Frontenac Medical Associates 791 Princess Street, Suite 201 Kingston, ON K7L 1E

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1 Dr. E. Du Bois Dr. G. M. Patey Dr. D. Marcassa Dr. S. Shephard Dr. J.F. Beliveau Dr. S. W. Hinton Frontenac Medical Associates 791 Princess Street, Suite 201 Kingston, ON K7L 1E Dr. F. Paolucci Dr. N. J. Cristoveanu Dr. P. Delaney Dr. J. Hataley Dr. L. Mileva Dr. V. Cheng To: Parents of Newborns From: Frontenac Medical Associates Re: Immunizations for your baby Children in Ontario are routinely vaccinated against nine serious diseases. Protection from these diseases is part of the requirement to attend school in this province. The vaccines are given in a series of injections as outlined in the Publicly Funded Immunization Schedule for Ontario. A copy of this schedule has been included for you information. Pediacel is given at two, four, six and eighteen months and protects against tetanus (lockjaw), diphtheria (severe respiratory disease), pertussis (whooping cough), polio, haemophilus b (Hib meningitis, etc). MMR is given just after the first birthday at twelve months and again between four and six years of age. It protects against measles, mumps and rubella. Additionally, there is extra protection available in three vaccines that are highly recommended by the Canadian Pediatric Society and your Family Physician. Although they are not required to attend elementary school, Menjugate, Varivax and Prevnar are required if your child attends a licensed childcare facility. You as a parent need to make an informed decision about which vaccines you want your child to receive. More information on all vaccines is available on request or by accessing the following websites: Canadian Pediatric Society: KFL&A Public Health: Rotarix - is offered at two and four months and protects against rotavirus, a common infection that causes vomiting and diarrhea in infants and children. This is an oral vaccine that must be given by a Nurse or Doctor. Both doses of the vaccine must be administered before the infant is 24 weeks. Due to this time sensitivity, we have included and information sheet so that you will be prepared to make your decision about this vaccine at the two month appointment with the Nurse. Menjugate/Neisvec is offered at twelve months and protects against meningococcal meningitis and blood infection. You may choose to get a prescription and buy it before one year, in case it would be three purchased doses with a free booster after twelve months of age. Prevnar 13 is offered at two, four and twelve months and protects against pneumococcal meningitis, blood infection, bacterial pneumonia, and some ear infections. Varivax is offered at fifteen months with a booster dose at 4-6 years of age. It protects against chicken pox. Please book an appointment with the Nurse on the same day as your baby s two month Well Baby check to start their immunizations.

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3 Keep your immunization card updated and in a safe place General Immunization Line or , ext lnfluenza Information Line or , ext This line is available during the influenza season. Travel Immunization Line Age General Immunization Line or , ext lnfluenza Information Line or , ext Available during influenza season Travel Immunization Line Age 2 and 4 months 6 months 12 months 15 months 18 months 4-6 years years Adults Two injections + one oral One injection Three injections One injection One injection Two injections One injection One injection Prevnar Pneumococcal conjugate vaccine Pediacel Varicella (Chicken Pox) Pediacel Pediacel One injection with five components (Tetanus, Diphtheria, Pertussis, Polio, and Hib). Rotarix Oral vaccine for protection against Rotavirus. Routine Immunization Chart Diphtheria Prevnar For high risk infants only. Tetanus Pertussis MMR One injection with three components (Mumps, Measles and Rubella). (Meningitis C) Prevnar Polio Hib Pneumo conjugate 2 months 4 months 6 months 12 months 15 months 18 months 4 to 6 years 12 years (Gr. 7) 13 years (Gr. 8 females) 14 to 16 years Every 10 years Every year 65 years Rotavirus Oral Measles Mumps Rubella Varicella Adacel-Polio One injection with four components (Tetanus, Diphtheria, Polio, and Pertussis). MMRV One injection with four components (Mumps, Measles, Rubella, and Varicella). Preferably given at four years of age. Group C Conj Hepatitis B Adacel or Boostrx (Tdap) One injection with three components (Tetanus, Diphtheria and Pertussis). ACY W-135 HPV Influenza Tetanus and Diphtheria (Td) One injection with two components every 10 years. Pneumo Poly Adacel or Boostrix (Tdap) One time between age 19 to 64 years instead of Td. (Tetanus, Diphtheria, and Pertussis) May 2012

