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Demystifying Beliefs Regarding the Risks of Vaccination

Demystifying Beliefs Regarding the Risks of Vaccination

Thanks to vaccination, fewer people suffer from vaccine-preventable diseases, and the effects of such diseases are rarer in the general population. Consequently, the benefits of vaccination are less apparent than the risks. Vaccination has therefore fallen victim to its success.

The risks associated with vaccines, whether real or perceived, are of concern to a lot of people. In fact, many people worry more about risks associated to vaccines than risks associated to diseases that vaccines help prevent. However, research has shown that serious risks associated with vaccines are much rarer than those related to diseases.

Some media and websites have helped create and maintain public anxiety regarding vaccination. Here are some scientifically proven facts to help clarify certain views about vaccination.

Vaccines usually do not cause serious illness

Vaccines are among the safest tools of modern medicine. Safety standards for vaccines are extremely strict. Research has also proven that serious risks associated with vaccines are much rarer than those related to diseases against which they protect.

However, vaccines are easy targets for people who seek to explain the emergence of a disease or health problem.

In Québec, a surveillance program allows for the detection of serious, rare or unexpected reactions that could be associated to vaccines. When such reactions occur, scientists are informed and must examine several criteria rigorously.

In particular, scientists must take into account time elapsed between the person receiving the vaccine and onset of symptoms of the illness presented. Time elapsed is an essential element but not the only criterion considered. For example, young children receive their 3rd dose of the DTaP-IPV-Hib Vaccine against diphtheria, whooping cough, tetanus, polio and serious Hib infections at around 6 months of age. Often, their first teeth appear at the same time. The fact that these two events occur at the same time does not mean the vaccine causes teething.

Scientists must also analyse other criteria in order to avoid reaching a wrong conclusion. They must continue their analysis by checking whether the reported problem is more common in those vaccinated than in those who are not. Furthermore, they must ensure that their conclusions are in line with those of other studies elsewhere in the world.

For example, scientific work conducted on a global scale on risks associated with vaccines clearly shows that:

  • The MMR Vaccine against measles, mumps and rubella does not cause autism or inflammatory bowel diseases
  • Thimerosal does not cause autism
  • The vaccine against whooping cough does not cause brain damage
  • The vaccine against hepatitis B does not cause multiple sclerosis or relapses in people with this disease. It does not cause chronic fatigue syndrome either
  • Vaccines given to children do not increase risk of asthma or allergies
  • Vaccines do not cause sudden infant death syndrome
  • Vaccines do not cause cancer or type 1 diabetes
  • Vaccines against the flu do not cause Bell’s palsy (facial paralysis)

In Québec, anyone who believes they have been injured by a vaccine can file a claim for compensation with the Ministère de la Santé et des Services sociaux. To find out more, consult the Vaccine Injury Compensation Program page.

Can vaccines cause the disease they protect against?

Most vaccines are inactivated.

Inactivated vaccines contain only pieces of bacteria or “killed” viruses. These vaccines stimulate the immune system of the person who is given the vaccine but cannot cause the disease.

Some vaccines are live.

Live vaccines contain a small amount of attenuated bacteria or viruses. During production, they are weakened so that they are incapable of transmitting disease. Like inactivated vaccines, live vaccines stimulate the immune system of the person who is given the vaccine. This means that a live vaccine is very unlikely to cause disease.

However, in a very small number of people, this type of vaccine may cause a mild form of the disease it protects against. For example, a child who is given the chickenpox vaccine might develop a few spots that look like chickenpox. They are very rarely contagious and clear up quickly. The mild form of a disease is not dangerous and shows that the vaccine is effective.

Furthermore, live vaccines should not be given to people who have a weakened immune system because of the risk of the vaccine causing a severe form of the disease.

In Québec, most vaccines given under the Québec Immunization Program are inactivated. Only the following vaccines are live: the combined measles, mumps and rubella vaccine (MMR), the combined measles, mumps, rubella and chicken pox (varicella) vaccine (MMR-Var), the chicken pox (varicella) vaccine, the rotavirus vaccine and the intranasal flu vaccine.

Vaccines do not spread animal diseases to humans

Given that vaccines are biological products, it is necessary to sometimes use animal cells in their production. This procedure is subject to strict regulations such that the vaccines present no risk to human health. During production, the vaccines are purified and rid of all animal cells. In addition, each batch of vaccines is tested to ensure it contains no infectious agent.

Vaccines cannot exhaust or overload the immune system

Scientists estimate that an infant’s immune system can react to 10,000 different microbes simultaneously. It is also able to recognise thousands, or even millions of different microbes and to react to them with no problem.

In addition, even if children receive more vaccines than before, their total content of weakened microbes or parts of microbes is much less. For example, in 1980, the four vaccines in the regular immunization schedule contained a total of 3,041 weakened microbes or parts of microbes. In 2000, the 11 vaccines in the regular schedule only contain a total of 126.

To learn more about how vaccines protect us by stimulating our immune system, read How Vaccines Work on the Vaccination page.

Several vaccines can be safely administered in a single appointment

There is no limit to the number of vaccines a person can receive in one shot. The administration of several vaccines at one time, referred to as ‘multiple injections’, has many benefits. To learn more, read Benefits of Multiple Injections on the Vaccination for Children page.

A healthy diet, breastfeeding or homeopathy cannot replace vaccination

Besides the disease itself, only a vaccine can stimulate the production of specific antibodies against the virus or bacterium responsible for that particular disease.

A healthy diet helps fight infections and illnesses but does not prevent them. Eating well only contributes to the proper functioning of the general mechanisms of the body’s defense.

Breastfeeding provides some protection against many infections, including colds and ear infections.

However, breastfed infants are protected against certain vaccine-preventable diseases only partially and for a short time.

Also, medicinal herbs, homeopathy and vitamins do not replace vaccines.

Relying on the natural protection given by catching a disease is much more risky than getting vaccinated against that particular disease

In most cases, catching an infection naturally protects better than a vaccine against that particular infection. However, relying on this natural protection entails considerably greater risk than vaccines and reactions they may cause. Indeed, vaccine-preventable diseases are accompanied by pain and complications. They may also lead to serious complications and even death. In all cases, serious risks associated with vaccines are much less frequent than those related to disease.

Some diseases can be caused by different types of microbes, or ‘strains’. When a disease is caught, only a single strain is contracted at a time. Therefore, natural protection is only valid for that particular strain. Some vaccines have the benefit of protecting against several strains of a disease.

Chickenpox can have serious consequences

Chickenpox can have serious consequences. Some complications of this disease can lead to death. Before establishment of the chickenpox vaccination program, hundreds of children were hospitalised each year in Québec due to complications of this disease.

Infections of the skin, blood and ears, as well as pneumonia, are all complications of chickenpox. This disease greatly increases the risk of getting a serious infection caused by streptococcus, including disease caused by flesh-eating bacteria.

Thimerosal does not cause autism or other developmental disorders

The flu vaccine contains a preservative called thimerosal. Thimerosal is a derivative of mercury that is not dangerous.

