Adult Vaccination: Which Vaccines Are Recommended in Quebec?

In the collective Quebec imagination, vaccination is often associated with childhood. The vaccination record, school boosters, visits to the CLSC with parents. Past a certain age, many people believe it's behind them. This is not the case. Several vaccines are recommended for adults, some once, others at regular intervals, and many go unnoticed due to a lack of structured medical follow-up.

However, complications that can be prevented by vaccination do not only affect children. In adults, they can be serious, disabling, and sometimes fatal.

The seasonal flu vaccine

The influenza vaccine is recommended every fall for the entire Quebec population. It is offered free of charge to people aged 60 and over, pregnant women, children aged 6 to 23 months, people with chronic illnesses, and healthcare workers as part of the Quebec immunization program. For other adults, it is available at pharmacies at a low cost.

The vaccine's effectiveness varies from season to season depending on the match between vaccine strains and circulating strains, but even partial protection significantly reduces the risk of hospitalization and serious complications, particularly in vulnerable individuals (INSPQ, 2024).

The shingles vaccine

Shingles is caused by the reactivation of the varicella-zoster virus, which remains dormant in the nerves after an initial chickenpox infection, often contracted in childhood. With age, the immune system weakens, and the virus can reawaken, causing a painful rash sometimes followed by chronic neuropathic pain, known as postherpetic neuralgia, which can last for months or even years.

In Quebec, the Shingrix vaccine is recommended for people 50 years and older. It is administered in two doses, two to six months apart, and offers high protection, even in immunocompromised individuals. This vaccine is not covered by the public plan for most healthy adults but is available at pharmacies and private medical clinics.

The pneumococcal vaccine

Pneumococcus is a bacterium responsible for pneumonia, meningitis, and serious blood infections. The risk of complications increases with age and in immunocompromised individuals. Pneumococcal vaccination is recommended in Quebec for people aged 65 and over, as well as for younger adults with certain medical conditions such as diabetes, chronic lung disease, or kidney failure.

Diphtheria-tetanus-pertussis boosters

Many adults are unaware that their protection against tetanus and diphtheria wanes over time. A booster shot for the dcaT vaccine, which protects against diphtheria, tetanus, and pertussis (whooping cough), is recommended every ten years in Quebec. Pertussis, in particular, experiences regular resurgences and can be transmitted to infants too young to be vaccinated, in whom it can be fatal.

For pregnant women, a dose of the whooping cough vaccine is recommended with each pregnancy between the 26th and 32nd week, in order to transfer protective antibodies to the newborn before birth (MSSS, 2024).

The HPV vaccine is now recommended not only for adolescents but also for adults up to 45 years old who have not been vaccinated. HPV is responsible for almost all cervical cancers, as well as cancers of the throat, vulva, vagina, penis, and anus. Vaccination remains effective even in adults who have already been exposed to certain strains of the virus.

Frequently Asked Questions About Adult Vaccination

How do I know which vaccines I've already received?
The vaccination record, if kept, is the primary reference. In the absence of a document, a doctor or a nurse practitioner can check the vaccination record in provincial systems and recommend missing vaccines or those whose protection has expired.

Can you receive multiple vaccines during the same visit?
Yes, in most cases. Giving multiple vaccines at the same time is safe and does not reduce their effectiveness. It is even recommended to simplify vaccination follow-up.

Are adult vaccines covered by the RAMQ?
Some are, depending on age and medical condition. The flu vaccine is free for target groups. Others, like shingles or HPV after age 18, are the patient's responsibility. Prices vary by clinic and pharmacy.

Do you need a family doctor to get vaccinated?
No. Pharmacists in Quebec can administer several vaccines without a prescription. Medical clinics also offer vaccination services without a designated family doctor.

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