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About vaccinations


List of Vaccines discussed below:

  1. 5-in-1 or 6-in-1 vaccine

    1. Diphtheria

    2. Tetanus

    3. Pertussis

    4. Polio

    5. Hib

    6. Hepatitis B

  2. Pneumococcal vaccine

  3. Meningococcal vaccine

  4. Rotavirus vaccine

  5. Influenza vaccine

  6. Hepatitis A vaccine

  7. MMR vaccine

    1. Measles

    2. Mumps

    3. Rubella

  8. Varicella (Chickenpox) vaccine

  9. Human papillomavirus (HPV) vaccine

  10. Diphteria-tetanus-acellular pertussis (dTap) vaccine


Here is what the Canadian Paediatric Society and the National Advisory Committee on Immunization currently recommend in the way of vaccines (shots) as part of your child's routine schedule:


5-in-1 or 6-in-1 vaccine

1 easy vaccine that protects against 5 diseases:

  1. Diphtheria

  2. Tetanus

  3. Pertussis (whooping cough)

  4. Polio

  5. Haemophilus Influenza type b disease


In BC, hepatitis B vaccine is also included, making it a 6-in-1 vaccine.

This 6-in-1 vaccince is given when children are 2, 4, and 6 months old together with a further 5-in-1 vaccine at 18months. Only three doses of hepatitis B vaccine are needed.


In addition, your child will get a booster of the 4-in-1 vaccine at 4 to 6 years of age. The 4-in-1 shot vaccine protects against:

  1. Diphtheria

  2. Tetanus

  3. Pertussis

  4. Polio

A booster of Hib vaccine is not needed if your child already received all 4 doses of the 5-in-1 vaccine (or 3 of the 6-in-1 together with a follow on 5-in-1).


For complete protection, your child needs to receive all vaccines at the right time.

You will be asked to keep a record book to help you keep track of your child’s immunizations.



  • Diphtheria is an illness caused by a poison producing bacteria, which kills cells in the lining of the throat and causes serious breathing problems. The heart, kidneys and nerves are also targets of this bacterium. 

  • ​Diphtheria is a serious illness killing approximately 1 in 10 people affected by it. Babies who get it are even more likely to die.

  • Diphtheria must be treated with an anti-toxin (a serum that fights the poison).

  • Antibiotics have no effect on the disease but are used to prevent the spread of the bacteria to others.

  • People who get diphtheria do not always become immune. Everyone needs to be vaccinated.



  • Tetanus is caused by bacteria found in dirt and dust as spores.

  • Tetanus is not contagious, however if tetanus gets into an open cut, like a puncture, bite or serious burn, poison from the bacteria can spread to your nerves and then to your muscles.

  • Muscles may lock in one place or go into spasm which causes excruciating pain.

  • Jaw muscles are often the first affected hence tetanus is also referred to as lockjaw.

  • You may not be able to swallow or even open your mouth.

  • If this same poison gets to the muscles that help you breathe, you can die quickly.

  • The main treatment for tetanus is anti-toxin (antidote to the poison).

  • Antibiotics are also given to kill the bacteria.

  • Other drugs are used to control the muscle spasms.

  • The use of a respirator (ventilator) may be needed to help breathing.

  • Between 1 and 8 people in 10 with tetanus will die.

  • People who survive tetanus may have long-lasting problems with speech, memory and thinking.

  • People who survive can get tetanus again - infection does not give immunity. Everyone needs the vaccine. 



  • Also known as whooping cough, pertussis is caused by bacteria that get into the throat and lungs and make it difficult to clear mucous from the airways.

  • Children may cough so long and so hard that they can’t breathe.

  • Young infants may not be able to cough forcefully and may stop breathing.

  • Babies with whooping cough may have seizures and in serious cases, go into a coma.

  • About 1 in 400 infants with pertussis will die, usually from pneumonia or brain damage.

  • Older children, adolescents and adults who get whooping cough will cough for more than 3 weeks, and the cough may last up to 12 weeks.

  • Coughing disturbs sleep and may be severe enough to cause a rib fracture, a hernia or loss of control of urine.



  • Polio is an infection caused by a virus called poliovirus.

  • It is important to know that some people with polio don’t feel sick at all.

  • Symptoms can include fever, sore throat, headache, muscle aches and pains, drowsiness, loss of appetite, nausea, vomiting, stomach pain and constipation. It can also cause meningitis (headache and stiffness in the neck and back).

  • About 1 in every 100 people who get the virus will get a severe form of the disease, which causes paralysis (not being able to move your arms or legs).

  • If the chest muscles are paralyzed, the person cannot breathe and will need a respirator (ventilator) to breathe for them.

  • Some people die from polio.

  • Most of those who survive are paralyzed for the rest of their lives.



  • Hib stands for Haemophilus Influenzae type b. Despite its name, it has nothing to do with the flu.

  • Hib is a bacteria that starts in the nose or throat and can infect almost any other part of the body, such as the brain, lungs, heart, joints, bones and skin.

  • It can cause meningitis when it infects the fluid and covering of the brain and spinal cord.

  • Without treatment, all children with Hib meningitis die. Even with treatment, about 1 in 20 children with Hib meningitis will die.

  • About 1 in 3 children who live will have permanent brain damage.


Hepatitis B

  • Hepatitis B is a disease caused by a virus that infects the liver.

  • Half of all people with hepatitis B don’t know they have it because they don’t feel sick. But they can still pass the disease to others.

  • Some people will become carriers and have the virus in their blood and other body fluids (like semen) for the rest of their lives.

  • Hepatitis B makes people very sick with fever, fatigue, loss of appetite, and yellow skin and eyes (jaundice).

  • 90% of infants infected before 1 year of age will be infected for life.

  • Sufferers are at high risk for getting liver disease, liver failure, and cancer of the liver.

  • There is no cure for hepatitis B, but treatment can sometimes decrease the amount of virus in the blood and body secretions. It can also prevent some of the other problems caused by the disease.

  • Many babies used to get hepatitis B at birth, but this doesn’t happen very often anymore, largely thanks to the vaccine.

  • Pregnant women are tested for the disease.

  • Babies whose mothers have the disease get the vaccine and hepatitis B immune globulin (a shot with a large amount of antibodies) soon after they are born.

  • You can stop the spread of disease by getting the vaccine and also ensuring your children have it too. 




Pneumococcal vaccine

Pneumococcal infections are caused by a bacteria called Streptococcus pneumoniae. These bacteria can cause many serious infections including meningitis, septicemia (blood infection), pneumonia, otitis media (middle-ear infection), and sinusitis.


There are two kinds of vaccine to protect your children from pneumococcal infections: 

  • The pneumococcal conjugate vaccine protects against the most common kinds of pneumococci bacteria. It’s recommended for all infants and children starting at 2 months of age. It contains 13 types of pneumcoccus.

  • The pneumococcal polysaccharide vaccine contains 23 types of pneumococcus. It is recommended for children 2 years of age or older who have serious medical problems that make them likely to have serious pneumococcal disease.

  • Your child will need both vaccines if he/she has:

    • a weak immune system

    • a spleen that is missing or not functioning well

    • chronic heart, lung, kidney or liver disease

    • diabetes

    • is deaf and has, or will have, an implant to help with hearing



Meningococcal vaccine

Meningococcal diseases are caused by bacteria called meningococcus. This bacteria can cause two serious diseases:

  • Meningitis, an infection of the fluid and lining that covers the brain and spinal cord, and

  • Septicemia, a serious blood infection that can damage many organs in the body. 

Without treatment, almost all children who get meningococcal disease will die or suffer damage that lasts the rest of their lives. 


There are three kinds of meningococcal vaccine available in Canada. Each vaccine provides different protection:

  • Meningococcal C vaccine (MCV-C) is usually given to babies and young children. It protects against type C of the meningococcus bacteria, which used to be very common before this vaccine was available.

  • MCV-4 protects against 4 types of the meningococcal germ (A, C, Y and W135). This vaccine is usually only given to people at higher risk of getting meningococcal disease (those with no spleen or who have certain medical conditions). 

