The current guideline expands on and updates the 2010 guideline with recommendations across the lifespan. This enhanced scope led to a revised team name of HELPinKids&Adults. The intended audience is all health care providers who administer vaccine injections. Recommendations for the management of fear in individuals with high levels of needle fear (i.e., individuals with persistent, intense apprehension of or fear in response to a needle procedure, who may endure needles with intense distress or avoidance) are reported separately, as they require knowledge and skills beyond those of practitioners who usually give vaccinations (C.M.M., unpublished data, 2015). Delayed pain (hours to days after injection) was not considered in this guideline.

Injections for vaccinations, the most common source of iatrogenic pain in childhood,[1][1] are administered at multiple times to almost all Canadian children throughout infancy, childhood and adolescence.[2][2] The pain associated with such injections is a source of distress for children, their