Canadian children deserve better than what looms before them: an inequitable 13-tier health care system. There are 13 provinces and territories, some poorer, some richer. All have varying abilities to attract and retain scarce paediatric health personnel. All have different vaccine schedules and offerings. Alberta offers infants the varicella and conjugated meningococcal C vaccines, and the conjugated pneumococcal vaccine. Most other provinces and territories offer some of these new and effective, but expensive, vaccines. What happens when even newer vaccine recommendations on how to actively prevent respiratory syncytial virus, adolescent/adult pertussis, group B streptococcus and HIV arrive? How as a nation can we ensure that all our children have equitable access to new and effective vaccines, and that these vaccines are safe, acceptable and reliably supplied? How will poorer provinces and territories pay for the more expensive vaccines at a time when other pressures (new drugs, an aging population) are driving health care budgets skyward at an unsustainable rate of 6% to 10% per annum? Who will coordinate vaccine research, program planning and evaluation, and harmonize the confusing array of different vaccine schedules? Who will ensure that a complacent public remains well informed on the need for strong immunization programs? Vaccinations save more lives and prevent more suffering, and have been more cost effective than any other medical intervention bar none. The National Immunization Strategy (NIS) was conceived in 1999 to address all the above concerns. The goals of the NIS are to ensure optimal levels of immunization for all Canadians, and ensure complete coverage of all children with routinely recommended vaccines. The NIS has two coordinators, one representing each level of government. A fundamental principle put forth by the provinces and territories is that delivery of immunization programs should be a shared responsibility between themselves and the federal government. The Canadian Paediatric Society (CPS) has just formed the Advocacy Committee for Children and Teens, whose mandate is to advocate to governments for legislative and budgetary change on issues such as the NIS, paediatric human resources, tobacco control and injury prevention. The NIS will be our first major project. We will be asking CPS members to meet with federal and provincial politicians to advance our advocacy goals. Harry Truman once said, “There is no limit to what you can accomplish if you don’t care who gets credit for it”. It is time to think outside the rigid box of traditional federal-provincial health care politics. Children are neither provincial nor federal responsibilities; they are everyone’s responsibilities. Federal leadership and funding will be essential to ensure that all Canadian children have equal access to safe and effective vaccinations, both now and well into the future. We at the CPS will do our best to make that happen.