Regional Immunization Manual

The WRHA Regional Immunization Manual has been developed collaboratively with the input and approval of the WRHA Regional Immunization Committee with representation from the following programs:

• Population and Public Health
• Occupational and Environmental Safety and Health
• Infection prevention and control
• Primary Care
• Home Care
• Long Term Care (Personal Care Homes)

This manual houses guidelines for the safe and effective provision of immunization services/programs. These guidelines:

• define and clarify recommended policies and procedures related to WRHA and provincially funded immunization programs;
• enhance the efficiency, safety, and effectiveness of immunization programs;
• provide standards for immunization competency;
• ensure maintenance of vaccine potency and reduction of vaccine wastage;
• provide guidelines for the management and reporting of adverse events, including anaphylaxis.

This manual was developed to support immunization practices throughout the Winnipeg Health Region and to provide staff with operational guidance to support practice at clinic sites. The manual is based on standards set out by the Public Health Agency of Canada, as well as Manitoba Health, and is not intended to replace these sources of information.

The Winnipeg Regional Health Authority (WRHA) has compiled this manual utilizing current sources and has made every effort to ensure that the information in the manual is correct at the time of printing/posting. This manual is intended for use by health professionals working for the WRHA and is not intended for distribution to the public.

Table of Contents

1. Introduction

• Purpose
• Manual Format
• Canadian Immunization Guide
• Immunization Competencies for Health Professionals in Canada
• Competence and Authority to Immunize
• Opportunity for Immunization in all Health Care Settings
• Clinical Practice Guidelines (CPG)

2. Basic Medical Sciences

• Competency #1: The Immune System and Vaccines
• Competency #2: Vaccine Preventable Diseases
• Competency #3: Vaccine Development and Evaluation
• Competency #4: The Types of Immunizing Agents and Their Composition
• Competency #5: Population Health

3. Essential Immunization Practices

• Competency #6: Communication and Informed Consent
• Competency #7: Storage and Handling of Immunization Agents
• Competency #8: Administration of Immunizing Agents
1. General Considerations Prior to Immunization
2. Infection Control Guidelines
3. Vaccine Administration
• Competency #9: Adverse Events Following Immunization 
• Competency #10: Documentation
• Competency #11: Populations Requiring Special Considerations

4. Contextual Issues

• Competency #12: The Canadian Immunization System
• Competency #13: Immunization Issues
• Competency #14: Legal and Ethical Aspects of Immunization

5. Program Specific Information

5.1 Influenza & Pneumococcal Program

• Eligibility Criteria
• Fact Sheets
• Product Monographs
• Influenza and Pneumococcal Resources - Forms
• Quick Reference Guides
• Surveillance
• Influenza Outbreak Protocol for Personal Care Homes
• Additional Resources / Websites

5.2. Large Scale (Mass) Immunization Clinics

• Clinical Practice Guidelines
• Resources
• Clinic Flow Diagram
• Roles/Task Sheets
• Process to Navigate Clients
• Consent form flow for mass immunization clinics

5.3. School Based Program

• General Information
• Grade 4 Program - Hepatitis B, Meningococcal C, Varicella
• Grade 6 Program - Human Papilloma Virus (HPV)
• Grade 9 Program - Tetanus, Diphtheria acellular pertussis (Tdap)

5.4. Occupational Health