Baby Immunization Schedule

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One of the greatest health achievements of our time has been the near elimination of many common childhood infectious illnesses, thanks to widespread vaccination. However, some of these diseases still linger in our communities, and we use vaccines for children as protection.

Read on to find out why immunizations are important, get the latest childhood immunization schedule in Canada, and learn about the most common childhood diseases and the vaccines that fight them.

What Are Vaccines and How Do They Work?

Vaccines are shots that contain harmless versions of the same germs that cause a specific disease. These germs are either dead or weakened to the point that they don’t do any harm. The vaccine, once injected, stimulates the body’s immune system to produce antibodies.

A person who is vaccinated will then develop immunity to that specific disease without ever having contracted it. Unlike medications that cure diseases, vaccines help prevent them in the first place. When it comes to immunization vs. vaccination, the terms are typically interchangeable, although immunization is specifically the process of becoming protected, whereas vaccination is the act of receiving the vaccine.

When it comes to your baby or toddler, through mandatory and routine vaccinations, you can protect your little one from serious diseases like polio, whooping cough, and more. Young infants are at the greatest risk, so it’s important that babies and toddlers receive all the recommended vaccinations before their second birthday.

Vaccines With Additional Doses

Some vaccines require more than one dose. Here are some situations in which additional doses may be needed, depending on the type of vaccine:

  1. For inactivated vaccines, one dose doesn’t provide enough immunity, so they require follow-up doses, such as with the Hib vaccine.

  2. Immunity may wear off after time for certain vaccines. In these cases, your child will need a booster shot to raise immunity levels again. The DTaP vaccine is a good example, as older children and adults need the Tdap vaccine booster shot.

  3. Some live vaccines require more than one shot so the individual can build the best immune response, which means developing plenty of antibodies to fight off a possible infection. This is the case for the MMR vaccine, for example.

  4. The flu vaccine is recommended for children over 6 months old and adults. But children between 6 months and 8 years old who haven’t had the flu vaccine will need two doses in the first year of receiving it. After that, once per year is enough. Because flu viruses change from year to year, the effectiveness of the vaccine wears off over time.

Vaccine Effectiveness

Vaccines are very effective. In the rare instance that your vaccinated baby catches a disease after vaccination, the symptoms will likely be much less severe than if your child wasn’t vaccinated.

Vaccines for children and adults have helped save millions of lives and continue to help prevent the spread of disease. Ensuring your child gets all her immunizations helps prevent her from catching certain potentially deadly diseases, while reducing the risk of community transmission.

Although you might think you no longer need certain vaccinations because the diseases have been eradicated from Canada, international travel within areas with outbreaks can still bring these diseases back.

Vaccine Safety for Children

Rest assured that Canadian vaccines are safe for children and adults. The Food and Drugs Act (FDA) classifies vaccines in a way that requires extra oversight, special expertise, and additional procedures. Each one is approved by Health Canada, which studies the vaccines to make sure they meet high standards of safety and effectiveness.

Once approved and distributed by local governments, Health Canada continues to monitor the safety and effectiveness of each vaccine in partnership with the Public Health Agency of Canada (PHAC) and the National Advisory Committee on Immunization (NACI).

Moreover, health care providers in Canada must adhere to mandatory reporting regarding adverse side effects associated with vaccinations. The PHAC then collects all incidences of side effects from local governmental health departments, health care providers, and the pharmaceutical industry to further study Canadian use of vaccines.

Vaccine Side Effects

Sometimes, the area where your baby receives the vaccination may become red or a little swollen, but these side effects don’t last long. Your child may also be a little fussy afterward and/or may sleep a little longer in the days after receiving a shot.

When anyone receives vaccinations, including babies, the body thinks it’s being invaded by an organism, triggering an immune response to fight the possible infection and build up defences. This is why your baby may experience these minor side effects. It’s a good sign that the immunizations are working!

In the very rare case that your baby experiences a more serious reaction, such as a fever over 39 degrees Celsius, a rash, or seizures, call her healthcare provider immediately.

What Is an Immunization Schedule?

An immunization schedule (or vaccine schedule) is a predetermined list of when to administer immunizations to children. Every year, medical professionals and top disease experts review the recommended vaccines that will help protect children in Canada from diseases. They also set the vaccine schedule so that parents know when their children should receive immunizations for maximum effectiveness.

In Canada, the immunization schedule for children is then approved by Health Canada. Here you’ll find the organization’s recommended immunization schedules for children of all ages and adults in Canada. Or, you can use Health Canada’s interactive database to create a vaccine schedule specific to your baby.

Other Factors that Influence Immunization Schedules in Canada

Experts determine the best time to administer the vaccine to children based on two important factors:

  1. The age at which a child’s immune system can provide the best protection after vaccination

  2. The earliest possible time the child can receive the vaccine based on the highest risk by age. This is why some vaccines are given when your baby is an infant, and others are scheduled later in childhood, even as late as the teenage years.

Don’t be surprised if your child’s vaccine schedule includes a shot that he’s already had, as some vaccines need multiple doses for optimal protection. This is reflected in the immunization chart below under “dose number.”

If you have any questions about the immunization schedule and what is right for your little one, consult your healthcare provider, who can give you all of the information and guidance you need.

Vaccine Chart: Recommended Immunization Schedule in Canada

Listed below are the vaccinations recommended by Health Canada for children with general time frames from birth to 18 months:

 

AgeVaccineDose Number
Birth
 HB (hepatitis B)1 of 3
1 month
 HB2 of 3
 Rota (rotavirus)1 of 3
2 months
 DTaP (diphtheria, tetanus, pertussis)1 of 5
 Hib (haemophilus influenzae type B)1 of 4
 IPV (polio)1 of 5
 Pneu-C-13 (pneumococcal infections)1 of 3
 Men-C-C (meningococcal disease)1 of 2
 Rota2 of 3
4 months
 DTaP2 of 5
 Hib2 of 4
 IPV2 of 5
 Pneu-C-132 of 3
6 months
 DTaP3 of 5
 HB3 of 3
 Hib3 of 4
 IPV3 of 5
 Rota3 of 3
 Influenzaannually from 6 months old
12 months
 Pneu-C-133 of 3
 Men-C-C2 of 2
 MMR (measles, mumps, rubella)1 of 2
 Var (varicella)1 of 2
18 months
 DTaP4 of 5
 Hib4 of 4
 IPV4 of 5

 

Remember, your child will eventually need to have booster shots of certain vaccines starting around 4 years old (such as for DTaP, IPV, MMR, and VAR). Additionally, she’ll need vaccines when she’s in her teenage years, including Tdap and HPV (human papillomavirus).

Can Immunization Schedules Change?

Since experts are always searching for ways to improve vaccines, and because different brands of shots may require slightly different doses, your child’s healthcare provider may recommend a different Canadian immunization guide for your baby.

New vaccines are always on the horizon, and this could also result in changes to your child’s vaccine schedule.

To be on the safe side, double check with your healthcare provider at each visit to make sure your baby or toddler is up to date.

Why It’s Important to Follow the Canadian Immunization Guide

It’s crucial that your child is protected from the diseases that vaccines help fight. Sticking to the recommended immunization schedule, whether you live in Ontario, British Columbia, or any Canadian province, is important to ensure your little one is or remains protected.

Skipping or putting off vaccinations for your children until later can leave them vulnerable to dangerous diseases that vaccines can protect. Some of these diseases can make your baby very sick, and may require hospitalization; in some cases, the diseases may even result in death. Not vaccinating your child can also contribute to the spread of disease in your area.

What Is a Delayed Immunization Schedule?

The vaccine schedule is the same for all children in each individual province of Canada. Although the recommended vaccines are the same, provinces may differ slightly on when a child should receive specific immunizations. For example, the immunization schedule in Ontario suggests children wait until after their first birthday to receive the Men-C-C vaccine, whereas British Columbia recommends it at 2 months and 12 months.

Additionally, there may be certain adjustments needed if your child has a weakened immune system, or if she’s taking certain medications that may weaken her immune system.

Your child’s healthcare provider will consider your baby’s entire medical history and the Canadian immunization guide when determining a vaccine schedule for your little one. In some cases, your healthcare provider may suggest delaying a shot, or not giving it at all, if this is the safest course of action for your child.

How to Get Your Child Vaccinated

Your child’s routine and mandatory vaccinations are typically planned and carried out by your child's healthcare provider at the regular well-child visits.

For example, your provider can tell you which vaccines your baby will receive at his current or upcoming well-child checkup. Your provider can also inform you if the vaccination will take place at another location—such as a health centre, local clinic, or a pharmacy—instead of at the physician’s office.

When going to the visit, it’s a good idea to bring a copy of your child’s immunization records. After each immunization, you’ll receive a Canadian vaccine tracker, which is your personal paper copy of your child’s records. Your healthcare provider also stores records, and you can request records from your local governmental immunization registry (if one exists).

