Pediatric immunization update

Issue: BCMJ, vol. 50, No. 4, May 2008, Page 192 News

The practise of immunization is dif­ficult given the rapid advances in science and the pace at which new products come on the market. This is further complicated by the delay of new products being placed on the provincial schedule. 

There are many international and national expert opinions on how immunizations should be given (see NACI,; CPS,; AAP,; BCCDC, The BC Pediatric Society (BCPS) feels we can help with the practical application of this information.

BC children should have the best in immunization practice available to them. Every opportunity should be taken to ensure children and their parents have up-to-date information on immunizations:

• Primary care providers should briefly discuss immunizations at all pertinent visits.
• Information on vaccines currently not part of the provincial schedule should be provided in the form of discussion, written information, or both.
• Consultants should discuss immunizations as part of office or hospital consultations.

For more information, please see the “Vaccines fact sheet” below, review the BC immunization schedule, and read our suggestions on how to use both the new vaccines and the products currently on the market  at

—Todd Sorokan, MD
President, BCPS

(These vaccines not part of BC provincial schedule)

Rotavirus vaccine (Rotateq): Oral vaccine for use in infants starting at 6–12 weeks of age to prevent gastroenteritis and admission to hospital from five serotypes of rotavirus for two seasons.

Hepatitis A vaccine: A hepatitis A vaccine is recommended in many countries as part of their routine series after the age of 12 months. Certainly if your patients are traveling or in day care, it is a consideration.

Meningococcal A,C,Y,W-135 conjugate (Menactra): Menactra can be used in any child 2 years and older and should then also be considered as a substitute for the Men-C given at 11 years/grade 6 for added protection against the three extra serotypes. The serotypes causing disease vary from year to year and are unpredictable. The addition of the added serotypes has the potential to prevent a number of cases of invasive meningococcal disease every year (likely an extra 25% of the preventable cases). It will also boost the Men-C given at 2 months and 1 year and offer greater protection for travel.

Traveler’s diarrhea vaccine (Dukoral): Oral vaccine that protects against enterotoxigenic E. coli. and cholera. The first dose needs to be started two weeks before travel so that two doses are finished at least 1 week before travel.

Human papillomavirus vaccine (Gardasil): Quadravalent vaccine offers excellent protection against genital warts and cervical cancer. The provincial program will not cover girls now in grade 9 and older, so the vaccine should be considered for this group of young women now. See the excellent position statement at the Canadian Pediatric Society web site at

Todd Sorokan, MD,. Pediatric immunization update. BCMJ, Vol. 50, No. 4, May, 2008, Page(s) 192 - News.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply