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Календарь прививок Канады, 2013 год

Финансируемые государством программы иммунизации в Канаде - обычный график для младенцев и детей, в том числе специальные программы и догоняющие программы, по провинциям / территориям
(по состоянию на сентябрь 2013 года)

Финансируемые государством программы иммунизации для лиц высокой степени риска, по провинциям / территориям (по состоянию на сентябрь 2013 года)

Государственное финансирование вакцинации против гриппа по провинциям / территориям
(по состоянию на сентябрь 2013 года)

Вакцинация конкретных групп населения
Иммунизация взрослых

Финансируемые государством программы иммунизации в Канаде - обычный график для младенцев и детей, в том числе специальные программы и догоняющие программы
(по состоянию на сентябрь 2013 года)

Обычный график для младенцев и детей

Провинция или территория	DTaP-IPV-Hib	DTaP-IPV	Tdap or Tdap-IPV	HB	MMR	Var	MMR-Var	Men-C	Men-C-A, C, Y, W-135	Pneu- C-13	Inf	HPV	Rot
Legend: DTaP: Diphtheria, Tetanus, Acellular PertussisHB:Hepatitis B Hib: Haemophilus Influenzae Type b HPV: Human Papillomavirus Inf: Influenza IPV: Inactivated Poliomyelitis Men-C: Meningococcal conjugate MMR: Measles, Mumps, Rubella MMRV: Measles, Mumps, Rubella, and Varicella Pneu-C-13: Pneumococcal conjugate 13 valent PP23 : Pneumococcal polysaccharide 23 valent Rot: Rotavirus Tdap: Tetanus, Diptheria, Acelluar Pertussis Var: Varicella HR: Children at high risk only (Definitions of High Risk for Publicly-funded Vaccines by Province/Territory)
Source: Canadian Nurses Coalition on Immunization, 2013
Recommended use: If meningococcal C conjugate vaccine is given to infants < 12 months of age, a booster dose should be given in the second year of life (from 12 to 23 months of age). The early adolescent dose may be given using either meningococcal C conjugate (Men-C) vaccine or quadrivalent conjugate meningococcal vaccine (Men-C-ACYW) depending on the burden of illness from serogroups A, Y and W135 and the age distribution of cases by serogroup in individual Provinces / territories. Updated Invasive Meningococcal Vaccine Conjugate Recommendations can be found at: Update on the Invasive Meningococcal Disease and Meningococcal Vaccine Conjugate Recommendations (PDF Document - 712 Kb - 40 pages) The HPV vaccine is recommended for females (HPV2 or HPV4) and males (HPV4) between 9 and 26 years of age. Update On Human Papillomavirus (HPV) Vaccines
NACI recom- mendation	2, 4, 6, 18 mths	4-6 yrs	14-16 yrs	Infancy (3 doses) OR Pre-teen/ teen (2-3 doses)	12 mths AND 18 mths OR 4-6 yrs OR MMR-Var 2 doses	12-18 mths AND 18 mths OR 4-6 yrs OR MMR-Var 2 doses	12 mths AND 18 mths OR 4-6 yrs	Infancy (1-4 doses)¹ AND Pre-teen (1 dose)¹	Pre-teen (1 dose)¹	2, 4, 6, 12-15 mths	6-59 mths (1-2 doses)	9-18 yrs (3 doses at 0, 2, 6 mths)²	2, 4, 6 mths