If your child is sick the day of the appointment, make sure to let the healthcare provider know. If the illness is mild, he may still be able to receive the vaccine; otherwise, your provider may recommend vaccinating at another time.

How to Prepare Children for Vaccines

If your little one is old enough to understand what’s going on, try describing the immunization schedule and appointment and what’s about to happen. Offer assurance that, although the shot may hurt a little, the pain won’t last. Also, consider bringing along your child’s favourite toy or even a security blanket to comfort her.

During the appointment, you may be able to hold your child in your lap, which can offer additional comfort. Also, consider trying to distract him with a toy, a story, or pointing out things in the room.

For a very young child, you might consider breastfeeding or bottle-feeding afterward. Even swaddling may help comfort her, especially if she’s crying after the shot.

The doctor or nurse who administers the shot can provide some advice for any steps you could take to help your child feel more comfortable. Sometimes, they may advise to your child to move his arm around after the vaccination, which can help reduce any pain or swelling.

The Diseases Vaccines Help Prevent

Here are brief descriptions of the diseases that routine and mandatory Canadian vaccines help prevent. Remember that the vaccine schedule may differ slightly from province to province.

Diphtheria

Diphtheria (the “D” in the DTaP vaccine) is a bacterial infection that spreads through the droplets from coughs and sneezes of an infected person.

Symptoms can include a mild fever, sore throat, and chills. In some cases, there may be nasal discharge, fatigue, and a thick coating on the throat.

If left untreated, the infection can lead to difficulty swallowing, paralysis, and even heart failure.

Adults receive another version of the vaccine called Tdap, which passes antibodies onto the baby while still in the uterus, giving him some level of protection against pertussis (whooping cough) in the first few months of life and until he’s old enough to get immunized.

Vaccination: The diphtheria vaccine is administered along with the vaccines for tetanus and pertussis (hence the DTaP abbreviation). Children should receive five doses altogether: at 2 months, 4 months, 6 months, 18 months, and finally the last one between 4 and 6 years of age.

Haemophilus Influenzae Type B

Hemophilus influenzae is a bacterial infection spread by coughing and sneezing. It can lead to pneumonia, meningitis (an infection of the brain lining), epiglottitis (the severe swelling of the throat), ear infections, and other serious infections.

Although the name may sound similar, it is not the same as influenza (a.k.a. “the flu”).

The disease most often occurs in children between 6 months and 5 years old. Symptoms include fever, seizures, vomiting, and a stiff neck.

Vaccination: The first dose of the Haemophilus influenzae type B vaccine (often shortened to Hib in the context of vaccines) is given at 2 months old with 2 or 3 more doses in the following months.

Hepatitis B

Hepatitis B is a viral disease of the liver that can be very serious, even leading to liver damage or cancer.

It spreads through infected blood and bodily fluids. The disease passes from person to person if a healthy person comes into contact with the bodily fluids of a sick person.

If a pregnant woman is infected with hepatitis B, she can pass the disease to her baby at birth. To prevent this from happening, babies receive this vaccination within 12 hours of birth.

Some who are infected may not show any symptoms, whereas others have symptoms that can last for several weeks. Symptoms include loss of appetite, jaundice, muscle pain, diarrhea, and vomiting.

Vaccination: The hepatitis B vaccine (HepB) is administered in 3 doses: the first at birth, the second at 1 to 2 months, and the third no earlier than 6 months and no later than 18 months.

Influenza

Known more commonly as “the flu,” influenza is a respiratory illness caused by a virus that spreads rapidly by coughing or sneezing.

It spreads easily through contact with an infected person, by sharing things like cups or spoons, or by touching contaminated surfaces and then transferring the droplets to the mouth or nose. This is why it’s so important that your little one washes her hands regularly and you disinfect surfaces often, especially if someone in the home is sick.

Flu season usually runs from fall to spring and outbreaks are riskier for school-age children who haven’t yet received vaccines. This is because children tend to touch things and then rub their eyes, nose, or mouth.

Flu symptoms can last a week or more, and may include a fever above 38 degrees Celsius, chills, body aches, sore throat, cough, and runny nose.

Complications from the flu can include pneumonia, dehydration, sinus problems, ear infections, brain dysfunction, and even death. Every year, thousands of children under the age of 5 are hospitalized with the flu, which is why the flu vaccine is so important.

Vaccination: The best way to prevent your little one from getting the flu is ensuring he gets the annual influenza vaccine in the late summer or early fall. Children aged 6 months or older should be vaccinated every year to stay protected.

