IMPACT is an active paediatrics-based surveillance system that collects

Issue 34 October 2012
IMPACT is an active paediatrics-based surveillance system that collects
information on hospitalizations and select outpatient hospital visits for
events that occur within a specified time frame after an immunization
and on vaccine-preventable or soon-to-be preventable illnesses.
The IMPACT team invites you to share this newsletter. You can also
subscribe at:
Surveillance update Recent IMPACT publications:
Doug Coyle MA MSc PhD, Kathryn Coyle BSc Pharm MSc, Julie A
Bettinger MPH PhD, Scott A Halperin MD FRCPC, Wendy Vaudry MD
FRCPC, David W Scheifele MD FRCPC, Nicole Le Saux MD FRCPC. Cost
effectiveness of infant vaccination for rotavirus in Canada.
Canadian Journal of Infectious Diseases and Medical Microbiology
2012; 23(2):71-77
Dat Tran, Wendy Vaudry, Dorothy L. Moore, Julie A. Bettinger, Scott A.
Halperin, David W. Scheifele and Samina Aziz for the IMPACT
Investigators. Comparison of children hospitalized with seasonal versus
pandemic influenza A, 2004-2009. Pediatrics 2012; 130(3); 397-406
In this issue
Surveillance update
Welcome to IMPACT
Case examples
Social media
Tan, Ben MD, Bettinger, Julie PhD, McConnell, Athena MD,
MSc, Scheifele, David MD, Halperin, Scott MD, Vaudry, Wendy MD,
Law, Barbara MD, for members of the Canadian Immunization
Monitoring Program, Active (IMPACT). The effect of funded varicella
immunization programs on varicella-related hospitalizations in IMPACT
Centers, Canada, 2000-2008. Pediatric Infectious Disease Journal 2012;
31(9); 956-963
The current IMPACT publications and presentations list can be found
Welcome to IMPACT
A warm welcome to the two new monitors and three co-investigators on
our team. Sharon Penney replaced Cheryl Crummell at the St. John’s N.L.
centre in April 2012. Annick Audet replaced Lorraine Piché for a one-year
leave of absence in July 2012. Co-investigators Karina Top, at the Halifax
centre, Otto Vanderkooi at the Calgary centre, and Athena McConnell at
the Saskatoon centre joined our investigator team this year.
Pertussis – These vaccines are not just for children!
In Canada cases of pertussis usually peak every 2 to 5 years. Over the past few years outbreaks have been
occurring at an alarming rate. Below are some of the recent news releases on outbreaks in specific areas in
Canada and the United States.
Complications from pertussis can be very serious for all ages but especially for infants, who are too young to
be fully immunized yet are at highest risk for severe disease and even death.
Pertussis is preventable. Getting the proper immunizations at the right time also protects those who
cannot yet be immunized. Infants are being exposed to the disease by family members and caregivers who
are not up-to-date with their immunizations or who, sadly, may not even be aware that they need to be
Children require pertussis immunizations at 2, 4, and 6 months of age (called their primary series) and then
a booster at 18 months and again prior to entering school at 4 to 6 years of age. Adolescents require a
booster in their teen years (usually given as part of a school program) and adults should be reimmunized
once in their adult years (usually along with tetanus and diphtheria vaccines, which are given every 10
Parents, child care providers and individuals who have regular contact with children should have a pertussis
vaccination if they are not up-to-date (i.e., have not been immunized at least once as an adult).
Studies are being conducted across Canada to determine whether vaccinating pregnant women against
pertussis provides protection for their newborn baby.
Some topical news releases follow …
British Colombia:
New Brunswick:
United States:;
Case examples
Here is a ‘snapshot’ of pertussis cases reported by IMPACT
An infant spent 27 days in hospital care and developed
rotavirus during treatment.
An infant infected with both pertussis and influenza required
nine days of hospital care (four in the intensive care unit
An infant spent 33 days in the ICU but survived without
complications. This child likely contracted pertussis from an
unimmunized sibling.
An infant with pertussis and a viral co-infection required 23
days of hospital care.
A toddler with multiple pulmonary and neurologic
complications from prematurity spent 34 days in hospital
(including 29 in the ICU). This child had received primary
immunizations but no booster was documented.
IMPACT reported one infant death due to pertussis in 2011.
Seasonal influenza
IMPACT continues to report paediatric influenza hospitalizations and
deaths to the Public Health Agency of Canada’s Flu Watch system: These were cases admitted
to one of the 12 Canadian tertiary care hospitals where an IMPACT
centre is located:
Centres are on active lookout, screening admission sheets and lab
testing results for positive influenza cases. Weekly tallies of such
cases are sent to the PHAC and followed up by collecting data from
the case medical history, including but not limited to the child’s
general health, manifestations of illness, treatment, travel record
and immunization history.
