Max Rady College of Medicine

Concept: Childhood Immunizations

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Concept Description

Last Updated: 2021-07-29


    This concept provides information on childhood immunizations, including the immunization schedule, access to immunization tariff codes that identify DPT (diphtheria, pertussis and tetanus), Polio, HiB (haemophilus influenza B), MMR (measles, mumps and rubella), and pneumococcal conjugate vaccine (PCV). It also includes information on how the immunization schedule has changed over time. Immunization rates available from MCHP publications are also available through links to this information. This concept also provides a link to an example of SAS code for determining "complete" immunizations (up to 2007). Please see the SAS code and formats section containing the following link to: Compute 1 and 2 year Rates of Immunizations - SAS Code - (internal access only).

    In Manitoba, the three levels of government - municipal (City of Winnipeg), provincial, and federal - and two types of providers - physicians (approximately 80%) and public health nurses (20%)- are involved in the delivery of immunizations. Immunizations are provided through a longstanding provincial program. The Manitoba Immunization Monitoring System (MIMS) records all immunizations of provincial registrants (as of Jan 1, 1980) and provides monitoring and reminders to families.

    MIMS files contain:

    • registry information
    • a code that identifies the vaccine administered and its sequence in the immunization schedule
    • service date
    • provider identifiers-to distinguish physician administered immunizations from those given by public health nurses

    Comparisons between physician and MIMS records have shown data quality for the non-aboriginal population to be high. Two percent or fewer immunizations or service dates are coded incorrectly, while physician failure to bill has been estimated at between 0.2% (urban) and 6.6% (rural).

Immunization Schedule

    In order for a child to be considered completely immunized, a minimum number of doses of each type of vaccine must be received within the first few months, up to 2 years of age.

    NOTE: Over time, there have been changes in the recommended immunization schedule. The information below identifies some of these changes:

    • In 1984 the recommended childhood immunization schedule was:
      • DPT (diphtheria, pertussis and tetanus) at 2, 4, 6 and 18 months
      • OPV (oral polio vaccine) at 2, 4, 6 and 18 months
      • MMR (measles, mumps and rubella) at 12 months

    • In 1992, Hib (haemophilus influenza B) vaccine was added at 2, 4, 6 and 18 months

    • In 1997, OPV was replaced with IPV (inactivated polio vaccine). This was combined with the DPT vaccine as a quadravalent vaccine. Hib was also added to form a pentavalent vaccine.

    • In Martens et al. (2003), they followed the recommended immunization schedule for infants and children in Manitoba, in the first 2 years of life for 2001.
      Age at vaccination DPT Polio HiB 1 MMR
      2 months
      4 months
      6 months
      12 months
      18 months






      • (X) - this dose is not needed routinely, but can be included.
      • 1 HiB (Hemophilus influenza B) vaccine added mid-1992.
      • Hepatitis B has been offered to all Grade IV students since Fall of 1998, but there is not currently any schedule for children.

    • In 2004, three vaccines applicable to this age group were introduced
      • influenza for infants age 6 - 23 months
      • pneumococcal conjugate at 2, 4, 6 and 18 months of age
      • varicella at age 12 months.

    • In Chartier et al. (2012), , they compared complete immunization rates of Francophone and all other Manitoban children using the following recommended schedule for 2006/2007:
      • four Diphtheria, Acellular Pertussis, Tetanus (DTP) immunizations;
      • three Polio immunizations;
      • four Haemophilus Influenzae type B (HiB) immunizations
      • one Measles, Mumps, and Rubella (MMR) immunization;
      • one Varicella immunization; and
      • four Pneumococcal Conjugate 7 (PCV-7) immunizations.

    • In Smith et al. (2013), they measured childhood immunization completion rates over two years (2007/08 to 2008/09) using the same immunization schedule presented above for 2006/2007.

    • In 2009, meningococcal conjugate C (Men-C) was added to the schedule; one dose at 12 months and another dose in grade 4.

    • In July, 2010 the pneumococcal conjugate vaccine (PCV) was transitioned from PCV-7 to PCV-13. Children who started with PCV-7 continued and finished their immunization series with PCV-7. Children starting after July 2010 would have been given PCV-13.

    • In July 2012, Manitoba Health offered a single booster of PCV-13 to children under the age of 5 who had never received PCV-13. Also in July 2012, a schedule change in PCV-13 reduced the amount of doses to three for children who are not at high risk of pneumococcal infection. Children at high risk continued to receive a total of four doses.

    • In Katz et al. (2014), they investigated complete childhood immunizations by age 2 using the schedule presented in Table 3.2 - Doses Required to be "Complete for Age" for Two Year-Olds of the report.

    • In Chartier et al. (2020), they investigated complete childhood immunizations by age 2, from children born in 2009 to 2013 until the end of 2015, using the schedule presented in Appendix Table 2.1: Technical Definitions - Complete Vaccination (Two Year Olds) of the report.