Measles

Measles (the first “M” of the MMR vaccine) is a viral disease that produces a red or brownish blotchy rash, a cough, a runny nose, fever, or pinkeye. In rare cases the infection can cause pneumonia or encephalitis (a brain infection). Young children may also develop an ear infection, croup, and diarrhea.

The characteristic rash appears two to three days after the other symptoms, and the rash may last five to eight days.

Measles spread when an infected person coughs or sneezes, or through direct contact with fluids from an infected person's nose and mouth. Because of widespread vaccination, measles is now rare in Canada, but it’s still prevalent elsewhere and there have been more recent cases of outbreaks.

Vaccination: The measles vaccine is administered along with the vaccines for mumps and rubella (MMR). A first dose is administered between 12 and 15 months, and a second dose between 4 and 6 years of age. If you’re travelling with your infant outside of the country, she can receive the first dose as early as 6 months.

Mumps

Mumps (the second “M” of the MMR vaccine) causes fever, headache, and swelling of the salivary glands on the sides of the face. The virus spreads through coughing and occurs most often in children who are between 5 and 14 years old.

Other symptoms may include nausea, vomiting, weakness, and loss of appetite. The contagious period lasts for about five days after the characteristic swelling of the salivary glands begins.

In severe cases, mumps can lead to deafness, meningitis, or encephalitis.

Vaccination: The mumps vaccine is included with the measles and rubella vaccines (known together as MMR). The first dose is given between 12 and 15 months, and the second between 4 and 6 years of age. If you’re travelling internationally with your baby when he’s between 6 and 12 months, he should receive the vaccination beforehand.

Pertussis

Pertussis (the “P” in the DTaP vaccine), commonly known as whooping cough, causes coughing and choking. The characteristic “whoop” sound of a child trying to catch her breath often follows a coughing spell. Vomiting afterwards is also common.

Caused by the pertussis bacteria, pertussis can lead to complications including pneumonia and convulsions. Very young unimmunized children are at the greatest risk and often need hospitalization if they become ill.

Experts recommend that pregnant women get the Tdap vaccine (the version of DTaP for older children and adults) in the third trimester. This ensures that high levels of antibodies are passed onto the baby before birth. This creates protection from whooping cough in the first few months of life and until the baby gets the first dose of the DTaP vaccination at 2 months old.

Vaccination: The pertussis vaccine is administered along with the vaccines for diphtheria and tetanus (DTaP), with five doses given altogether. The first dose is given at 2 months, the second at 4 months, the third at 6 months, the fourth between 15 and 18 months, and the fifth between 4 and 6 years.

Pneumococcal Infections

The pneumococcus bacteria can cause pneumonia, bacteremia, and meningitis as well as ear, eye, and sinus infections. Infections spread through sneezing or coughing. Very young children don’t have fully developed immune systems, and so they are most at risk for infection prior to receiving the vaccine.

Vaccination: The pneumococcal vaccine (Pneu-C-13) protects against 13 different types of pneumococcal bacteria. It’s usually administered to children in three doses: the first at 2 months, the second at 4 months, the third at 12 months. Some children with chronic health conditions may receive a different vaccine.

Polio

Polio is a viral disease that causes fever, sore throat, nausea, headaches, and stiffness and weakness in the neck, back, and legs. In some cases, it can cause paralysis. Some children may recover from a mild case, but others may end up disabled for a lifetime.

The virus affects infants and young children more than any other age group. It spreads by close contact with an infected person. Luckily, the polio vaccine has virtually eradicated the virus from Canada, and ensuring your child is vaccinated helps it stay this way.

Vaccination: The polio vaccine (IPV) is administered in four doses before your child starts school. The first is given at 2 months old, the second at 4 months old, the third around 18 months old, and the fourth between 4 and 6 years old. This schedule may vary, especially if you’re planning to travel abroad with your child, so it’s best to ask your child’s healthcare provider for personalized advice.

Rotaviral Gastroenteritis

Rotaviral gastroenteritis is an intestinal viral infection commonly known as the “stomach flu.” After one to two days of infection, symptoms can last for three to eight days and include watery diarrhea, vomiting, fever, and/or abdominal pain. In children younger than 2, rotavirus is the most common cause of severe diarrhea, which can lead to dehydration, a serious complication.

It’s best to carefully watch infants and toddlers with the illness for signs of dehydration, such as decreased urination, dry mouth, reduced tears, and weight loss.

Children who have received the rotavirus vaccine usually don’t get the illness—or if they do, they only exhibit mild symptoms that don’t lead to severe dehydration.