BC	2, 4, 6 (DTaP- HB-IPV-Hib), 18 mths (DTaP-IPV-Hib)	4-6 yrs	Tdap, Gr. 9	2, 4, 6 mths (DTaP- HB-IPV-Hib)	12 mths, 4-6 yrs	12 mths, 4-6 yrs; Catch-up; Gr. 6		2, (4 HR), 12 mths, Gr. 6		2, 4, (6 HR), 12 mths	6-59 mths	Females Gr. 6	2, 4 mths
AB	2, 4, 6, 18 mths	4-6 yrs	Tdap, Gr. 9	Gr. 5			12 mths, 4-6 yrs	2, 4, 12 mths	Grade 9 (1 dose)	2, 4, (6 HR), 12 mths	≥ 6 mths	Females Gr. 5
SK	2, 4, 6, 18 mths	4-6 yrs	Tdap, Gr. 8	Gr. 6	Catch-up Gr. 6, 8 until Aug 2013	Catch-up Gr. 6 until Aug. 2015	12, 18 mths	12 mths	Gr. 6	2, 4, (6 HR), 12 mths	≥ 6 mths	Females Gr. 6	2, 4 mths
MB	2, 4, 6, 18 mths	4-6 yrs	Tdap, 14-16 yrs	Gr. 4	4-6 yrs		12 mths	12 mths, Gr. 4 until 2017		2, 4, (6 HR), 12 mths	2012-13 ≥ 6 mths	Females Gr. 6; Catch-up ≤ Gr. 10 in 2012-13
ON	2, 4, 6, 18 mths		Tdap-IPV 4-6 yrs, Tdap 14-16 yrs	Gr. 7	12 mths	15 mths	4-6 yrs	12 mths	Gr. 7	2, 4, (6 HR), 12 mths	≥ 6 mths	Females Gr. 8	2, 4 mths
QC	2, 4, 18 (DTaP- HB-IPV-Hib), 6 mths (DTaP-IPV-Hib)		Tdap-IPV 4-6 yrs, Tdap 3^rd year of high school	2, 4, 18 (DTaP- HB-IPV-Hib), Gr. 4	12 mths		18 mths	12 mths, 3^rd year of high school; Catch-up < 18 yrs		2, 4, 12 mths	6-23 mths	Females Gr. 4; Catch-up Females < 18 yrs	2, 4 mths
NB	2, 4, 6, 18 mths	4 yrs (DTaP-IPV or Tdap-IPV)	Tdap, Gr. 7 Tdap-IPV, 4 yrs (currently in place but will switch over to DTaP-IPV)	0, 2, 6 mths		One dose children born between 2000 and 2008; Catch-up 2 doses children born in 2009 or later	12, 18 mths	12 mths	Gr. 9	2, 4, 12 mths	6 mths – 18 yrs	Females Gr. 7
NS	2, 4, 6, 18 mths		Tdap-IPV 4-6 yrs, Tdap Gr. 7	Gr. 7			12 mths, 4-6 yrs	12 mths, Gr. 7		2, 4, 12 mths	≥ 6 mths	Females Gr. 7
PE	2, 4, 6, 18 mths	4-6 yrs	Tdap, Gr. 9	2, 4, 18 mths			12, 18 mths	12 mths	Gr. 9	2, 4, (6 HR), 18 mths	6-59 mths	Females Gr. 6	2, 4 mths
NL	2, 4, 6, 18 mths	4-6 yrs	Tdap, Gr. 9	Gr. 6	18 mths		12 mths	12 mths	Gr. 4	2, 4, 12 mths	6-59 mths	Females Gr. 6
NT	2, 4, 6, 18 mths	4-6 yrs	Tdap, Gr. 9	0, 1, 6 mths; Catch-up Gr.9	12, 18 mths, Post secondary students attending schools outside NT	12 mths; Catch-up <5 yrs, Gr.9		2, 12 mths; Catch-up < 5 yrs, Gr. 9	Post secondary students attending schools outside NT	2, 4, 6, 18 mths	≥ 6 mths	Females Gr. 4; Catch-up Gr. 9-12 2009-14	2, 4 mths (to be introduced late Fall 2013)
YT	2, 4, 6 (DTaP-HB-IPV-Hib), 18 mths (DTaP-IPV-Hib)	4-6 yrs (DTaP-IPV or Tdap-IPV)	Tdap, Gr. 9	2, 4, 6 mths (DTaP-HB-IPV-Hib); Catch-up ≤ 19 yrs	12 mths, 4-6 yrs	12 mths, 4-6 yrs		2, 12 mths; Gr. 6, post-secondary students not previously immunized		2, 4, (6 HR), 12 mths (3 doses)	> 6mths	Females Gr. 6	2, 4 mths
NU	2, 4, 6, 18 mths	4-6 yrs	Tdap, Gr. 9 (14-16 yrs)	0, 1, 9 mths	12, 18 mths; Catch-up Gr. 12	15 mths		12 mths; Catch-up Gr. 9 (14-16 yrs)		2, 4, 6, 15 mths, plus PP23 (1 dose) 2-3 yrs	Universal ≥ 6 mths	Females Gr. 6 (≥ 9 yrs)

http://www.phac-aspc.gc.ca/im/ptimprog-progimpt/table-5-eng.php

Финансируемые государством программы иммунизации для лиц высокой степени риска
(по состоянию на сентябрь 2013 года)

Провинция или территория	Conjugated Pneumococcal	Conjugated Meningococcal Group C	Conjugated Meningococcal Groups A, C, Y, W-135	Varicella	Human Papillomavirus
Source: Canadian Nurses Coalition on Immunization, 2013
BC	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 or severe rheumatoid arthritis requiring immunosuppressive therapy) Congenital immunodeficiencies 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	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	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)	(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, kidney). (3) Children: With acute lymphocytic > leukemia in remission for> at least 12 months With asymptomatic HIV, > CD4% ³ 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
AB	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 (excluding asthma unless treated with high-dose oral corticosteroid therapy) 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	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.	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	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)	Females students eligible for vaccine in Gr. 5 continue to be eligible until the end of Gr. 12 if they present to public health
SK	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)	High Risk individuals include: those with asplenia, functional or anatomic transplant recipients complement, properdin or factor D deficiencies	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	Susceptible high risk individuals include: those with cystic fibrosis long term acetylsalicylic > acid therapy immunocompromised individuals as determined by their specialist Individuals born since Jan.1, 1993 that are susceptible	No
MB	Children 24 - 59 months with high-risk medical conditions as per the CIG and NACI statements	Individuals (2 months or older) with high-risk medical conditions as per the CIG and NACI statements	Individuals 2 – 55 years of age with high-risk medical conditions as per the CIG and NACI statements	Individuals with high-risk medical conditions and their household contacts as per the CIG and NACI statements	Females 9 to ≤ 17 year olds with increased risk of getting HPV, as determined by a health care provider, including: 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
ON	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)	Close contacts of a case of serogroup C invasive Meningococcal disease; close contacts of a case include: Individuals with functional or anatomic asplenia (vaccine should be given at least 10-14 days before splenectomy). Individuals with complement, properdin or factor D deficiency. HIV positive individuals, close contacts of a case of serogroup C invasive Meningococcal disease, 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	Individuals 2-55 years of age with high-risk medical conditions as per the CIG and NACI statements	High Risk Criteria for Varicella Vaccine: 1. Children and adolescents given chronic salicylic acid therapy (consider stopping treatment for 6 weeks after vaccination, see product monograph). 2. People with cystic fibrosis. 3. Susceptible household contacts of immunocompromised persons. 4. Immunocompromised individuals
QC	Children aged between 5 and 17 years old with medical conditions that increase the risk of invasive pneumococcal infections: Anatomic or functional asplenia (splenectomy, sickle cell anemia) 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 (chronic obstructive disease, cystic fibrosis, emphysema). Asthma has not been associated with high risk of invasive infections unless combined with chronic bronchitis, emphysema or long-term systemic cortisone therapy Cardiac (cardiac deficiency, cardiomyopathy, cardiac cyanosis) Hepatic (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)	Children ≥ 2 mths who had close contacts with a case of serogroup C invasive Meningococcal disease	Children ≥ 2 months at high risk: Functional or anatomic asplenia (exp. splenectomy, sickle cell anemia) Complement, properdin or factor D deficiency Congenital antibody deficiency Close contact of a case of serogroup A, Y or W135 Meningococcal disease	Individuals 1 year and older receptive to varicella After age 50, it is preferable to give the herpes zoster vaccine	Females 18 to 26 years old immunocompromised or HIV infected
NB	Children, with health conditions that place them at greater risk of IPD: 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 are excluded) Complement, properdin, or factor D deficiency Diabetes mellitus and other metabolic diseases Sickle cell disease and anaemia, hemoglobinopathy Cancers HIV (acute or chronic cases, contacts) Cochlear implant (pre and post procedure)	Individuals with the following conditions: Splenic disorders (functional asplenia or splenectomy) Complement, properdin, or factor D deficiency Close contacts of a case	Individuals with the following conditions: Splenic disorders (functional asplenia or splenectomy) Complement, properdin, or factor D deficiency Close contacts of a case	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)
NS	HIV infection, immunocompromising conditions (e.g. primary immunodeficiency, malignancies, immunosuppressive therapy, solid organ transplant, bone marrow/stem cell transplants, long term systemic corticosteroids, nephrotic syndrome)	High risk individuals include: those with functional or anatomic asplenia and persons with complement, properdin or factor D deficiency.	Children 2 months of age or older and adults with splenic disorders or complement, properdin, or factor D deficiencies, bone marrow/stem cell transplant	High risk groups include: splenic disorders, immunosuppression/ immunosuppressive therapy (when immunocompetent, as determined by an health care provider), bone marrow/stem cell or organ transplant
PE	Splenectomized patients Individuals with decreased immunity due to sickle cell anemia or primary IgG deficiency Cochlear implant recipients All children up to age 59 mths 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	Splenectomized patients Individuals with decreased immunity due to sickle cell anemia or primary IgG deficiency Cochlear implant recipients	Splenectomized patients Individuals with decreased immunity due to sickle cell anemia or primary IgG deficiency Cochlear implant recipients Close contacts of cases	Routine immunization since 2000
NL	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 (excluding asthma unless treated with high-dose oral corticosteroid therapy) 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	Children > 2 months -10 years with the following conditions Stem Cell Transplant (SCT) Bone Marrow Transplant (MBT) Functional or anatomic asplenia Immunosuppressive therapy	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	Susceptible health care workers Susceptible household contacts of immunocompromised people Selected immuno-compromised individuals
NT	As per NACI recommendations	As per NACI recommendations	As per NACI recommendations	As per NACI recommendations
YT	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	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	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)	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
NU	Routine infant immunization	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	Contacts of cases (A, Y and W135) ≥ 2 years	Women who test negative at prenatal screen

http://www.phac-aspc.gc.ca/im/ptimprog-progimpt/fluvacc-eng.php

Государственное финансирование вакцинации против гриппа по провинциям / территориям
(По состоянию на сентябрь 2013 года)

Target	BC	YK	AB	NT	NU	SK	MB	ON	NS	PE
Original Source: Canadian Pharmacists Association, 2009 1 Police, firefighters, ambulance personnel, and correctional officers 2 The flu vaccine is available free of charge to all residents; however, public education campaigns focus attention on immunizing high risk groups. 3 Vaccine is available free of charge to individuals aged 6 mths or older who live, work or attend school in Alberta/Ontario. 4 Vaccine is free of charge to anyone who requests it 5 For the year 2012-2013, the vaccine is available free of charge to all Manitoba residents aged 6 months or older; however, public education campaigns focus attention on immunizing high risk groups. 6 Vaccine is free of charge to all residents of PEI; however, administration of the vaccine is not covered except for those noted above The following priority groups are recommended for annual influenza vaccination programs by the National Advisory Committee on Immunization (NACI): people at high risk for influenza-related complications, those capable of transmitting influenza to individuals at high risk for complications, and those who provide essential community services. As significant morbidity and societal costs are associated with seasonal interpandemic influenza illness and its complications occurring in healthy children age ≥ 2 years and healthy adults, healthy children age ≥ 2 years and adults should also be encouraged to receive the annual influenza vaccine. For the full NACI recommendations for influenza immunization go to: Statement on Seasonal Influenza Vaccine for 2012–2013
Universal vaccination		²	³	⁴	⁴	²	⁵	³	²	⁶
Special considerations for the 2013-2014 season
▪ Persons with morbid obesity (BMI ≥ 40)
▪ Aboriginal peoples
▪ Healthy children 6 to 59 months of age
Pregnant women in their 3rd trimester, expecting to deliver in influenza season
Pregnant women, any trimester
Children 6 months to 23 months
Persons 18 years and older
Persons 50-64 years
Persons 60 years and older
Persons 65 years and older
Residents of nursing homes or chronic care facilities
Health care workers
Children and adolescents on long-term ASA
Persons on long-term ASA (e.g. RA patients)
Household contacts of people at high-risk
Persons with weakened immune systems
Essential community services: first responders	¹
Persons at risk travelling to destinations where influenza is likely circulating
Persons in direct contact with poultry infected with avian influenza during culling operations
Adults and children with chronic conditions severe enough to require regular medical follow-up or hospital care such as:
▪ Cardiac disease
▪ Pulmonary disease
▪ Asthma
▪ Diabetes
▪ Renal disease
▪ Liver disease
▪ Anaemia or hemoglobinopathy
▪ HIV patients
▪ Immunosuppression, cancer

