Childhood Vaccination Schedule in Canada
In Canada, childhood vaccinations begin at birth with the first dose of hepatitis B vaccine for infants born to HBsAg-positive mothers, while routine vaccinations for all infants typically begin at 2 months of age.
Birth Dose Vaccinations
- Hepatitis B: The first dose is administered at birth for infants born to HBsAg-positive mothers 1
- Includes hepatitis B immune globulin (HBIG) within 12 hours of birth if mother is HBsAg-positive
- For infants of mothers with unknown HBsAg status, hepatitis B vaccine should be given within 12 hours of birth
Standard Vaccination Schedule Beginning at 2 Months
The core routine vaccination schedule for Canadian infants starts at 2 months of age with:
- DTaP-IPV-Hib (Diphtheria, Tetanus, acellular Pertussis, Inactivated Polio, and Haemophilus influenzae type b) 1
- Pneumococcal conjugate vaccine (PCV) 1, 2
- Rotavirus vaccine 1
Quebec and some other provinces use a "2+1" schedule (2,4, and 12 months) for pneumococcal conjugate vaccine for low-risk infants 2.
Vaccination Schedule Timeline
| Age | Recommended Vaccines |
|---|---|
| Birth | Hepatitis B (for infants of HBsAg-positive mothers) |
| 2 months | DTaP-IPV-Hib, PCV, Rotavirus |
| 4 months | DTaP-IPV-Hib, PCV, Rotavirus |
| 6 months | DTaP-IPV-Hib, Influenza (annually thereafter) |
| 12 months | MMR, PCV (booster), Meningococcal C conjugate |
| 15-18 months | DTaP-IPV-Hib (booster), Varicella |
| 4-6 years | DTaP-IPV, MMR (second dose) |
Important Considerations
- Minimum ages: Most vaccines have minimum ages for administration - for example, rotavirus vaccine should not be started after 12 weeks of age 1
- Combination vaccines: Several combination vaccines are available in Canada to reduce the number of injections (e.g., DTaP-IPV-Hib) 1
- Catch-up schedules: Children who start their vaccination schedule late follow specific catch-up schedules 1
- Seasonal considerations: There may be seasonal variations in adverse events following vaccination, with higher rates observed for certain birth months 3
Vaccination Coverage
Despite recommendations, not all Canadian children receive timely vaccinations:
- Approximately 69% of Canadian children receive their first dose of measles-containing vaccine on time 4
- About 29% of children are unvaccinated before turning 13 months of age 4
Special Populations
For children with specific risk factors (immunocompromised, certain medical conditions), additional or modified vaccination schedules may be required:
- Children with complement component deficiencies, functional or anatomic asplenia, or HIV infection may need additional meningococcal vaccine doses 1, 5
- Children traveling to areas with high disease prevalence may need accelerated schedules or additional vaccines 1
The Canadian vaccination schedule prioritizes protection against serious childhood diseases beginning in early infancy, with the core routine schedule starting at 2 months of age for all infants.