Vaccine Preventable Diseases
Vaccines are our best defence against many diseases. Please visit the Ontario’s immunization schedule for a list of free vaccines. Talk to your health care professional to make sure you are immunized according to your age and lifestyle.
Chickenpox is very contagious. It is a viral infection that often starts with fever, headache and fatigue. An itchy rash first appears as raised pink or red bumps and can spread to almost anywhere on the body. The bumps will gradually form into blisters and then scab over. The virus is spread by airborne droplets or direct contact with the blisters. Healthy children tend to have milder symptoms. In rare cases, chickenpox can cause severe complications such as pneumonia, blood infections, severe skin infections, swelling to the brain and birth defects.
- Chickenpox vaccine is part of routine immunization at 15 months of age.
- MMRV vaccine is a four-in-one combination vaccine that protects against chickenpox, measles, mumps and rubella and is recommended as a booster for children between four to six years of age.
- Children born on or after January 1, 2000 can get the chickenpox vaccine for free.
- Children born on or after January 1, 2010 need to show proof of immunization against chickenpox to attend school.
- Adults who have never had the chickenpox should get two doses of the vaccine. Chickenpox can be severe in adults.
Diphtheria is a bacterial infection that can spread easily. Although very rare in Canada, it is still common in developing countries where immunizations are not given routinely. Diphtheria can be very serious, especially for infants and very young children. Symptoms include sore throat, fever and difficulty breathing. It was once the most common causes of death in Canadian children under the age of five. The bacteria also produces a toxin, or poison that can spread through the bloodstream and cause damage to the heart, kidneys or nerves.
There are several combination vaccines used to prevent diphtheria as part of routine childhood immunization:
- DTap-IPV-Hib is recommended for all infants two, four, six and 18 months of age.
- DTap-IPV is given as a booster vaccine for children four to six years of age.
Adults should also get one dose of Tdap as a booster and tetanus/diphtheria every 10 years for continued protection.
Haemophilus Influenzae Type b (Hib)
Haemophilus influenzae, despite its name has nothing to do with the influenza (flu) virus. There are several types of haemophilus influenzae bacteria. Type b (also know as Hib) can cause serious and life threatening illness, especially for children under five. The Hib bacteria can spread through coughing and sneezing and can be carried in the nose and throat of some people without symptoms. Before the vaccine, Hib was a common cause for meningitis in young children.
The DTap-IPV-Hib vaccine is part of the routine infant immunization schedule at two, four, six, and 18 months.
Hepatitis A is a viral infection of the liver usually caused by eating contaminated food or water. Some people may not show symptoms, while others may experience fever, fatigue, nausea, loss of appetite, vomiting, abdominal pain or jaundice (yellowing of skin and eyes).
Immunization with Hepatitis A vaccine is free for individuals at higher risk of infection such as persons with chronic liver disease; persons engaged in use of street drugs; MSM.
Travel health notice
Hepatitis A vaccine is also recommended for travel to regions with high risk of transmission such as Africa, Asia, Central and South America. Consult a health care provider or travel health clinic six weeks before you travel. The vaccine for travel purposes is not free.
Hepatitis B is a viral infection of the liver. It is spread through contact with infected blood and body fluids. For some people, symptoms can take two to six months to appear, while others may not develop symptoms at all. During this time, they can spread the infection to others. Babies, young children and persons with a weakened immune system are at a greater risk of becoming chronic carriers. A person may not know they have hepatitis B infection until damage has been done to their liver. Complications from chronic infection include cirrhosis of the liver and liver cancer.
Toronto Public Health offers free Hepatitis B vaccines for Grade 7 students in school.
Individuals at greater risk of infection can get the vaccine for free through their health care provider. Examples of high-risk individuals are infants born to infected mothers; persons on renal dialysis; persons requiring frequent blood products; or household and sexual contact of hepatitis B carriers.
See complete list of eligibility criteria for free hepatitis B vaccine.
Human Papillomavirus (HPV)
Human Papillomavirus is the most common sexually transmitted disease. Approximately three out of four sexually active Canadians will be infected with HPV at some time in their life. The infection peaks in young adults. Many may not show symptoms and can infect their sexual partner(s).
HPV is associated with genital warts, and cancer in the cervix, genitals, head and neck. Beginning September 2017, students in Grade 7 will receive Gardasill®-9, two doses, given six months apart.
Parents can visit the School Immunization Program page for more information and for the consent form. Grade 8 students can still get the vaccine through the School Immunization Program. High school females can still get the free vaccine by making an appointment at our clinic.
Three doses are still needed for individuals who receive their first dose on or after their fourteenth birthday and for persons with a weakened immune system. The cost for a three-dose series of HPV vaccine is between $400 to $500. Talk to your health care provider to see if you are eligible through the high-risk program.