http://www.phac-aspc.gc.ca/publicat/cig-gci/p03-eng.php

Вакцинация конкретных групп населения

http://www.phac-aspc.gc.ca/publicat/cig-gci/p03-02-eng.php

Иммунизация взрослых

Рекомендации по плановой иммунизации здоровых взрослых людей с низким риском

Vaccine	Recommendations for routine immunization
Diphtheria Tetanus	Primary series for previously unimmunized adults Booster dose every 10 years
Herpes zoster (shingles)	60 years of age and older - 1 dose 50 to 59 years of age - may be given 1 dose
HPV	Women up to and including 26 years of age - bivalent (HPV2) or quadrivalent (HPV4) vaccine Men up to and including 26 years of age -HPV4 vaccine
Measles Mumps	Susceptible adults born in or after 1970 - 1 dose Born before 1970 - consider immune
Meningococcal conjugate	Adults up to and including 24 years of age not immunized in adolescence - 1 dose
Pertussis	One dose of acellular pertussis-containing vaccine (Tdap) in adulthood Adults who will be in close contact with young infants should be immunized as early as possible
Pneumococcal 23-valent polysaccharide (Pneu-P-23)	65 years of age and older - 1 dose
Polio	Primary series for previously unimmunized adults when a primary series of tetanus and diphtheria toxoid-containing vaccine is being given or with routine tetanus and diphtheria-toxoid containing vaccine booster doses
Rubella	Susceptible adults - 1 dose If vaccine is indicated, pregnant women should be immunized after delivery
Varicella (chickenpox)	Susceptible adults up to and including 49 years of age - 2 doses; if previously received 1 dose should receive a second dose Known seronegative adults 50 years of age and older - 2 doses - routine testing is not advised

