A vaccine is a substance that primes the body’s immune system to make antibodies, T-cells and memory cells which are the body’s defense against infection. When you are vaccinated you actually build up your immune system, making you stronger and more resistant to disease as you grow. Vaccines are the best way to protect you and your family against some very serious infections. The National Advisory Committee on Immunization and the Canadian Pediatric Society strongly recommend routine immunization.
Vaccination means having the vaccine − actually getting the injection.
Immunization means both receiving the vaccine and becoming immune to ward off a disease as a result of immunization.
Like eating well and exercise, getting immunized is a foundation for a healthy life.
Immunizations help save lives, prevent serious illnesses, and are recognized as one of the most effective public health interventions. Immunizations help the body make its own protection (or antibodies) against certain diseases. In Ontario, immunizations are given against rotavirus, diphtheria, pertussis (whooping cough), tetanus, polio, haemophilus influenzae type b (Hib), measles, mumps and rubella (German measles). Immunizations may also be given against hepatitis, influenza, chickenpox, meningococcal disease, pneumococcal disease and human papillomavirus. There are also a number of vaccines for other circumstances, for example, people traveling to a country with diseases that are not common in Canada, such as typhoid fever.
When children are immunized, their bodies make antibodies that fight specific infections. If they are not protected and come in contact with one of these infections, they may get very sick and potentially experience complications, or even die.
Vaccines are very effective in preventing disease when given as recommended. However, no vaccine will work for 100 per cent of the children who receive it. Studies of disease outbreaks show that although some immunized children can develop the infection, the illness is often less severe.
All vaccines have to be tested to make sure they are both safe and effective. The most common side effects are mild pain, swelling and redness where the injection was given.
Some infant vaccines may cause a low-grade fever (approximately 38°C) or fussiness for a day or two after the injection. Physicians may recommend acetaminophen to prevent fever and pain. Serious side effects from immunizations are rare. Please report any side effects or severe vaccine reactions to your health care provider or local public health unit. You should always discuss the benefits and risks of any vaccine with your health care provider.
For children attending school in Ontario, a written immunization record or proof of immunization is required, by law, for diphtheria, tetanus, polio, measles, mumps and rubella unless there is a valid written exemption. Parents/guardians are required to provide this information to their local public health unit, and to update the information as necessary.
Children attending licensed childcare centres should be immunized according to their age and as recommended in the Publicly Funded Immunization Schedules for Ontario – August 2011. You may contact your local public health unit for more information.
You may decide because of medical, religious or philosophical reasons not to immunize your child. In this case, you will need to provide a valid written exemption to your local public health unit. If the disease appears in your child's school or childcare centre, your child may have to stay out of school/childcare until the disease is no longer present.
Call your doctor or nurse practitioner to make an appointment. If you don't have a physician, nurse practitioner or health card, call your local public health unit to find out where you or your child can get immunized.
Recommended routine immunizations begin at two months of age to protect infants from illnesses that can be very serious for them. The following chart outlines the schedule for publicly funded vaccines in Ontario available for children beginning their routine immunization in early infancy.
Publicly Funded Routine Immunization Schedule for Children Beginning Immunization in Early Infancy
Download the Publicly Funded Immunization Schedules for Ontario (August 2011) [PDF]
Vaccines that protect against the following diseases are available free of charge, and are required for attendance at school (unless there is a valid written exemption) :
- Diphtheria is a very serious bacterial infection. It can cause breathing problems, heart failure, nerve damage and death in about 10% of cases.
- Tetanus (Lockjaw) causes painful muscle spasms, breathing failure and can lead to death. It is caused by bacteria and spores in the soil that can infect wounds.
- Polio can cause paralysis (loss of control over muscles in the body), inflammation of the brain and death. People get polio from drinking water or eating food with the polio virus in it. It is no longer common in Canada because of high immunization rates, but cases do occur elsewhere in the world and polio may be acquired when traveling if you are not fully immunized.
- Measles causes rash, high fever, cough, runny nose and watery eyes. It can cause middle ear infection, pneumonia (lung infection), inflammation of the brain, hearing loss, brain damage and death.
- Mumps causes fever, headache, painful swelling of the glands in the mouth and neck, earache and can cause inflammation of the brain. It can cause temporary or permanent deafness and swelling of the ovaries in women and testes in men, possibly leading to sterility.
- Rubella (German Measles) causes fever, rash, swelling of the neck glands and swelling and pain in the joints. It can cause bruising and bleeding. If a pregnant woman gets rubella, it can be very dangerous for the unborn baby.
Vaccines against the following diseases are recommended but not required for attendance at school. These vaccines are available free of charge :
- Pertussis (Whooping Cough) causes severe coughing spells for weeks or months. It can also cause pneumonia (lung infection), middle ear infection, convulsions (seizures), inflammation of the brain and death. The risk of complications is greatest in children younger than one year of age.
- Hepatitis B is a virus that can cause serious liver problems that can be fatal, such as liver failure and liver cancer. The vaccine is free for grade 7 students and certain high-risk groups (including infants born to mothers who are infected with hepatitis B and can pass the disease on to their babies).
- Influenza (the Flu) is a viral infection that causes cough, high fever, chills, headache and muscle pain. It can cause pneumonia (infection of the lungs), middle ear infections, heart failure and death. The danger of this infection varies from year to year depending on the strain and can be mild to life-threatening. Any one six months of age and older who lives, works or attends school in Ontario can get the vaccine each year free of charge. Find out more about Ontario’s flu shot program here.
- Varicella (Chickenpox) is a highly contagious viral infection. It can cause fever, headache, chills, muscle or joint aches a day or two before the itchy, red rash appears. A pregnant woman with chickenpox can pass it on to her unborn baby. Mothers with chickenpox can also give it to their newborn baby after birth. Chickenpox can be very severe or even life-threatening to newborn babies.
- Meningococcal disease is a very serious bacterial infection and a common cause of meningitis (infection of the lining of the brain and spinal cord) and meningococcaemia (severe infection of the blood) that can cause severe complications and death.
- Human Papillomavirus (HPV) is a very common virus transmitted through sexual activity. HPV has been found to cause cervical cancer, some other rare cancers and genital warts. (About 75 per cent of adults will have at least one HPV infection in their lifetime.) The vaccine is free for grade 8 females.
Vaccines against the following diseases are recommended for younger children. These vaccines are available free of charge :
- Rotavirus is one of the leading causes of severe diarrhea in infants and children. Rotavirus is a very common and is easily spread from person to person. Rotavirus causes inflammation of the stomach and intestines (gastroenteritis). This vaccine is recommended for infants between 6 to 24 weeks of age.
- Haemophilus Influenzae type b (HIB) is a bacteria that can infect any part of the body. It can cause middle ear infections, breathing problems, damage to joints, pneumonia (lung infection), inflammation of the brain leading to brain damage and death. This vaccine is recommended for children less than 5 years of age.
- Pneumococcal disease is a bacterial infection that can cause serious illnesses such as pneumonia, blood infection and meningitis. The pneumococcal conjugate vaccine is now available free of charge in Ontario for the routine immunization of children less than 2 years old as well as high-risk children 2 to 59 months of age.
Talk to your doctor or nurse practitioner for more information on these vaccines and the diseases they prevent.
It is important to keep an immunization record.
Get a yellow immunization card from your doctor, nurse practitioner or local public health unit to keep a record of the vaccines you and your child have received. An up-to-date immunization record will prevent unnecessary extra shots. Written immunization records are needed when :
- starting child care or school,
- transferring to a school in another area,
- going to camp,
- starting university, college or a job,
- receiving emergency health care,
- traveling to other countries.
It is the parent/guardian's responsibility to provide immunization records for all school children to the local public health unit. Don't forget to update the health unit when/if your child gets another shot.
Always remember :
Because of changes in the influenza (flu) strains, adults also need to receive the flu shot each year.
In addition, all adults 19 to 64 years of age, not immunized in adolescence, are now eligible to receive one lifetime dose of the tetanus, diphtheria and pertussis vaccine to replace a dose of the tetanus and diphtheria vaccine. Parents of newborns, infants and young children are considered a priority to receive the pertussis-containing vaccine.
Adults should continue to get the tetanus and diphtheria vaccine every 10 years throughout life, to be protected against these diseases.
Recommended immunizations begin at two
months of age to protect infants from diseases
that can be very serious for them. Depending
on your child's age, he or she may have to get
more than one vaccine at the same time. This
recommended practice has many advantages
but there are still questions you may have.
Why should my child get
more than one vaccine at the
Thanks to vaccines, children are protected
against more devastating diseases then ever
before. Vaccines are recommended for children
at ages when they are at greatest risk for
specific diseases and when the vaccines will
give the best protection. To ensure your child is
fully protected, it is important that he or she
get the vaccines when they are recommended.
Not immunizing your child will leave your child
unprotected at a time when the risk for the
disease is greatest.
Is giving more than one vaccine
at the same time as effective as
giving them separately?
Yes, giving more than one vaccine at the
same time is just as effective as giving them
separately. Delaying one or more vaccine shots
to a later clinic visit could increase the risk of
your child being exposed to serious diseases.
Is giving more than one
vaccine at the same time risky
for my child?
No. Studies show that many vaccine shots can
be safely given at the same clinic visit. Every
vaccine is tested many times before being
licensed for use. The safety of vaccines is
continuously checked for as long as the vaccine
is being used. Studies show that children - even
infants - can handle many shots at once.
Does giving more than one
vaccine at the same time overload
my child's immune system?
No. Infants and children are exposed to
millions of different germs and bacteria
everyday. According to Dr. Gold (2006), a
paediatrician from the Canadian Paediatric
Society, it would take more than 10,000
vaccines to "use up" or overload an infant's
immune system. Having several vaccines at
once is safe, even for a newborn.
Are there more side effects
with giving more than one
vaccine at the same time?
No. Getting several vaccine shots during one
clinic visit does not cause more side effects. The
risks from the vaccines are much, much less
than the risks from the diseases themselves.
Most side effects from vaccines are mild, such
as soreness where the shot was given or a low
grade fever (less than 40oC or 104oF). After
getting the vaccine, children may cry and be
fussy because of pain where the shot was given.
Serious side effects are rare.
What are the benefits to
giving several vaccines at the
Sometimes, more than one vaccine may be
recommended for children at a given age. When
your child is vaccinated at the recommended
age, he or she gains protection at a time of
highest risk for these diseases. Studies also
show that an increased number of clinic visits
for separate vaccine shots can be more stressful
for children. Getting more than one vaccine at
the same time will reduce the number of visits
to the doctor and may reduce the stress
children experience with each visit.
There are additional benefits for you as a parent
such as saving time with fewer appointments,
less travel and fewer hours of work missed.
How can I prepare my child for
getting a vaccine shot?
You can prepare by talking to your child about
the clinic appointment positively and honestly.
- Talk to your child about the vaccine shot and
focus on why it is needed.
- Explain how these serious diseases are
avoided when we get immunized.
- Tell your child about how serious these
diseases are if we get sick.
- Be honest if your child asks if the shot hurts.
Let your child know that the shot can hurt
sometimes, but the hurt does not last long.
Can the pain and stress from
the vaccine shot be reduced?
The pain from getting the vaccine shot is
mild and does not last long. There are ways
to reduce the pain and stress from the shot.
- Swaddling, holding, giving your child a
pacifier, or breastfeeding infants help to
reduce stress of the shot.
- Giving something sweet such as oral sucrose or
glucose at the time of the shot can reduce the
pain among infants up to 12 months of age.
- Distraction activities such as reading a book
or watching a video together on the subject
may reduce stress of the shot.
- Activities such as blowing soap bubbles,
blowing windmills to "blow away the hurt"
can be helpful.
There are many more ways that the pain and
stress can be reduced. Talk to your health care
provider giving the shot for more strategies.
For more information talk to your health care provider,
call your local public health unit, or call:
The goal is to protect your child as quickly
as possible from diseases that are very
dangerous to young children. More than
ever before, children are protected from
devastating diseases, thanks to vaccines.
To learn more about immunization, please visit your local bookstore or
library for the following books:
- Your Child's Best Shot: A parent's guide to vaccination.
3rd edition (2006). Dr. Ron Gold.
- What every parent should know about vaccines (2003).
Dr. Paul Offitt and Dr. Louis M. Bell.
Be sure you are protected against rubella before pregnancy to protect your future baby from serious problems during its development.
For further information about immunization, or any other health topics, please contact your local public health unit or doctor/nurse practitioner.
Additional Immunization Links
To learn more about immunization, visit your local bookstores or library for the following books :
- Your Child's Best Shot : A Parent’s Guide to Vaccination. 3rd edition (2006). Dr. Ronald Gold.
- What Every Parent Should Know About Vaccines (2003). Dr. Paul Offit and Dr. Louis M. Bell.