4 Why is Immunization Important? Immunization begins in infancy and continues throughout your life. Your immunization record assists with knowing if you are up to date and protected against potentially serious preventable diseases. Each time you receive an immunization it should be recorded in your yellow immunization card. As your child grows, he or she will need proof of immunization for a number of reasons, including: starting childcare or preschool, entering kindergarten, transferring to a new school in another region, going to camp, receiving booster immunizations, in case of emergency health care, starting college, university or a job, and travelling outside of Canada. Immunizations Required for Childcare or Preschool All children entering a licensed childcare or preschool program must be fully immunized according to the publicly funded immunization schedule from the Ministry of Health and Long-Term Care. Immunizations Required for School The Ministry of Health requires a record of immunization for admission into school. Failure to provide proof of immunizations or documentation of exemption for reasons of medical, conscientious, or religious belief may result in exclusion from school. The Immunization of School Pupils Act Parents are responsible to ensure that their children are immunized against diphtheria, tetanus, polio, mumps, measles, and rubella. Additional Immunizations Provided for School Age Children Hepatitis B-All grade 7 students in Ontario. -All grade 7 students. Human Papillomavirus (HPV)-All grade 8 females. Influenza-Age 6 months and older. Diphtheria A disease of the nose, throat and skin. It can cause breathing problems, heart failure and nerve damage. Hepatitis B Can cause scarring of the liver (cirrhosis), liver cancer, and in some cases, death. It is the second leading cause of cancer in the world. Hib (Hib B ) Is not the same as influenza (flu), and until recently was the most common cause of bacterial meningitis in children less than 5 years old. Influenza An infection in the airways caused by the influenza virus. Symptoms may begin as cold-like followed by headache, chills, dry cough, rapid onset of body aches, and fever. Full recovery may take up to 6 weeks. Influenza may lead to more severe and life-threatening illnesses, such as pneumonia, resulting in hospitalization and even death. Influenza vaccination is safe for anyone 6 months of age and older. Measles A virus that causes high fever, cough, runny nose, watery eyes, and a rash. Ear infections or pneumonia may follow. Measles can also affect the brain (encephalitis). A serious bacterial infection that can cause inflammation of the brain and spinal cord or infection of the blood and other organs. The infection can progress quickly. Symptoms include headache, high fever, stiff neck, rash and other flu-like symptoms. It can result in blindness, deafness, seizures and death. Mumps Can cause fever, headaches, and swelling of the salivary glands around the jaw and cheeks. Deafness and infertility are other rare consequences of mumps. Pertussis (whooping cough) This strong cough, which can last for months, often causes the child to vomit. Children may also develop breathing problems, pneumonia, brain damage, and death. The risk of complications is greatest in children younger than one year of age. Pneumococcal A common cause of bacterial infections in children and may lead to several different infections that include meningitis (brain infection), septicemia (blood infection), pneumonia (lung infection) and otitis media (ear infection). Polio (poliomyelitis) May cause nerve damage and permanent paralysis. People get polio from drinking water or eating food with the polio virus in it. Rotavirus A common infection that causes vomiting and diarrhea in infants and children under 5 years of age and can lead to hospitalization. Rotavirus is very contagious and spreads easily between children, infants and even adults. Symptoms present as fever, vomiting, watery diarrhea and stomach pain which may last from three to eight days. Rubella (german measles) Is usually a mild viral illness in children. If a woman gets rubella in the early part of pregnancy, the baby may be severely affected or death can occur. Tetanus (lockjaw) A disease caused by a germ (often found in soil) that gets into the body through an opening in the skin. As many as 3 in 10 people who become infected may die. Those who survive often have lasting problems with speech, memory and mental function. Varicella (chickenpox) Begins with a fever, followed by a rash that can be very itchy. The rash starts with red spots that quickly become fluid-filled blisters. It is common in children and usually mild. However, it can also lead to severe skin infections, scarring, pneumonia, brain damage and death. If adults get it, they can become very sick. Diseases can be prevented!