Рекомендации по иммунизации взрослых людей для конкретных ситуаций риска

Vaccine	Recommendations for risk situations
Bacille Calmette-Guérin (BCG)	Consider use for adults: who may be repeatedly exposed to persons with untreated, inadequately treated or drug-resistant active tuberculosis (TB) in conditions where protective measures against infection are not feasible and if early identification and treatment of latent TB infection are not available who are long‑term travellers to high prevalence countries (in exceptional circumstances as noted above)
Cholera and travellers' diarrhea	Consider use for cholera prevention in adult travellers to cholera-endemic area(s) at high-risk of exposure, including those with occupational risk for exposure (e.g., health care or humanitarian workers in endemic countries) Consider use for prevention of travellers' diarrhea in adults: with chronic diseases at risk for complications at increased risk of acquiring travellers' diarrhea who are immunosuppressed
Haemophilus influenzae type b (Hib)	Recommended for adults with increased risk of invasive Hib disease: congenital immunodeficiencies malignant hematologic disorders HIV anatomic or functional asplenia all transplant recipients cochlear implant recipients Following HSCT adults should receive 3 doses of Hib vaccine at least 4 weeks apart starting 6 to 12 months post-transplant
Hepatitis A	Recommended for adults: travelling to hepatitis A (HA) endemic areas who are immigrants from HA endemic areas who are household or close contacts of children adopted from HA endemic countries in communities or populations at risk of outbreaks or in which HA is highly endemic who are household or close contacts of proven or suspected cases of HA with occupational or lifestyle risk for exposure with chronic liver disease from any cause, including those infected with hepatitis C with hemophilia A or B receiving plasma-derived replacement clotting factors for post-exposure or outbreak management
Hepatitis B	Recommended for adults: who have immigrated to Canada from areas where there is a high prevalence of HB who are household or sexual contacts of acute hepatitis B (HB) cases and HB carriers, including close contacts of children adopted from HB endemic countries if the adopted child is HBsAg positive with occupational or lifestyle risk for exposure travelling to HB endemic areas in communities/populations in which HB is highly endemic who are residents of institutions for the developmentally challenged or inmates of correctional facilities with chronic liver disease, including those infected with hepatitis C with chronic renal disease, including chronic dialysis hemophiliacs and other people who receive repeated infusions of blood or blood products who have undergone hematopoietic stem cell transplantation or are awaiting solid organ transplant who have congenital immunodeficiencies who are HIV-infected for post-exposure management
HPV	May be given to men and women 27 years of age and older at ongoing risk of exposure*
Influenza	Recommended annually for adults: at high risk of influenza-related complications capable of transmitting influenza to individuals at high risk who provide essential community services in direct contact during culling operations with poultry infected with avian influenza
Japanese encephalitis	Recommended for adults: with occupational risk for exposure travelling to endemic area(s) during transmission season with specified exposure risks Booster dose 12 months after primary immunization for persons at continuous risk
Measles Mumps	Recommended for adults born in or after 1970: If susceptible and at increased risk of exposure (travellers to destinations outside of North America, health care workers, students in post-secondary educational settings, and military personnel) - 2 doses, at least 4 weeks apart. Recommended for adults born before 1970 if: non-immune military personnel or health care workers - 2 doses, at least 4 weeks apart non-immune travellers - 1 dose non-immune students - consider 1 dose Recommended for early post-exposure management of measles
Meningococcal quadrivalent conjugate	Recommended for adults: with occupational risk for exposure (i.e., laboratory workers and the military) who are travellers for whom meningococcal vaccine is recommended or required, including travellers to sub-Saharan African and pilgrims to the Hajj in Mecca, Saudi Arabia at high risk of meningococcal disease due to medical conditions: anatomic or functional asplenia (including sickle cell disease) congenital complement, properdin, factor D or primary antibody deficiencies acquired complement deficiency due to receipt of the terminal complement inhibitor eculizumab consider use for HIV-infected adults who are close contacts of a case of invasive meningococcal disease caused by a vaccine preventable serogroup for management of an outbreak caused by a vaccine preventable serogroup Booster doses every 5 years if risk is ongoing
