Definitions of High Risk for Publicly-funded Vaccines by Province/Territory (as of March 2015)

Information on immunization programs was collected by the Canadian Nurses Coalition on Immunization (CNCI). PHAC and the CNCI have worked together since July 2004 to develop this tool containing the latest provincial/territorial program information.

British Columbia

Pneumococcal Conjugate

Children 2-59 months of age who are at high risk of pneumococcal disease due to:

  • Sickle cell disease
  • Immunosuppression related to disease (e.g. HIV, lymphoma, Hodgkin's, multiple myeloma) or therapy (e.g. high dose, systemic steroids or severe rheumatoid arthritis requiring immunosuppressive therapy)
  • Congenital immunodeficiencies
  • Receipt of hematopoietic stem cell transplant (HSCT) up to and including 18 years of age.
  • Solid organ or islet cell transplant (candidate or recipient)
  • Chronic heart or lung disease (except asthma, unless management involves ongoing high dose oral corticosteroid therapy.)
  • Chronic liver disease including cirrhosis, chronic hepatitis B, chronic hepatitis C.
  • Chronic kidney disease
  • Diabetes
  • Cystic fibrosis
  • Chronic CSF leak
  • Cochlear implant, candidate or recipient
  • Anatomic or functional asplenia (children up to and including 18 years of age)
  • Chronic neurological conditions that may impair clearance of oral secretions
Meningococcal Conjugate Group C

Children 2-10 years of age who have not previously received meningococcal C conjugate who have:

  • Functional or anatomic asplenia
  • Congenital immunodeficiency states including complement, properdin, factor D, and primary antibody deficiencies
  • Hematopoietic stem cell transplant (HSCT)
  • Solid organ transplant (candidate or recipient)
  • Islet cell transplant (candidate or recipient)
  • Close contacts of a case of invasive meningococcal group C disease
Meningococcal Conjugate Groups A, C, Y, W-135

Individuals ≥ 2 years of age with the following conditions:

  • Functional or anatomic asplenia
  • Congenital immunodeficiency states including complement, properdin, factor D, and primary antibody deficiencies
  • Hematopoietic Stem Cell Transplant
  • Solid organ transplant (candidate or recipient)
  • Islet cell transplant (candidate or recipient)
  • High risk ≥ 2 years, and contacts  (≥ 2 year) of cases (serotypes A, Y and W-135)
Varicella
  1. Susceptible high risk persons:
    • With cystic fibrosis
    • With nephrotic syndrome
    • Undergoing hemo- or peritoneal dialysis
    • On chronic salicylate therapy
  2. Children and adults with:
    • IG deficiency
    • Neutrophil deficiency
    • Complement deficiency
    • Asplenia
    • Receiving inhaled or topical steroids
    • Child and adult candidates for solid organ transplant (liver, heart, lung, and kidney)
  3. Children:
    • With acute lymphocytic leukemia in remission for at least 12 months
    • With asymptomatic HIV, CD4% ≥ 25% for age
    • ≥ 2 years after HSCT or solid organ transplant
    • ≥ 3 months after being cured of a malignant disease and the end of immunosuppressive treatment

