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School-based vaccination


Since September 2020, changes were made to the Québec Immunization Program. These changes are based on a recommendation made by the Comité sur l’immunisation du Québec and concern vaccines administered at school. To find out more, go to the Changes made to the school-based vaccination program section.


Under the Québec immunization schedule, some vaccines are administered to children at school. They are provided free of charge in Grade 4 of primary school and in Secondary 3 of high school.

The school nurse administers the vaccines to children during vaccination sessions, that take place during the school year. All the relevant information will be provided to parents at the start of the school year, through the school.

Consent for vaccination

In Québec, anyone 14 years of age or over can give their consent for vaccination.

If a child is under 14 years of age, one of his or her parents or guardian must give their consent for vaccination. The school nurse can provide parents, upon request, with additional information so that they can make an informed decision.

A letter is usually sent to all parents of children in Grade 3 of primary school. In Grade 4 of primary school, an information leaflet is sent through the school. A vaccination consent form This hyperlink will open in a new window. is enclosed with the leaflet. If you have a child in Grade 4 of primary school, you must complete the form and return it to the school quickly, regardless of whether or not you choose to have your child vaccinated. Consent of one parent is sufficient.

General tips

Before the vaccination session

You can prepare your child for vaccination. To find out more, consult the page Reducing the pain and anxiety of vaccination in children.

On the day of vaccination

Ask your child to wear a short-sleeved top. Ask him to give his vaccination record to the nurse at the vaccination session if he has not already done so.

If your child is absent on the day of the vaccination, you will still be able to have him or her vaccinated free of charge. Follow the school nurse’s instructions or make an appointment at your local community services centre (CLSC). To find the contact information, consult the page Finding a CLSC. It is also possible to have your child vaccinated in certain pharmacies.

Multiple injections

Some vaccines can be given at the same time during the same vaccination session. They are called “multiple injections”. This is a common practice around the world. Scientific studies have shown that it is safe. There is no additional risk if several vaccines are given at the same vaccination session instead of just one vaccine.

There are also a number of benefits associated with multiple injections, including fewer vaccination sessions. To find out more, consult the Benefits of multiple injections section.

Changes made to the school-based vaccination program

Since September 2020, for the school-based vaccination program a single visit is planned to vaccinate children in Grade 4 of primary school. During this visit, your child will receive two doses of vaccine:

  • One dose of hepatitis A and B vaccine (Twinrix Junior®);
  • One dose of HPV vaccine (Gardasil 9®).

A second dose of hepatitis A and B vaccine and HPV vaccine will be given in Secondary 3.

These changes are based on the following facts:

  • The experts consider that a 5-year interval between the 2 of these vaccines provides the same protection against those diseases as when the doses are given at a 6-month interval, as done previously;
  • A single dose of HPV and hepatitis A and B vaccines offers good protection against these diseases;
  • In children under 15 years old, the risk of HPV infection and of hepatitis A and B is very low.

Vaccines administered at school

Vaccines administered in Grade 4 of primary school*


The vaccine protects against:

Hepatitis A and hepatitis B vaccine

Hepatitis A and hepatitis B

Human papillomavirus (HPV) vaccine

Human papillomavirus (HPV)

*Students with weak immune systems will need additional doses, given according to a special schedule. If this is the case for your child, the school nurse can give you more information and refer you to the CLSC so your child can get the additional doses.

Under the Hepatitis A and B Vaccination Program, your child will receive:

  • 1 dose of hepatitis A and hepatitis B vaccine (Twinrix®) in Grade 4 of primary school for protection against hepatitis A and partial protection against hepatitis B;
  • 1 dose of hepatitis B vaccine (EngerixB® or an equivalent vaccine) in Secondary 3 for long-term protection against hepatitis B

The Hepatitis school-based vaccination program was launched in 1994 with protection against hepatitis B only. Since 2008, children have been given the Twinrix® vaccine, which protects against both hepatitis A and hepatitis B.

Another vaccination program aims to protect children against human papillomavirus (HPV) infection. Your child will be given 2 doses of this vaccine:

  • 1 dose of HPV vaccine (Gardasil 9®) in Grade 4 of primary school
  • 1 dose of HPV vaccine (Cervarix®) in Secondary 3

Benefits of vaccination in Grade 4 of primary school

Vaccination against hepatitis A and B, and HPV begins in Grade 4 of primary school for the following reasons:

  • The immune system responds best to these vaccines between the ages of 9 and 11, when children are in Grade 4 of primary school.
  • It is preferable for children to have received at least one dose of HPV and hepatitis A and B vaccines before they are exposed to these infections.
  • With school-based vaccination, many children can be vaccinated in a short period of time, which helps protect everyone. It also means that parents do not have to go out to have their child vaccinated.

In addition to the vaccines scheduled in Secondary 3, the nurse will check if all children’s vaccination is up to date for the following diseases:

  • Diphtheria
  • Whooping cough
  • Tetanus
  • Poliomyelitis
  • Measles
  • Rubella
  • Mumps
  • Meningococcal serogroup C
  • Chickenpox
  • Hepatitis A
  • Hepatitis B
  • HPV infections

Useful websites

Last update: February 23, 2023


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