CPHA Canvax

School-based vaccination programs can be a source of distress for many students due to the pain from the needle injection and related fears. We created a multifaceted Knowledge Translation (KT) intervention to address vaccination and pain, fear, and fainting called The CARD™ System. The objectives were to document acceptability of key tools included in the multifaceted KT intervention and their effectiveness in improving knowledge and attitudes about vaccination pain and fear.

Quantitative and qualitative methods were used. Students, school staff, public health nurses, and parents participated in separate focus groups whereby they independently completed a knowledge and attitudes survey and provided structured and qualitative feedback on key KT tools of the multifaceted KT intervention. They then repeated the knowledge and attitudes survey.

Altogether, 22 students (grade 6 and 7), 16 school staff (principals, grade 7 and 8 teachers, resource teachers, secretaries), 10 nurses (injecting, charge, and school nurses), and 3 parents participated. Knowledge test scores increased post-KT tool review: 8.5 (2.1) versus 7.3 (1.9); P<0.001. Attitudes were more positive about the individual nature of pain and fear experience during vaccination. Student fear scores were lower post-tool review: 5.1 (2.9) versus 4.6 (3.0); P<0.001. The majority of the participants reported they understood all the information, the amount was just right and that the information was useful.

The KT tools were demonstrated to be acceptable and to improve knowledge. Future research is warranted to determine their impact on student experience during school vaccinations.


Rating See Comments Ratings


Program Planning and Delivery,Program Delivery and Evaluation,School Based Immunizations,Vaccination Decision Making,Vaccine Acceptance and Uptake,Anxiety and Pain Management Program Planning and Delivery
Program Delivery and Evaluation
School Based Immunizations
Vaccination Decision Making
Vaccine Acceptance and Uptake
Anxiety and Pain Management


Using the comment box below, provide your feedback for this resource. Tell the immunization community how you used the resource, what worked, what didn't and the changes you made. The feedback provided will help inform the immunization community and improve upon the resource made available on CANVax.

All comments are anonymous. Submitted comments will be reviewed for approval by the CANVax team to ensure it meets content submission guidelines. Please note that although CANVax aims to approve comments in a timely manner, volume may result in delays.