Alberta

Pneumococcal Conjugate
  • 5 years to ≤ 17 years of age with conditions resulting in high risk for IPD as listed below:
    • Cochlear implants (candidates and recipients)
    • Asplenia / hyposplenism (functional or anatomic)
    • Solid organ or islet transplant (SOT) candidates and recipients
    • Hematopoietic stem cell transplant (HSCT) recipients
    • HIV infection
    • Immunosuppressive therapy including use of long term corticosteroids, chemotherapy, radiation therapy , post-organ transplant therapy and certain anti-rheumatic drugs
    • Malignant neoplasm including Hodgkin's disease, lymphoma, multiple myeloma and leukemia
    • Chronic renal disease, including nephrotic syndrome
    • Chronic cardiac disease
    • Chronic pulmonary disease (excluding asthma unless treated with high-dose oral corticosteroid therapy)
    • Chronic cerebral spinal fluid (CSF) leak
    • Diabetes mellitus (poorly controlled)
    • Chronic neurologic condition that may impair clearance of oral secretions.
    • Congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humeral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin, or factor D deficiencies), or phagocytic functions.
    • Chronic liver disease (including hepatitis B and C, and hepatic cirrhosis due to any cause).
    • Sickle-cell disease and other hemoglobinopathies
  • Adults ≥ 18 years of age with conditions resulting in high risk for IPD as listed below:
    • Asplenia (anatomic or functional)
    • Chronic CSF leak
    • Cochlear implants (candidates and recipients)
    • Congenital immunodeficiencies involving any part of the immune system, including B-lymphocytes (humoral) immunity, and T-lymphocytes (cell) mediated immunity, complement system (properdin or factor D deficiencies) or phagocytic functions
    • Immunosuppressive therapy including use of long term corticosteroids, chemotherapy, radiation therapy , post-organ transplant therapy, biologic and non-biologic immunosuppressive therapies for rheumatologic and other inflammatory diseases
    • Malignant neoplasm including lymphoma and leukemia
    • Sickle-cell disease and other hemoglobinopathies
    • Candidates/recipients of solid organ transplant (SOT)
    • Recipients of hematopoietic stem cell transplant (HSCT)
    • HIV Infection
Meningococcal Conjugate Group C
  • Pre-exposure:
    • Children at high risk 5 to 10 years of age inclusive who have not received meningococcal conjugate monovalent C vaccine previously. Children at high risk include those with the following conditions:
      • Candidates and recipients of cochlear implant surgery
      • Anatomical or functional asplenia (including sickle-cell disease)
      • HIV without any contraindications to immunization
      • Complement, properdin or factor D deficiency; hypogammaglobulinemia and primary antibody deficiency
      • Candidates and recipients of solid organ transplant
      • Recipients of hematopoietic stem cell transplant
  • Post-exposure 2 to 23 months of age and 56 years of age and older:
    • Susceptible household and close contacts of laboratory-confirmed cases of serogroup C invasive meningococcal disease that are eligible for chemoprophylaxis and have not been adequately immunized. Results of index case serogrouping should be known (generally within 2 to 5 days) before proceeding with immunization
Meningococcal Conjugate Groups A, C, Y, W-135
  • Pre-exposure:
    • Laboratory workers who are routinely exposed to Neisseria meningitidis, if they are involved in conducting subculture identification, susceptibility testing, serological and/or molecular characterization and deep freeze for storage
    • Candidates and recipients of cochlear implant surgery
    • Individuals with anatomical or functional asplenia (including sickle-cell disease)
    • Candidates and recipients of solid organ transplant
    • Recipients of hematopoietic stem cell transplant
    • Individuals who are HIV positive with no contraindication to immunization
    • Individuals with complement, properdin or factor D deficiency or hypogammaglobulinemia
  • Post-exposure:
    • Susceptible household and close contacts, 2 years of age and older, of laboratory-confirmed cases of serogroups A, Y or W-135 invasive meningococcal disease
Meningococcal Conjugate Group B
  • Post-exposure:
    • Immunization of identified household and close contacts of laboratory-confirmed cases of meningococcal serogroup B invasive meningococcal disease (IMD)
Varicella
  • Non-immune:
    • Household or close contacts of immunocompromised individuals
    • Susceptible health care workers
    • Women identified through routine prenatal screening
    • Individuals 13 years and older if susceptible (unknown, no or uncertain history of chickenpox and negative serology)
    • Immunocompromised individuals (medical consultation should be sought before)
Human Papillomavirus

Students eligible for vaccine in Gr. 5 continue to be  eligible until the end of Gr. 12 if they present to public health

  • Hematopoietic Stem Cell Transplantation (HSCT) recipients
  • Solid organ transplant (SOT) candidates and recipients

Saskatchewan

Pneumococcal Conjugate

High risk groups 5-17 years include:

  • Sickle cell disease, congenital or acquired asplenia, or splenic dysfunction
  • Human immunodeficiency virus (HIV) infection
  • Congenital immune deficiency
  • Diseases associated with immunosuppressive therapy or radiation therapy including malignant neoplasms, leukemias, lymphomas, Hodgkin's disease and solid organ transplantation or stem cell transplants
  • Chronic cardiac disease (particularly cyanotic congenital heart disease and cardiac failure)
  • Chronic pulmonary disease (excluding asthma, except those treated with oral corticosteroid therapy)
  • Cerebrospinal fluid leaks
  • Diabetics
  • Cochlear implant recipients (pre and/or post implant)
  • Nephrotic Syndrome
  • Recipients of hematopoietic stem cell transplant (HSCT) at any age (4 doses)
Meningococcal Conjugate Group C

