Dorothy Moore - Your Childs Best Shot: A parents guide to vaccination:

Your
Childs
Best
Shot

4TH EDITION

Your Childs Best Shot

A parents guide to vaccination

Edited by Dorothy L. Moore, MD

Foreword by Andr Picard

Copyright Canadian Paediatric Society, 2015

All rights reserved.

First edition 1997

Fourth edition 2015

ISBN 978-1-926562-03-2 (English paperback)

ISBN 978-1-926562-04-9 (French paperback)

Printed and bound in Canada

Library and Archives Canada Cataloguing in Publication

Your childs best shot (2015)

Your childs best shot : a parents guide to vaccination / Dorothy L. Moore, editor. 4th edition.

Includes index.

ISBN 978-1-926562-03-2 (pbk.)

1. Vaccination of childrenPopular works. 2. VaccinesPopular works. 3. Communicable diseasesPopular works. I. Moore, Dorothy L., 1943-, editor II. Canadian Paediatric Society, issuing body III. Title.

RJ240.Y68 2015 614.47083 C2014-904611-1

This book is available in English and French, and may be ordered from the publisher:

Canadian Paediatric Society

2305 St. Laurent Blvd.

Ottawa, Ontario K1G 4J8

Tel. 613-526-9397

Fax 613-526-3332

www.cps.ca, www.caringforkids.cps.ca

Cover and book design: Fairmont House Design

Translation: Dominique Par (Le bout de la langue)

Please note: The information in this book should be used to support, not to replace, the advice given by a physician, other health professional, or any provincial/territorial health authority. Information is not intended, and should not be used, to contradict specific laws or policies in any jurisdiction. All medical content has been developed by the Canadian Paediatric Society and reviewed by experts.

Website addresses are current as of January 2015

Tables

Text boxes

The Canadian Paediatric Society is profoundly grateful to Dr. Ronald Gold, who researched and wrote the first three editions of Your Childs Best Shot: A Parents Guide to Vaccination. His work over more than a decade established the book as a definitive Canadian resource and is both foundation and springboard for the present text.

The 4th edition of Your Childs Best Shot was reviewed and revised by members of the CPS Infectious Diseases and Immunization Committee for 2013-14.

Special thanks go to the Committee Chair, Joan L. Robinson, MD, Divisional Director, Pediatric Infectious Diseases, University of Alberta, Stollery Childrens Hospital, Edmonton, Alta, who provided important input for Part I.

Upton D. Allen, MD, Professor, Pediatrics and Health Policy Management and Evaluation, University of Toronto; Chief, Division of Infectious Diseases, Hospital for Sick Children, Toronto, Ont.

Natalie Bridger, MD, Assistant Professor of Pediatrics, Memorial University; Pediatric Infectious Diseases, Janeway Childrens Hospital and Rehabilitation Centre, St. Johns, NL; Immunization Monitoring Program, ACTive (IMPACT).

Charles P.S. Hui, MD, Associate Professor, Department of Pediatrics, University of Ottawa; Pediatric infectious disease physician, Childrens Hospital of Eastern Ontario, Ottawa, Ont.; Committee to Advise on Tropical Medicine and Travel (CATMAT), Public Health Agency of Canada.

Nicole Le Saux, MD, Associate Professor, Department of Pediatrics, University of Ottawa; Division of Infectious Diseases, CHEO Research Institute, Childrens Hospital of Eastern Ontario, Ottawa, Ont.; Immunization Monitoring Program, ACTive (IMPACT)

Noni E. MacDonald, MD, Professor of Pediatrics and Microbiology, Dalhousie University, IWK Health Centre, Halifax, N.S.

Jane C. McDonald, MD, Associate Professor of Pediatrics, Chief, Division of Infectious Diseases and Department of Microbiology, Montreal Childrens Hospital, McGill University, Montreal, Que.

Dorothy L. Moore, PhD, MD, Associate Professor of Pediatrics, McGill University; Paediatric infectious disease specialist and associate infection control physician, Montreal Childrens Hospital, Montreal, Que.; Immunization Monitoring Program, ACTive (IMPACT).

Heather Onyett, MD, Professor Emeritus, Departments of Pediatrics, Biomedical and Molecular Sciences, and Community Health and Epidemiology, Rehabilitation Therapy, Queens University, Kingston, Ont.

Portions of this book also benefitted from input from other expert reviewers:

Julie A. Bettinger, PhD, Epidemiologist, Investigator, Vaccine Evaluation Center, CFRI; Associate Professor, Division of Infectious and Immunological Diseases, Department of Pediatrics, University of British Columbia.

Barbara J. Law, MD, Chief Vaccine Safety, Vaccine and Immunization Program Surveillance Division, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada.

Caroline Quach, MD, Associate Professor, Departments of Pediatrics and Epidemiology, Biostatistics and Occupational Health, McGill University; Paediatric infectious disease specialist and infection control physician, Montreal Childrens Hospital.

Aline Rinfret, PhD, Chief Viral Vaccines Division, Biologics and Genetic Therapies Directorate, Health Canada.

David W. Scheifele, OC, MD, Director, Vaccine Evaluation Center, CFRI; Professor, Division of Infectious and Immunological Diseases, Department of Pediatrics, University of British Columbia; Data Centre Chief, IMPACT, Public Health Agency of Canada.

Your Childs Best Shot is available in French under the title Les vaccins : Avoir la piqre pour la sant de votre enfant. The CPS thanks Dr. Franois Boucher, Dr. Marc Lebel and Dr. Marie-Astrid Lefebvre for their meticulous review of the French text.

Thanks also to Jennie Strickland, Publications Coordinator, and Elizabeth Moreau, Director, Communications and Public Education with the Canadian Paediatric Society, for their invaluable input and advice, and their limitless patience with the revision of this book.

We thank the Healthy Generations Foundation for providing the funds to translate this book into French.

The Canadian Paediatric Society acknowledges, with gratitude, the following corporate sponsors for their unrestricted educational grants in support of this publication:

AstraZeneca Canada Inc.

GlaxoSmithKline Inc.

Merck Canada Inc.

Pfizer Canada Inc.

The Canadian Medical Association granted permission to reproduce two copyrighted works adapted from Reducing the pain of childhood vaccination: An evidence-based clinical practice guideline, CMAJ 2010;182(18):E843-55. Reduce the pain of vaccination in babies: A guide for parents, and Reduce the pain of vaccination in kids and teens: A guide for parents are published as an annex to .

Andr Picard

A generation or two ago, vaccination was an easy sell. Infectious disease was omnipresent. So too were the tragic consequences: Large numbers of children sickened, crippled and killed. Parents yearned for protection from common viruses and bacteria that stalked their babies and embraced childhood vaccines as a godsend. So too did hospitals, which were able to shut down their polio and measles wards, and mothball the iron lungs.

The reality is much different today. Once-common childhood illnesses have virtually disappeared from everyday life. The threat posed by pathogens seems more illusory than real. Vaccination feels more like an ordeal than a necessity, anxieties around the side effects of vaccinesreal and imaginedseem to have blinded many parents to the benefits, and they are left with nagging doubts about there being too many shots.