Once in the body, it is metabolised to ethylmercury. The form of mercury that can cause serious brain and nerve damage if consumed in large quantities is called methylmercury. Contrary to methylmercury, the body gets rid of ethylmercury very quickly and there is little risk of it accumulating.

Aluminum salts contained in some vaccines are not toxic

Vaccines may contain aluminum salts, but the amount of aluminum is less than 1 mg per dose of vaccine, a quantity that can cause no harm to a person. When someone takes antacids, for example, their body absorbs a significantly higher quantity of aluminum salts without causing any side effects.

Vaccines are still necessary in Canada, even if hygiene and sanitary conditions are good

Improving living conditions reduces the risk of infection and disease transmission, but does not eradicate them.

In many countries with living conditions similar to ours, vaccine-preventable diseases make a strong comeback when the number of people vaccinated drops. Even in a country such as Canada, 1 person in 3,000 still dies today as a result of measles.

Infectious diseases were not already in the process of disappearing before the advent of vaccines

Before the advent of vaccines, infectious diseases had started to decrease due to the improvement of living conditions. However, they were not disappearing. It is with vaccines that some infectious diseases have become rare and others have disappeared. For example, the biggest cause of bacterial meningitis in children is the bacterium Haemophilus influenzae type b. Over the last few years, this bacterium has decreased significantly in countries that offer the vaccine against the infection. However, conditions of life have remained the same. Vaccination is the only explanation for the decrease.

How to Recognize a Good Source of Information

There are many sources of information on vaccination: websites, television shows, magazines, social media such as Facebook, etc.

However, credible sources of information are sometimes lost in a flurry of sources that do not have any recognized scientific basis and may even contain misleading information.

You can find trustworthy information on vaccination by keeping in mind that a reliable source does the following:

  • Clearly articulates its mission and purpose
  • Offers current information based upon serious scientific data approved by recognized organizations and experts
  • Indicates the groups or organizations financing it as well as their contact information, where applicable

Here are a few questions to ask yourself to find out if a source of information is reliable:

  • What is the mission and purpose of the source of information?
    • Does it aim to inform the public?
    • Does it support a personal cause or a specific group?
    • Is it selling products or documents?
  • What is the basis of the information given?
    • Is it personal testimonials or opinions?
    • Is the information based on serious scientific data approved by recognized organizations in the field?
  • What is the source of information’s competency in health issues?
    • Is it someone with recognized medical training?
    • Is it a health organization renowned in the field of vaccination?
    • Is the person a member of recognized associations of public health professionals, doctors, nurses or scientists?
      Some writers are merely presented as eminent “specialists”, internationally recognized researchers or renowned scientists. If there is no further mention of their training or their membership of a recognized organization, be wary of the information
  • Is the information current?
    • Does it refer to current data?

Useful websites

The following links are reliable websites for information on vaccination:

World Health Organization (WHO)

  • WHO website 
  • Immunization 

How to Identify Anti-Vaccination Sites

Anti-vaccination sites share many characteristics:

  • The source of the information on the site is not clearly indicated and it does not come from recognized organizations and experts.
  • They make statements about vaccines that have not been scientifically proven. They even go so far as to deny or reject the scientific evidence.
  • They propose new theories on the possible side effects of vaccines.
  • They try to silence critics by insulting their detractors or threatening them with legal action.
  • They provide links to other anti-vaccination sites.
  • They promote alternative medicine, such as homeopathy, naturopathy and chiropractic, which they believe is superior to vaccination.
  • Over half of their site is devoted to stories about damage alleged to have been caused by vaccines. Most of these stories are related by parents. Sometimes they even make associations between the evidence and these stories without any evidence of a scientifically proven association.
  • They suggest that vaccine manufacturers or governments cover up the possible side effects of vaccines in order to promote acceptance of vaccination and to generate enormous profits for pharmaceutical companies.

Last update: April 15, 2019

Vaccination for Children

Vaccination for Children

Description

The risk of catching many diseases is very high in the first year of a child’s life. That’s why it is recommended that you get children vaccinated according to the immunization schedule. In respecting this schedule, you ensure that your child is protected at the time they need to be most. Even if you dislike the idea of giving your child an injection by getting them vaccinated, you are protecting them from catching diseases that can leave after-effects.

For further information on immunization in general and how to get your child vaccinated, see the Vaccination file.

Risks Associated with not Vaccinating your Child

Children not vaccinated are more likely than anyone else to catch a contagious disease. Such risk is present even in countries where the vast majority of people are vaccinated. For example, data in the United States shows that children not vaccinated are:

  • 22 to 35 times more likely to have measles than children vaccinated
  • 6 times more likely to have whooping cough than children vaccinated

Also, children who are not vaccinated can spread contagious diseases to others. 

Benefits of Multiple Injections

Depending on their age, your child is likely to receive more than one vaccine in a single visit. Vaccines administered at the same time are called “multiple injections”. Only vaccines that are safe and effective when given together can be administered at the same time. This practice has several benefits, including:

  • Vaccines given together protect against diseases just as effectively as when administered separately
  • Children are protected earlier against a larger number of diseases
  • Parents save time and avoid travel and costs related to repeated appointments
  • The child experiences less vaccine-related stress because the multiple injections reduce the number of vaccination appointments. In fact, it is proven that a child in pain after a recent immunization session is likely to be more anxious at the following session
  • Symptoms that may occur after a vaccine are felt only once instead of being experienced several times

Safety of multiple injections

Scientific studies have shown that children risk nothing in receiving several vaccines in a single immunization session. This practice is safe and applied worldwide.

Vaccines are just a small fraction of all substances to which a child is exposed daily. Every day, their immune system is exposed to thousands of microbes. The immune system’s ability to react would require 1000 times more strength than what is necessary to respond to vaccines. There is therefore no limit to the number of vaccines a child can receive at the same time.

Moreover, administering several vaccines at the same time does not increase the frequency, intensity or severity of symptoms. Symptoms are the same as when the vaccines are administered on different visits.

Also, treatment of the child’s discomfort is the same whether they’ve received one or several vaccines.

When possible, children preferably receive a combined vaccine, which is a single-injection vaccine that fights several diseases. For example, the DTaP/IPV/Hib Vaccine protects your child against diphtheria, whooping cough, tetanus, polio and Hæmophilus influenzae type b infections. Giving a combined vaccine to protect against these diseases both decreases the number of injections and the child’s discomfort.

There is continued research to find other effective and safe methods for administering vaccines, including oral vaccines given through the mouth or nasal vaccines sprayed into the nose. The objective lies in protecting children and not making them suffer needlessly.

Preparing Children for Vaccination

You can prepare your child for vaccination, especially if they are of an age to understand.

There are several ways to reduce the pain and anxiety of vaccination. See the Reducing the Pain and Anxiety of Vaccination in Children page and discuss them with the person administering the vaccines during your appointment. 

Last update: April 18, 2017

School-based vaccination

School-based vaccination

Description

some vaccines are administered to children at school. They are provided free of charge in Grade 4 of primary school and in Secondary 3 of high school.