High Risk individuals:

  • Asplenia, functional or anatomic
  • Transplant recipients
  • Complement, properdin or factor D deficiencies
Meningococcal Conjugate Groups A, C, Y, W-135

Medically high risk individuals 2 years and older including:

  • Cerebrospinal fluid leak or hydrocephaly
  • Functional or anatomic asplenia
  • Congenital immunodeficiency states (e.g., complement, properdin, factor D deficiency, primary antibody deficiencies)
  • Hematopoietic stem cell transplant recipient
  • Cochlear transplant candidate or recipient
  • Solid organ transplant candidate or recipient
  • Islet cell transplant candidate or recipient
Varicella
  • Susceptible high risk persons:
    • Cystic fibrosis
    • Long term acetylsalicylic acid therapy
    • Immunocompromised individuals as determined by their specialist
    Individuals born since Jan.1, 1993 that are susceptible
  • Non-immune:
    • Household or close contacts of immunocompromised individuals
    • Susceptible health care workers
    • Women identified through routine prenatal screening
    • Individuals 13 years and older if susceptible (unknown, no or uncertain history of chickenpox and negative serology)

Manitoba

Pneumococcal Conjugate
Children 24-59 months with high-risk medical conditions as per the CIG and NACI statements
Hematopoietic stem cell transplant (HSCT) recipients ≥ 60 months (3 doses).
Human immunodeficiency virus (HIV) and/or solid organ transplant recipients 60 months (1 dose).
Meningococcal Conjugate Group C
Individuals (2 months or older) with high-risk medical conditions as per the CIG and NACI statements
Meningococcal Conjugate Groups A, C, Y, W-135
Individuals under 55 years of age with high-risk medical conditions as per the CIG and NACI statements
Meningococcal Conjugate Group B
Individuals 2 months to ≤ 17 years of age with at least one of the following high-risk medical conditions:
  • anatomic or functional asplenia (including sickle cell disease)
  • congenital complement, properdin, factor D or primary antibody deficiencies
  • acquired complement deficiencies
  • human immunodeficiency virus (HIV)
Two to four doses are required, depending on the age at first dose.
Varicella
Individuals with high-risk medical conditions and their household contacts as per the CIG and NACI statements
Human Papillomavirus

Females with increased risk of getting HPV, as determined by a health care provider, include:

  • Early onset of sexual activity
  • Multiple sexual partners
  • A previous STI
  • Adolescent pregnancy
  • An immune system weakened by disease or medical treatment
  • Previous abnormal pap tests
  • Family-history of HPV-associated cancers

Ontario

Pneumococcal Conjugate

All children under 5 years of age with the following medical conditions:

  • Chronic respiratory disease (excluding asthma, except those treated with high-dose corticosteroid therapy)
  • Chronic cardiac disease
  • Chronic liver disease (including hepatitis B and C, and hepatic cirrhosis due to any cause)
  • Chronic renal disease, including nephrotic syndrome
  • Diabetes mellitus
  • Asplenia (functional or anatomic), splenic dysfunction, sickle-cell disease and other sickle cell haemoglobinopathies
  • Chronic neurologic condition that may impair the clearance of oral secretions
  • Chronic cerebrospinal fluid leak
  • Primary immune deficiency
  • Congenital immunodeficiency involving any part of the immune system, including B-lymphocytes (humoral) immunity, T-lymphocytes (cell) mediated immunity, complement system (properdin or factor D deficiencies), or phagocytic functions  
  • HIV infection
  • Other conditions associated with immunosuppression (e.g. malignant neoplasms, including leukemia and lymphoma)
  • Immunosuppressive therapy, including use of long term systemic corticosteroids, chemotherapy, radiation therapy, post-organ transplant therapy, certain anti-rheumatic drugs and other immunosuppressive therapy
  • Hematopoietic stem cell transplant (candidate or recipient)
  • Solid organ or islet cell transplant (candidate or recipient)
  • Cochlear implant recipients (pre/post implant)
Meningococcal Conjugate Group C