The immunization history is a crucial piece of information that is
often not well documented in case histories, requiring monitors to
take a number of additional steps to determine a child’s
immunization status. In provinces and territories with a number of
different immunization providers (e.g., public health, walk-in clinics,
family physicians and nurse practitioners) finding this information
can be difficult. Immunization registries only exist in a few places in
Canada, making this searching even more complex.
Acute flaccid paralysis
IMPACT nurse monitors continue to report cases of acute flaccid
paralysis to the Canadian Paediatric Surveillance Program. To access
the 2011 CPSP Annual Results, please visit:
Social Media
New ways to communicate and share
health program-related information
have exploded in recent years. The
following recommended social media
resources offer tools and strategies for
health professionals:
The Health Communicator’s Social
Media Toolkit from the U.S. Center for
Disease Control, at:
helps health professionals provide
credible, science-based health
messaging and helps to empower
individuals and communities toward
positive health decision making.
The government of Alberta uses
social media to encourage
Immunize Canada (formerly the
Canadian Coalition for Immunization
Awareness and Promotion) has its own
YouTube channel: Check it out!
For IMPACT on YouTube, visit
Vancouver IMPACT nurse monitor,
Karen Kroeker, speaks about the
program and vaccine safety in a video
produced by Immunize B.C. Best thanks
to them for highlighting IMPACT’s
important work and the manifold
benefits of immunization.
Canadian Adverse Event Following Immunization information
To report an AEFI in Canada, complete the form on the PHAC website, at For additional help, consult the user guide at
The 10th Canadian Immunization Conference will be held at the Vancouver
Conference Centre in Vancouver, B.C. on December 3-5, 2012:
Public Health Agency of Canada
Canadian Paediatric Society
Caring for Kids (resources to share with families)
Immunize Canada (previously CCIAP)
Aboriginal Peoples Immunization Information
PHAC/Canadian Influenza Research Network
Meningitis Research Foundation of Canada
Immunization Education Initiative
Flu Watch
Canadian Healthcare Influenza Immunization Network
Provincial and territorial websites and immunization schedules:
U.S. Centers for Disease Control
Immunization Action Coalition
Children’s Hospital of Philadelphia
Parents of Kids with Infectious Diseases (PKIDs)
PATH: A catalyst for global health
The following article from the Immunization Action Coalition gives some tips for locating old immunization
IMPACT contacts
Nurse Monitor
IWK Health Centre
Halifax, N.S.
Andrea Hudgin
Heather Samson (Nurse Monitor Liaison)
Dr. Scott Halperin (Co-PI)
Dr. Karina Top (Co-Investigator)
Le Centre Mère-Enfant de
Lynn Poirier
Dr. Pierre Déry
The Hospital for Sick Children
Toronto, Ont.
Suganya Lee (lead)
Dr. Dat Tran
Children’s Hospital
Winnipeg, Man.
Debbe Cote (lead)
B.C. Children’s Hospital
Vancouver, B.C.
Karen Kroeker
Dr. Laura Sauvé
Children’s Hospital of Eastern
Ontario, Ottawa, Ont.
Chantal Bergeron
Dr. Nicole Le Saux
Alberta Children’s Hospital
Calgary, Alta.
Shannon Pyra
Dr. Taj Jadavji
Dr. Otto Vanderkooi (Co-investigator)
The Montreal Children’s Hospital
Montreal, Que.
Annick Audet (lead)
and Teena Marie Johns (additional)
Dr. Dorothy Moore
Eastern Health Janeway
St. John’s, NL
Sharon Penney
Dr. Natalie Bridger
CHU Sainte-Justine
Montreal, Que.
Sophie Bouchard
Dr. Marc Lebel
Stollery Children’s Hospital
Edmonton, Alta.
Barb Neufeld
Dr. Wendy Vaudry (Co-PI)
Royal University Hospital
Saskatoon, Sask.
Brenda Andreychuk
Dr. Ben Tan
Dr. Athena McConnell (Co-investigator)
Québec City, Que.
and Kim Simpson (additional)
Dr. Joanne Embree
and Michelle Breton (additional)
Other contacts:
Public Health Agency of Canada (PHAC), Centre for Immunization and Respiratory Infectious Diseases (CIRID):
Monique St-Laurent (Director); Dr. Barbara Law (Chief Vaccine Safety); Heather Deehan (Chief Vaccine-Preventable Diseases);
Dr. Holy Akwar (Chief influenza)
Canadian Paediatric Society (CPS): Marie Adèle Davis (Executive Director); Melanie Laffin-Thibodeau (Manager, Surveillance);
Dominique Paré (French translator)
IMPACT Data Center: Dr. David Scheifele (Data Centre Chief); Kim Marty (Data manager); Dr. Julie Bettinger (Epidemiologist);
Debbe Heayn (Data scrutineer)
Canadian Center for Vaccinology (CCfV): Natalie Giorgis (newsletter formatting); Heather Samson (Nurse Monitor Liaison)
For Media requests please contact Andrée Dion at the CPS office: (613) 526-9397 ext 247
To connect with an IMPACT centre please contact Heather Samson by email, at [email protected]