The school nurse administers the vaccines to children during vaccination sessions, usually in fall and spring. All the relevant information will be provided to parents at the start of the school year, through the school.

Consent for vaccination

In Québec, anyone 14 years of age or over can give their consent for vaccination.

If a child is under 14 years of age, one of his or her parents or guardian must give their consent for vaccination. The school nurse can provide parents, upon request, with additional information so that they can make an informed decision.

The consent form must be completed and returned to the school quickly, regardless of whether or not you choose to have your child vaccinated. Consent of one parent is sufficient.

General tips

On the day of vaccination

Ask your child to wear a short-sleeved top. Ask him to give his vaccination record to the nurse at the vaccination session if he has not already done so.

If your child is absent on the day of the vaccination, you will still be able to have him or her vaccinated free of charge. Follow the school nurse’s instructions or make an appointment at your local community services centre (CLSC). To find the contact information, consult the page Finding a CLSC. 

Multiple injections

Some vaccines can be given at the same time during the same vaccination session. They are called “multiple injections”. This is a common practice around the world. Scientific studies have shown that it is safe. There is no additional risk if several vaccines are given at the same vaccination session instead of just one vaccine.

There are also a number of benefits associated with multiple injections, including fewer vaccination sessions. To find out more, consult the Benefits of Multiple Injections section.

Vaccines administered at school

VaccineThe vaccine protects against:
Hepatitis A and Hepatitis B VaccineHepatitis A and Hepatitis B
Hepatitis B VaccineHepatitis B
Human Papillomavirus (HPV) VaccineHuman Papillomavirus (HPV)

Under the Hepatitis B Vaccination Program, you child will be given 2 doses of these vaccines, the 1st dose in fall and the 2nd dose in spring:

  • 1 dose of hepatitis A and hepatitis B vaccine (Twinrix®) to protect him against hepatitis A
  • 1 dose of hepatitis B vaccine (Recombivax® or an equivalent vaccine) for long-term protection against hepatitis B

The Hepatitis B Vaccination Program for children in Grade 4 of primary school was launched in 1994. Since 2008, children have been given the Twinrix® vaccine, which protects against both hepatitis A and hepatitis B.

Another vaccination program aims to protect children in Grade 4 of primary school against human papillomavirus (HPV) infection. Your child will be given 2 doses of these vaccines at the same time as the hepatitis A and hepatitis B vaccines:

  • 1 dose of HPV vaccine (Gardasil 9®)
  • 1 dose of HPV vaccine (Cervarix®)

A letter is usually sent to all parents of children in Grade 3 of primary school. In Grade 4 of primary school, an information leaflet is sent through the school. A vaccination consent form  is enclosed with the leaflet. If you have a child in Grade 4 of primary school, you must complete the form and return it to the school quickly, regardless of whether or not you choose to have your child vaccinated.

Benefits of vaccination in Grade 4 of primary school

The hepatitis A and hepatitis B vaccine and HPV vaccine are given in Grade 4 of primary school for the following reasons:

  • The immune system responds best to these 2 vaccines between the ages of 9 and 11, when children are in Grade 4
  • It is preferable for children to have the vaccine before they are exposed to these diseases
  • School-based vaccination means that parents do not have to go out to have their child vaccinated
VaccineThe vaccine protects against:
Meningococcal Serogroup C Conjugate VaccineMeningococcus C
Combined tetanus and diphtheria vaccine (Td)TetanusDiphtheria

In addition to the vaccines scheduled in Secondary 3, the nurse will check if all children’s vaccination is up to date for the following diseases:

  • Diphtheria
  • Whooping cough
  • Tetanus
  • Poliomyelitis
  • Measles
  • Rubella
  • Mumps
  • Meningococcal serogroup C
  • Chickenpox
  • Hepatitis A
  • Hepatitis B
  • HPV infections

Last update: April 8, 2020

Reducing the Pain and Anxiety of Vaccination in Children

Reducing the Pain and Anxiety of Vaccination in Children

Description

It is important to vaccinate children and to respect the immunization schedule in order to protect them from serious infectious diseases.

Most vaccines are administered with a needle, which may frighten both children and their parents. This fear can lead to some parents delaying their children’s vaccination, leaving them unprotected against many serious diseases.

The attitude and behaviour of parents towards vaccination is important to a child. In fact, children observe their parents to know how to act and feel. 

There are proven methods for reducing the pain and anxiety in children who need to get vaccinated. The following tips and advice will allow you to make the vaccination experience more positive for your child. You can use more than one method to obtain the best results.

Preparing Children for Vaccination

Children old enough to understand can be prepared for vaccination. Here are some tips on how to prepare your child a few hours before the vaccination appointment:

  • Discuss the vaccination with your child and answer his or her questions. Explain why the vaccine is needed. Mention, for example, that it is important for keeping him or her healthy.
  • Describe to him or her how the vaccination appointment will proceed.
  • Never use vaccination as a punishment for your child.
  • Do not tell your child that the injection will be painless. Instead, explain that he or she will feel a stinging, tingling or pinching sensation and that it will not last long.
  • Tell or read your child a story about a child who gets vaccinated.
  • Watch a video about vaccination together.

Be Calm and Reassuring

Behave in the following ways to help your child feel safe and reassured regarding vaccination:

  • Stay calm and smile, and talk in your normal voice.
  • Avoid apologizing and using words that refer to pain. Doing so will only scare your child further.
  • If you feel anxious, take a deep, slow breath to help you relax and keep calm.
  • After the vaccination, hug, congratulate and reward your child.

Breastfeed your Baby

If you are breastfeeding your baby, you can do so during the vaccination to calm and reassure him or her. Research shows that babies do not associate the pain of vaccination with being breastfed.

Position of the baby for breastfeeding

It is recommended that you hold your baby in a cradle position when breastfeeding him or her during vaccination. In this position, your baby’s head rests on your forearm or in the hollow of your elbow, on the side of the feeding breast. Use your other arm to support your baby’s buttocks and to keep his or her feet out of the way. Make sure that the arm or leg where the vaccine will be administered is clear.

Give your Baby a Sugar Solution

If your baby is less than 2 years old, you can give him or her a sugar solution before the injection. This is a proven method for relieving pain in children of this age.

Do not use sugar water to soothe your baby when he or she is crying or upset. The sugar solution must be used only as a way of relieving pain during vaccination.

Prepare the sugar solution with the following ingredients:

  • 5 mL (1 tsp) of sugar
  • 15 mL (1 tbsp) of water

Do not substitute the sugar with honey Honey can cause serious food poisoning in babies younger than a year old. You should therefore avoid giving them both pasteurized and non-pasteurized honey.

1 to 2 minutes before the injection, give your baby small sips of the sugar solution from a cup, spoon or syringe. You can also dip a pacifier in the sugar solution.

If you plan on breastfeeding your child during the vaccination, do not give him or her a sugar solution before the injection.

Hold your Child in the Proper Position

You can reassure your child by holding him or her in your arms during the vaccination. Holding your child properly will also ensure that he or she is vaccinated safely. Do the following:

  • Hold your child on your knees in the position indicated by the person who is administering the vaccination. Make sure that your child is comfortable.
  • Put your arms around your child, but do so gently; holding your child tightly might make him or her more anxious.