Influenza, also known as the flu, can spread from person to person by cough or sneeze droplets. Unlike the common cold, the flu can develop into more serious health problems such as pneumonia or worsening of pre-existing medical conditions such as asthma, heart disease or uncontrolled diabetes.
Pregnant women should also receive the vaccine. Changes in immune, heart and lung functions during pregnancy can make the mother seriously ill from the flu. It also increases the risk of premature labour and delivery.
The flu vaccine is available, each season, beginning in October.
Measles (Red Measles)
Measles, also called red measles, is highly contagious. The virus is spread by cough or sneeze droplets. Measles begins with high fever, runny nose, cough and red eyes. After a few days, a red blotchy rash will appear on the face and spread down the body. Most people recover fully from measles within two to three weeks. Measles can cause problems such as ear infections and pneumonia. In severe cases, it can cause swelling to the brain, hearing loss, seizures, or death.
Outbreaks of measles occur from time to time in Canada. Since there is no cure, prevention is very important:
- MMR vaccine is part of routine childhood immunization at 12 months of age. It is a three-in-one combination vaccine that protects against measles, mumps and rubella.
- MMRV vaccine is recommended for children between four and six years of age. It is a four-in-one combination vaccine that protects against measles, mumps, rubella and chickenpox.
Follow the schedule below if you or your children have not been vaccinated:
- Children four to 12 years of age should get two doses of MMRV, at least three months apart.
- Children 12 years and older should get two doses of MMR, at least 28 days after the first dose.
- Women of reproductive age, without proof of immunization, should get one dose of MMR unless pregnant.
- Women who are breastfeeding can be vaccinated with MMR vaccine
- Health care workers and all persons born in 1970 or later should get two doses of MMR, at least 28 days apart.
Travel health notice
Measles remains a common disease in many parts of the world. If you have plans to travel to endemic countries with your family, make sure they are vaccinated. Consult a health care provider or a travel health clinic six weeks before you travel.
Infants six months or older can get one dose of MMR vaccine before travel to endemic countries. However, your child will still need two doses of MMR as part of the regular immunization schedule after their first birthday.
Meningococcal Disease (Invasive)
Meningococcal disease is very rare, however, when it strikes, the disease progresses very quickly. Early symptoms include fever, aches, joint pain and headache. Within a few hours, children can become irritable, develop red or purple skin rash, become drowsy or semi-conscious. Complications include low blood pressure (shock), seizures, loss of hearing, amputations, brain damage or death.
Protect your family. There are four types of meningococcal vaccines available. Vaccination against meningococcal disease is now a requirement for school attendance. Talk to your doctor for more information.
- Meningococcal Conjugate Type C Vaccine is part of routine immunization for infants at one year of age (publicly funded).
- Meningococcal Conjugate ACYW -135 Vaccine is free for all Grade 7 students through the school-based immunization program.
- Multicomponent Serogroup B vaccine is a now available for children 17 and younger. This vaccine is not publicly funded for routine use.
- Meningococcal Polysaccharide ACYW-135 vaccine is recommended for persons 55 years of age and older.
Travel health notice
Persons taking part in large gatherings, such as the Hajj; living or working in areas where outbreaks are occurring, should consider taking the vaccines. Vaccines for travel purposes are not publicly funded.
Mumps is usually a mild disease. The virus spread through direct contact with respiratory droplets from an infected person. It can take14 to 25 days for symptoms to develop. Symptoms can include fever, headache, swelling and pain of the salivary glands around the jaw and cheeks. Complications from mumps can include inflammation of the testicles or ovaries; pancreatitis, hearing loss and swelling of the brain. Infection in the first trimester of pregnancy can result in miscarriage.
The mumps vaccine is given as a combination vaccine:
- MMR vaccine is a three-in-one combination vaccine that protects against measles, mumps and rubella. It is part of routine childhood immunization at one year of age.
- MMRV vaccine is a four-in-one combination that protects against measles, mumps, rubella and chickenpox. It is recommended for children between four to six years of age. Children need two doses of MMR or MMRV vaccine, no later than school entry.
Follow the schedule below if you or your family have not been vaccinated:
- Children four to 12 years of age, should get two-doses of MMRV, at least three months apart.
- Children 12 years and older, get two-doses of MMR, at least 28 days after the first dose.
- Women of reproductive age, without proof of immunization, should get one dose of MMR, unless she is pregnant.
- Women who are breastfeeding can be vaccinated with MMR vaccine.
- Health care workers and all persons born in 1970 or later should get two-doses of MMR, at least 28 days apart.
- Adults born prior to 1970 are assumed to have naturally acquired immunity to mumps.
