tetanus/diphtheria) | booster dose every 10 years |
| Tdap (pertussis) | single dose in adulthood |
| Influenza | annually |
| Pneumococcal (Pneu-C) | one dose at age 65+ |
| Shingles (RZV) | 2 doses at age 50+ |
| COVID-19 | according to current NACI recommendations |
| Hepatitis B | unvaccinated 18–19 years old or born after 1980 |
| HPV | up to 18 years old |
| Meningococcal (ACWY) | 18–24 years old |
| RSV | 75+ years old |
Risk groups (chronic diseases, healthcare workers, etc.):
- Hepatitis A/B
- Additional meningococcal and pneumococcal doses
- Pertussis vaccine
5. Vaccination during pregnancy
Recommended:
- Influenza (any trimester)
- Tdap (21–36 weeks; optimally 27–32)
- COVID-19 (any trimester)
- RSV (32–36 weeks; from December 2023)
Contraindicated live vaccines:
- MMR (measles/mumps/rubella)
- Chickenpox
- Yellow fever
- Oral polio vaccine
- Oral typhoid vaccine
6. Special considerations for new arrivals
- Catch-up vaccination: “from scratch” according to age, in accordance with catch-up schedules.
- Free of charge: from the moment of obtaining a provincial health card.
7. Provincial differences (examples)
- British Columbia: hepatitis A at 6 and 18 months
- Alberta: hepatitis B in grade 6; HPV in grade 6
- Quebec: hepatitis A in grade 4; hepatitis B in grade 3 of secondary school
- Northwest Territories/Nunavut: BCG at 1 month
8. New developments in 2025
- COVID-19: mandatory for 65+ and at-risk groups; Alberta has limited free access to high-risk groups only.
- Provincial registries: immunization records; parents report vaccinations.
9. Requirements for healthcare workers
- British Columbia: mandatory COVID-19 vaccination for healthcare workers
- Other provinces: annual flu vaccination and specific requirements
10. Exclusions during outbreaks
Unvaccinated children may be excluded from school during outbreaks in all provinces.
Summary:
Canada's vaccination system combines federal recommendations and provincial autonomy, ensuring high coverage for children and adults with free access to routine vaccinations.