Medical researchers have teamed up with some southern Ontario students to come up with ways to manage the pain and fear associated with vaccinations. Researchers at the University of Toronto and the Hospital for Sick Children dub it the CARD System, which is an acronym for Comfort, Ask, Relax, and Distract. They say these four strategies can make a big difference in the amount of pain and anxiety a young person might feel when faced with a needle. A clinical trial involving Grade 7 students at 10 Niagara Region schools helped shape the game. During the game a nurse will ask each student to choose one or more cards they'd like to play to help them cope. A student may choose category "A" and ask to be vaccinated in a private place, or "D" and bring an electronic device to distract them during injection. Researchers say the trial saw reduced fear and dizziness, and fewer children returning to the clinic after vaccination with associated symptoms. The Niagara Region has since implemented the CARD system in all of its schools.