Here are examples of how to hold your child depending on where the vaccine will be administered.

Recommended position for an injection in the thigh

Recommended position for an injection in the thigh
  1. Undress your child so that the leg to be vaccinated is exposed.
  2. Sit your child on your thigh to the side of you.
  3. Position one of your child’s arms on your back or under your arm.
  4. Hold your child’s other arm with just enough force to prevent him or her from moving.
  5. Hold the leg to be vaccinated firmly.

Recommended positions for an injection in the arm

Recommended positions for an injection in the arm
  1. Sit your child on your thigh to the side of you.
  2. Undress your child so that the arm to be vaccinated is exposed.
  3. Place your child’s other arm on your back or under your arm.
  4. Hold your child’s legs firmly between your thighs.
  5. Hold the arm to be vaccinated with just enough force to prevent him or her from moving it.
Recommended positions for an injection in the arm
  1. Sit your child on your lap, and lean his or her back against your chest.
  2. Undress your child so that the arm to be vaccinated is exposed.
  3. Place your child’s other arm under your arm.
  4. Hold the arm to be vaccinated with just enough force to prevent him or her from moving it.
Recommended positions for an injection in the arm
  1. Sit your child on your lap facing you.
  2. Undress your child so that the arm to be vaccinated is exposed.
  3. Place your child’s other arm on your back.
  4. Turn your child’s head away from the arm to be vaccinated.
  5. Hold the arm to be vaccinated with just enough force to prevent him or her from moving it.

Distract your Child

Distracting your child while he or she is being vaccinated can help reduce pain and anxiety. The part of the brain associated with pain is less active when children are distracted.

Guiding principles

  • There are many methods of distraction. Use methods that are suitable for your child’s age.
  • If your child is calm, start distracting him or her before the vaccination.
  • Choose a distraction that will allow your child to use several senses (such as sight, touch and hearing). Encourage him or her to participate actively. The more your child is absorbed in the distraction, the better it will work.
  • Keep in mind that the methods you use to distract your child must never get in the way of the person who is administering the vaccine.
  • You can use toys to distract your child. Ask beforehand what types of toys you can bring to the appointment.

Distraction methods for children under 3 years

  • Bring along your child’s favourite toy or a blanket that he or she usually uses for comfort.
  • Hold your child close to you. Distract and comfort him or her with hugs, songs and by talking softly or telling a story.
  • You can distract your child by pointing out interesting things in the room, such as a poster or an object.

Distraction methods for children between 3 and 6 years

  • Before the vaccination, help your child pick out fun and comforting objects that he or she can bring along to the appointment.
  • Practise a few activities with your child that he or she could do at the time of the injection. For example, blow bubbles, blow on a toy windmill or blow out an imaginary candle.
  • Distract your child with a mobile device, toys or music.
  • Direct your child’s attention to something interesting in the room.
  • Talk to your child about things that interest or amuse him or her in order to divert attention away from the injection. For example, talk about his or her favourite movie or tell a joke.
  • Remind your child to breathe slowly and deeply before, during and after the injection. Breathing deeply will distract and relax him or her.
  • Allow your child to watch the injection if he or she wishes. Some children handle the vaccination better if they watch.

Relieving Pain and Reactions Caused by Vaccination

Some medicines can relieve the effects of vaccination in children. If necessary, talk to your doctor, pharmacist or the person who administered the vaccine.

Before vaccination

You can use a topical anesthetic to reduce pain caused by the needle. Topical anesthetics numb the skin. However, they do not relieve discomfort or the burning or cold sensation caused by the injection of liquid into the skin.

Various topical anesthetics are available over the counter:

  • Lidocaine (such as Maxilene® cream or Emla® cream or patch, which also contains prilocaine)
  • Tetracaine (such as AMETOP® gel)

Before using a topical anesthetic, read the instructions on the package carefully. Respect all precautions and avoid any contact with the eyes or mouth.

Apply the topical anesthetic 30 to 60 minutes before the vaccination. You can apply it at home or when you arrive for the appointment.

Apply the topical anesthetic on the skin of the area to be vaccinated.

Children are vaccinated on their upper outer thigh or their upper outer arm.

Vaccine on the upper outer thigh
Vaccine on the upper outer arm

When a child is getting more than one vaccine in a single appointment, apply the topical anesthetic in both places.

Reactions may occur in areas where the topical anesthetic is applied. For instance, skin may become pale, red or swollen. Your child may also feel itchy. These reactions will disappear by themselves in the hours after the vaccination.

After the vaccination

Analgesics help bring down fever and relieve pain. They can be used after vaccination. However, analgesics do not have proven effectiveness for relieving pain due to an injection. It is therefore not recommended that you use them before vaccination.

Different analgesics are available over the counter in syrup or tablet form:

  • Acetaminophen (such as Tempra® or Tylenol®)
  • Ibuprofen (such as Advil® or Motrin®)

Before using an analgesic, read the instructions on the package carefully.

Understanding Vaccines

Understanding Vaccines

Description

Vaccination is the best way to protect yourself and others against certain diseases.

Vaccines protect us against diseases with serious consequences and that can even cause death. Some of these illnesses have no medical treatment. By getting vaccinated, you also avoid transmitting contagious diseases.

In Québec, getting vaccinated is not mandatory but is highly recommended. The vast majority of people do get vaccinated. The Québec Immunization Program [Programme québécois d’immunisation] provides free vaccines to the entire population of Québec according to an immunization schedule.

To protect yourself and avoid the risks and complications of illnesses

Vaccine-preventable diseases cause suffering, complications and after-effects. They may also cause death. Catching certain diseases naturally offers subsequent protection against these diseases, in the same way that vaccines do. However, letting nature take its course presents very great risks to your health. Here are a few examples:

  • Meningococcal infection, which causes meningitis, is a serious disease. It can cause permanent brain damage and be fatal in 10-15% of cases
  • Chickenpox is a common disease that is not dangerous most of the time. However, it can lead to complications such as skin and ear infections and pneumonia. In 2006, the chickenpox immunization program was established in Québec. In the six years that followed, hospitalisation due to chickenpox complications dropped by 85%
  • A communicable disease such as measles spreads very easily from one person to another. This disease can be serious or even fatal in people who are at higher risk of developing complications from measles. For examples, very young children, people with a weak immune system and pregnant women are more vulnerable to complications of measles. To prevent this disease from spreading in the population, at least 95% of the public must be vaccinated

Vaccination also carries some risks, but the serious risks associated with vaccines are much rarer than those related to diseases. For example, after receiving the measles vaccine, there is a risk of encephalitis, which is an inflammation of the brain. However, this risk does not even represent 1 case in 1 million. This risk increases to 1 in 1,000 cases when a person catches measles.

To protect the people around you

People who are vaccinated against a disease will not catch it. As a result, they cannot transmit it to others. Hence, they protect those who have not received the vaccine.

