Immunizations
Childhood Immunizations
Recommended immunizations
Childhood immunization recommendations and schedules may vary by province and territory. These schedules outline the immunizations and booster shots needed from birth to age 18 and when catch-up immunizations are given.
The Canadian National Advisory Committee on Immunization (NACI) recommends a specific childhood immunization schedule that includes immunizations for:4
Diphtheria, tetanus, and pertussis (DTaP)
A total of five shots (injections) are usually given: four before 18 months of age and one at 4 to 6 years of age. The shots protect against diphtheria, tetanus, and whooping cough (pertussis).
Children age 7 or older who have not been immunized or it is not known if they have may get the Tdap vaccine, which is the adult formulation used for people 7 and older.
There are 4-in-1 and 5-in-1 shots that combine several vaccines. The 4-in-1 protects against diphtheria, tetanus, pertussis, and polio. And the 5-in-1 protects against diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b (Hib).
The inactivated poliovirus vaccine (IPV) should be given at 2 months, 4 months, between 6 and 18 months, and between 4 and 6 years of age, for a total of four doses. This shot protects against polio. This vaccine may not be given separately if the 4-in-1 or 5-in-1 vaccine is used.
Measles, mumps, and rubella (MMR)
Two doses provide lifelong protection against measles, mumps, and rubella. One shot is given at 1 year of age and the other at least 1 month after the first shot. To make it easy on parents, some provinces and territories may recommend that the second shot is given with other vaccines: at 18 months or between 4 and 6 years of age, before starting school. Research has not shown a link between the MMR shot and autism.2, 3
One dose of this shot is recommended for all healthy children 12 months of age and older who have not had chicken pox. Many provinces require that children entering daycare or school get immunized against chicken pox unless they can show proof of immunity (having had chicken pox or blood test results). The vaccine is given as a single dose at 12 to 18 months of age. Not all health plans cover the cost of the chicken pox shot. You may have to pay for it.
Three shots provide long-lasting immunity against hepatitis B. When a baby is immunized depends on whether the mother has tested positive for hepatitis B. In general, the NACI and the Canadian Paediatric Society recommend that a baby receive the first dose of hepatitis B vaccine at birth (before leaving the hospital) or within 12 hours of birth if the mother has tested positive for hepatitis B. The remaining doses are given by about 6 months of age. Children who have not been immunized for hepatitis B and are age 18 or younger can be given the three shots separately over a period of about 6 months.
Haemophilus influenzae type b (Hib)
This immunization protects against a bacteria that can cause an infection in the covering of the brain (meningitis) or lungs (pneumonia), skin and bone infections, and other serious illnesses in young children. It does not protect against viral influenza (flu). Hib is given as 3 or 4 shots, beginning when a baby is 2 months old and completed by 18 months of age. Children with certain health conditions who are older than 5 years of age may also need the Hib immunization.
The pneumococcal conjugate vaccine (PCV) helps protect young children against meningitis, blood infections (sepsis), and pneumonia. It also helps protect against ear infections.5 Babies and toddlers should be immunized with PCV at 2, 4, 6, and 12 to 15 months for a total of four shots. Depending on what is recommended in your province, the 3 doses of the vaccine may be given at 2, 4, and 12 months of age. Your doctor may call this vaccine by its brand name Prevnar.
This vaccine is recommended for infants at 2, 4, and 6 months of age, or at the ages recommended by your doctor. In children ages 1 to 4 years, a single dose can be given, and it may be considered for children age 5 and older who have not been immunized.6 Children 2 and older who have a high risk for getting and having severe problems from meningitis should also have another type of meningococcal vaccine. These children include those who have a damaged or missing spleen or who have certain immune system problems.
Your province or territory may have different recommendations about who should get a yearly flu shot. Flu shots are not given to children younger than 6 months of age. The National Advisory Committee on Immunization (NACI) and the Canadian Paediatric Society (CPS) suggest that everyone older than 6 months have a flu shot once a year. But it is especially important that people who have a high risk of having complications from the flu get one each year. People who have a high risk of having complications from the flu include.7, 8
- All children 6 through 23 months of age.
- Children 24 months and older, as recommended by the Canadian Paediatric Society, especially those with certain medical conditions (such as asthma, chronic heart or lung disorders, or an impaired immune system).
- Close contacts, including household contacts and out-of-home caregivers, of children 23 months of age and younger and of children 24 months and older who are at high risk for complications from the flu.
If your child is not high risk, you may have to pay for the flu shot.
Some immunizations require more than one dose given at varying intervals. Although your child does not need to restart the series if a scheduled dose is missed, the immunization should be given as soon as possible.
Ask your health professional or local health unit for detailed information about whether your child needs a specific immunization and for the schedule used in your province or territory.
Other immunizations
Your child's doctor may recommend other immunizations, depending on whether your child is at higher risk than other children for certain health problems. Some of these other immunizations may include:
This immunization is recommended for anyone 1 year of age or older who lives in a community where there is increased risk for hepatitis A or who will travel to a foreign country where hepatitis A is common. Hepatitis A vaccines are licensed in Canada for people age 1 and older. But studies show that the vaccines are safe and work in infants 6 months and older.9, 10
Rotavirus vaccine
This vaccine (RotaTeq) was approved by Health Canada's Therapeutic Products Directorate (TPD) in 2006. The NACI has not made a formal statement on when to give the vaccine. It is swallowed rather than given as a shot. Without the vaccine, most children will get rotavirus infection by the time they are about 5 years old. Rotavirus infection causes severe diarrhea.
Keeping good immunization records
It is important to keep accurate records of immunizations, including any reactions to the vaccines. You may need to show proof of immunizations when you enroll your child in daycare or school.
- Know when each immunization should be scheduled and put reminder notes on your calendar. You also may want to ask your health professional to send you notices when immunizations are due.
- Make sure your health professional goes over your child's immunization record with you during each office visit.
- Keep the record in a safe place and never throw it away. These are an important part of your child's permanent medical records.
For a form you can use to track your child's immunizations, see the national childhood immunization record
(What is a PDF document?) or the British Columbia childhood immunization record
Immunization safety
Many parents worry that immunizations are dangerous if given when their child has a cold or other minor illness. Talk to your health professional if you have concerns about the timing of immunizations. Keep in mind that immunizations can usually still be given during a mild illness, while medications are being taken, and in other situations where a child may not be in perfect health. There are very few valid reasons for not getting your child immunized.
Some parents also fear that the measles-mumps-rubella (MMR) vaccine may cause their child to develop autism. Misleading stories about the MMR shot and autism have circulated through Web sites, the media, and word of mouth. However, scientific studies investigating these claims have found no connection between autism and the vaccine.2, 3
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| Author: | Debby Golonka, MPH Carrie Henley | Last Updated August 24, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Michael J. Sexton, MD - Pediatrics William Atkinson, MD, MPH - Public Health and Preventive Medicine Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics | |
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