Making sense of kids’ vaccinations

Along with school supplies, lunchbox snacks, running shoes and uniforms, don’t forget to add vaccination appointments to your child’s back-to-school list.

Feeling uncertain about vaccines? Dr. Marvin Gans’ busy practice includes a lot of parents with differing views on vaccinations. Partly due to changing schedules and misinformation about links between vaccines and conditions such as autism, some parents are asking to break out combination vaccines into individual doses or delay their kids’ shots. Or they’re just asking many questions about safety.

Gans is patient. “I try to explain to them: The greatest advances in medical care are immunizations,” says the Toronto paediatrician. “We used to see way more reactions. But now hardly anyone says ‘my kid was sick’ after a vaccination,” he adds.

Instead, the vast majority of his patients are vaccinated with no issues whatever. And he has yet to see a patient suffer a serious adverse reaction to a vaccine.

The biggest issues Gans sees now are staying on top of ever-changing vaccination schedules and knowing about new vaccines on the market.

While vaccination schedules vary by province in terms of timelines and funding, the Public Health Agency of Canada lists immunization schedules recommended by the National Advisory Committee on Immunization. The website lets you pull up an immunization schedule tool for children under six, by age and province. And, because immunization requirements for entering school also vary among provinces, the site includes an immunization schedule tool for school-age children.

New vaccines for kids

While DTaP — diphtheria, tetanus and acellular pertussis (whooping cough) — and MMR (measles, mumps and rubella) are vaccine mainstays on provincial immunizations schedules, new vaccines and formulations are emerging.

In some cases, existing vaccines are being bundled together with newer vaccines to reduce the number of shots kids receive, says Gans. These vaccines include DTaP-IPV-Hibor five-in-one, which is DTaP plus polio and Hib (Haemophilus influenzae type b, a common cause of bacterial meningitis). Other vaccines include:

• The varicella vaccine, which is used to prevent chicken pox. Your kids should get two shots of the vaccine, the first of which is recommended for children between 12 to 15 months and is usually covered under provincial health plans. The second shot should be given at 18 months or after, but no later than when the child starts school. This second shot is not always covered.
• HPV vaccine. This protects against the nine strains of human papillomavirus, a sexually transmitted infection that can show up as genital warts and lead to cancers of the cervix, anus, vagina and vulva. Girls and boys in grades five, six or seven – depending on the province – can get the HPV vaccine for free.
• Pneumococcal vaccine. This vaccine protects against pneumococcal infections caused by the Streptococcus pneumoniae bacteria, which can cause meningitis, bloodstream infections, pneumonia and ear infections. For babies, this vaccine can be administered on a three-dose schedule at two, four and six months of age. This can be followed up with an additional dose when a child reaches 12 to 15 months.
• Rotavirus. A vaccine that protects against diarrhea in babies and young children, The Canadian Paediatric Society recommends that all infants between six weeks and 32 weeks (eight months) of age receive it. Covered in most provinces, this vaccine can be given with other routine immunizations.
• Meningococcal vaccine. Three versions of this vaccine exist in Canada. The meningococcal C vaccine (Men-C-C) protects babies and young children from meningitis, a serious infection of the brain and spinal cord; it’s usually given at age one. Teens and adolescents, starting at age 12, are given a Men-C-C or a quadrivalent conjugate meningococcal (Men-C-ACYW) vaccine, even if they were previously vaccinated as an infant. What’s more: The multicomponent meningococcal (4CMenB) vaccine is recommended for kids with an increased risk of invasive meningococcal disease (IMD). Children of families travelling abroad have a greater chance of catching IMD. For more info, consult your doctor or paediatrician.

The key to success is staying on top of your child’s vaccinations, says Gans. While paediatricians keep records of their young patients’ shots, “parents should also take some responsibility for keeping track,” he says.

What parents can do

Besides getting good information from reliable sources such as the Public Health Agency of Canada, there are several things you can do to help ensure your children are vaccinated properly:

• Bring your child’s vaccination record each time he or she receives a shot. Doctors may move — and take your child’s vaccination record with them. Or you may move to another province with a different vaccination schedule.
• Ask to see the bottle. Checking the vaccine vial will put your mind at ease that your child is receiving the right shot.
• Report any mild adverse effects right away to your doctor. If your child has a serious reaction such as a high fever after a vaccination, head straight to the ER.
• Skip the acetaminophen. Doctors no longer recommend giving fever reducers as a preventive measure before or after any vaccination to boost immunity — unless a child develops a high fever.
• Talk to your doctor. If your child has a fever, reduced immunity, a chronic illness or a long-term medical condition, ask about whether vaccination is safe.
• Use an app to store your vaccination records and set up reminders. Free apps and digital tools like CANImmunize allow you to carry your family’s vaccination information on the go and set up alerts for upcoming appointments. You’ll also find plenty of facts about vaccinations in your province or territory.