It is therefore important to get vaccinated in order to protect others. Indeed, some people cannot get vaccinated for one or more of the following reasons:

  • Allergy to the content of certain vaccines
  • Their age
  • Their health (a weak immune system, for example)

Also, some people remain inadequately protected even if they are vaccinated.

Therefore, they’ll always be people not protected against a particular disease. That’s why as many people as possible need to be vaccinated in order to prevent transmission of diseases and to protect the entire population.

To prevent the resurgence of vaccine-preventable infectious diseases

With the advent of vaccines, some infectious diseases have become rare and others have disappeared. If there were no more vaccines, infectious diseases would reappear quickly and spread through the population. This has happened in some countries. For example, in 2015, there was a measles outbreak in the United States and Canada because a significant number of people were not vaccinated.

Despite some infectious diseases having become rare in Québec, vaccine-preventable diseases are still present. For example, tetanus will continue to exist because it is caused by a bacterium that lives in the soil.

In addition, certain vaccine-preventable diseases are very common in several countries. People travelling can catch and spread them upon their return. Therefore, it is important to continue to be protected against vaccine-preventable diseases.

How Vaccines Work

From birth, the human body defends itself every day against thousands of microbes in water, air, food and on objects. Through evolution, the body has developed a defence mechanism known as the ‘immune system’ to protect itself against microbes. The immune system’s function is to detect intruders entering the body, such as microbes, and to eliminate them.

Vaccine ingredients

Vaccines are made from small amounts of microbes responsible for certain diseases. These microbes are processed in order to deactivate their ability to transmit diseases. However, they are still able to stimulate the immune system into learning to defend itself against those particular diseases. The processed microbes that contain the vaccines may be:

  • Entire dead or weakened bacteria or viruses
  • Portions of dead or weakened bacteria or viruses

Vaccines currently distributed in Canada also contain various other ingredients, including:

  • Culture media, which serve to multiply the viruses and bacteria used in the production of vaccines, chicken eggs, for example
  • Suspending fluids that hold all ingredients of the vaccine in liquid form, for example, a saline liquid or sterile water
  • Inactive substances that facilitate the preparation and administration of vaccines. Examples of inactive substances include:
    • Preservatives or antibiotics, which prevent the rapid multiplication of bacteria in the vaccine
    • Stabilisers, which prevent viruses or bacteria from being destroyed during production of the vaccine. They also prevent them from sticking to the walls of vaccine vials, which would make them less effective
    • Adjuvants, which are used to strengthen vaccines and ensure longer protection against diseases

Ways to administer vaccines

Vaccines can be administered through various methods. Methods vary depending on the vaccine.

  • Injectable vaccine is introduced into the body through injection with a syringe
  • Intranasal vaccine is introduced into the body through a spray in the nose, a squirt in each nostril
  • Oral vaccine is drunk or swallowed

How the immune system responds to vaccines

Once in the body, the weakened microbes or parts of the microbes contained in the vaccine cause the immune system to react.  

As it is the first time that the immune system encounters these microbes, it produces antibodies, or a type of protein, specifically to fight them.

Once produced, these antibodies remain in the system for a period that varies depending on the vaccine. Some vaccines offer protection for a lifetime or very close to that, the hepatitis B vaccine is one such example. Other vaccines offer protection for a much shorter period, the flu vaccine, for instance.

When the system encounters these microbes again, the antibodies are able to quickly recognise them given their ability to ‘remember’ the tactics employed to fight them. In other words, it’s a bit as if the body made a replica image of the virus or bacterium in order to recognise it and respond quickly next time. If the virus or bacterium that actually causes the disease enters the body after vaccination, the immune system is able to defend itself rapidly and can destroy the threat before it becomes dangerous.

Inflammatory reaction

Vaccination causes an inflammatory reaction. Heat, redness and swelling at the injection site are common reactions to vaccines.

Such reaction is neither abnormal nor a sign of illness. On the contrary, it is a defense mechanism, a bit like a gathering of the troops around the action. Thus, the inflammatory reaction is to isolate and protect the area of the body at risk from viruses or bacteria contained in the vaccine. It triggers a mechanism that directs as much blood as possible to this area, which allows the different blood cells to fight together to avoid infection.

In addition, the inflammatory reaction forces neighbouring cells in the threatened area to swell with water in order to create a barrier of protection. Hence the reason why there is often swelling at the site of the injection. 

Effectiveness of Vaccination

Like all other medicines, no vaccine is 100% effective. The effectiveness of a vaccine depends on the following:

  • The age of the person vaccinated
  • The health condition of the person vaccinated (pregnancy, state of immune system)
  • Relatedness of strains of virus circulating and those contained in the vaccine

Despite this, immunization remains one of the greatest medical successes. It is one of the most effective medical interventions. The World Health Organization estimates that immunization saves over 2 million lives each year. In Canada, the number of sick people has significantly declined since the introduction of immunization programs in 1920.

Through vaccination, smallpox was eradicated from the planet. Polio has disappeared from Canada and several diseases, including diphtheria, tetanus and rubella, are now very rare. The main cause of bacterial meningitis among children, the bacterium Haemophilus influenzae type b, is much rarer. In addition, hepatitis B has virtually disappeared among younger children because they are vaccinated as infants.

Safety of Vaccination

Vaccines are very safe. They are produced according to very strict safety standards. However, like many medicines, vaccines can cause side effects.

Most often, the side effects of vaccines are minor and temporary. It could be a light fever or sensitivity at the site of the injection. These effects are normal reactions of the body to the vaccine.

In very rare cases, vaccination can cause serious allergic reactions, in the same way that an allergy can occur when you eat a new food. People administering vaccines are able to treat these allergic reactions. That’s why it is recommended you stay onsite at least 15 minutes after receiving a vaccine.

Research and Surveillance Programs

In Québec and elsewhere worldwide, side effects of vaccines are constantly monitored. Surveillance helps detect unexpected, serious and rare side effects, and to intervene as needed. Thus, when vaccinators discover unusual reactions to a vaccine, they must report it to public health authorities.

One such surveillance scheme in Québec is the ESPRI program or ‘side effects possibly caused by immunization program’ (Effets secondaires possiblement reliés à l’immunisation). This Québec program is in line with the Public Health Agency of Canada’s program, as well as the World Health Organization’s international program.

Through research, vaccines continue to improve. For example, the vaccine used in the 1950s against whooping cough has been replaced with one that causes far fewer side effects.

There are many beliefs about the supposed risks of immunization.

Vaccine Injury Compensation Program

In Québec, anyone who believes they have been injured by a vaccine can file a claim for compensation with the Ministère de la Santé et des Services sociaux. To find out more, consult the Vaccine Injury Compensation Program page.

Last update: April 8, 2020

Injectable flu vaccine

Injectable flu vaccine

Description

Injectable flu vaccine must be administered once every fall. Those aged 6 months and older can receive the injectable vaccine unless contraindicated.

The flu vaccine does not protect against the common cold and respiratory infections caused by other viruses.