Pneumococcal 23-valent polysaccharide (Pneu-P-23)	Recommended for adults: who are residents of long-term care facilities who are at increased risk of invasive pneumococcal disease (IPD) due to lifestyle factors: persons with alcoholism smokers persons who are homeless who are at high risk of IPD but without immunosuppression. Persons with: asthma requiring regular medical care chronic cerebral spinal fluid (CSF) leak chronic neurologic condition that may impair clearance of oral secretions cochlear implants (including those who are to receive implants) chronic cardiac or pulmonary disease diabetes mellitus chronic kidney disease, including nephrotic syndrome chronic liver disease (including hepatic cirrhosis due to any cause) who are at high risk of IPD AND are immunosuppressed. These persons should receive Pneu-C-13 vaccine followed by Pneu-P-23 vaccine eight weeks later. Persons with: asplenia (functional or anatomic) sickle cell disease or other hemoglobinopathies congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin, or factor D deficiencies), or phagocytic functions HIV infection immunosuppressive therapy including use of long‑term corticosteroids, chemotherapy, radiation therapy, post-organ transplant therapy, and biologic and non-biologic immunosuppressive therapies for rheumatologic and other inflammatory diseases malignant neoplasms including leukemia and lymphoma solid organ or islet cell transplant (candidate or recipient). Consider for individuals who use illicit drugs One lifetime booster dose for adults at highest risk of IPD.
Pneumococcal 13-valent conjugate (Pneu-C-13)	The following adults should receive 1 dose of Pneu-C-13 vaccine followed 8 weeks later by 1 dose of Pneu-P-23 vaccine. Adults with: asplenia (functional or anatomic) sickle cell disease or other hemoglobinopathies congenital immunodeficiencies involving any part of the immune system, including B-lymphocyte (humoral) immunity, T-lymphocyte (cell) mediated immunity, complement system (properdin, or factor D deficiencies), or phagocytic functions HIV infection immunosuppressive therapy including use of long-term corticosteroids, chemotherapy, radiation therapy, post-organ transplant therapy, and biologic and non-biologic immunosuppressive therapies for rheumatologic and other inflammatory diseases malignant neoplasms including leukemia and lymphoma solid organ or islet cell transplant (candidate or recipient) Following HSCT, adults should receive 3 doses of Pneu-C-13 vaccine at least 4 weeks apart followed by a dose of Pneu-P-23 vaccine 6 to 12 months after the last Pneu-C-13 dose (refer to Immunization of Immunocompromised of Persons in Part 3 for additional information)
Polio	Priority for adults who are: travelling to, or receiving travellers from, areas where poliovirus is known or suspected to be circulating health care workers who have close contact with patients who might be excreting wild type or vaccine type poliovirus members of communities or specific population groups with disease caused by polio people who come in close contact with those who may be excreting poliovirus (e.g., people working with refugees, or the military and people on humanitarian missions in endemic countries) laboratory workers handling specimens that may contain poliovirus family or close contacts of internationally adopted infants who may have been or will be vaccinated with OPV vaccine For previously unimmunized adults - primary series of IPV-containing vaccine For previously immunized adults - one lifetime booster dose of IPV-containing vaccine
Rabies (pre-exposure prophylaxis)	Recommended for adults: with occupational risk of exposure with lifestyle risk of exposure travelling to high‑risk areas with specified exposure risks Booster doses if required
Smallpox	Recommended for adults with occupational risk of exposure
Typhoid	Recommended for adults: travelling to endemic area(s) with specified exposure risks who have ongoing household or intimate exposure to an S. typhi carrier with occupational risk of exposure Booster doses if at ongoing risk
Yellow fever	Recommended for adults: less than 60 years of age travelling to areas where there is evidence of yellow fever transmission or if required for foreign travel with occupational risk of exposure Consider use for adults aged 60 years and over travelling to areas where risk of yellow fever is the highest Re-immunization recommended every 10 years for immunocompetent people, if indicated

