Recommended vaccines for students
This page lists the vaccines that are most relevant to - and recommended for - the average university student. All vaccines listed below are available at Student Health by making an appointment with a nurse.
Please note that we can not provide immunizations for infants or children.
It is recommended that all young adults (born after 1970) who have not received two doses of the Measles, Mumps and Rubella vaccine (MMR) go to a clinic and receive a second vaccine.
Measles, red measles or Rubeola is a viral illness that is characterized by fever, cough, a runny nose, teary eyes and a red rash that covers large parts of the body. Complications can include pneumonia and ear infections. The infection is transmitted by direct contact with infectious droplets released during coughing. The incubation period is from eight to twelve days from the exposure to the onset of symptoms and a person is infectious for four days after the appearance of the rash.
The best treatment is prevention. In the early 1970s a vaccine was made available and in 1976 it was used routinely in Quebec. In the late 1990s several cases of measles were reported in young adults in various areas in North America. This was believed to be the result of probable vaccine failure. It was then suggested that a second dose of vaccine be given to those individuals at risk, which can be defined as anyone born after 1970. Due to the increasing number of cases of measles that are being reported, it is recommended that all young adults who have not received two doses of the Measles, Mumps and Rubella vaccine (MMR) go to a clinic and receive a second vaccine.
It is recommended that all young adults (born after 1970) who have not received two doses of the Measles, Mumps and Rubella vaccine (MMR) go to a clinic and receive a second vaccine.
Mumps is a disease caused by a virus and usually occurs with fever and swelling of the salivary glands (swollen cheeks). The disease is more severe in adults than in children and may involve other organs in the body, including the thyroid, the pancreas, and commonly the testicles. The infection is transmitted by exposure to respiratory tract secretion, e.g. coughing, sneezing. The virus is most communicable one to two days prior to the appearance of symptoms and up to five days after. The incubation period ranges from twelve to twenty days.
There has recently been a rise in the number of cases of mumps reported in Canada especially in the Atlantic provinces. The major reason for the increase in mumps at this time is believed to be vaccine failure. Most of us received a vaccine against mumps as children but for a variety of reasons not everyone has developed an adequate response. If you were born after 1970 and have not received two doses of the mumps vaccine with the first one after the age of one, then you should be given a second dose of the vaccine. The mumps vaccine comes as part of a triple vaccine called MMR which contains measles, mumps and rubella.
Rubella is included in the measles, mumps and rubella (MMR) vaccine. As such, two vaccines are now given. All women planning to become pregnant should be screened for the presence of antibodies to rubella. If they are not immune then they should be vaccinated at least three months prior to conceiving.
Rubella, commonly known as German measles, is a mild infection with a characteristic rash. Many people have no symptoms but the virus can cause significant birth defects in the fetus. It is acquired through inhalation of droplets. The incubation period is 14 to 23 days, usually 16 to 18 days. When the infected person manifests symptoms, these include a rash, swollen lymph nodes, and a slight fever. Commonly, college health individuals will have transient joint pains.
The vaccine was introduced in the 1970s. It is a very effective vaccine which produces long lasting immunity. However, sometimes infections have occurred in previously immunized people. Since it is included in the measles, mumps and rubella (MMR vaccine) two vaccines are now given. All women planning to become pregnant should be screened for the presence of antibodies to rubella. If, they are not immune then they should be vaccinated at least three months prior to conceiving.
If you are travelling to a tropical area of Africa or Latin America you may be at risk. The risk is greater for those travelling for extended periods of time to rural or jungle areas. Get vaccinated (at a travel health clinic) at least 10 days before you travel. Fee applicable.
Yellow Fever is a viral infection that is spread through the bite of an infected mosquito. Its name can be explained by the yellowing of the skin and eyes (jaundice) that may occur when the virus attacks and compromises the liver.
Yellow Fever is caused by an arbovirus of the flavivirus genus (similar to the West Nile and Dengue fever viruses). It is usually transmitted by mosquito - it transfers the virus from one host to another, mainly between monkeys, from monkeys to humans, and from person to person.
Some cases of Yellow Fever can occur without presenting any symptoms, whereas other cases can be fatal. Symptoms can take 3 to 6 days to appear. The infection can occur in one or two phases. The first, "acute" phase usually causes people to experience flu-like symptoms (fever, headache, joint pain, loss of appetite, abdominal pain, nausea/vomiting and dehydration). Most people recover from this phase after 3 to 4 days.
However, around 15% of cases enter a second, more deadly phase within 24 hours of the end of the first phase. Multiple body systems are affected. Symptoms may include: high fever; jaundice; abdominal pain; vomiting; and bleeding from the mouth, nose, eyes, stomach or intestines. Half of the people who enter the second phase die within 10 to 14 days; the remainder recover without significant organ damage.
If you are travelling to a tropical area of Africa or Latin America you may be at risk. The risk is greater for those travelling for extended periods of time to rural or jungle areas.
Prevention & treatment
Thankfully, Yellow Fever can be prevented by the Yellow Fever vaccine which is 95 percent effective. Get vaccinated (at a travel health clinic) at least 10 days before you travel. This is a legal requirement for countries requiring a yellow fever certificate. Use protective measures to avoid mosquito bites (e.g. spray clothing and mosquito netting with permethrin; use mosquito repellent with DEET).
There is no treatment for yellow fever, only supportive care to treat symptoms such as dehydration and fever. Seek medical attention as soon as possible at the onset of fever both during your trip and upon your return.
Yellow Fever Vaccination Centres in Canada, Measures to avoid insect bites, World Health Organization (WHO) Yellow Fever fact sheet
- The Department of Public Health provides the vaccine free to those individuals who are part of risk groups, including men who have sex with men and people with pre-existing liver disease.
- It is strongly recommended that those traveling to developing countries be immunized prior to departing. In this case the vaccine is not paid for by Public Health but is available at Student Health at a reduced cost.
- Fee applicable.
Cause and symptoms
Hepatitis A is one of the many viruses that cause an infection of the liver. It is transmitted when food or water contaminated by human waste is ingested or during oral-anal sexual contact. The incubation period is from 15 to 49 days. Symptoms include fatigue, malaise, vomiting, loss of appetite, fever and abdominal pain followed by jaundice. Commonly a person will feel sick for several weeks. Once recovered the person is fine and does not become a carrier of the disease. A more serious - and very rare - form of the disease is called fulminant hepatitis. Fulminant hepatitis is more common in those individuals with pre-existing liver diseases, and can sometimes result in death.
Groups at risk
The Department of Public Health provides the vaccine free to those individuals who are part of risk groups, including men who have sex with men, people with pre-existing liver disease and students working with non-human primates. Consult a nurse to find out if you are part of a group at risk.
Since the disease is very common in developing countries it is strongly recommended that everyone traveling to these countries be immunized prior to departing. In this case the vaccine is not paid by the Public Health Department but it is available at Student Health at a reduced cost.
The vaccine exists as a single vaccine or as a combination with hepatitis B. If you haven’t been vaccinated for the latter then taking advantage of the combined vaccine is recommended.
If you have been exposed to a person infected with Hepatitis A then you should come to Student Health to be given appropriate prophylaxis.
The vaccine is recommended and provided free of charge to certain people at risk including men having sex with men, individuals with multiple sex partners, those recently diagnosed with an STI, intravenous drug users, those with liver diseases and family contacts of a person infected with hepatitis B. Fee applicable.
Hepatitis B causes an infection of the liver. It is transmitted by blood and mucous secretions, including semen or saliva. In North America and Western Europe the mode of transmission is mainly through sexual contact, injection drug use or accidental exposure to blood. In areas like China or Southeast Asia where the infection is common, transmission occurs at childbirth.
The incubation period for hepatitis B is from one to four months. A majority of infected individuals will have no obvious symptoms. Those who do will usually experience lose of appetite, nausea, jaundice and abdominal pain. For some individuals the symptoms will be more severe, and death can result. The symptoms may last one to three months but in some fatigue may last for a longer period of time. Most adults who become infected will develop antibodies within six months and rid themselves of the virus. A small percentage, approximately 5% will develop a chronic form of the disease. On the contrary, 90% of children infected at birth will become chronic carriers. A chronic carrier is a person who still has the disease, who may develop liver cirrhosis or cancer over time and who can infect others. Treatment is available for these individuals; the medications used may cause severe side-effects and are not entirely effective. The most effective treatment is prevention.
A vaccine can be used prior to an infection to prevent the disease. The vaccine consists of three injections over a period of three months. In Quebec, all children in grade 4 are vaccinated. The vaccine is recommended and provided free of charge to certain people at risk including men having sex with men, individuals with multiple sex partners, those recently diagnosed with an STI, intravenous drug users, those with liver diseases and family contacts of a person infected with hepatitis B. Ask a nurse at Student Health to find out if you fall into one of these categories.
The hepatitis B vaccine can also be given in combination with hepatitis A.
If you believe that you may have been recently exposed to hepatitis B through blood or mucous secretions you should go to the emergency room of a hospital to be treated. Once there you will be given Hepatitis B Immune Globulins, which is pooled human serum containing large amounts of hepatitis B antibodies to help you fight off the disease and the first injection of the vaccine will be given. This should be done within 48 hours of exposure, except for sexual contacts where it can be done up to two weeks after the contact, but the sooner the better.
Chicken Pox (Varicella)
It is recommended that students who have never had chicken pox be vaccinated.
Varicella is better known as Chicken Pox. This is a very infectious virus that is easily transmitted from one person to another. The disease can be transmitted via droplets a day or two prior to the appearance of the typical rash of chicken pox. Once the rash appears the fluid inside the poxes is also infectious.
The incubation period is from 10 to 21 days after a contact. Most people present with a mild fever, runny nose and 200 to 500 very itchy pimples like lesions call poxes. Complications of this disease can include bacterial skin infections, middle ear infection, pneumonia, encephalitis and even death. The most severe complications are more common in adolescents and young adult. The infected person develops antibodies which allow the rash to heal and the disease resolve. However, these antibodies are unable to rid the person of the virus. As a result the virus will hide in a nerve root to potentially reemerge in 15% to 20% of people as herpes zoster or shingles often in times of stress.
It is recommended that, because of the severity of the complications related to this disease, that students who do not have a past history of chicken pox should be vaccinated. The vaccine is contraindicated in certain individuals such as people who are immunocompremized. So, if you have never had the disease or don’t remember you can come in to see a nurse and be vaccinated assuming that you do not have any contraindications to the vaccine. The vaccine is free of charge for students in health care fields but not for others but it is sold at cost at Student Health.
It is important to get a booster shot of the Diphtheria vaccine every 10 years.
Diphtheria is a disease that you seldom hear about these days. The very effective childhood immunization program that has been in place for many years is the primary reason for this. All children within there first year of life are immunized for this disease and follow-up vaccines are given throughout infancy.
In North America Diphtheria primarily manifests as a severe sore throat. It is characterized by a mild fever and after one or two days the development of a marked, pussy throat called a membranous nasopharyngitis. The membranous nasopharyngitis may be accompanied with swelling of the throat and larynx. If this swelling is severe enough it may lead to obstruction of the upper airways, which can then lead to respiratory arrest.
As previously mentioned most children are vaccinated against this disease very early in life. This vaccine is a more commonly a combination vaccine with tetanus and whooping cough. However, the immunity to diphtheria does wane over time so it is important to get a booster every 10 years. Human are the only reservoir for this disease. So, even if you don’t get severe ill from becoming infected you may be the source for someone else. So get a booster! At Student Health at no cost to you!
It is recommended that you get a booster every 10 years, as immunity wanes over time. This vaccine is provided free of charge.
The common name for this disease is Lockjaw and this name is a very good description of what happens when you get infected. The onset is gradual, occurring over one to seven days. Symptoms progress from spasm of the muscles of the jaw, hence lockjaw, to the entire body. The least little external stimulus will set the patient into spasm.
The bacteria which causes Tetanus is called Clostridium tetani. This bacterium is everywhere and usually grows in a wound to produce a toxin. This is why patients receive a booster when they are wounded. It is recommended that you get a booster every 10 years - as immunity wanes over time.
Whooping Cough (Pertussis)
All children are routinely immunized but the level of antibodies falls over time. A new vaccine has been developed that can safely be given to adolescents and adults, and it is recommended that all students receive the new vaccine. It is available at Student Health free of charge.
The infection is caused by a bacterium called Bordetella pertussis. It is transmitted from person to person by droplets when a person coughs. The incubation period is 6 to 21 days. The bacteria invade and damage the epithelium or inner lining of the respiratory tree.
The disease is divided into three phases. The first phase resembles a cold or mild upper respiratory infection and last one to two weeks. As with any cold this is accompanied by a cough that gets worse with time. This is then followed by the paroxysmal phase, phase two, characterized by spells of coughing. This consists of a coughing “fit” with little time for a breath and ending in a “whoop” like noise, so, whooping cough. This cough may be accompanied by vomiting, and loss of breath. In infants this may be severe enough to cause a respiratory arrest. The person slowly gets better during the third phase. This last phase may last weeks. Complications may include pneumonia and other infections such as middle ear and sinus infections. Not to mention difficulty sleeping because of the cough, fatigue because you are not sleeping and failing exams because you are tired.
Groups at risk
The two main age groups that are afflicted by this disease are infants too young to be vaccinated and adolescents and young adults whose immunity has decreased over time.
Until recently little could be done about this problem. All children are routinely immunized but the level of antibodies falls over time and because of severe side-effects the vaccine could not be given to adults. However, recently a new vaccine has been developed that can safely be given to adolescents and adults. It is recommended that all students receive this new acellular pertussis vaccine. It is available at Student Health free of charge.
If you are traveling to areas of the world where the wild form of polio exists a booster is recommended.
Polio is caused by a virus. The majority of people who become infected do not manifest any symptoms; however a small percentage may develop permanent paralysis of parts of the body.
The last case of wild Polio in the Americas occurred in 1994, which speaks to the effectiveness of the childhood immunization program.
Childhood vaccination provides immunity to a majority of people, however, if you are traveling to areas of the world where the wild form of polio exists a booster is recommended.
The meningitis vaccine is recommended for all students and is available at cost at Student Health Services. Fee applicable.
Meningitisis an inflammation of the leptomeninges and cerebrospinal fluid. This likely doesn’t tell you much, so let's start at the beginning. First we have the brain and spinal cord which are “the mother board” of the body. These structures are bathed in a liquid call the cerebrospinal fluid and the leptomeninges are three layers of tissue that envelop all of this. Finally, the whole thing is protected by the skull and vertebra. Therefore, you can see that if the meninges and cerebrospinal fluid become infected this can cause chaos in the brain.
Meningitis may result from a variety of causes including viruses, bacteria, chemicals or drugs, and tumors. The latter two are rare and will not be discussed here. A number of viruses can cause meningitis. These include enteroviruses, herpes simplex virus, HIV, West Nile virus, Varicella zoster and mumps. The meningitis caused by viruses is called aseptic meningitis because the cerebrospinal fluid when tested does not contain any pus cells. The majority of individuals infected with these viruses will recover and will not require any specific therapy.
The most serious form of meningitis is bacterial meningitis. Several bacteria have been implicated as a cause of meningitis, and the main source of bacterial meningitis varies depending on age group. The bacterium which causes the most cases of meningitis in the university age population is Neisseria Meningitidis. There are several strains of this bacterium including A, B, C, Y and W-135. Strains B and C are the most common causes of bacterial meningitis at this time in Canada.
Meningitis is a disease that develops very quickly. Within 24 hours the person will develop a high fever, neck rigidity, a change in mental status becoming confused, lethargic and in some case unresponsive to any stimuli and a characteristic rash may appear. Complications are severe and very frequent, and often patients will die from this infection. When such symptoms appear it is important to seek help immediately so that antibiotics maybe started as soon as possible. Of course, prevention is best.
Human Papilloma Virus (HPV)
We recommend vaccination to all students, especially (but not exclusively) if you are just starting to, or have never been, sexually active. The vaccine is available at cost at Student Health Services. Fee applicable.
More that 100 types of Human Papilloma Virus have been identified to date. Some of these cause common verrucae or warts on the hands and feet while about 40 types infect the anogenital area. These are further subdivided into low-risk types, which are associated with genital warts and high-risk types that may cause changes on the cervix that can lead to cancer. The epidemiological association between HPV and cancer of the cervix in women is currently the strongest in medical literature.
Human papilloma virus is transmitted through contact. Therefore, this means that, for the transmission of the types that affect the anogenital area, vaginal or anal penetration is not required for one person to give the virus to another. All you need is for an infected person to touch their genitals and then yours and transmission occurs. At any one time 15% to 60% of university age individuals are infected with this virus.
The majority of people who are infected do not manifest any symptoms but they can still infect others. When there are symptoms these include genital warts or changes in the cells of the cervix or more rarely of other anogenital structures such as the penis and anus. The latter changes can be mild or low-grade or more advance or high-grade. The high-grade forms are more likely to proceed to cancer. However, most of these lesions will disappear on their own within a period of 3 to 6 months. Close follow-up by a physician is required to make sure that in fact the lesions do revert back to normal. These lesions can appear within a few weeks of infection or may take several months. Once a person has been infected they don’t necessarily develop antibodies to that strain or other strains so a person can be infected with other strains or even be reinfected with the same strain even if they have had an HPV infection before. So what can be done about this? To decrease the likelihood of infection you can avoid sexual contact, use condoms, eat nutritious foods, and avoid tobacco but the best thing is to get vaccinated.
There are two vaccines currently available in North America that prevent against certain strains of HPV. Gardasil vaccinates against four types of HPV, types 6 and 11 which are most commonly associated with genital warts and types 16 and 18, most commonly associated with changes in the cells of the cervix. The other vaccine available is Cervarix, which vaccinates against strains 16 and 18. We recommend vaccination especially if you are just starting or have never been sexually active but even if you have been active for a while it is still good idea to get vaccinated. The vaccine is available at cost at Student Health Services.
Seasonal flu (Influenza)
If you are part of a risk group (see "More Details" below for a list of these groups) then you should make sure to get vaccinated. The vaccine is available to these groups free of charge. For all other groups the vaccine is available at cost at Student Health. Fee applicable.
Seasonal flu is a form of influenza that comes every year. The WHO based on epide-miological data determines annually the types of virus that may circulate in the population and a vaccine is prepared using the three most likely strains to cause trouble. Usually this vaccine is given in October and November and is now available at Student Health.
The Ministry of Health has determined that the following groups are at greatest risk for influenza and its complications:
- Children aged 6-23 months
- People with Chronic Illnesses (Heart Disease, Pulmonary Disease, Nephropathy, Diabetes, Cancer, Asthma, Immunodeficiency, Liver Disease, Hemoglobinopathy, Asplenia)
- All those aged 60 years and over
- People who have contact with individuals at risk (Healthcare providers)
If you are part of a risk group then you should definitely be vaccinated and the vaccine is available for you free of charge. If you are not eligible for the free vaccine program but want to have protection then the vaccine is available at cost at Student Health.