5.3 School-Based Program

PHN To Do List for School Based Mass Clinics

School Immunization Clinic Huddle NEW (Lead PHN to review with staff before the clinic begins)

General Information for School Based Program

i. Eligibility Criteria

ii. School Based Resources

• School Immunization Program
  • Provincial School Based Immunization Quick Reference Guide (July 2025)
• School Immunization Consent Form, Grade 6 or Grade 8/9
  • English – Letter I English – Legal
  • French – Letter I French – Legal
• Grade 6 and Grade 8 Letter to Parents 2025-2026  English | French
• Record of Immunization Form
• Record of Immunization Form *For Students that required 3 doses of HPV/HBV
• Child Requires Additional Dose Bilingual Letter
• Child not Immunized Letter English | French 
• Child/Adolescent (General) Immunization Consent Form English | French
• Immunization reminder letter English | French
• Kindergarten letter English | French
• Home School Letter English | French
• Dear Parent Grade 6-8 Bilingual Letter

iii. Training

• Manitoba Health School Based Immunization Program (Updated July 2025)

Grade 6 and 8 Program – Human Papilloma Vaccine (HPV),  Hepatitis B Vaccine (HBV) & Meningococcal Quadrivalent Vaccine (Men-C-ACYW-135)

i. Resources- Grade 6

• Grade 6 School Immunization Program Factsheet for Parents & Guardians June 2025
• Programme d’immunisation de la 6^e année Santé publique – Feuille de renseignements pour les parents et les tuteurs juin 2025
• Grade 6 School Immunization Program Factsheet for Parents & Guardians in Additional Languages (Select language via the drop-down menu)

ii. Human Papilloma Virus

• Fact Sheet  English | French
• HPV vaccine – Gardasil® 9 Product Monograph

iii. Hepatitis B Vaccine

• Fact Sheet  English | French
• Hepatitis B Vaccine – Engerix®-B Product Monograph

iv.  Meningococcal Quadrivalent Vaccine (Men-C-ACYW-135)

• Fact Sheet  English | French
• Product Monograph:
  • Menactra
  • Meningococcal Conjugate Quadrivalent Vaccine – Nimenrix® Product Monograph

Grade 8 Program – Tetanus, Diphtheria acellular pertussis (Tdap) & Tdap/ IPV (Polio);

i. Resources- Grade 8

• Grades 8/9 School Immunization Program Factsheet for Parents & Guardians August 2021
• Programme d’immunisation de 8e et 9e années – Santé publique – Feuille de renseignements pour les parents et les tuteurs  août 2021

ii. Tetanus, Diphtheria acellular pertussis (Tdap) & Tdap/ IPV (Polio)

• Fact Sheet Tdap English | French
• Fact Sheet Tdap-IPV English | French
• Product Monograph:
  • Tetanus, Diphtheria, acellular pertussis (Tdap) Vaccine – Boostrix® Product Monograph
  • Tetanus, Diphtheria, acellular pertussis and inactivated polio (Tdap-IPV) vaccine – Boostrix®-Polio Product Monograph

Back to Section 05 – Population Public Health Program Specific Information

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