Close contacts of a case of serogroup C invasive Meningococcal disease; close contacts of a case include:

  • Individuals include those with functional or anatomic asplenia (vaccine should be given at least 10-14 days before splenectomy).
  • Individuals with complement, properdin or factor D deficiency.
  • Cochlear implant recipients (pre/post implant)

Close contacts of a case of serogroup C invasive Meningococcal disease. include anyone who has come into direct contact (including respiratory droplets) with a case, including but not limited to family/household, school/work colleagues, and social contacts.

Meningococcal Conjugate Groups A, C, Y, W-135

Individuals 2-55 years of age with high-risk medical conditions can receive publicly funded vaccine includes;

  • Individuals include those with functional or anatomic asplenia
  • Individuals with complement, properdin or factor D deficiency.
  • Cochlear implant recipients (pre/post implant)
Varicella

High Risk Criteria for Varicella Vaccine:

  • Susceptible children and adolescents given chronic salicylic acid therapy (consider stopping treatment for 6 weeks after vaccination, see product monograph).
  • All persons with cystic fibrosis.
  • Susceptible household contacts of immunocompromised persons.
  • Susceptible persons receiving low-dose steroid therapy or inhaled/topical steroids 

Immunocompromised individuals, see CIG for varicella vaccination recommendations regarding specified susceptible immune comprised individuals

Quebec

Pneumococcal Conjugate

Children aged between 5 and 17 years old with medical conditions that increase the risk of invasive pneumococcal infections:

  • Anatomic or functional asplenia
  • Immunosuppression
  • Cochlear implant recipients
  • Chronic renal deficiency or nephrotic symptoms
  • High prematurity (< 32 weeks or weight <1500 g at born), risk in the first year of life
  • Chronic disease or condition:
    • Pulmonary (cystic fibrosis, chronic bronchitis, emphysema, bronchopulmonary dysplasia). Asthma is not an indicator unless combined with chronic bronchitis, emphysema or long-term systemic cortisone therapy
    • Cardiac (cardiac deficiency, cardiomyopathy, cardiac cyanosis)
    • Hepatic (ex.: carrier of hepatitis B or C viruses, cirrhosis, alcoholism)
    • Diabetic
    • Chronic cerebrospinal fluid leak
    • Medical condition that may impair clearance of oral secretions or increase their risk of aspiration (cognitive impairment, spinal cord injury, seizure disorder, neuromuscular disorders)
    • Homeless
    • Actual and regular use of injected or inhaled hard drugs with decreasing health condition or precarious living conditions

Individuals 18 years old and over with specific health conditions (anatomic or functional asplenia or immunosuppression)

Meningococcal Conjugate Group C
Individuals aged 2 months and older who had close contacts with a case of serogroup C invasive Meningococcal disease
Meningococcal Conjugate Groups A, C, Y, W-135

Individuals aged 2 months and older at high risk:

  • Functional or anatomic asplenia
  • Complement, properdin or factor D deficiency
  • Congenital antibody deficiency

Close contact of a case of serogroup A, Y or W135 Meningococcal disease

Meningococcal Conjugate Group B

Individuals aged 2 months and older at high risk:

  • Functional or anatomic asplenia
  • Complement, properdin or factor D deficiency
  • Congenital antibody deficiency
  • Close contact of a case of serogroup B Meningococcal disease

Individuals considered at high risk, by public health authorities, of contracting serogroup B invasive meningococcal disease during an outbreak or the emergence of endemic or virulent strains

Varicella
  • Individuals 1 year and older receptive to varicella
  • After age 50, it is preferable to give the herpes zoster vaccine
Human Papillomavirus
  • Females 18 to 26 years old immunocompromised or HIV infected
  • Males 9 to 26 years old immunocompromised or HIV infected

New Brunswick

Pneumococcal Conjugate

Children, with health conditions that place them at greater risk of IPD as per CIG:

