Immunize Canada      Immunisation Canada

Pain management during immunization

Immunizations are the most common recurring health-related procedure undertaken in childhood. For most children, these procedures can cause unnecessary stress and anxiety which can lead to long-term non-adherence with recommended health care interventions and missed immunizations, but health care providers such as doctors, nurses and pharmacists can help.

Clinical practice guidelines (CPG) developed by the Help ELiminate Pain in KIDS (HELPinKIDS) team at the University of Toronto provide four steps that demonstrate how health care providers can help mitigate pain during childhood immunization and provide guidance to parents.


Reducing pain during vaccine injections: clinical practice guideline. Adapted from CMAJ 2010:182;E843-E855 and CMAJ 2015:187;975-82 with the permission of the publisher, the Canadian Medical Association.

Below is a reference guide for health care providers on how to eliminate pain during immunization.

The 5 P’s of Pain Management during Vaccine Injections – A Clinician’s Guide: Children 3 Years and Under


Webinar – Reducing Pain and Fear: Integrating Evidence into Routine Immunization Practice
Webinar presented on 11 June 2015 by Public Health Physicians of Canada and Immunize Canada
Speaker: Dr. Anna Taddio
Webinar recording (external link)

Reducing pain during vaccine injections: Clinical practice guideline (Taddio A et al., CMAJ, 2015.) (external link)

Canadian Pain Coalition: November 2016 Newsletter focusing on adult immunization (external link)

Further reading & links

Updated: 8 November 2016