The quadrivalent injectable vaccine, which contains 4 different strains of the flu virus, is recommended for people aged 6 months and over with chronic illnesses. For a child younger than 9 years, 2 doses of the vaccine, given 1 month apart, are required when it is a first vaccination against the flu.

For the 2019-2020 season, the vaccine offered through the Québec Flu Vaccination Program contains the following strains:

  • A/Brisbane/02/2018 (H1N1)
  • A/Kansas/14/2017 (H3N2)
  • B/Colorado/06/2017
  • B/Phuket/3073/2013

For the 2019-2020 season, only the injectable flu vaccine will be offered in Québec. Due to supply difficulties, the intranasal vaccine will not be available for the 2019-2020 season.

Symptoms after vaccination

Some symptoms may be caused by the vaccine, such as redness at the injection site. Other problems may occur by chance and are not related to the vaccine, such as cold, gastro or headache.

The injectable flu vaccine is safe. Most reactions are harmless and do not last long.

FrequencyPossible reactions to vaccine
In most cases
(more than 50% of people)
Pain at injection site
Very often
(less than 50% of people)
Redness and swelling at injection siteMuscle pain, joint pain, headache, fatigueLoss of appetite, drowsiness (difficulty staying awake), irritability
Often
(less than 10% of people)
Bruising or itching at injection siteFever, chills and discomfort, particularly in people receiving the flu vaccine for the first timeNausea, vomiting, diarrhea, stomach acheOculo-respiratory syndrome, or ORS (red eyes, sore throat, coughing, difficulty breathing)
Sometimes
(less than 1% of people)
Swelling of the face (this reaction is also part of ORS)Redness of the skinDizzinessSwollen glands
Rarely
(less than 1 person in 1,000)
Seizures (the body stiffens, and muscles contract in a jerky and involuntary manner)Numbness, neuralgia (pain along the course of a nerve)

Extremely rare reactions

Extremely rare reactions may occur after a flu vaccine.

The Guillain-Barré syndrome (GBS) is one such reaction. This syndrome causes progressive paralysis, meaning that one or more parts of the body go numb until you are no longer able to move. This paralysis eventually disappears, but it can sometimes leave permanent effects. The cause of GBS is unknown. In most cases, GBS occurs following infection of the intestines or lungs. It mostly affects young adults and people aged 60 years and older.

The risk of having Guillain-Barré syndrome after receiving a flu vaccine, if such risk exists, is extremely low. In fact, there is less of a chance of developing GBS after flu vaccination than after contracting an infection such as the flu.

Serious allergic reactions are also extremely rare.

What to do after vaccination

Tips to follow immediately following vaccination

Wait 15 minutes before leaving premises where vaccine is received. If an allergic reaction occurs, the symptoms will appear a few minutes after the vaccination.

If you feel side effects, immediately inform the person giving the vaccine. That person will be able to treat you immediately.

Tips to follow at home

If you experience redness, pain or swelling at the injection site, apply a cold, damp compress on it.

Use medication for fever or discomfort if needed.

When to seek medical help

See a doctor if one of the following applies to you:

  • You experience serious and unusual symptoms
  • Your symptoms get worse instead of improving
  • Your symptoms last over 48 hours

Last update: August 6, 2019

Flu vaccine

Flu vaccine

It is highly recommended that people most at risk of developing complications get vaccinated each year in order to protect themselves. For these people, vaccination is the best protection against the flu and its complications.

Vaccination allows the body to make antibodies to fight the flu. However, studies have shown that the number of antibodies may decrease in the year after vaccination. This decrease particularly affects older adults and people with a weakened immune system.

In addition, viruses that cause flu constantly change. The composition of flu vaccines are reviewed annually in order to include the virus strains most likely to be in circulation during the flu season.

Consult the details of the Flu Vaccination Program to know how to proceed and where to get vaccinated.

Description of vaccine

For the 2019-2020 season, only the injectable flu vaccine will be offered in Québec. Due to supply difficulties, the intranasal vaccine will not be available for the 2019-2020 season.

Vaccine safety

Flu vaccine is safe. It cannot transmit flu or other illnesses. In fact, the viruses or a part of the viruses that it contains are killed or too weak to reproduce and cause the flu.

In Canada and at the World Health Organization (WHO), there are several vaccination surveillance programs. These programs ensure, among other things, the quality of vaccines offered. Among these is the Québec surveillance program, ‘Effets secondaires possiblement reliés à l’immunisation’ (ESPRI). This program was established in 1990 by the Ministère de la Santé et des Services sociaux.

Effectiveness of vaccine

The flu vaccine generally takes 2 weeks before being fully effective.

The protection offered by the vaccine may vary from person to person, but it lasts at least 6 months. 

The vaccine protects only against strains of the flu virus that it contains. It does not protect against other respiratory infections such as the cold. Flu is often confused with cold. To learn more, go to the Differences between flu and cold page.

Factors that determine effectiveness

The vaccine’s effectiveness depends on the following:

  • The age of the person vaccinated
  • The state of the person’s immune system, meaning the system that allows their body to defend itself against infections
  • The degree of kinship between the virus strains circulating and those contained in the vaccine

The vaccine therefore does not offer 100% protection against the flu. The vaccine prevents the flu in about 40 to 60% of healthy people when the strains of viruses it contains correspond to strains circulating.

A strain of the virus included in the vaccine may not match the circulating strains. Indeed, the virus can evolve differently from what was predicted. As a result, the vaccine will be less effective against this strain. Nonetheless, the annual flu vaccine is still recommended, since it protects against the other strains included the vaccine that might be circulating.

For people aged 75 and over and those with chronic illnesses, the vaccine especially help reduce the risks of complications from the flu, hospitalisation and death.

Vaccinating children

Vaccination is recommended for children between the age of 6 months and 17 years who have certain chronic diseases to ensure they are effectively protected against the flu and its complications. To reduce the risk of complications, vaccination is also offered free of charge to members of the same household and informal caregivers of these children.

If vaccination is recommended for your child and he does not feel well enough on the day of vaccination, go to the Conditions for postponing vaccination section to find out whether or not you need to postpone his vaccination.

Children less than 6 months old

It is not recommended to vaccinate children aged less than 6 months. Indeed, the effectiveness of the vaccine has yet to be proven for children that age. The vaccine is therefore not offered to them.

However, children under 6 months of age can also catch the flu. Furthermore, they are among those who are more at risk of being hospitalized after the flu. Therefore, vaccination is recommended for members of the same household and informal caregivers of children under 6 months of age to avoid passing on the flu to them.

If you are a member of the same household or the informal caregivers of a child under 6 months of age, you can get vaccinated free of charge under the Flu Vaccination Program.

Children less than 9 years old

Children less than 9 years old getting the flu vaccine for the first time must receive 2 doses of vaccine. The second dose must be given a month after the first. Parents must therefore plan 2 appointments to get their child a flu vaccination.  

Indeed, as most vaccines given in childhood, the first injection of the flu vaccine must be followed by a booster dose. The first dose of the vaccine allows the child’s immune system to, in a way, ‘get acquainted with the virus’ and to fight it, but for only a few weeks. The second dose allows the child’s immune system to produce more antibodies to fight the virus on a longer term.

