Immunizations

Childhood Immunizations

Recommended immunizations

Childhood immunization recommendations and schedules may vary by province and territory. Immunizations are recommended because they protect against diseases (give immunity) and make a disease less severe if your child does get it. 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)

The shots (immunizations) protect against diphtheria, tetanus, and whooping cough (pertussis).

Who should get it?

  • All children should get a total of 5 shots at 2 months, 4 months, 6 months, 18 months, and between 4 to 6 years of age.
  • 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.

Polio

This shot protects against polio.

Who should get it?

  • Children should get a total of four doses at ages 2 months, 4 months, between 6 and 18 months, and between 4 and 6 years.

Measles, mumps, and rubella (MMR)

The shots protect against measles, mumps, and rubella.

Who should get it?

  • All children need one dose at 12 months of age and a second dose after 15 months. 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.5, 3

Chicken pox (varicella)

This shot protects against chicken pox.

Who should get it?

  • All children 12 months of age and older who have not had chicken pox should get one dose at 12 to 18 months of age.

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). Not all provincial or territorial health plans cover the cost of the chicken pox shot. You may have to pay for it.

Hepatitis B (Hep B)

The shots protect against hepatitis B.

Who should get it?

  • All babies need three doses. The first dose is given right after 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).

Who should get it?

  • All children need three or four doses, starting at 2 months of age and ending by 18 months of age.
  • Children who are older than 5 years and have certain health conditions may also need this shot.

Pneumococcal infections

The shots (called PCV or Prevnar) protect against meningitis, blood infections (sepsis), pneumonia, and ear infections.6

Who should get it?

  • All children need a total of three doses at ages 2, 4, and 12 to 15 months. Depending on what is recommended in your province, an additional dose may be given at 6 months of age.

Meningococcal disease

This shot protects against meningitis and blood infections (sepsis).

Who should get it?

  • Children at 2, 4, and 6 months of age, or at the ages recommended by your doctor, need this shot.
  • 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.7

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.

Influenza (flu)

This immunization helps protect against the flu. Flu viruses are always changing, so the flu vaccines are updated every year.

Who should get it?

  • 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.8, 9
    • 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:

Hepatitis A (Hep A)

This shot protects against hepatitis A.

Who should get it?

  • 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.10, 11

Rotavirus vaccine

This immunization (called RotaTeq) protects against rotavirus infection.

Who should get it?

  • 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 recordClick here to view a form.(What is a PDF document?) or the British Columbia childhood immunization recordClick here to view a form.(What is a PDF document?).

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.1


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Author: Alison Allen
Debby Golonka, MPH
Last Updated: January 29, 2008
Medical Review: Michael J. Sexton, MD - Pediatrics
Andrew Swan, MD, CCFP, FCFP - Family Medicine

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