  • 4CMenB protects children against group B. This vaccine is not given routinely but is usually given to children at higher risk of getting meningococcal disease.

Currently, no provinces or territories cover the cost of 4CMenB for all children. Some provide it for children at high risk of getting meningococcal disease. It was newly approved for use by Health Canada late in 2013. 



Rotavirus vaccine

Rotavirus is the most common cause of serious diarrhea in babies and young children.

It usually affects children between the ages of 6 months and 2 years.

Without vaccine, almost all children will have at least one episode of rotavirus diarrhea before they turn 5 years old.

  • The Canadian Paediatric Society recommends that all babies between 6 weeks and 32 weeks (8 months) of age get the vaccine. Two vaccines exist: RotaTeq (RV5) and Rotarix (RV1). Both vaccines are effective.

  • The vaccines are usually given with other baby vaccines, but can be given as early as 6 weeks. Babies must receive the first dose before 20 weeks of age. All doses need to be given by 8 months (32 weeks) of age.

  • It is given in liquid form by mouth. Your child will need 3 doses of RotaTeq, or 2 doses of Rotarix. Doses are given at least 4 weeks apart.



Influenza vaccine

Influenza (or “flu”) is a respiratory infection caused by influenza virus. Influenza outbreaks happen every year.

Influenza vaccination is safe for anyone 6 months of age and older. It protects you and those around you from the flu and its complications.

Because influenza viruses change – often from year to year – people don’t stay immune for very long. Flu shots are usually given once a year from October to mid-November. The shots provide protection throughout the flu season — October to April.

  • Babies and children 6 months to 9 years of age who have never had a flu shot will need 2 doses of the vaccine, given at least 4 weeks apart.

  • Children who had one or more doses of the regular seasonal flu shot in the past will only need one dose per year.

All children over 6 months old should get a flu shot each year. The vaccine does not work in infants under 6 months of age. Those babies can get antibodies against the flu transferred through breast milk hence the flu shot is not only also safe but highly recommended for breastfeeding women


The vaccine is especially important for children and teenagers who are at high risk of complications from the flu, including those who:

  • are between 6 months and 5 years of age - at higher risk of fever, convulsions and pneumonia.

  • have chronic heart or lung disorders (such as chronic lung disease, cystic fibrosis, asthma) serious enough to need regular medical follow-up.

  • have chronic conditions that weaken the immune system, such as immune deficiencies, cancer, HIV or a treatment that causes immune suppression.

  • have diabetes or other metabolic diseases.

  • have chronic kidney disease.

  • have chronic anemia or a haemoglobin disorder.

  • have a chronic neurological disorder.

  • are severely obese (body mass index ≥40).

  • are pregnant.

  • have to take acetylsalicylic acid (ASA or Aspirin) on a daily basis.

  • live in a chronic care facility.

  • live in First Nation or Inuit communities.

  • live with another child or adult who is at risk of complications from the flu.

If you have children younger than 5 years old or who have health complications, everyone living in the house should get a flu shot. This is especially important if you have children under 6 months old or a member of your household who is pregnant. 


The influenza vaccine is safe for individuals with an egg allergy. 

The influenza vaccine cannot cause the flu. (However the nasal vaccine has not yet been tested for safety in this group).


The nasal flu vaccine ("FluMist") is given as a nose spray instead of injection.

  • Healthy children over the age of 2 can get the nasal flu vaccine.

  • The vaccine is given in 1 or 2 doses.

  • Each dose is one squirt into each nostril.

  • The nasal flu vaccine should not be given if: a child is less than 2 years of age, a woman is pregnant, you are immunocompromised, you take acetylsalicylic acid (ASA or Aspirin) on a daily basis, you have had a serious allergic reaction to eggs, you have severe asthma and have been treated with steroids or had severe wheezing in the past 7 days (the vaccine may make the wheezing worse). These people should get the injected vaccine.



Hepatitis A vaccine

  • Hepatitis A is an infection of the liver caused by a virus.

  • Adults and children are equally at risk.

  • The virus most frequently spreads through direct contact with infected people or indirectly through ingestion of contaminated foods or water.

  • Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, and jaundice (yellow skin and eyes)

  • The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine.

  • Vaccination is recommended for all children age 12 months and older, for travelers to certain countries, and for people at high risk for infection with the virus. It can be given as early as 6 months of age. 

  • The hepatitis A vaccine is given as two shots, six months apart.

  • The hepatitis A vaccine also comes in a combination form, containing both hepatitis A and B vaccine, that can be given to persons 18 years of age and older. This form is given as three shots, over a period of six months or as three shots over one month and a booster shot at 12 months.

  • The first dose should be given at 12-23 months of age. Children who are not vaccinated by 2 years of age can be vaccinated at later visits.

  • Hepatitis A vaccine is recommended for healthy international travelers age 12 months or older; the first dose of Hepatitis A vaccine should be administered as soon as travel is considered.




MMR: Measles-Mumps-Rubella vaccine

In Canada, children get two doses of the MMR vaccine:

  • The first shot is given at 12 to 15 months of age.

  • The second shot is given at 18 months or between ages 4 to 6 years (before your child starts school), or as soon as one month after the first MMR shot, if needed.

  • If your baby receives the MMR vaccine early (after 6 months but before 12 months), know that your baby will still need to get his/her regular MMR shot when he/she is 12 months old.

  • Although the subject of a lot of controversy, this vaccine is very safe and effective, and all the controversies are unproven and unfounded. 



  • Measles is a severe and highly contagious respiratory infection. 

  • If you have not been vaccinated or already had measles, you will probably get it if you are in the same room as someone who has it.

  • It is not “an ordinary infection that all children should have.”

  • Sometimes measles is called “red measles” (or rubeola). It should not be confused with “German measles,” which is another name for rubella.

  • Measles causes fever, aches and pains, runny nose, a severe cough (often bronchitis) and very red eyes. You may think your child has a cold.

  • A characteristic rash then follows a few days later.

  • Serious complications can occur as a result of measles including, pneumonia, serious ear infection, deafness, serious neurological disease and even death.

  • There is no cure for measles.



  • Mumps is a contagious infection caused by a virus. Mumps is most common in children, although sometimes adults get it too.

  • Mumps causes fever, aches and pains, headaches and swelling of the salivary glands around the jaw and cheeks.

  • The glands usually become more swollen and painful over 1 to 3 days. Chewing and swallowing can become painful.

  • Some children infected with mumps have no symptoms at all, or may seem to have a cold, but can still spread the infection to others.

  • In severe cases, mumps can cause meningitis leading to seizures, hearing loss, or death.

  • Older boys and men sometimes get orchitis (painful swelling of the testicles), which can cause sterility

  • You can protect against mumps by getting the vaccine.



Rubella is also known as “German measles”

It is also caused by a virus and is different from measles.

Rubella is generally a mild disease in children.

However, in pregnant women, rubella is serious because it can harm an unborn child.

Rubella in pregnancy is now very rare in Canada because most women have been vaccinated against it.

  • If a pregnant woman gets rubella during the first 20 weeks of pregnancy, she usually passes the disease on to her unborn baby (fetus). The baby will have congenital rubella.

  • If the fetus gets rubella during the first 12 weeks of pregnancy, the baby will likely be born with many life-long problems. The most common are eye problems, hearing problems and damage to the heart.

  • There is no treatment for rubella infection.

  • If you are not protected against rubella either from previous infection or vaccination, and are considering becoming pregnant, you should get the MMR vaccine right away. The vaccine should be given at least 4 weeks before you become pregnant.  You cannot get this vaccine when you are pregnant. 



Chickenpox vaccine

Chickenpox (also known as varicella) is a very contagious infection caused by the varicella-zoster virus.

You can protect your child from chickenpox with a vaccine.

Although most people think of chickenpox as an irritating but relatively minor disease it can be quite serious:

  • Babies who get chickenpox from their mothers before birth could be born with birth defects like skin scars, eye problems, brain damage or arms and legs that are not fully formed.

  • Chickenpox can be very severe or even life-threatening to babies in the first month of life, to adolescents and adults, and to anyone who has a weak immune system.

