Latest Ministry Updates Including Provincial Outbreak Immunization Information

Hepatitis A

Current Situation

The Ministry of Health and Long Term Care is monitoring a recent increase in cases of hepatitis A in men who have sex with men (MSM). Some recent cases have also reported experiencing homelessness and/or use of illicit drugs.

Travel history for Ontarians is also an important consideration as there are currently several large international outbreaks of hepatitis A in MSM in Europe, New York City, Chile and Brazil. As well, outbreaks in homeless individuals and/or those who use illicit drugs are being reported in the United States.

Ontario’s Immunization Program:

Hepatitis A vaccine is recommended and publicly funded for:

  • men who have sex with men,
  • people who use intravenous drugs, and
  • those with chronic liver disease, including hepatitis B and C.

The hepatitis A vaccine is also recommended (however not publicly-funded in Ontario) for other groups including those who use non-injectable illicit drugs, individuals living in communities at high risk for hepatitis A outbreaks and travellers. See the Canadian Immunization Guide for additional groups recommended to receive the hepatitis A vaccine. Two doses of hepatitis A vaccine are recommended at least six months apart.

Measles, Mumps and Rubella (MMR) Vaccine for Adults - two doses for those born in 1970 or later

Current Situation

Ontario is currently experiencing increased mumps activity; between January 1 and September 30, 2017, a total of 209 cases of mumps were reported in Ontario. Approximately 59% of cases were between 25 and 47 years of age. Among the 134 cases with known immunization status, 40% received only one dose of mumps-containing vaccine, and 22% are unimmunized. Additional information on recent mumps activity is available on  Public Health Ontario’s website.

Ontario’s Immunization Program:

Two doses of MMR vaccine have been routinely given to children in Ontario since the mid-1990s.  Adults born in 1970 or later who are unimmunized or are unsure of their immunization status can receive up to 2 doses of publicly funded MMR vaccine if they are healthcare workers, post-secondary students, planning travel outside of North America, or based on the healthcare provider’s clinical judgment. In the setting of increased mumps activity, individuals who have not received two doses of MMR should be encouraged to be vaccinated. Due to changes in Ontario’s immunization schedule over time, individuals born between approximately 1970 and 1992 (who are currently between 25 and 47 years of age) likely received only one dose of MMR vaccine and are therefore more susceptible to disease than those who are fully vaccinated. If a patient’s immunization record is unavailable, immunization is preferred, rather than ordering serology to determine immune status. There should be at least a four-week interval between doses of MMR.


Last Updated: November 3, 2017