The goal of this initiative is to reduce the pain experienced by children receiving vaccinations, thereby encouraging children and their parents to adhere to vaccination schedules, leading to increased personal and community protection against vaccine preventable diseases.

The BC Centre for Disease Control’s Immunization Nursing Team (Brittany Deeter, Karen Pielak, and Cheryl McIntyre) utilized the evidence base provided by a Canadian Medical Association Journal (CMAJ) article entitled “Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline” to develop a new Reducing Immunization Injection Pain guideline for use by immunization providers in BC.

This clinical practice guideline was created collaboratively with input from all health authorities in BC, including parents, pharmacists, and physicians. Strategies outlined in the guideline to reduce immunization injection pain include:
• Preparing child before procedure and structuring the environment
• Pharmacological strategies, including breastfeeding, oral sucrose solution, and topical anaesthetics
• Physical strategies and injection procedures
• Psychological strategies including distraction and breathing techniques

In addition, in collaboration with Healthy Families BC, Immunize BC, and HealthLinkBC, the team developed tools to assist health care providers and families in implementing the strategies outlined in the guideline:
• The Child Health Passport
• “A Better Immunization Experience For You and Your Child” brochure
• "A Better Immunization Experience For Your Child” HealthLinkBC File

In the face of difficulty implementing the practice guideline due to the large gap between current practice and the acknowledged best practices, the knowledge translation project undertook creative strategies to demonstrate to staff that the guideline was effective and feasible to use in practice.

The project helped show that even large gaps between best and current practice can be overcome with multifaceted and creative collaborations. Guideline available at:

Contact Information:

Contact Title: Senior Practice Leader, Immunization Programs
Contact Email:

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