http://www.phac-aspc.gc.ca/publicat/cig-gci/p03-04-eng.php

Резюме рекомендаций для иммунизации восприимчивых беременных женщин или кормящих матерей

(Вакцины, перечислены в алфавитном порядке.)

Vaccine	Use in pregnancy	Use in breastfeeding	Comments
1 - when benefits outweigh risks
Inactivated vaccines
Cholera and travellers' diarrhea	Use if indicated in high risk situations¹	Use if indicated	No data on use during pregnancy or breastfeeding
Hepatitis A	Use if indicated in high risk situations¹	Use if indicated	No data on efficacy and safety during pregnancy Hep A vaccine should be considered for pregnant women when potential benefits outweigh risks such as for post-exposure prophylaxis or for travel to high risk endemic area
Hepatitis B	Use if indicated¹	Use if indicated	HB vaccine can be used safely in pregnancy and during breastfeeding
Human papillomavirus (HPV)	Currently not recommended	Use if indicated	Limited data on use during pregnancy and breastfeeding
Influenza (inactivated)	Recommended	Recommended
Japanese encephalitis	Use if indicated in high risk situations¹	Use if indicated in high risk situations¹	No data on safety or efficacy during pregnancy or breastfeeding
Meningococcal conjugate	Use if indicated¹	Use if indicated	No data on use during pregnancy. Should be considered for pregnant women in circumstances such as travel to a high -risk area; post-exposure prophylaxis against a vaccine preventable strain; or during an outbreak. Refer to Meningococcal Vaccine in Part 4 for a listing of high risk conditions.
Pneumococcal conjugate 13-valent (Pneu-C-13)	Use if indicated for high risk conditions	Use if indicated for high risk conditions	No data on use during pregnancy Refer to Pneumococcal Vaccine in Part 4 for a listing of high risk conditions.
Pneumococcal polysaccharide (Pneu-P-23)	Use if indicated for high risk conditions	Use if indicated for high risk conditions	Lack of evidence of risk to fetus or pregnancy Refer to Immunization of Persons with Chronic Diseases and Immunization of Immunocompromised Persons in Part 3
Polio (inactivated)	Use if immediate protection needed and at increased risk of exposure to wild poliovirus	Use if indicated	Lack of evidence of risk to fetus or pregnancy
Rabies	Use if indicated for post-exposure prophylaxis Delay pre-exposure immunization unless substantial risk of exposure	Use if indicated
Tetanus-reduced diphtheria (Td)	Use if indicated	Use if indicated	Lack of evidence of risk to fetus or pregnancy
Tetanus-reduced diphtheria-reduced acellular pertussis (Tdap)	Consider use in second half of pregnancy if pertussis is circulating locally and Tdap vaccine not previously received in adulthood	Recommended - administer as early as possible post-partum if Tdap vaccine not previously received in adulthood	Lack of evidence of risk to fetus or pregnancy Use Tdap vaccine during pregnancy is currently under review by NACI
Typhoid (inactivated)	Use if indicated in high risk situations¹	Use if indicated	No data on use during pregnancy or breastfeeding
Live vaccines
Bacille Calmette-Guérin (BCG)	Contraindicated	Generally should not be used May be considered in high risk situations	Lack of evidence of risk to fetus No data on use in pregnancy or breastfeeding
Influenza (intranasal)	Should not be used	Use if indicated	Live attenuated influenza vaccine has a similar or lower efficacy than inactivated influenza vaccine in adults; inactivated influenza vaccine is preferred if chronic health condition. No data on use during pregnancy
Measles-mumps-rubella	Generally contraindicated Immunize rubella-susceptible women immediately post-partum	Recommended if not immune	No known fetal effects; theoretical risk Inadvertent immunization is not a reason for pregnancy termination
Smallpox	Generally contraindicated Consider use in high risk situations (e.g., post-exposure, outbreak)¹	Generally should not be used May be considered in high risk situations (e.g., post-exposure, outbreak)¹	May cause fetal infection Suspend breastfeeding until scab falls off Close contacts who are vaccinated should be isolated from pregnant women as well as lactating women and their newborn until scab falls off
Typhoid (oral)	Contraindicated	Use inactivated vaccine if indicated	Although there are no data, it is reasonable to assume that either Typh-I vaccine could be used safely in lactating mothers.
Varicella	Contraindicated Immunize varicella-susceptible women immediately post-partum	Recommended if not immune	No known fetal effects; theoretical risk Inadvertent immunization is not reason for pregnancy termination
Yellow fever	Generally contraindicated unless travel to area at high risk of transmission is unavoidable and high level of mosquito protection is not feasible	Generally contraindicated unless travel to area at high risk of transmission is unavoidable and high level of mosquito protection is not feasible	Seroconversion rates lower during pregnancy; post-immunization serology recommended Limited data on fetal safety Inadvertent immunization is not reason for pregnancy termination Probable transmission of vaccine strain of yellow fever virus to the infant via breastfeeding has been reported

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