Since routine meningococcal C conjugate vaccination was introduced into Canada in 2002, there have been a large regional variation in the routine programs, changes to the timing of the infant series in some provinces, and wide differences in catch-up programs. As immunization is viewed as a provincial responsibility, less attention has been paid to determining national coverage rates and the direct and indirect effects of the widely varying provincial/territorial vaccination programs on the nation as a whole. Canada's disjointed regional immunization campaigns leave the population at risk of disease for an extended length of time. The United Kingdom has proven that with a pro-active approach to planning, coordination, and implementation of a national immunization program, excellent long-term control of invasive meningococcal disease in a large population could be achieved in as little as one year. A summation of the current meningococcal immunization strategies used in Canada and an estimate of overall vaccine coverage of children and youth is provided.