Vaccines are also called immunizations. They help the body's immune system to recognize and fight bacteria and viruses that can cause disease. Immunization means receiving a vaccine and becoming immune to a disease through vaccination. Vaccination and immunization are often used interchangeably. Some vaccines can protect against more than one disease. These vaccines are known as “combination vaccines.” Giving combination vaccines means receiving fewer needles overall.

Vaccines have saved more lives in Canada in the last 50 years than any other health intervention. The World Health Organization estimates that every year, more than two million deaths are prevented throughout the world as a result of immunization. Vaccines are also important because they not only protect the people who get immunized, they also help to protect those around them. When most people are immunized for a disease, it reduces the chances of spreading it to others, and helps to protect those who are too young to be immunized and those who are unable to be immunized for medical reasons.

Physicians, public health nurses, pharmacists, physician assistants, nurses and nurse practitioners are among the health care providers who can administer vaccines in locations such as public health offices, nursing stations, doctor’s offices, pharmacies, and Walk-in Connected Care Clinics.

Respiratory Illnesses
Every fall, vaccines are available throughout the province to protect Manitobans from respiratory illnesses such as influenza and COVID-19.
To find locations where Flu and COVID-19 vaccines are available, contact your primary health care provider, a pharmacy, or your local public health office or nursing station or refer to the Manitoba Flu and COVID-19 Vaccine Provider Map.

School Programs
Public health nurses routinely offer students the following vaccines in schools across Manitoba:

• Grade 6 - Human papillomavirus (HPV) vaccine, Meningococcal conjugate quadrivalent (Men-C-ACYW) vaccine, and Hepatitis B vaccine
• Grade 8 or 9 - Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine

If your child missed the opportunity to be immunized at school, contact your local public health office or nursing station, your primary health care provider or a pharmacist.

Pharmacists
Pharmacists can administer the following vaccines:

• 2 years of age and older: Influenza and COVID-19 vaccines
• 7 years of age and older:
• publicly funded vaccines: tetanus, diphtheria, pertussis (Tdap), human papillomavirus (HPV), pneumococcal vaccines, and tetanus, diphtheria (Td)
• non-publicly funded vaccines: vaccines for travel, occupational or educational purposes that are prescribed by a physician.

Vaccines approved for use in Canada are safe and effective. It can take several years of development, research and testing before a vaccine is considered for approval by Health Canada. Even after a vaccine becomes publicly available, public health officials in Manitoba and across Canada continually monitor and report any serious side effects or adverse events following immunization. If a link is found between a possible adverse event and a vaccine, public health officials take immediate action to determine whether the recommendation for using the vaccine should change. As with any medical procedure, common side effects are to be expected, and individuals may react differently to certain vaccines. Both the risks and benefits should always be reviewed and discussed with your health care provider.

No vaccine is 100% effective, but they all help to protect from disease(s) and serious disease complications, including death. If vaccinated people do get sick they are likely to have milder symptoms of the disease.

For more information, visit:

• Vaccine Safety - (Manitoba Health)
• The Regulation of Vaccines for Human Use in Canada (Health Canada)

Almost all vaccines are given by needle, either into a muscle (intramuscular) or the fat just under the skin (subcutaneous). Certain vaccines can be given by mouth (oral) or between layers of the skin (intradermal).

The number of doses required depends on the age when immunization is started, the type of vaccine, and the underlying health conditions of the individual. Some vaccines can be given in one dose while others may need to be given in a series of doses, spaced apart at certain intervals (ex: 2 months later). When more than one dose is required at a time, they are usually given in different locations (ex: one in each leg or each arm). Not all vaccines offer lifelong immunity and therefore, additional doses of the vaccine, commonly referred to as “booster doses,” may be offered at a later time. For more information refer to Manitoba’s Routine Immunization Schedules.

Combination vaccines protect against more than one disease (i.e., the tetanus, diphtheria, pertussis [Tdap] vaccine, among others). They are made so that two or more vaccines can be given as one injection. Many of the vaccines available today are combination vaccines.

Studies show that receiving combination vaccines or several vaccines at the same visit does not have a higher risk of side effects and is just as effective as receiving a single disease vaccine or one vaccine at a time. In fact, a child’s immune system, which fights and protects against infections, is exposed to and is capable of reacting to thousands of germs every day, even before birth. Giving combination vaccines and/or more than one vaccine during a visit not only reduces the number of needles and appointments that are needed, it also reduces the risk of getting sick by being protected against more diseases sooner. It is important for everyone to receive their immunizations on time and as outlined in Manitoba’s Routine Immunization Schedules.

This is especially true for infants and children as many diseases can be much more serious among young children and are more likely to spread to others.

Protection from vaccines will not occur immediately as it takes time for the immune system to respond. It can take approximately 2 weeks following an immunization for the vaccine to start working. Vaccines that require more than one dose will only provide partial protection until all the doses have been received.

Some vaccines provide lifelong protection while others require one or more booster doses. Some vaccines such as influenza and COVID-19 are required more frequently in order to protect against current circulating strains of disease. These vaccines are updated with new formulations that protect against those specific strains of current viruses.

Manitoba Health, Seniors and Long-Term Care (MHSLTC) provides publicly funded vaccines to Manitoba residents with a valid Manitoba Health Card, as per Manitoba’s Eligibility Criteria for Publicly Funded Vaccines. Publicly funded vaccines are provided free-of-charge for routine immunizations, and for those at a higher risk of exposure to certain diseases. Eligibility can vary, depending on certain age indications, high-risk medical conditions, and other risk factors for infection.

Uninsured visitors such as those who live, work and/or study in Manitoba for an extended period and who are not registered with MHSLTC can obtain a publicly funded vaccine if the health care provider determines there to be a public health need. Public health need could mean outbreaks, pandemics, seasonal influenza, or exposure to a vaccine preventable disease that may put a susceptible client at increased risk of illness while they are in Manitoba. The vaccine is to be provided free-of-charge using provincial supply, but the provider may charge an administration fee. Whenever possible visitors should obtain their immunizations prior to arriving in Manitoba.

You must request a personal health identification number (PHIN) from Manitoba Health, Seniors, and Long-Term Care. You can register online Registration Form | Manitoba Health | Province of Manitoba (gov.mb.ca) or in-person at Registration and Client Services at 300 Carlton Street in Winnipeg. If you live outside Winnipeg, you can contact your local city or municipal office to register. Health care providers can provide vaccinations if needed to individuals while waiting for their personal health identification number; however, it is important that you update your immunization records after you receive your PHIN. You can update your immunization records here: Your Immunization Record Matters | Communicable Disease Control | Public Health | Manitoba Health | Province of Manitoba.

Manitoba Health, Seniors, and Long-Term Care (MHSLTC) conducts a full review of provincial epidemiology, vaccine safety, effectiveness, cost effectiveness, ethics and equity, and looks at the overall impact of a vaccine on disease in Manitoba. Best-practice, evidence-informed information is gathered from current research, other provinces and territories as well as from provincial and national vaccine experts as constituted in Manitoba's Provincial Vaccine Advisory Committee and the National Advisory Committee on Immunization. All of these sources of evidence, weighed against other departmental initiatives, are considered when developing recommendations for inclusion of new vaccines, or expanded use of vaccines, as part of Manitoba’s Publicly Funded Immunization Program.

Parents and caregivers have an important role in supporting their children to reduce stress and anxiety during immunizations. The following strategies can be effective:

Infants (up to age two):

• Swaddle or hold your baby, exposing the leg or arm where the needle will be given.
• Let your baby suck a pacifier (if applicable).
• Breastfeed or offer “sweet solution” (sucrose)
• Use a puppet or bell as a distraction.

Toddlers and preschoolers:

Before (Do not begin discussions too far in advance as this may increase fear for some children):

• Explain what is going to happen at the clinic visit and how it may feel. (HINT: Remind the child of dealing in the past with the pain of a bicycle fall or bee sting.)
• Be honest about what will happen before, during and after the immunization. (“It will hurt a little bit but only for short time.”)
• Read your child a book or watch a video about a child receiving vaccines.
• Let the child practice giving an immunization. (HINT: Suggest the child immunize a doll or a stuffed toy with an object that looks like a syringe, such as a drinking straw.)
• Acknowledge the child’s feelings and give permission to cry. For example, tell the child: “I bet you would rather not get a needle today” or, “Wouldn’t it be great if we could put the vaccines in ice cream?”
• Be calm, positive and use neutral language. Do not use words that cause fear (i.e., “you are getting a needle or a shot today”, instead say “you are getting a vaccine today”)
• If more than one child needs to be immunized, the most anxious child (usually older) should be first.
• Do not threaten the child because needles may become seen as a punishment.
• Do not bribe; instead, encourage the child’s efforts.

During

• Use distraction techniques (ex: blow soap bubbles – to blow away the pain of the needle; use party blowers – to make noise; make the child laugh with a toy or funny movie).
• Provide choices (ex: let the child choose the left or right arm; choose to hold a favorite toy).

After

• Reward the child. (“Great job! I knew you could do it.”)
• Remain at the clinic and observe the child for 15 minutes afterwards. This is important in case the child feels unwell, feels faint or – in rare cases – experiences an allergic reaction following the vaccine.
• Some doctors recommend acetaminophen (Tylenol® or Tempra®) or ibuprofen (Advil® or Motrin®) for fever. Never give acetylsalicylic acid (ASA or aspirin®) to children. A cold damp cloth may also help ease minor pain where the needle was given.