It is therefore important that children less than 9 years old getting the flu vaccine for the first time receive the 2 doses of vaccine. The second dose will allow them to be best protected during the entire flu season.

Only children less than 9 years old who have already received the flu vaccine need to receive a single dose of it.

Children from 6 to 23 months old and those who have certain chronic diseases can get vaccinated free of charge under the Flu Vaccination Program.

Children aged 9 and up

From the age of 9, children that get the flu vaccine receive a single dose of it, even if they have never received a flu vaccine before.

The immune system of a 9 year old child is indeed sufficiently developed to produce enough antibodies to protect them with a single dose of the vaccine.

Children who have certain chronic diseases can get vaccinated free of charge under the Flu Vaccination Program.

Conditions for postponing vaccination

There are very few reasons for delaying getting a vaccine.

As such, people with a cold can get vaccinated with no problem.

Only a serious illness can cause a vaccinator to delay a vaccine after evaluating the general condition of the person to be vaccinated. The fact of having a fever is not the only indication of a serious illness.

Last update: October 9, 2019

Gastroenteritis (stomach flu)

Gastroenteritis (stomach flu)

Gastroenteritis, also referred to as ‘stomach flu’, is inflammation of the stomach and intestinal lining, which causes diarrhea and vomiting.

It can be caused by a virus, a bacteria or a parasite. Norovirus is the most common cause of gastroenteritis in adults. In children, rotavirus is more often involved. These viruses circulate mainly in the fall and winter. Other viruses and bacteria can spread stomach flu, especially in people traveling abroad.

Gastroenteritis is extremely contagious. You can avoid spreading and catching it through simple hygienic measures such as washing your hands.

Symptoms

The main symptoms of gastroenteritis are the following:

  • Diarrhea: at least 3 liquid or semi-liquid stools every 24 hours or stool that is more abundant and frequent than usual
  • Abdominal cramps
  • Nausea
  • Vomiting

Other symptoms may sometimes appear:

  • Mild fever
  • Headache
  • Muscle pain

Symptoms of gastroenteritis usually last 24 to 72 hours. However, they can last up to 10 days if the stomach flu began while travelling abroad or upon your return.

Persons with gastroenteritis are usually contagious when showing symptoms, and most particularly so when symptoms are severe. They may be contagious even a few weeks after symptoms have subsided.

If you have symptoms of gastroenteritis, it is important that you stay home to heal and to avoid transmitting the illness to other people, until all symptoms have disappeared. Should you have questions regarding your condition, contact Info-Santé 811.

When to consult

Gastroenteritis is generally not serious. Most people take care of themselves at home and self-heal without taking medicines.

Call Info-Santé 811

People likely to experience complications should contact Info-Santé 811. Some cases also require evaluation by a nurse. For instance, you should call Info-Santé 811 if you or your child are in one of the following situations:

  • You have diarrhea and your stools are frequent and abundant or they contain a little blood
  • You are unable to drink or keep fluids down
  • Your diarrhea starts while travelling abroad or upon your return
  • You are unsure whether or not to see a doctor

A nurse will give you specific advice and tell you whether or not you need to see a doctor right away.

Consult a doctor the same day

You should see a doctor the same day if you or your child are in one of the following situations:

  • You have diarrhea which does not subside after 48 hours despite following instructions for rehydrating and eating when you have gastroenteritis
  • You have diarrhea and fever (over 38 ºC or 100,4 ºF) for over 48 hours
  • You have been vomiting for 48 hours and the situation does not improve despite following instructions for rehydrating and eating when you have gastroenteritis
  • You have diarrhea that has persisted for over 1 week. However, if your diarrhea started during a trip abroad or upon your return, it could last more than a week

You can find a resource near you offering medical consultation on the same or next day.

Go to emergency immediately

You should go to emergency immediately if you or your child are in one of the following situations:

  • You have a lot of blood in your stool, or your stool is black
  • You have diarrhea with intense abdominal pain
  • You have diarrhea, extreme thirst, have not urinated in 12 hours
  • You are vomiting frequently, and it does not slow down after 4 to 6 hours
  • There is stool or blood (red in colour or ground coffee-like) in your vomit
  • Your general health is deteriorating (weakness, drowsiness, irritability, confusion)

Treatment

Rehydrating yourself and eating well are the two main ways of treating gastroenteritis.

Complications

The main complication of gastroenteritis is dehydration. It occurs when the body eliminates too large a quantity of water and mineral salts, which are essential to the proper functioning of the body.

People likely to experience complications

Some people are more at risk of experiencing complications. They include:

  • Children less than 2 years old
  • People aged 65 years and over
  • Pregnant women
  • People with a chronic disease such as diabetes

If you or your child are in these categories of people and show symptoms of gastroenteritis, contact Info-Santé 811. A nurse will evaluate your condition and give you the appropriate recommendations.

Transmission

Gastroenteritis is a contagious illness. An infected person can transmit the illness as long they have symptoms and up to 2 weeks after they have disappeared. He or she can be contagious even a few weeks after symptoms have subsided.

Gastroenteritis can be transmitted:

  • Through consumption of contaminated water or food
  • Through direct contact with a contaminated person, for example by kissing or shaking hands, if the person’s hands are contaminated with microbes from stools
  • Through indirect contact with contaminated people or objects
    • By eating food that has been contaminated through handling by an infected person
    • By touching surfaces or objects that have been touched or handled by an infected person (example: door handles, utensils, clothes, toys)
    • By touching surfaces or objects contaminated by stool or vomit
  • Through breathing droplets spewed into the air, by vomit for instance

Protection and prevention

Adopt simple hygiene measures

You can protect yourself from gastroenteritis and avoid transmission by adopting simple hygiene measures:

  • Wash your hands often
    • Before, during and after preparing meals
    • Before eating
    • Before breastfeeding or feeding a child  
    • After using the toilet or having helped a child use the toilet
    • After changing a child’s diaper
  • Clean toilet seats and surfaces or objects that might have been contaminated by stool or vomit with a disinfectant
  • Put toddlers in superabsorbent diapers to prevent leakage
  • Prepare and clean feeding bottles under the cleanest possible conditions

You can find additional hygiene measures at Preventing transmission of viruses and bacteria.

Vaccinate your children

Rotavirus is the main virus responsible for gastroenteritis in children. Giving young children vaccination against this virus is the best way to protect them against gastroenteritis. Depending on the vaccine used, 2 or 3 doses are required. Children must receive the first dose of the vaccine before the age of 20 weeks and the last before 8 months.

For information on the vaccine against rotavirus, consult a doctor or contact Info-Santé 811.

Last update: January 8, 2020

Flu (influenza)

Flu (influenza)

Where to get Vaccinated
For all the information about the flu vaccination campaign for each region of Québec, see the Where to get vaccinated section.

Description

The flu is a respiratory infection that spreads very easily. It is caused by influenza viruses.

The flu circulates each year in Québec and around the world. In Québec, it circulates mainly from late fall to early spring.

The duration of the flu season can vary. It can start earlier or later and be shorter or longer depending on the year.

