Immunisation catch-up in Canada: missed doses and moving province

What catch-up means, and what it does not

This page is about doses that were missed, delayed, or given in another country. It is not the routine schedule. If your child is simply due their next scheduled vaccine at the usual age, that is an ordinary appointment.

The reassuring part first: an interrupted course is normally resumed, not restarted. A vaccinator reviews what your child has already had, compares it with the schedule for your province, and gives what is outstanding at appropriate intervals. Delay reduces protection in the gap; it does not usually waste the doses already given.

The real obstacle is the record, not the vaccine

Canada has no single national immunisation registry. Records are held provincially, and they do not travel with you. Families who move between provinces, or who arrive from another country, routinely find that a complete vaccination history exists on paper somewhere but is invisible to the system now responsible for their child.

The practical rule is to keep your own copy. Ask for a printed or digital record every time your child is vaccinated, keep the provincial immunisation card, and photograph it. If you are moving, request a full record from your current province before you go, because retrieving it afterwards is slower.

Ontario: the law has teeth

Ontario is the province where an incomplete record has the sharpest consequence. Under the Immunization of School Pupils Act, children attending school must be immunised against diphtheria, tetanus, polio, measles, mumps, rubella, meningococcal disease and whooping cough, with chickenpox required for children born in 2010 or later.

Ontario states that students who are not up to date on their routine immunisations may be excluded from attending school in certain circumstances. Crucially, that includes children who have been vaccinated but whose local public health unit has not been told, because the health unit acts on the record it holds.

Reporting is the parent's job

Ontario is explicit that you must report immunisations to your local public health unit as part of the Act. Vaccines given by a family doctor do not reach public health automatically. The province directs parents to Immunization Connect Ontario, the ICON tool, through their local public health unit's website.

Exemptions exist in two forms. A medical exemption requires a Statement of Medical Exemption signed by a physician or nurse practitioner. A non-medical exemption on grounds of conscience or religious belief requires an education session, a vaccine video, a signed Vaccine Education Certificate, and a notarised Statement of Conscience or Religious Belief submitted in original to the local public health unit.

Quebec: Clic Sante and the booklet

Quebec runs its own immunisation programme and its own booking system, and the details do not map onto Ontario's. The Gouvernement du Quebec describes the Quebec Immunization Program as offering certain vaccines or preventive treatment free of charge, and directs residents to their CLSC, doctor or pharmacist.

Appointments are booked through Clic Sante, and Quebec publishes 1-877-644-4545 for information or to book. The province also tells you to bring your immunisation record to the appointment, noting that the record is generally given at birth or at the first vaccination appointment. That booklet is the document a Quebec vaccinator will want to see, so treat it as valuable rather than as a souvenir.

British Columbia and the rest

British Columbia does not make vaccination a condition of school attendance in the way Ontario's Act does, but it does collect immunisation status for school-age children, and public health follows up incomplete records. HealthLink BC publishes the provincial immunisation information for parents, and the provincial 8-1-1 line will tell you which clinic or public health unit does catch-up in your area.

Across provinces the pattern is the same: routine childhood vaccines on the provincial schedule are publicly funded, and catch-up doses for children on that schedule are funded too. Vaccines outside the schedule, including some travel vaccines and some doses for older teenagers and adults, may be charged for, and the rules differ by province, so ask before you book rather than after.

What a catch-up appointment looks like

Expect a plan rather than a single visit. Vaccines have minimum intervals between doses, so a child who is a long way behind is caught up over weeks or months, with the most important protection given first. Ask for the plan in writing, ask which doses were given today and which were deferred, and ask when the next appointment should be booked.

Arriving from another country

Bring every document you have, even if it is in another language and even if it looks incomplete. A vaccinator can usually map a foreign schedule onto the provincial one and identify the genuine gaps, which is almost always fewer doses than starting from scratch. Where no record exists at all, your provider will discuss an appropriate plan rather than assume nothing was given.

Two specifics catch families out. Some vaccines used routinely in Canada are not used everywhere, so a child with a complete record from abroad may still have real gaps. And some doses given very early abroad may not count towards the Canadian schedule if they were given below the minimum age, which is a clinical judgement your vaccinator will make.

Where to get help

Your family doctor, nurse practitioner or local public health unit can review a record and build a catch-up plan. In Ontario, contact your local public health unit and use ICON to report doses. In Quebec, book through Clic Sante or call 1-877-644-4545, and bring the immunisation booklet. In British Columbia and most other provinces, 8-1-1 will point you to the right clinic. Take every record you have to the first appointment.