Vaccination: The rotavirus vaccine (rota) is administered in three doses, with a first dose just before 2 months old, a second at 4 months old, and a third dose at 6 months old.

Rubella

Also known as German measles, rubella (the “R” of the MMR vaccine) is a viral illness that causes a pink rash, mild fever, and swollen lymph nodes.

The viral infection spreads through close contact with an infected person or contact with airborne particles. Those infected are contagious for up to 7 days after the appearance of symptoms, and symptoms can last up to 21 days.

Vaccination: The rubella vaccine is included with the measles and mumps vaccines (known together as the MMR vaccine). A first dose is given between 12 and 15 months, and a second between 4 and 6 years. If you’re planning to travel overseas with your baby who is 6 months or older, she should get the first dose beforehand.

Tetanus

Tetanus (the “T” in the DTaP vaccine) causes headaches as well as serious and painful muscle tightening in the jaw, which is why it’s sometimes called “lockjaw.”

The bacteria are present in soil, dust, and manure, and transmitted through open wounds and cuts. Even a cut from a dirty garden tool can lead to tetanus. Tetanus isn’t contagious or spreadable from person-to-person contact.

Vaccination: The tetanus vaccine for children is administered along with the vaccines for diphtheria and pertussis (DTaP), which is done in five doses. The first dose is given at 2 months old, the second at 4 months old, the third at 6 months old, the fourth between 15 and 18 months, and the fifth between 4 and 6 years of age.

Varicella Zoster

Chicken pox is a highly contagious infection caused by the varicella zoster virus.

Most children who have chicken pox develop a mild fever and itchy, blistering rashes on the scalp and body. The rash appears 10 to 21 days after the initial exposure to the virus. The contagious period begins a few days prior to the appearance of the rash and lasts up to seven days.

The varicella vaccination protects against chicken pox, plus shingles much later in life.

Vaccination: The first dose of the varicella zoster vaccine (VAR) is given between 12 and 15 months, and the second between 4 and 6 years of age. Sometimes, the vaccine is given along with the MMR vaccine in a single shot, and in that case, you’ll see it as the MMRV vaccine.

FAQs at a Glance

  • Children start getting vaccines right after birth and continue through their teen years and older. Although the immunization schedule can vary slightly from province to province, experts recommend routine vaccinations at

    • birth
    • 1 to 2 months
    • 4 months
    • 6 months
    • 12 months
    • 4 to 6 years

    In addition, your child should get the flu vaccine annually and can receive the Tdap vaccine, plus immunizations for HPV and meningitis in his teen years. Every child is different, so check with your health care provider for your specific vaccine schedule.

  • Your baby will receive routine and mandatory vaccinations for 15 different infectious diseases (in approximately 30 different shots, not including the annual flu vaccine), starting from birth and going through her teen years. Talk to your healthcare provider about comforting your baby while receiving immunizations.

  • Although immunization schedules can vary, babies tend to receive about 20 vaccinations within their first year. These include

    1. DTaP (diphtheria, tetanus, pertussis)
    2. HB (hepatitis B)
    3. Hib (haemophilus influenzae type B)
    4. IPV (polio)
    5. Pneu-C-13 (pneumococcal conjugate)
    6. RV (rotavirus)
    7. Influenza
    8. Men-C-C (meningococcal disease).
  • The first vaccine your baby will receive as part of his immunization schedule is HB, which is short for hepatitis B. Because mothers can pass hepatitis B to their babies, this vaccination is administered soon after birth as an important precautionary measure.

The Bottom Line

Vaccinations are safe and effective for children, and ensuring your little one follows her immunization schedule plays an important role in helping prevent your baby or older child from contracting at least 16 different diseases—any of which can be deadly.

Routine and mandatory vaccinations for all children also play an important role in safeguarding the entire community’s health.

Even though Canada has eradicated many diseases here at home, several still linger outside of the country, and people returning from abroad (or visiting from overseas) can bring them back again. This is why it’s important to adhere to your baby’s vaccine schedule.

If you have any concerns about vaccines for children or the Canadian immunization guide, speak to your baby’s healthcare provider. And, if your child has a condition that may prevent him from receiving a vaccine, such an immune deficiency, your provider can determine the best course of action.

We are lucky to live in modern times, when breakthroughs in science and medicine mean that we can protect children from many life-threatening diseases. By ensuring your baby gets the vaccinations she needs, you’re helping to keep her protected so she can grow and develop into a healthy adult.

How we wrote this article
The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.