Measles Community Clinic Booking

Vaccine Eligibility
Screening Questions
Demographic Information
Confirmation

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For those who live, play, travel to, worship or otherwise, in the Grand Erie Public Health (GEPH) and Southwestern Public Health (SWPH) regions:

Expanded eligibility for infants 6 months to 11 months of age
Accelerated schedule for second doses in children under 4 years of age
Second dose for adults born in and after 1970

EXPANDED ELIGIBILITY FOR INFANTS 6 MONTHS TO 11 MONTHS:

To create additional protection for this highly vulnerable age group, an additional publicly funded dose of measles containing vaccine can now be provided to infants 6 months to 11 months of age
The use of MMR vaccine down to 6 months of age for infants at risk of measles exposure (in the setting of an outbreak-affected area or travel) is a long-standing off-label vaccine recommendation from the National Advisory Council on Immunization (NACI).
Two additional doses of measles containing vaccine must be administered after 12 months of age (and at least 28 days after the previous dose) to ensure long-lasting immunity to measles.

ACCELERATED SCHEDULE FOR SECOND DOSES:

To increase immunization coverage among children and prevent complications from measles infection that are more common under the age of 5 years, the second dose of the measles-containing vaccine scheduled at 4-6 years of age should instead be provided as early as 28 days from the previous
At an interval of 28 days or beyond, the second dose is considered valid under the Immunization of School Pupils Act and effective to provide long-lasting immunity. An additional dose of measles-containing vaccine at 4-6 years would not be required

SECOND DOSE FOR ADULTS BORN IN AND AFTER 1970:

Adults born in and after 1970 with only one dose of measles-containing vaccine should be offered a second dose.
Individuals born prior to 1970 in Canada are likely to have immunity as the result of being exposed to measles through natural infection. Additional doses of measles containing vaccine are not required.

I have read, understood and meet the eligibility criteria to receive measles vaccine

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Vaccination History:

Have you ever received the MMR (Measles, Mumps, Rubella) vaccine before?

Yes

Have you received 2 or more doses of measles containing vaccine, at least 4 weeks apart, after 12 months of age?

Yes

⚠️ Due to your vaccine history, you have received the required two doses of measles containing vaccines. Another dose is not required.

When was your last dose of the MMR vaccine administered?

Recent Contact with Measles Cases:

Have you recently been in close contact with someone diagnosed with measles?

Yes

Were you in a setting where there was a confirmed case of measles, such as a daycare, school, place of worship, or community setting?

Yes

⚠️ Due to your potential exposure to the measles virus, you cannot book an appointment at one of our community measles vaccine clinics. Please speak with a member of our team for further details at 519 753 4937 ext.454

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Client's First name

Client's Last name

Date Of Birth (mm/dd/yyyy)

Gender

Ontario Health Card #

Without letters, dashes or spaces, eg.0000000000

Alternate ID type (if Health Card is not available)

Would you like a Reminder?

Yes

By selecting YES you are agreeing to GEPH (Brantford) to use your email and/or phone number to send a confirmation of registration and reminders about your vaccination appointment. The contact information provided will not be used for any other purpose.

e.g. abc@xyz.com

Cell Phone

e.g. 000-000-0000

Reason to receive Measles containing vaccine?

Individuals born prior to 1970 in Canada are likely to have immunity as the result of being exposed to measles through natural infection. Additional doses of measles containing vaccine are not required.

Book appointment

Date

No dates are available

Time

No time slots are available

I have read and understand the information about Measles vaccine as provided in theMMR - Grand Erie Public Health

I have read, understand and agree to the Grand Erie Health Unit Privacy Statement regarding the collection of information.

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Measles Community Clinic Booking Tool