5 Public Health Division Rotavirus Vaccine Program Questions and Answers for Parents and Caregivers Attachment G This fact sheet provides basic information for parents and caregivers. It is not intended to provide or take the place of medical advice, diagnosis or treatment. Always talk to a health care professional about any health concerns you may have before you make any changes to your current diet, lifestyle or treatment. Immunization is one of the most effective ways to protect yourself and your family against vaccine preventable diseases. The Ministry of Health and Long-Term Care is introducing a new rotavirus vaccine (Rotarix TM ) to the Publicly Funded Immunization Schedules for Ontario to protect infants against diarrhea and vomiting caused by rotavirus infection. What is rotavirus? Rotavirus is a common infection that causes vomiting and diarrhea in infants and children. Rotavirus is very contagious, spreading easily from children who are already infected to other infants, children and sometimes adults. Most children are infected with rotavirus at least once by five years of age. Serious but rare symptoms commonly seen in children less than two years of age include severe diarrhea leading to hospitalization. Rotavirus infection is a major cause of visits to health care providers and hospital-stays for infants and children under five years of age in Ontario. Deaths in Ontario due to rotavirus are rare. What are the symptoms of rotavirus? Symptoms include fever, vomiting, watery diarrhea and stomach pain which may last from three to eight days. When do symptoms usually appear? Symptoms appear about hours after a person has been exposed to the rotavirus infection. What are the potential complications of rotavirus infection? In infants and children, rotavirus can lead to loss of body fluids (dehydration) that may require a visit to the emergency department or admission to a hospital where intravenous (IV) fluids may need to be given. Children with weakened immune systems may experience more severe illness for a longer period of time. At what age should the rotavirus vaccine be given? In Ontario, the rotavirus (Rotarix ) vaccine is a publicly funded two-dose series recommended for infants at two and four months of age. The vaccine series should be completed by 24 weeks of age. What is the risk of spreading rotavirus after being vaccinated? The live vaccine form of the rotavirus can be in the stool or feces of infants for up to 10 days after vaccination. To prevent the spread of the live vaccine virus, anyone caring for the immunized baby should wash their hands frequently especially after changing diapers. Catalogue No July 2011 Queen s Printer for Ontario

6 Who should not receive the rotavirus vaccine? Infants should not receive the vaccine if they have: an allergy to the vaccine or any of its components; a condition or disease that weakens their immune system; Severe Combined Immunodeficiency Disorder (SCID); a history of intussusception (a condition where the bowels twist and become blocked); uncorrected congenital abdominal disorders (such as Mechel s diverticulum); and/or received blood products, including immunoglobulin, within 42 days. Consult with your health care provider if your child has a severe allergy to latex. Administration of the rotavirus vaccine should be temporarily delayed in infants suffering from fever, diarrhea and/or vomiting. You should always discuss the benefits and risks of any vaccine with your health care provider or local public health unit. Is the rotavirus vaccine safe? Yes. The rotavirus vaccine is safe. Most babies who get the rotavirus vaccine do not have any complications. Your child may become irritable or have mild, temporary diarrhea after getting a dose. Rarely, babies may experience an allergic reaction such as itchy skin rash, shortness of breath and swelling of the face or tongue. Severe reactions are very rare and may include a slight increased risk of bowel obstruction (intussusception). What is bowel obstruction (intussusception)? Intussusception is a rare type of bowel obstruction that occurs when one portion of the bowel slides into an immediately adjacent segment (also known as telescoping or prolapse). Complications of this can lead to intestinal swelling, inflammation and decreased blood flow to the part of the intestines involved. What are the symptoms of intussusception? Symptoms of intussusception include stomach pain with severe crying (which may be brief) as well as several episodes of vomiting and blood in the stool. A baby may act weak or become very irritable. Is my child likely to get intussusception from the rotavirus vaccine? Rotarix has been studied for risk of developing intussusception. There are a few studies that suggest a very small increase in intussusception cases during the first week after getting the rotavirus vaccine. In large studies of the vaccine used in Ontario, children were not likely to get intussusception after getting the rotavirus vaccine. This information still requires further investigation and studies are ongoing. The rotavirus vaccine offers tremendous benefits by protecting infants and children from rotavirus disease. Rotavirus is the most common cause of severe diarrhea among infants and young children. According to the United States Center for Disease Control, the risk of intussusception after rotavirus vaccination is much lower than the risk of severe rotavirus disease in children who do not receive rotavirus vaccine. How do I ensure that my child receives this vaccine? Contact your child s health care provider or your local public health unit for more information about how to get the vaccine for your child. This vaccine is free of charge from your health care provider. Be sure to read and understand the information that will be provided to you by your health care provider. When should I call my health care provider? You should seek medical attention if you believe that your child or someone in your care has had a reaction to a vaccine. If your child experiences symptoms of intussusception (see above) within seven days after receiving the first dose of the vaccine, or anytime after receiving the vaccine, see a health care provider immediately. Call your health care provider or go to the nearest hospital emergency department if your child has any of the following reactions within three days of receiving the vaccine: hives; swelling of the face or mouth; trouble breathing, hoarseness or wheezing; 2

7 high fever (over 40 C); or convulsions or seizures. Any of the reactions listed above should be reported to your health care provider who will report it to your local public health unit. Who should I talk to if I have any questions? For more information please contact your health care provider or your local public health unit. How should my child s immunization be recorded? After your child receives any immunization, make sure his/her personal immunization record (i.e., the Yellow Card ) is updated. Keep it in a safe place! 3