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Middlesex-London Health Unit

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Immunization Information for Healthcare Providers

This webpage provides general information and timely updates for healthcare professionals who order and administer publicly funded immunizations from the Middlesex-London Health Unit.

 

Questions

Please contact us by phone or fax if you questions about vaccine ordering, vaccine schedules and information, vaccine storage and handling or client immunization questions or records.

Phone:
519-663-5317

Fax:
519-663-0416


Email:
Please email the Health Unit for general vaccine information only (please do not include specific client details)
shots@mlhu.on.ca

 

Publicly Funded Immunization Program Updates

Pneumococcal Vaccine Program

In July 2024, Ontario’s publicly funded pneumococcal vaccine program transitioned to the following pneumococcal vaccine products:

  • Pneumococcal 15-valent conjugate (Pneu-C-15), VAXNEUVANCE – this replaces Pneu-C-13 (PREVNAR-13)
  • Pneumococcal 20-valent conjugate (Pneu-C-20), PREVNAR-20 – this replaces Pneu-P-23 (PNEUMOVAX)

These pneumococcal conjugate vaccines will provide broader protection against invasive pneumococcal disease (IPD) compared to Pneu-C-13 and longer-term protection than Pneu-P-23.

On July 2, 2025, the following eligibility enhancement was announced for infants and children:

  • Children aged 6 weeks to 17 years who are at high risk of invasive pneumococcal disease (IPD) who have completed their Pneu-C-13 immunization series are now eligible for one dose of Pneu-C-20 vaccine.

For more information on the provincial Pneumococcal Vaccine Program, including healthcare provider factsheets, visit this Ministry of Health webpage.
Previous pneumococcal vaccines are to be replaced and returned to the health unit through the regular vaccines return process

RSV Vaccine Program

The 2024/2025 publicly funded RSV prevention programs have ended for infants (Beyfortus monoclonal antibody), pregnant women (Abrysvo vaccine), and older adults. More information on the 2025/2026 program will be provided closer to the upcoming respiratory season.


Immunization Information

Middlesex-London Health Unit

  • Alerts and eNewsletter for Healthcare Providers - sign-up, read past alerts and eNewsletters
  • A Guide to Measles, Mumps Rubella and Varicella Vaccines (PDF)
  • A Guide to Tetanus-Containing Combination Vaccines (PDF)
  • A Guide to Meningococcal Vaccines (PDF)

Ontario Ministry of Health

Public Health Agency of Canada

Public Health Ontario


Immunization Schedules 

Publicly Funded Immunization Schedules for Ontario - 2022 is intended primarily for health care providers who administer immunizations. It is to be used as a reference tool for immunizers and provided information regarding:

  • The routine immunization schedule,
  • Catch-up immunization schedules,
  • High risk immunization programs and schedules,
  • Eligibility criteria for all publicly funded immunizations, and
  • Minimum and recommended intervals between doses for immunization series

Immunization Medical Exemptions

Under provincial legislation, children and students attending licensed child care, elementary or secondary school must either have proof of immunization, or have a valid medical or non-medical exemption.

The appropriate form must be completed by a physician or nurse practitioner and submitted to the Middlesex-London Health Unit for children who require a medical exemption.

In addition to being completed for children and students that are contraindicated for immunization, a medical exemption may be used to indicate immunity to a particular vaccine preventable disease (such as history of varicella disease). A lab report demonstrating immunity may replace the exemption form.

Statement of Medical Exemption Forms (*available in English and French)
*If PDF files do not open in the internet browser, download and open with Adobe Acrobat
**If a child attending child care still requires an exemption when they begin school, the appropriate school-age form must be completed.
Instructions
1. Fill out the appropriate State of Medical Exemption Form
  • Indicate which vaccine preventable disease(s) the individual is being exempt from receiving immunization for. Indicate whether the exemption is permanent or temporary. If temporary, include an end date.
2. Submit the form to the Middlesex-London Health Unit.
  • The physician or nurse practitioner may submit the form by fax to 519-663-0416, OR
  • The family can submit a copy of the form. If child attends child care, the child care centre will also require a copy of the form.

Immunization Ordering and Returns

Healthcare providers in the Middlesex-London area who have passed their annual fridge inspection may order publicly funded vaccines from the Health Unit. Healthcare providers who have not yet had fridge inspected by public health and those wanting to learn more about immunization storage and handling should visit the Health Unit’s Immunization Storage and Handling webpage.

How to order publicly funded immunizations:
1. Review your current inventory of immunizations in your fridge.
  • When submitting your order, you will be required to indicate how many of each immunization you currently have in your fridge.
  • To minimize waste and loss in the event of a cold chain incident, you should not store more than a one-month supply of immunizations
2. Gather your fridge temperature logs from the last 4 weeks. These will need to be submitted with your order.
3. Submit your order request through the online Public Health Ordering System (PHOS).
  • If you have yet to register for PHOS, please have your organization's primary contact complete the online registration form.
  • Orders submitted via fax or email will not be processed.
Other important information about ordering immunizations
  • Allow 72 hours (3 business days) for orders to be filled. You will be notified by email when your order is ready for pick-up.
  • All orders must be picked up from the Middlesex-London Health Unit receiving zone located in the Citi Plaza loading dock at 355 Wellington St., London. Instructions on accessing the loading dock will be sent by email with your order confirmation and are also available here.
  • Healthcare providers, staff or couriers MUST arrive for order pick-up prepared with a conditioned insulated container that contains cold ice packs, packing material and a working min-max thermometer that is reading temperatures within +2 to +8 ⁰C. Large orders may require more than one conditioned insulated container. For more information on immunization transportation and temporary storage, visit the Health Unit’s Immunization Storage and Handling webpage.
  • When ordering school immunization program vaccines (HPV, Hepatitis B and Meningococcal ACYW-135), you may be required to provide patient information. Once you have administered these immunizations, healthcare providers must report back to the Health Unit using the form provided.

 Immunization Returns

Immunizations should be returned to the Middlesex-London Health Unit when:

  • Expired (exception - *COVID-19 vaccine)*
  • You have been instructed by a public health nurse to return immunization(s) following the investigation of a cold chain incident.
  • *COVID-19 vaccine that has expired (by manufacture expiry freezer-to-fridge expiry date) should be wasted at the site where it is being stored. The wastage must be reported in the COVAXon system by the site's superuser.
How to return publicly funded immunizations:
  1. Complete the Vaccine Return Form. This form is REQUIRED for all immunization returns. Returns without this form will not be accepted. Vaccine Return Form (PDF)
  2. Place the vaccine you are returning in a bag and write “Vaccines – DO NOT USE” on the bag. Do NOT leave expired or spoiled vaccines in your fridge.
  3. Attach the Vaccine Return Form to the bag or place the form inside the bag and label the outside of the bag with the healthcare provider/office name.
  4. Drop the return off at the Middlesex-London Health Unit receiving zone located in the Citi Plaza loading dock at 355 Wellington St., London. Instructions on accessing the loading are available here. Returns are accepted during regular business hours.
  5. Vaccines are expensive biological agents. You can work to prevent the need for returning vaccine by ordering only a one-month supply at a time and taking care of your vaccine properly.
Other important information regarding immunization returns:
  • Diluent does not need to be returned and can be disposed of at your site.
  • Do not return other medications or medical products that were not distributed by the Vaccine Distribution Program
  • Immunizations that are expired or wasted do not need to be returned in a conditioned cooler as the vaccine will not be re-used.
  • Immunizations are expensive biological agents. You can prevent waste by limiting ordering to a one-month supply.
 
Date of creation: February 27, 2013
Last modified on: August 18, 2025