Symptoms

Flu symptoms and their severity can vary with age and health status. The main symptoms are as follows:

  • Sudden fever, between 39°C and 40°C (102°F and 104°F)
  • Sudden cough
  • Sore throat
  • Muscle or joint pain
  • Extreme fatigue
  • Headaches

Symptoms can also include nausea, vomiting, diarrhea and abdominal pain. These symptoms are more common in children.

In older adults, feeling weak and confused sometimes may be the only symptoms.

The flu is often confused with other respiratory infections such as the cold.

When to see a doctor

Generally, the flu can be treated at home. In some cases, however, you must see a doctor.

Same day consultation

You must see a doctor on the same day if you have flu symptoms and also one of the following symptoms:

  • Persistent or increasing pain when breathing
  • A fever that is getting worse or has lasted for over 5 days

If your symptoms get worse or do not improve after 7 days, you must also see a doctor.

You can get a consultation at a resource near you, for example at a medical clinic or at a CLSC.

Immediate consultation at an emergency room

You must go to the emergency room immediately if you have flu symptoms and also one of the following symptoms:

  • Persistent or increasing difficulty breathing
  • Blue lips
  • Severe chest pain
  • Persistent or increasing severe headache
  • Drowsiness, difficulty staying awake, weakness
  • Confusion, disorientation
  • Seizures (the body stiffens and muscles contract in a jerky and involuntary manner)
  • No urination for 12 hours, intense thirst

If your baby is less than 3 months old and has a fever, bring him or her to the emergency room quickly.

If your child has a fever and appears very sick, lacks energy and refuses to play, bring him or her to a doctor quickly or call Info-Santé 811.

If you require immediate help to get to an emergency room, call 9-1-1.

Call Info-Santé 811

Some situations require you to be assessed by a nurse who can give you specific advice about your situation. She can also tell you if you should see a doctor quickly.

You should call Info-Santé 811 if you or your child are in one of the following situations:

  • you are short of breath;
  • you do not know if you must see a doctor.

Treatment

Most healthy people recover from the flu by themselves after 5 to 7 days. You must get plenty of rest and eat according to your appetite.

Coughing and fatigue may, however, last up to 2 weeks or even longer.

You can relieve flu symptoms by taking the following measures:

  • Drink plenty of fluids often
  • Use medications as directed

Drink plenty lot of liquids often

If you have a fever, your body naturally loses a lot of fluid, especially through sweating. It is therefore important to drink plenty of fluids often.

  • Drink fluids, such as water, milk, juice or broth.
  • Avoid alcoholic beverages or caffeinated drinks such as coffee, tea and energy drinks. These drinks make you urinate, increasing fluid loss.

Use medications as directed

In the absence of complications or risk factors for complications, you do not need prescription medication to treat the flu. However, to relieve the fever and pain, you can take over-the-counter medications such as acetaminophen, for example Tylenol®, or ibuprophen, for example Advil®.

Avoid taking medications that contain identical ingredients at the same time. For instance, do not take Tylenol® and Tylenol® Sinus together because both of these medications contain acetaminophen.

In some cases, your doctor may prescribe an antiviral medication to reduce the duration and severity of your symptoms. This type of medication is more effective when taken at the onset of an infection.

Children and teenagers

If your child is over 3 months old and has a fever, you can give him or her acetaminophen, for example Tylenol®, making sure you follow the instructions that come with the product and based on your child’s weight.

Avoid giving children and teenagers acetylsalicylic acid, for example aspirin. This medication could cause a serious brain and liver disease known as “Reye’s syndrome” in children and teenagers who have the flu.

Complications

The flu can lead to complications. The most common complications are:

  • Dehydration due to sweating caused by fever
  • Pneumonia
  • Bronchitis
  • Sinusitis
  • Otitis

For more vulnerable people, some complications can lead to hospitalization and even death.

People who have a higher risk of developing complications

People who have a higher risk of developing complications are:

  • Babies under 6 months of age
  • Children and adults who have chronic diseases
  • Pregnant women who have chronic diseases throughout their pregnancy
  • Healthy pregnant women in the 2nd and 3rd trimesters of their pregnancy
  • People age 75 and over

If you or your child has a higher risk of developing complications and you have flu symptoms, call Info-Santé 811. A nurse will assess your health and make recommendations based on your situation.

Transmission

The flu virus prefers cool, dry places. It can live up to 2 days on contaminated objects and up to 5 minutes on skin.

The flu virus is very contagious. It spreads quickly from person to person:

  • By droplets expelled into the air from the mouth or nose of a person infected with the flu when they cough or sneeze
  • By direct contact with secretions from the nose or throat of a person infected with the flu, when kissing for instance
  • When you bring your hand to your nose, mouth or eyes after shaking the hand of a person who is infected or touching contaminated objects

A person infected with the flu virus may be contagious:

  • 24 hours before showing symptoms
  • Up to 7 days after the onset of symptoms and sometimes even a little longer. Young children and older adults may be contagious for up to 14 days after the onset of symptoms.

If you have the flu, avoid direct contact with people who have a higher risk of developing complications as much as possible. This way, you reduce the risk of transmitting the illness to them.

Protection and prevention

The best way to protect yourself from flu-related complications is by getting vaccinated.

Protection and hygiene measures can also help prevent the spread of the flu.

At all times

  • Wash your hands often
  • Clean your immediate environment, such as furniture, counters, door handles and switches.

If you have the flu

Stay at home as soon as you develop flu symptoms. Unless advised otherwise by a doctor, home is the best place to recover. By staying at home, you limit contact with other people or with other infections that may cause complications. You also limit the spread of the virus.

Last update: October 16, 2019

Preventing transmission of viruses and bacteria

Preventing transmission of viruses and bacteria

Certain viruses and bacteria are transmitted through close contact between people. Several situations increase such contacts, including the following:

  • Living or working with other people
  • Sharing items
  • Giving care to a person
  • Frequenting public areas

There are a number of measures that you can take to prevent the spread of viruses and bacteria.

Measures to take

Get vaccinated

Vaccination is the best way to protect yourself and others. When a vaccine against an infection or a disease is available, get it.

Apply recognised hygiene measures

  • Always keep your hands clean.
  • Avoid touching your nose, eyes and mouth with unwashed hands. The nose, eyes and mouth are entry sites for viruses and bacteria.
  • Avoid touching your nose, eyes and mouth. These are entry points for viruses and bacteria.
  • Avoid contact with people that are sick as they may be contagious. Do not get close to them and do not touch objects they have used, like their utensils for instance.
  • Clean your surroundings regularly, as well as the sanitary appliances you use. For example, clean your counters and other surfaces that you touch often with your hands. Also wash toilets and sinks in order to keep them clean. Cleaning is very effective in killing viruses, which can survive on hard surfaces.
  • Clean with soap and water or use domestic detergents.

When you are sick

  • Avoid contact with more vulnerable people. For example, avoid visiting people in hospital, people living in extended care centres and people who have a chronic disease.
  • Avoid direct contact when you greet someone, such as shaking hands.