Topical anaesthetics can also help to reduce pain when receiving immunizations and are safe for use in all ages. You can get these without a prescription from a pharmacy. They are applied for a period of time before the immunization to temporarily numb the area where the vaccine will be given.

For children or adults who tend to get dizzy or faint during needles, the muscle tension technique can also be effective:

Step 1: tense or squeeze the muscles in legs or stomach (not the arms where the vaccine will be given)

Step 2: Squeeze for 10-15 seconds until face feels flushed or warm

Step 3: Release tension for 20-30 seconds

Step 4: Repeat steps until immunization is completed or until the feeling of dizziness/faintness passes.

For more information and resources on immunization pain and anxiety management:

• Immunize.ca - Pain Management
• C.A.R.D (Comfort, Ask, Relax, Distract) – strategies and resources to help cope before and during vaccinations

Temporary, mild, side effects to vaccines are common and are the body’s natural response as it is working to build immunity to the disease. Some of these common side effects include redness, swelling and soreness where the vaccine was given; headache, chills, mild fever up to 38ºC, drowsiness (being sleepy), and muscle aches. Children may be more fussy (cranky). Allergic reactions or severe side effects such as hives, difficulty breathing, or swelling of the throat and face are rare. It is important to stay in the clinic and be monitored by your health care provider for 15 minutes after getting any vaccine. Vaccine reactions are recorded and monitored in Manitoba and across Canada to ensure vaccines remain safe.

The benefits of vaccines are far greater than the potential risks of vaccination. When considering possible side effects, it’s important to discuss your concerns with your health care provider. Health care providers assess your health status and will inform you of the benefits and risks of receiving vaccines. Serious side effects are extremely rare. Choosing not to vaccinate also has serious risks. Vaccines protect against potentially fatal diseases; avoiding vaccination raises the risk of getting preventable diseases and spreading them to others.

There are very few individuals who cannot receive vaccines. Consult your immunization provider regarding whether you should, or should not, receive a vaccine. Each individual situation will be assessed, and a decision will be made either to offer the vaccine at the time of the clinic visit, at a later date or not at all.

If you are planning a trip, talk to your immunization provider or visit your local travel health clinic at least 6 weeks prior to your expected departure to see what vaccines may be recommended. Vaccines for travel purposes are not publicly funded by Manitoba Health. It is also an opportunity to catch up on any publicly funded vaccines for which you may be due.

For more information about travel vaccines, advice and advisories, visit:

• Travel vaccinations (Government of Canada)

No, immunizations are voluntary in Manitoba. Vaccines are strongly recommended as they help protect you and your child from diseases and also help protect others who cannot be immunized because they have certain health conditions. Vaccines save lives, protect communities, and prevent outbreaks of diseases. If you want to know more about immunization and why it is important, talk to your health care provider, pharmacist or a public health nurse.

Immunizations received in Manitoba are recorded in Manitoba’s official immunization registry (Public Health Information System (PHIMS)). This registry:

• allows the health care provider to find out which immunizations you or your child(ren) have had or need to have;
• may be used to produce immunization records, or notify you or your health care provider if a particular immunization has been missed;
• allows Manitoba Health, Seniors, and Long-Term Care (MHSLTC) and public health officials to monitor how well vaccines work in preventing disease.

If you received immunizations in another province or outside of Canada, you can submit your records to Manitoba Health to be added to Manitoba’s immunization registry.
To submit a copy of your immunization records, complete this eForm and follow the directions.

To add or update an immunization record, you must provide:

• Your Manitoba Personal Health Information Number (PHIN).
• If you don't have a PHIN, call Registration and Client Services at 204-786-7101 or Toll-free 1-800-392-1207
• An image of your official immunization record (for example, an immunization card or record from a physician's office) showing the details of the dose(s) you received.
• Your personal contact information

For further information on immunizations records in Manitoba, refer to Manitoba Health: Your Immunization Record Matters.

Note: Your personal health information, including your immunization record, is confidential and protected by law under The Personal Health Information Act. You can have your personal health information and/or that of your child(ren) hidden from view from health care providers. For more information, please refer to The Public Health Information Management System (PHIMS) or contact your local public health office to speak with a public health nurse.

You can get your immunization record by submitting a request via the Immunization Update Request Form and it will be mailed to you.

You may also be able to get a copy by:

1. Contacting your local public health office
2. Check if your local medical clinic or physician’s office can provide them to you
3. Asking at a local nursing station or health centre

The Manitoba Immunization registry was started in 1988. Immunizations provided prior to 1988 are unlikely to be included in Manitoba Health’s official registry. Please check for paper records at home or with your local health care provider.

Manitoba Health sends out a copy of your immunization record when you turn 7 and 18 years old.

For further information on immunizations records in Manitoba, refer to Manitoba Health: Your Immunization Record Matters.