CTF Summary Table: Childhood Immunizations

Canadian Task Force on Preventive Health Care

Summary Table of Recommendations

Childhood Immunizations

Prepared by Ronald Gold, MD, MPH, FRCPC Peds, Department of Pediatrics, University of Toronto and Anne Martell, MA, CMC, Martell Consulting Services Ltd., Halifax NS

These recommendations were finalized by the Task Force in 1994

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Vaccination with diphtheria-pertussis-tetanus (DPT) and polio vaccines at 2, 4, 6, 18 months and 4-6 years. Incidence of diphtheria, pertussis, tetanus and polio is greatly reduced in Canada compared to pre-vaccination era except where there is poor access to health care; no indigenous paralytic polio due to wild strains since 1979. Dramatic differences between times and places, randomized controlled trials <4-7,13> (I) Good evidence to include in periodic health examination. (A)

Hemophilus influenzae type b (Hib) conjugate vaccine at 2, 4, 6 and 18 months. Incidence of invasive disease due to Hib decreased by >90% based on reported cases and pediatric hospital-based surveillance system. Dramatic differences between times and places, randomized controlled trials <26-28> (I) Good evidence to include in periodic health examination. (A)

Measles-mumps-rubella (MMR) vaccine at 12 months and 4-6 years. Incidence of measles, mumps, rubella and congenital rubella syndrome is greatly reduced in Canada except where there is poor access to health care. Second dose of MMR is required for measles eradication and will improve immunity against mumps and rubella. Second dose of measles vaccine or MMR is not cost-effective but is essential for measles eradication. Dramatic differences between times and places, randomized controlled trials <17,18,20,23,25> (I) Good evidence to include in periodic health examination. (A)

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
Vaccination with diphtheria-pertussis-tetanus (DPT) and polio vaccines at 2, 4, 6, 18 months and 4-6 years.	Incidence of diphtheria, pertussis, tetanus and polio is greatly reduced in Canada compared to pre-vaccination era except where there is poor access to health care; no indigenous paralytic polio due to wild strains since 1979.	Dramatic differences between times and places, randomized controlled trials <4-7,13> (I)	Good evidence to include in periodic health examination. (A)
Hemophilus influenzae type b (Hib) conjugate vaccine at 2, 4, 6 and 18 months.	Incidence of invasive disease due to Hib decreased by >90% based on reported cases and pediatric hospital-based surveillance system.	Dramatic differences between times and places, randomized controlled trials <26-28> (I)	Good evidence to include in periodic health examination. (A)
Measles-mumps-rubella (MMR) vaccine at 12 months and 4-6 years.	Incidence of measles, mumps, rubella and congenital rubella syndrome is greatly reduced in Canada except where there is poor access to health care. Second dose of MMR is required for measles eradication and will improve immunity against mumps and rubella. Second dose of measles vaccine or MMR is not cost-effective but is essential for measles eradication.	Dramatic differences between times and places, randomized controlled trials <17,18,20,23,25> (I)	Good evidence to include in periodic health examination. (A)