    Current Information from Manitoba Health
    For current information on recommended immunization schedules, click on the following links that are available on the Manitoba Health - Communicable Disease Control website:

Working with Immunization Tariff Codes

    Tariff codes for immunizations have responded to changes in vaccine technology over the last several years. Not only are vaccines being improved in terms of efficacy and reduction of adverse effects, but the trend has been toward combining several antigens into one vaccine. The greater convenience of these combined doses makes them easier for the health care provider to administer, making it more likely that the required number of doses of each will be given on time.

    Counting immunizations is equivalent to a search for tariff codes. The date of the immunization must also be checked to see if it falls within the specified time period. Any doses outside of this time period (i.e. too late) are not counted. For example, according to the 2001 immunization schedule, in order to be considered at one year, a child requires three DPT, two Polio, and three Hib vaccines in the first 12 months of life. The MMR at 12 months is not usually counted in this first 12 month period. The Canadian Immunization Guide 1998 states this dose should be given "shortly after the first birthday." Tables for subsequent periods, such as 13 months or 18 months, should count the MMR.

    Tariff Codes

    The following sources provide a list of tariff codes used to identify immunizations in MCHP research:

    Tariff Codes - Manitoba Health
    For a current list of active and cancelled MIMS tariffs from Manitoba Health, please see Manitoba Health Web Site - MIMS Tariffs - Quick Reference for Health Professionals .

Immunization Rates Available Through MCHP Publications

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Related terms 



  • Black C, Roos NP, Fransoo R, Martens PJ. Comparative Indicators of Population Health and Health Care use for Manitoba's Regional Health Authorities: A POPULIS Project. Winnipeg, MB: Manitoba Centre for Health Policy and Evaluation, 1999. [Report] [Summary] (View)
  • Brisson M, Edmunds W, Gay N, Law B, DeSerres G. Modelling the impact of immunization on the epidemiology of varicella zoster virus. Epidemiology and Infection 2000;125(3):651-669. [Abstract] (View)
  • Chartier M, Finlayson G, Prior H, McGowan K, Chen H, de Rocquigny J, Walld R, Gousseau M. Health and Healthcare Utilization of Francophones in Manitoba. Winnipeg, MB: Manitoba Centre for Health Policy, 2012. [Report] [Summary] (View)
  • Chartier M, Brownell M, Star L, Murdock N, Campbell R, Phillips-Beck W, Meade C, Au W, Schultz J, Bowes JM, Cochrane B. Our Children, Our Future: The Health and Well-being of First Nations Children in Manitoba. Manitoba Centre for Health Policy, 2020. [Report] [Summary] [Updates and Errata] [Additional Materials] (View)
  • Fransoo R, Martens P, The Need to Know Team, Burland E, Prior H, Burchill C, Chateau D, Walld R. Sex Differences in Health Status, Health Care Use, and Quality of Care: A Population-Based Analysis for Manitoba's Regional Health Authorities. Winnipeg, MB: Manitoba Centre for Health Policy, 2005. [Report] [Summary] [Additional Materials] (View)
  • Hilderman T, Katz A, Derksen S, McGowan K, Chateau D, Kurbis C, Allison S, Reimer JN. Manitoba Immunization Study. Winnipeg, MB: Manitoba Centre for Health Policy, 2011. [Report] [Summary] (View)
  • Katz A, Chateau D, Bogdanovic B, Taylor C, McGowan K-L, Rajotte L, Dziadek J. Physician Integrated Network: A Second Look. Winnipeg, MB: Manitoba Centre for Health Policy, 2014. [Report] [Summary] [Updates and Errata] (View)
  • Martens PJ, Fransoo R, The Need to Know Team, Burland E, Jebamani L, Burchill C, Black C, Dik N, MacWilliam L, Derksen S, Walld R, Steinbach C, Dahl M. The Manitoba RHA Indicators Atlas: Population-Based Comparison of Health and Health Care Use. Winnipeg, MB: Manitoba Centre for Health Policy, 2003. [Report] [Summary] [Additional Materials] (View)
  • Roberts JD, Poffenroth LA, Roos LL, Bebchuk JD, Carter AO. Monitoring childhood immunizations: a Canadian approach. Am J Public Health 1994;84(10):1666-1668. [Abstract] (View)
  • Roos LL, Traverse D, Turner D. Delivering prevention: the role of public programs in delivering care to high-risk populations. Med Care 1999;37(6 Suppl):JS264-JS278. [Abstract] (View)
  • Smith M, Finlayson G, Martens P, Dunn J, Prior H, Taylor C, Soodeen RA, Burchill C, Guenette W, Hinds A. Social Housing in Manitoba. Part II: Social Housing and Health in Manitoba: A First Look. Winnipeg, MB: Manitoba Centre for Health Policy, 2013. [Report] [Summary] (View)


  • health status
  • Immunization Schedule
  • MIMS
  • Vaccines

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Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada