But parents in Alberta don't have to spend a dime.

One of the easiest places to spot cracks in Canada's national health-care system is in the inequities surrounding immunization. The 13 provinces and territories all have their own vaccination schedules and offerings, so your vaccination coverage depends on where you live.

Some provinces, like Alberta, cover the new regime of pediatrician-recommended vaccines under their provincial health plans. But in other provinces, like Ontario, if you want to immunize your child with those same potentially life-saving vaccines, you must pay for it.

"This is the ultimate in two-tier medicine," Dr. Morton Goldbach said. The busy Toronto pediatrician had just finished administering a syringe full of Prevnar into 9-month-old Morrison Reback's plump leg. The dark-haired baby took it with barely a whimper.

This was Morrison's third shot of Prevnar. Each one cost his parents $100.

Prevnar is a new vaccine that protects against invasive pneumococcal diseases such as meningitis, an infection that attacks the membranes covering the brain and spinal cord, with damaging consequences.

Jill Reback, Morrison's mother, swallows the cost without a second thought.

"It's important, otherwise we wouldn't do it," she said as she put her credit card away.

"We'd love this to be covered. We are paying a lot of money."

Luckily, they can afford it. But Reback thinks it's unfair that less fortunate children in Ontario will go without because OHIP doesn't pick up the tab.

She's not the only one. Earlier this month, health-care workers attended an immunization conference in Victoria.

They closed their meeting by sending more than 400 Christmas cards to federal Health Minister Anne McLellan, imploring her to implement a co-ordinated, national vaccine plan. Some had messages such as, "All I want for Christmas is the National Immunization Strategy."

The Canadian Paediatric Society believes all of Canada's children deserve better. They want the federal government and the provinces to quit their bickering over who should pay for what and ensure every child is offered equal access to the same vaccines, regardless of geography.

"Children are neither provincial nor federal responsibilities; they are everyone's responsibilities," said Dr. Andrew Lynk, chair of the society's advocacy committee.

A Canada-wide immunization network would ensure equal access, regulate vaccine supply to prevent shortages, and educate the public and doctors as to what's out there and how it can help prevent disease. It would also allow doctors to get a better picture of adverse vaccine reactions.

Perhaps this would help ease the concerns of parents who worry that vaccinations are the cause of devastating problems such as autism, Lynk said. Doctors are at a loss to explain why the rate of autism, a neurological disorder, appears to be rising sharply. Autistic children are often unable to verbally communicate or relate to others and can be absorbed in a fantasy-like world.

A growing number of parents are choosing not to vaccinate their infants at 12 months with the standard measles-mumps-rubella shot, fearing a link between the shot and autism. Lynk said it's difficult to get a handle on how many are opting out, because there isn't a national vaccine registry.

There isn't a shred of evidence to support the theory that autism is linked to the measles-mumps-rubella vaccine, Lynk said. However, some in the anti-vaccine movement believe there is an association because symptoms usually appear shortly after the standard period for administering the vaccine.

"We don't know why autism has been increasing recently," he said. "There is no evidence it's vaccination-related."

Roy Romanow, author of the federal government's new report on how to fix the Canadian health-care system, figures the cost to equalize the vaccine program across the country could be about $100 million. He'd like to set aside another $400 million to help pay for the next generation of vaccines under development.

On a recent swing through Toronto, Romanow touted the importance of a national vaccine strategy.

His report described the Canadian immunization program as dated and in need of overhaul. "There is no doubt about it; this is something that makes a lot of good sense," Romanow said.

Ontario's chief medical officer of health, Dr. Colin D'Cunha, agreed. He said he's "delighted" with Romanow's recommendation. "What we have now is checkerboard coverage, and that's not good enough for Canada."

Vaccines are arguably one of the most important innovations of modern medicine, he said.

He'd like to provide four more of them free to Ontario children: those that would protect against chicken pox, whooping cough in adolescents, meningococcal infections and pneumococcal meningitis.

"My general philosophy is that these four have been shown to work. They prevent disease and they keep people well," he said.

Currently, Ontario parents pay for them out of pocket — or, if they're lucky, through private drug plans. But the drugs are costly.

Prevnar, Wyeth-Ayerst's vaccine for pneumococcal meningitis, was approved for use in Canada last year.

Health Canada's national advisory committee on immunizations has recommended it be given to all young children. The shots are given four times, starting at 2 months. Each dose costs between $75 and $100.

Menjugate, a vaccine imported by Merck Frosst that helps prevent meningococcal group C, is also pricey. Also recommended by Health Canada, it can be given to infants as young as 2 months. It is administered in three shots, each about $100. Quebec provides it to children at no cost.

In Alberta, the province pays for Prevnar and Menjugate and is phasing in the chicken pox vaccine, said John Tuckwell, spokesperson for Alberta's health ministry.

Lynk believes all children should be immunized against chicken pox. While fatal cases are rare, it makes many children seriously ill. Parents often must stay home for days to care for the sick child, and that costs everybody money.

"If you have two or three children in your family and they all get chicken pox, and you've got to stay home for two or three weeks, there is an economic cost to the family," he said from his Cape Breton office.

Romanow's report notes that Canada is not well prepared to face emerging infectious-disease problems. And in some areas, immunization rates have declined because of public fear of vaccines and lack of policing by health-care professionals, the report said.

A national vaccine program would benefit the health of all Canadians, D'Cunha said.

"When you have a national program, it's cheaper for everyone because of purchasing advantages; buying in bulk is cheaper," he said.

Ontario's current vaccine budget is $60 million. Two years ago, the province invested heavily in the program by providing flu shots for everyone who wanted one, D'Cunha said.

He figures spending tens of millions of dollars to improve Canada's immunization strategy is money well spent.

"Romanow has it right."