VACCINE AVAILABILITY IN ONTARIO
1882 - 1997

1882 Smallpox vaccine was made available
1907 The Provincial Board of Health distributed diphtheria antitoxin free of charge to physicians for the treatment of this disease.

(Ehrlich had standardized diphtheria antitoxin at the Koch Institute in 1895, Roux having produced the crude equine preparation in 1892).
1910 Rabies vaccine treatment became available.
1916 Diphtheria antitoxin became freely available. The forerunner, the toxin-antitoxin mixture introduced by von Behring in 1913 was used on a very limited scale in Ontario.
1917 Pertussis vaccine became available on a limited scale to physicians.
1922 Schick testing and immunization of positive cases with the toxin-antitoxin preparation became available.
1925 Diphtheria toxoid (Ramon) was introduced and administered as a single dose causing a distinct reduction in cases and deaths, which improved when a second dose was given in 1926.
1926 Diphtheria toxoid, the formalized product was prepared at the Pasteur Institute by Roux and was introduced.
1927 The three dose schedule (McKinnon and Ross) reduced the attack rate of diphtheria by 91% with no deaths from diphtheria during 1927-1932. The time interval between doses was one year. Diphtheria was the main cause of death in the 2-14 year age group prior to this period. It may sound remarkable, but in 1930 physicians spoke of the possibility of diphtheria eradication.
1929 Poliomyelitis serum was provided on a very limited basis.
1935 Pertussis vaccine (Sauer type) became available.
1943 Diphtheria toxoid and pertussis vaccine were combined. This was discontinued in 1959.
1947 Diphtheria and tetanus toxoids and pertussis vaccine combination was provided (TRIAD, DPT).
1949 Diphtheria toxoid and tetanus toxoid combined was provided.
1955 Poliomyelitis vaccine (Salk) became available.
1959 Diphtheria and tetanus toxoids combined with pertussis and poliomyelitis vaccines provided (QUAD).

Diphtheria and tetanus toxoids with poliomyelitis vaccine provided (DPT).

Diphtheria toxoid and poliomyelitis vaccine also became available.

Tetanus toxoid and poliomyelitis vaccine was provided.
1962 Sabin vaccine (oral polio) was introduced.
1963 The live measles vaccine was available through commercial outlets to physicians.
1967 Killed measles vaccine was distributed to Medical Officers of Health only.
1970 Live further attenuated measles vaccine was distributed through Medical Officers of Health. The rubella vaccine (live) HPV-77DE5 was also distributed through Medical Officers of Health. Rubella vaccine monovalent - HPV-77DE5 available.
1970 October. Killed measles vaccine was discontinued.
1972 Combined measles - rubella vaccine was distributed to physicians and Medical Officers of Health.
1974 Rubella vaccine HPV-77DE5 was distributed to physicians and Medical Officers of Health.
1975 Combined measles, mumps and rubella vaccine distributed to physicians and Medical Officers of Health. Referred to as MMRI - RI = HPV-77DE5.
1977 December 10. Measles-rubella vaccine discontinued.
1980 January. Rubella vaccine RA27/3 monovalent was introduced and replaced the HPV-77DE5.
1980 April 16. MMRII vaccine with RA27/3 component was introduced to replace the MMRI.
1981 Introduction of diploid cell rabies vaccine for all post-exposure treatment (HDCV).
1982 July. Immunization of School Pupils Act introduced.
1983 Hepatitis B vaccine distributed at cost to specific groups at risk. Discontinued in 1985.
1984 Introduction of absorbed vaccine. DPT Polio, Td Polio, Tetanus Polio and Tetanus.
1985 Introduction of hepatitis B vaccine for neonates (Heptavax).
1986 Hepatitis B program expanded to include family contacts of carriers.
1987 January. TriVirix (MMR vaccine) was introduced.
1987 April. Immunization of 2 year old children against Haemophilus influenzae b with PRP (polysacchride) Hib vaccine.
1988 Conjugate Haemophilus b vaccine introduced for children aged 18 months to 5 years (PRP-D, ProHIBiT). PRP discontinued.
1988 April to July. TriVirix discontinued.
1988 Introduction of recombinant hepatitis B vaccine (Engerix).
1989 April. Enhanced IPV (MRC5 Salk), only single component IPV only available.
1989 Public health program for influenza vaccine introduced to groups at high risk of influenza-related complications.
1989 December. Tetanus-polio vaccine discontinued.
1990 January. OPV (Sabin) introduced into the routine Ontario immunization schedule. Routine use of IPV discontinued. Routine polio boosters for adults discontinued.
1991 August 31. Two Haemophilus influenzae type b vaccines licensed in Canada for use for children aged 2-59 months: HbOC (HibTITER Lederle Laboratories) and PRP-OMP (PedvaxHIB, Merck Frosst Canada). Commercially available in Ontario beginning October 1991 (Merck) and February 1992 (Lederle).
1991 October 25. Expansion of hepatitis B high risk program to include household and sexual contacts of acute cases, sexual contacts of chronic carriers, IV drug users, those with multiple sex partners, those having needle stick injuries in a non-health care setting.
1992 March. A third infant Hib vaccine licensed for use in children aged 2-59 months: PRP-T (ActHIB), Connaught Laboratories Ltd). Commercially available in Ontario in June.

September 1. HbOC (HibTITER) introduced into the routine infant immunization schedule in Ontario at 2, 4, 6 and 18 months of age.
1993 Expansion of influenza program to cover patient-care staff of long term care facilities.
1993 April. OPV discontinued. DPT-eIPV introduced.
Tetanus toxoid discontinued.
1994 June 1. PENTA (DPT-eIPV/PRP-T) introduced for routine immunization at 2, 4, 6 and 18 months.

September. Hepatitis B program further expanded to include routine immunization of all grade 7 students against hepatitis B.

HibTITER discontinued. ActHIB (PRP-T) introduced, as a component of PENTA.
1996 February - June. Measles "catch-up" campaign conducted to administer a second dose of measles vaccine (Connaught Laboratories Limited) to all 2.1 school aged children age 4-18 at school-based clinics; 89% of target group immunized. Following the campaign, a second dose of MMR recommended for all children immunized with a single dose of MMR after their first birthday, to administered at 4-6 years of age (school entry).

September. Adolescent high school hepatitis B catch-up program, targeted at students in grades 10 to OAC. The grade 7 program continues.

September. Pneumococcal vaccine, 23-valent, for high risk groups, introduced in the public health immunization program, with a "catch-up" over 3 years as follows: 1996/97: 400,000 doses; 1997/98: 500,000 doses; 1998/99: 500,000 doses. Product from Merck Frosst Canada used in first year, product from Pasteur-Merieux Connaught used in following two years. Vaccine thereafter to be purchased for those entering the high risk group each year, estimated at 80,000 doses per year.
1997 July. Acellular pertussis vaccine introduced, in the form of PENTACEL (Pasteur Merieux Connaught), at 2, 4, 6, and 18 months of age, and as QUADRACEL given at 4-6 years. Products containing whole cell pertussis vaccines (PENTA DPT-Polio, pertussis vaccine) were discontinued.