Vaccine and STI Medication Orders and Reporting

Health care provider COVID-19 vaccine orders 

These order and reporting forms are for pre-approved clinics at this time.  When general vaccine availability is known, further communication will follow. For more information on current eligibility for the COVID-19 vaccines, please visit our COVID-19 Vaccines page.  

• Health care provider COVID-19 Vaccine order form
• COVID-19 Vaccine Clinic reporting form

 Long-term care and retirement home COVID-19 vaccine orders

• Long-term care and retirement home COVID-19 vaccine orders
• COVID-19 Vaccine Clinic reporting form

Pharmacy COVID-19 vaccine orders

Community agency referral: COVID-19 immunization for individuals from vulnerable populations

Refer your vulnerable clients for COVID-19 immunization using. Please complete a form for each client you are referring.

• Community Agency Referral: COVID-19 Immunization for Individuals from Vulnerable Populations.

Influenza vaccine

• Influenza Vaccine Order Form
• If you need to return vaccine, you must complete our Non-Reuseable Vaccine (Spoiled or Expired) Return Form (PDF). Returns will not be accepted unless accompanied by this form.

KFL&A Public Health site specific regular vaccines 

• Correctional Facilities Vaccine Orders
• Hospitals Vaccine Orders
• Health Care Provider Vaccine Orders
• Long-Term Care and Retirement Homes Vaccine Orders

KFL&A Public Health special order vaccines

• Publicly Funded High Risk Vaccine Orders
• School Based Immunization Vaccine Orders

STI medications order form

Health Care Provider STI Drug Orders

Non-reuseable vaccine (spoiled or expired) returns

• If you need to return vaccine, you must complete our Non-Reuseable Vaccine (Spoiled or Expired) Return Form (PDF).
• Returns will not be accepted unless accompanied by this form.

Adverse event following immunization (AEFI)

• Report of Adverse Event Following Immunization (PDF) - If one of your patients experiences an adverse event following immunization, please complete this form from Public Health Ontario, and fax to KFL&A Public Health at 613-549-0985. Public Health Ontario provides an AEFI reporting fact sheet (July 2016) for more information.

Cold chain incidents

Vaccines must be kept between 2°C to 8°C to ensure the vaccines stay as potent and effective as possible. 

When the vaccine storage refrigerator varies above or below these temperatures, this is known as a cold chain incident and must be immediately reported to KFL&A Public Health. This includes minor excursions between +1.5 to 2.0°C, and +8.0 to 8.5°C. 

Should a cold chain incident occur:

1. Separate the exposed vaccines in the refrigerator by placing these vaccines in a labelled container or bag. Mark DO NOT USE. If the refrigerator is not currently stable, move the vaccines to a stable monitored refrigerator or cooler as per your contingency plans.
2. Call KFL&A Public Health at 613-549-1232 or 1-800-267-7875 and ask to speak to the immunization nurse. A manager is on call after-hours.
3. Check to ensure your temperature monitoring device is working correctly. Is it in the correct place? Does the battery need to be changed?
4. After checking the temperature monitoring device and the refrigerator, record the date, time, and current maximum and minimum temperatures and record them in your log book.
5. Fax to 613-549-0985:
   • The most up-to-date temperature log book, including the previous 2 weeks’ worth of temperatures.
   • Completed Cold Chain Exposure Form (PDF).
6. Do not discard any of the exposed vaccines until KFL&A Public Health has assessed whether any of the vaccines may still be used.

Failure to report temperature excursions will result in suspension from ordering additional doses of publicly funded vaccine.

 High-risk and school immunizations

• High Risk and School Publicly Funded Immunization Program Reporting Form (PDF) - After administering vaccines to eligible high-risk patients and school-aged children please complete and fax to KFL&A Public Health at 613-549-0985.

 Routine immunizations

• Childhood Vaccines Given By Physicians (PDF) - By reporting immunizations for childen from birth to 17 years of age, health care providers can ensure that KFL&A Public Health has up-to-date immunization records for each child in the KFL&A area.