  • Chronic liver disease (hepatitis B, hepatitis C, cirrhosis due to any cause)
  • Chronic renal and dialysis
  • Splenic disorders, functional asplenia or splenectomy
  • Immunosuppression/ immunosuppressive therapy/immune disorders: B-lymphocyte (humoral) immunity T-lymphocyte (cell) mediated immunity or phagocytic functions deficiencies
  • Bone marrow/stem cell or islet transplant (pre and post procedure)
  • Organ transplant (pre and post procedure)
  • Cerebral fluid leak
  • Heart disease or stroke or pulmonary disorders (individuals with asthma up to 18 years of age)
  • Complement, properdin, or factor D deficiency
  • Diabetes mellitus and other metabolic diseases
  • Sickle cell disease and anaemia, hemoglobinopathy
  • Cancers
  • HIV
  • Cochlear  implant (pre and post procedure)
  • Adults at greater risk of IPD:
    • HIV infection, immunocompromising conditions (e.g. primary immunodeficiency, malignancies, immunosuppressive therapy, solid organ transplant, bone marrow/stem cell transplants, splenic disorders)
Pneumococcal polysaccharide
  • Chronic liver disease (hepatitis B, hepatitis C, cirrhosis due to any cause)
  • Chronic renal and dialysis
  • Splenic disorders, functional asplenia or splenectomy
  • Cerebral fluid leak
  • Heart disease or stroke or pulmonary disorders
  • Diabetes mellitus and other metabolic diseases
  • Sickle cell disease and anaemia, hemoglobinopathy
  • Cancers
  • HIV
  • Cochlear implant (pre and post procedure)
  • Anyone 65 and older
  • Alcoholism
  • Injection drug users
  • Immunosuppression/ immunosuppressive therapy/immune disorders: B-lymphocyte (humoral) immunity T-lymphocyte (cell) mediated immunity or phagocytic functions deficiencies
  • Bone marrow/stem cell or islet transplant (pre and post procedure)
  • Organ transplant (pre and post procedure)
  • Complement, properdin, or factor D deficiency
  • Residents of long term facilities
  • Chronic neurological conditions that may impact the clearance of oral secretions
Meningococcal Conjugate Group C

Individuals with the following conditions:

  • Splenic disorders (functional asplenia or splenectomy)
  • Complement, properdin, or factor D deficiency

Close contacts of a case

Meningococcal Conjugate Groups A, C, Y, W-135

Individuals with the following conditions:

  • Splenic disorders (functional asplenia or splenectomy)
  • Complement, properdin, or factor D deficiency

Close contacts of a case

Meningococcal Conjugate Group B
Individuals considered at high risk, by public health authorities, of contracting serogroup B invasive meningococcal disease during an outbreak or the emergence of endemic or virulent strains
Varicella

Individuals with the following conditions:

  • Chronic renal disease or dialysis
  • Splenic disorders (functional asplenia or splenectomy)
  • Pulmonary disorders (cystic fibrosis)
  • Malignant neoplasms including lymphoma and leukemia, HIV (if prerequisite condition allow)
  • Individuals given chronic salicylic acid therapy (if prerequisite condition allow)

Nova Scotia

Pneumococcal Conjugate
  • Pneumococcal 13; Individuals with the following conditions:
    • Cancer
    • Congenital immunodeficiency
    • HSCT
    • HIV
    • Immunosuppressive therapy
    • Solid organ transplant
    • Splenic disorders
  • Pneumococcal 23; Adults age 65 and older; Individual older than 2 years of age with the following conditions:
    • Splenic disorders
    • Chronic renal disease/dialysis
    • Neurological conditions that may impair clearance of oral secretions
    • Chronic liver disease
    • Lung disease (not asthma)
    • Diabetes
    • Heart disease
    • Congenital immunodeficiency
    • HSCT
    • Solid organ transplant
    • HIV
    • Cancer
    • Immunosuppressive therapy
    • Cochlear implant
    • Illicit drug use / alcoholism
    • Homelessness
    • Chronic cerebral spinal fluid leak
    • Cystic fibrosis
    Residents of long term care facilities
Meningococcal Conjugate Group C

Post-exposure prophylaxis of persons with serogroup C and for those with the following high-risk conditions:

  • Congenital immunodeficiency
  • Splenic disorders including sickle cell disease
  • Hematopoietic stem cell transplant (HSCT)
  • Immunosuppressive therapy using eculizumab (Solaris)
Meningococcal Conjugate Groups A, C, Y, W-135

Children 2 months of age or older for post-exposure prophylaxis for Men A,C,Y,W-135 serotypes and for children 2 months of age or older with the following high-risk conditions:

  • Congenital immunodeficiency
  • Splenic disorders including sickle cell disease
  • Hematopoietic stem cell transplant (HSCT)
  • Immunosuppressive therapy using eculizumab (Solaris)
Meningococcal Conjugate Group B
Contacts of cases
Varicella
  • The following high risk groups once immunocompetent:
    • Immunosuppressive therapy
    • Hematopoietic stem cell transplant (HSCT)
    • Solid organ transplant
    • HIV
  • Individuals with:
    • Cystic fibrosis
    • Chronic salicylate therapy
    • Nephrotic syndrome or on hemo/peritoneal dialysis
    • Splenic Disorders
    Post-partum women who are found to be non-immune to varicella during prenatal testing
  • Non-immune health care workers; Non-immune individuals who live with or care for anyone in the following categories:
    • Blood dyscrasias
    • Leukemia (except Acute Lymphoblastic Leukemia)
    • Lymphoma
    • Other malignancies affecting the bone marrow or lymphatic system
    • Other defects of cell-mediated immunity, receiving treatment associated with T-cell abnormalities (eg. intensive chemotherapy)
    Post exposure prophylaxis

Prince Edward Island

Pneumococcal Conjugate
  • Splenectomized patients
  • Individuals with decreased immunity due to sickle cell anemia or primary IgG deficiency
  • Cochlear implant recipients

All children up to age 59 months who: were born before 32 weeks gestation & fit the following diagnosis:

  • Congenital immune deficiency
  • Diseases associated with immunosuppressive therapy or radiation therapy (including malignant neoplasms, leukemias, lymphomas, and Hodgkin's disease) and solid organ transplantation
  • Chronic renal insufficiency, including nephrotic syndrome
  • Chronic cardiac disease (particularly cyanotic congenital heart disease and cardiac failure)
  • Chronic pulmonary disease (excluding asthma, except those treated with high-dose oral corticosteroid therapy)
  • Cerebrospinal fluid leaks
  • Poorly controlled diabetes mellitus
Meningococcal Conjugate Group C
  • Splenectomized patients
  • Individuals with decreased immunity due to sickle cell anemia or primary IgG deficiency
  • Cochlear implant recipients
 
Meningococcal Conjugate Groups A, C, Y, W-135
  • Splenectomized patients
  • Individuals with decreased immunity due to sickle cell anemia or primary IgG deficiency
  • Cochlear implant recipients
Varicella
Routine immunization since 2000

Newfoundland Labrador

Pneumococcal Conjugate
  • 2 months to ≤ 5 years of age:
    • Aboriginal children (including First Nations, Inuit and Metis)
    • Cochlear implants (candidates and recipients)
    • Congenital or acquired asplenia, splenic dysfunction and sickle-cell disease
    • Candidates/recipients of solid organ transplant (SOT)
    • Recipients of hematopoietic stem cell transplant (HSCT)
    • HIV infection
    • Immunosuppression (e.g., congenital immune deficiency, Hodgkin's disease, lymphoma, multiple myeloma, leukemia and therapy with alkylating agents, antimetabolites, systemic corticosteroids or radiation therapy)
    • Chronic renal disease, including nephrotic syndrome
    • Chronic cardiac disease
    • Chronic pulmonary disease
    • Cerebrospinal fluid leaks
    • Poorly controlled diabetes mellitus
    • Chronic neurologic condition that may impair clearance of oral secretions.
    • Congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humeral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin, or factor D deficiencies), or phagocytic functions.
    • Chronic liver disease (including hepatitis B and C, and hepatic cirrhosis due to any cause)
  • 6 to ≤ 16 years of age:
    • Congenital or acquired asplenia, including those with sickle-cell disease and other hemoglobinopathies (functional asplenia) and splenic dysfunction
    • Candidates/recipients of solid organ transplant (SOT)
    • Recipients of hematopoietic stem cell transplant (HSCT)
    • HIV Infection
  • 17 years and older:
    • Candidates/recipients of solid organ transplant (SOT)
    • Recipients of hematopoietic stem cell transplant (HSCT)
    • HIV Infection
Meningococcal Conjugate Group C