  • Children with chickenpox can get pneumonia or get inflammation of the brain.

  • The blisters can get infected with bacteria and this can lead to lifelong scars. Though most of these infections are minor and clear up on their own, some can lead to a serious illness called necrotizing fasciitis (or “flesh-eating disease”).


In terms of who should get the vaccine

  • Children should get 2 shots for chickenpox: the first when they are 12 to 15 months old and a second “booster” shot when they are 4 to 6 years old (before they start school). In some provinces/territories, the second dose is given at 18 months old.

  • Children who have had chickenpox before 1 year of age may not stay immune and should receive the vaccine at the recommended times indicated above.

  • People who have had chickenpox after they are 1 year of age do not need to get the vaccine. But if they do get the vaccine, it will not hurt them.

  • Teens and adults up to age 50 who have not had chickenpox or the vaccine should get 2 shots, given at least 6 weeks apart.

  • Women planning for pregnancy who have not had chickenpox or the vaccine should receive the 2 shots at least 4 weeks before getting pregnant. 



Human papillomavirus (HPV) vaccince

HPV is the most common sexually transmitted infection (STI) in Canada. That means it passes from person to person through sexual contact. 

  • HPV infection can be passed through any type of sexual activity (vaginal, oral or anal), not just intercourse. Some types of HPV are spread by skin-to-skin contact.

  • HPV is very common and very contagious. Teens have high rates of infection. People usually get it after they start any type of sexual activity.

  • As many as 3 in 4 Canadians get HPV sometime during their life

  • Most people don’t know they have HPV, because usually there are no symptoms.

  • However, HPV can cause genital warts (flat, flesh-colored bumps or tiny, cauliflower-like bumps that vary in size).

  • In addition HPV is the leading cause of cervical cancer (cancer of the cervix) in women. Cervical cancer is the second most common form of cancer in women.

  • HPV can also cause cancer of the vulva in women, and anal and penile (penis) cancer in men. 

  • There is a safe and effective vaccine that can help protect girls and women, boys and men from the kinds of HPV that most often cause cancer and warts. 

  • Children and adults between the ages of 9 and 26 years should get this vaccine. For best results, all children should be vaccinated at 9 to 13 years old, before they become sexually active.

  • Adults older than 26 years may also be vaccinated if they are having new sexual partners.

  • To be protected you will need 2 or 3 doses of vaccine, depending on your age and which vaccine is used. If 3 doses, the second dose is given 2 months after the first, and the third dose 6 months after the first. If 2 doses, the second dose is given 6-12 months after the first. 

  • For the vaccine to work the best, you need to get it before you start any sexual activity. Remember that it may take up to a month after the last dose before you are protected. 

  • The HPV vaccine does not protect against other STIs nor does it against all types of HPV, only the most common types causing genital warts and cervical or penile cancer.

  • You cannot get HPV from the vaccine. 



Diphtheria-tetanus-acellular pertussis (dTap) vaccine

  • If you are a teenager, you need a booster shot for 3 serious diseases: diphtheria, tetanus and pertussis (whooping cough) despite being probably vaccinated against these diseases as a child.

  • The vaccines against diphtheria and tetanus protect you for about 10 years. And recently, many teenagers have been getting whooping cough because the protection from their earlier shots has worn off. 

  • The sixth dose of diphtheria, tetanus and pertussis vaccine will help prevent teenagers from getting these diseases.  

  • On the other hand, boosters for Hib (Hemophilus influenzae type b) and polio are not needed. Hib does not cause serious disease in healthy older children, adolescents and adults; and immunity after polio vaccine lasts for many, many years.




Canadian Pediatric Society - Your Child's best Shot

Immunize BC

BC Center for Disease Control



Here are some helpful website links on this common topic:


A Parent's Guide to Vaccination


Infants, Children & Teens (birth - 18months) - 


5-in-1 or 6-in-1 vaccine
Hepatitis B
Pneumococcal vaccine
Meningococcal vaccine
Rotavirus vaccine
Influenza vaccine
Hepatitis A vaccine
MMR vaccine
Varicella vaccine
HPV vaccine
dTap vaccine
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