Pertussis (Whooping Cough)
Pertussis, also as known as whooping cough spreads by respiratory droplets. Pertussis causes violent coughing fits that can lead to choking or vomiting. The coughing can be so intense that a whooping sound is made when trying to catch the next breath. The cough can last for weeks or months. Whooping cough can cause more than just severe coughing. Babies may have spells where they cannot breathe or have seizures. Infants under six months of age are at the greatest risk. Pertussis outbreaks cycle in Ontario every two to five years.
There are several combination vaccines used to prevent pertussis as part of the routine immunization schedule:
- DTap-IPV-Hib is for infants at two, four, six and 18 months of age.
- DTap-IPV is a booster for children four to six years of age who have received previous vaccines.
- Tdap is given to youth between 14 and 16 years of age. Adults of all ages should also get one dose as an adult booster to protect against these diseases.
When an outbreak is occurring, vaccinating pregnant women with Tdap increases maternal antibody transfer. This provides immediate protection to babies who are at the greatest risk.
Pneumococcal infection is most common in both children and adults. Pneumococcal infection is also a common complication of influenza. The very young, people 65 and older, and people with health conditions are at greater risk of complications from the disease. Besides pneumonia, the bacteria can also cause ear infections, sinus infections, meningitis and infections in the bloodstream.
There are two types of Pneumococcal vaccines. Refer to vaccine fact sheet to see who is eligible or talk to your healthcare provider.
Polio, short for poliomyelitis, is a disease that can cause nerve damage or paralysis for life. Canada has been polio-free for the last 20 years. But as long as polio exists in other countries, there is still a risk of contracting polio. Immunization is the best protection.
There are several combination vaccines used to prevent polio as part of the routine immunization schedule:
- DTap-IPV-Hib for infants at two, four, six and 18 months of age
- DTap-IPV as a booster for children four to six years of age who have received previous vaccines
- Imovax® Polio is recommended for children and adults who have not been fully immunized against polio. It is also given as a booster for people at greater risk of polio exposure such as travellers, health care workers, or family of internationally adopted infants who may have or will be vaccinated with oral polio vaccine.
Travel health notice
Persons making international travel plans, please make sure your immunization is up to date.
Human rabies cases in Canada are very rare. Rabies is often transmitted to humans through the bite of an infected animal. The rabies virus infects the brain and nervous system and is fatal if not treated. If you are bitten or scratched by an animal that appears sick or is behaving strangely, wash the wound with soap and water immediately and seek medical attention.
For post-exposure treatment with rabies vaccine, talk to your doctor or call Toronto Public Health at 416-338-7600 for more information.
Rotavirus is the most common cause of severe diarrhea in infants and young children in Canada. Rotavirus is very contagious. Most children will have at least one episode of rotavirus diarrhea before the age of five. Symptoms include high fever, vomiting, severe watery diarrhea and stomach pain. Watch for signs of dehydration especially in babies and toddlers. Practice frequent hand washing especially after changing diapers.
In Ontario, the two-dose Rotavirus vaccine is publicly funded for infants at two and four months of age. The live vaccine is given as oral drops.
Rubella, also known as German measles, is transmitted by droplets. It primarily affects the skin and lymph nodes. It is generally a mild disease in children that may cause mild fever, red eyes, itchy red rash and swollen glands. Rubella in a pregnant woman can cause congenital rubella syndrome in developing babies which can result in miscarriage, stillbirth and/or fetal malformation.
Women of childbearing age should make sure they have had at least one dose of the rubella containing vaccine.
Shingles (herpes zoster)
Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you have had chickenpox, the virus remains inactive in the nerve cells of the body. Later in life, the virus can reactivate as shingles. Symptoms of shingles include headache; fever and a painful rash that develops on one side of the face or body. The rash forms blisters; eventually scabs over and clears up within two to four weeks.
About one in five people who get shingles may have severe pain that lasts months to years after the rash has cleared. This is known as post-herpetic neuralgia. The occurrence and severity of shingles and its complications increase with age or low immunity.
Shingles vaccine is recommended for adults 60 years of age and older. It may be used in adults 50 years of age and older who have previously had chickenpox infection or chickenpox vaccine. The vaccine is not publicly funded. Some health insurance plans cover this cost. Talk to your health care provider to see if you are at risk.
Tetanus is caused by a neurotoxin produced by the bacterium Clostridium tetani, which lives as spores in soil and dust. The bacteria enter the body through an open wound in the skin or an animal bite. The toxin can cause painful contractions of the muscles, usually starting with the jaw and is also known as lockjaw. Tetanus can be prevented by vaccination.
There are several combination vaccines used to prevent tetanus as part of routine childhood immunization: