Topic Overview

What are immunizations?

Immunizations save lives. They are the best way to help protect you or your child from certain infectious diseases. They also help reduce the spread of disease to others and prevent epidemics. Most are given as shots. They are sometimes called vaccines, or vaccinations.

In many cases when you get a vaccine, you get a tiny amount of a weakened or dead form of the organism that causes the disease. This amount is not enough to give you the actual disease. But it is enough to cause your immune system to make antibodies and cells that can recognize and attack the organism if you are ever exposed to it.

Sometimes a vaccine does not completely prevent the disease, but it will make the disease much less serious if you do get it.

Some immunizations are needed only one time. Others require several doses over time to help your body be able to fight the disease (build immunity).

What are some reasons to get immunized?

• Immunizations protect you or your child from dangerous diseases.
• They help reduce the spread of disease to others.
• They are often needed for entrance into school or daycare. And they may be needed for employment or for travel to another country.
• The risk of getting a disease is much greater than the risk of having a serious reaction to the vaccine.
• When immunization rates drop below a certain level, preventable diseases show up again. Often these diseases are hard to treat. For example, measles outbreaks still occur in Canada.

If you are a woman who is planning to get pregnant, talk to your doctor about what immunizations you have had and what you may need to protect your baby. And if you live with a pregnant woman, make sure your vaccines are up-to-date.

Travelling to other countries may be another reason to get immunized. Talk with your doctor months before you leave, to see if you need any shots or other medicines.

What immunizations are recommended for children and adolescents?

Childhood immunization schedules may vary in each province and territory. Ask your health professional what shots your child should get. Other shots may be recommended too, if your child is more likely to have certain health problems.

The Canadian National Advisory Committee on Immunization (NACI) provides recommendations for the use of vaccines in Canada, but specific immunization schedules are developed by provincial and territorial health authorities. Commonly recommended immunizations include:^{footnote 1}

• Bacterial meningitis.
• Chickenpox.
• Diphtheria, tetanus, and pertussis (also known as whooping cough).
• Influenza (flu).
• Haemophilus influenzae type b disease, or Hib disease.
• Hepatitis A.
• Hepatitis B.
• Human papillomavirus (HPV).
• Measles, mumps, and rubella.
• Pneumococcal disease.
• Polio.
• Rotavirus.

Immunizations start right after birth, and many are given throughout a baby's first 23 months. Booster shots (the later doses of any vaccines that need to be repeated over time) occur throughout life.

Fewer immunizations are needed after age 6. But older children and adolescents need shots too. Talk with your health professional about the specific vaccines that your child or teenager may need. Some shots are also given during adulthood (such as a tetanus shot).

It is important to keep a good record, including a list of any reactions to the vaccines. When you enroll your child in daycare or school, you may need to show proof of immunizations. Your child may also need the record later in life for university, employment, or travel.

Talk to your health professional if you or your child plans to be in a group living situation, like a university dormitory or summer camp. You may want certain shots, like those for meningitis.

What vaccines are recommended for adults?

The vaccines you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans but also on who you are in close contact with and what vaccines you had as a child.

Talk to your health professional about which vaccines you need. Common adult vaccines include:

• Influenza (flu).
• Human papillomavirus (HPV).
• Pneumococcal.
• Shingles.
• Tetanus, diphtheria, and pertussis.

What are the side effects of vaccines?

Most side effects from vaccines are minor, if they occur at all. Ask your health professional about the reactions that could occur. They may include:

• Redness, mild swelling, or soreness where the shot was given.
• A slight fever.
• Drowsiness, crankiness, and poor appetite.
• A mild rash 7 to 14 days after chickenpox or measles-mumps-rubella shots.
• Temporary joint pain after a measles-mumps-rubella shot.

Severe reactions, such as trouble breathing or a high fever are rare. If you or your child has an unusual reaction, call your doctor.

How safe are vaccines?

False claims in the news have made some parents concerned about a link between autism and the shot for measles, mumps, and rubella. But studies have found no link between vaccines and autism.^{footnote 2, footnote 3}

Some parents question whether mercury-containing thimerosal (used as a preservative in vaccines) might cause autism. Studies have not found a link between thimerosal-containing vaccines and autism.^{footnote 4, footnote 5} Today, all routine childhood vaccines made for Canada contain either no thimerosal or only trace amounts.^{footnote 6}

Travel Immunizations

Recommended immunizations

Talk with your health professional months in advance of a trip to find out whether any immunizations are recommended. Certain things, such as your age and health, where you are going, and the length of your stay, affect your risk of disease and your need for immunization.

Your age and health

People with certain medical conditions, such as immune system problems, may have different immunization recommendations than healthy people. Also, young children who are travelling may need to receive their routine immunizations sooner than normally scheduled.

Where you travel

In most developed countries (including the United States, Australia, New Zealand, Japan, and western and northern European countries), the risk of exposure to serious diseases is generally no greater than it is in Canada.

The risk of exposure to serious disease may be much higher in developing countries (such as those in most parts of Africa and Asia and many parts of South and Central America) than it is in most developed countries. This is especially true for areas with poor sanitation (for example, poor water and food handling). For example:

• If you are going to South America and Africa, you may need the yellow fever vaccine.
• Travellers to developing countries should take precautions to prevent hepatitis A infection, which includes getting immunized. Additional immunizations, such as typhoid vaccine, Japanese encephalitis, or rabies vaccine, may be recommended.

The need for these vaccines depends on your immunization history, the specific area you plan to visit, the time of year, and whether any outbreaks of disease have recently occurred.

How you travel and types of activities

Certain activities or modes of travel increase your risk of exposure to disease. These include:

• Exploring rural areas or those off the usual tourist route.
• Taking backpacking trips.
• Visiting people in another country.

Length of stay

The longer you stay in a country, the more exposure you have to local pathogens that could cause harm.

More information

You can get information about travel immunizations by:

• Contacting your local travel clinic, health unit, or health professional.
• Go to the Travel Health website of the Public Health Agency of Canada www.canada.ca/en/public-health/services/travel-health.html for more information.

Bioterrorism and Immunizations

The Canadian government has developed plans on how to respond to possible bioterrorism threats.

Certain diseases have been identified that pose the greatest threat to the Canadian public. At this time, there is a supply of anthrax and smallpox vaccines only. These immunizations are not currently available to or recommended for the general public. But the government has advised immunization for people at high risk of exposure to anthrax or smallpox, such as health care workers specifically designated to respond to a bioterrorism emergency. Some of these recommendations are listed below.

Anthrax vaccine

This shot protects against anthrax.

Who should get it?

• This shot is for people who are at high risk of exposure, such as certain lab workers, people who work with imported animals where preventive standards are lacking (such as veterinarians who travel to work in other countries), and certain military members.

Six shots are given over 18 months. And booster shots are needed every year for continued protection (immunity).

Smallpox vaccine

This shot protects against smallpox.

Who should get it?

• This shot is for certain health care and public health workers, infection-control specialists, and military members.

This shot is given once as several quick punctures on the upper arm, using a special prong device. Immunity after a first-time vaccination is likely to be 3 to 5 years. If you have been vaccinated in the past, successful revaccination may extend your immunity.

The Government of Canada has enough smallpox vaccine to vaccinate Canadians in an emergency.^{footnote 11}

Visit the Public Health Agency of Canada's Emergency Preparedness and Response website at www.canada.ca/en/public-health/services/emergency-preparedness-response.html for more information. For more general information about bioterrorism issues, see the topic Disasters and Other Public Health Threats.

When To Call

Call 9-1-1 or other emergency services if you or your child has:

• An allergic reaction, such as difficulty breathing, wheezing, hives, hoarseness, paleness, weakness, a fast heart rate, or dizziness
• Changes in behaviour, such as passing out (losing consciousness), acting confused, being very sleepy or hard to wake up, or not responding to being touched or talked to.
• A seizure

Call your doctor if:

• Redness and swelling at the site of the shot (injection) last longer than 48 hours.
• Your child is 6 months of age or younger and has a fever of 38 °C (100.4 °F) or higher.
• A fever lasts longer than a few days after a shot is given.
• Any unusual reaction occurs.

Talk with your doctor about whether you need special immunizations because you:

• Are in close contact with people who have an infectious disease.
• Have planned international travel, especially to developing countries.
• Live with or visit a baby or someone who is pregnant.
• Live with someone who has an impaired immune system.

Home Treatment

Help your child handle immunizations

Many immunizations are given as shots (injections). Your child may experience brief pain as the needle penetrates the skin or muscle. Some vaccines cause more discomfort than others. In general, you can help decrease your child's discomfort by making sure that he or she is physically comfortable and well rested before getting immunized. You can use home treatment measures to help relieve some of the common minor reactions to immunizations.

Relieve mild reactions to immunizations

You can help relieve some of the common, temporary, mild reactions to immunizations with basic home care.

• Fever. A slight fever may occur after you or your child gets a shot. Acetaminophen (such as Tylenol) or ibuprofen (such as Advil) may help lower a fever. Follow the package instructions carefully. If you give medicine to your baby, follow your doctor or health professional's advice about what amount to give. Check with your doctor first if you are not sure your young baby's fever is related to getting immunizations. Do not give aspirin to anyone younger than 18 because of the risk of Reye syndrome, a rare but serious disease. For more information on fevers, see the topic Fever or Chills, Age 11 and Younger or Fever or Chills, Age 12 and Older.
• Swelling or redness. The area around the injection site may become red and swollen. Apply a wrapped ice pack or cool compress to the area for about 10 to 20 minutes. If this does not reduce the symptoms, acetaminophen or ibuprofen may help relieve the discomfort. Follow the package instructions carefully.
• Fretfulness and poor appetite. For a few hours after getting immunized, a baby may be fretful and drowsy and may refuse to eat. Plan quiet activities at home for the evening after your child receives an immunization. Hold and cuddle your child when needed. Keep your home at a comfortable temperature, because your child is more likely to be fretful if he or she gets too warm.
• Skin rash. A mild skin rash 7 to 14 days after your child gets the chickenpox or measles, mumps, and rubella (MMR) shot. These types of rashes can last several days and go away without treatment.

For more information about reactions to immunizations, see When to Call a Doctor.