Children > 2 months -10 years with the following conditions

  • Stem Cell Transplant (SCT)
  • Bone Marrow Transplant (MBT)
  • Functional or anatomic asplenia

Immunosuppressive therapy

Meningococcal Conjugate Groups A, C, Y, W-135

High risk groups include:

  • Household and intimate social contacts of individuals with meningococcal disease
  • Individuals > 2 years with the following conditions:
  • Stem Cell Transplant (SCT)
  • Bone Marrow Transplant (MBT)

Pre or post splenectomy

Varicella
  • Susceptible health care workers
  • Susceptible household contacts of immunocompromised people
  • Selected immuno-compromised individuals

Northwest Territories

Pneumococcal Conjugate
As per NACI recommendations
Meningococcal Conjugate Group C
As per NACI recommendations
Meningococcal Conjugate Groups A, C, Y, W-135
As per NACI recommendations
Varicella
As per NACI recommendations

Yukon

Pneumococcal Conjugate

Children 2-59 mths of age who are at high risk of pneumococcal disease due to:

  • Sickle cell disease
  • Immunosuppression related to disease (e.g. HIV, lymphoma, Hodgkin's, multiple myeloma) or therapy (e.g. high dose, systemic steroids)
  • Receipt of hematopoietic stem cell transplant (HSCT)
  • Solid organ or islet cell transplant (candidate or recipient)
  • Chronic heart or lung disease (except asthma, unless management involves ongoing high dose oral corticosteroid therapy)
  • Chronic liver disease including cirrhosis, chronic hepatitis B, chronic hepatitis C
  • Chronic kidney disease
  • -Diabetes
  • Cystic fibrosis
  • Chronic CSF leak
  • Cochlear implant, candidate or recipient
  • Anatomic or functional asplenia (children up to and including 16 years of age)
  • Chronic neurological conditions that may impair clearance of oral secretions
  • HIV positive individuals
Meningococcal Conjugate Group C

Children 2 up to 19 years of age who have not previously received meningococcal C conjugate vaccine or who present a medical high risk condition, including:

  • Functional or anatomic asplenia
  • Complement, properdin, or factor D deficiencies
  • Hematopoietic stem cell transplant (HSCT)
  • Solid organ transplant (candidate or recipient)
  • Islet cell transplant (candidate or recipient)
  • Cochlear implant, or who will be receiving a cochlear implant
Meningococcal Conjugate Groups A, C, Y, W-135

Individuals 2 years of age and older with the following conditions:

  • Functional or anatomic asplenia
  • Congenital immunodeficiency states including complement, properdin, or factor D deficiencies
  • Hematopoietic Stem Cell Transplant
  • Solid organ transplant (candidate or recipient)
  • Islet cell transplant (candidate or recipient)
  • High risk ≥ 2 years, and contacts (≥ 2 years) of cases (serotypes A, Y and W-135)
Varicella

The varicella vaccine is recommended for:

  • Susceptible older children and adolescents
  • Susceptible women of childbearing age (not during pregnancy)
  • Susceptible health care workers
  • Susceptible household contacts of immunocompromised people
  • Susceptible adults who may be exposed occupationally to varicella
  • Other susceptible adults, especially new immigrants from tropical climates
  • Children and adolescents given chronic salicylic acid therapy
  • People with cystic fibrosis
  • Immunocompromised individuals

Nunavut

Pneumococcal Conjugate
Routine infant immunization
Meningococcal Conjugate Group C
  • Contacts of cases
  • Certain students or athletes
  • < 25 years, if not previously vaccinated
  • Other high risk individuals including those with asplenia, certain immunodeficiencies, and cochlear implants
Meningococcal Conjugate Groups A, C, Y, W-135
Contacts of cases (A, Y and W135) ≥ 2 years
Varicella
Women who test negative at prenatal screen & healthcare workers
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