Concerns about needle fear and pain can result in vaccination avoidance. The CARD (Comfort, Ask, Relax, Distract) system is a vaccine planning and delivery framework that reduces immunization stress-related responses (ISRR) such as fear and pain to improve vaccination experiences for patients and providers alike. The University of Toronto hosted four pop-up influenza vaccination clinics where pharmacy students were the immunizers. Our aim was to evaluate CARD implementation using a before and after quality improvement (QI) paradigm.  Clients reported on their overall experience (primary outcome), stress-related responses (fear, pain, dizziness) and areas for improvement using Likert scales, numerical rating scales (0-10) and open-ended questions, respectively. Staff reported on attitudes and behaviours, and areas for improvement using Likert scales and open-ended questions. Quantitative data was analysed using descriptive statistics. Qualitative feedback was deductively coded using the Proctor Framework. More people rated their experience as better than their last vaccination after CARD (p<0.001). Stress-related symptom scores were lower for fear and pain after CARD (p=0.03 and p=0.02, respectively). Pharmacy students reported positive attitudes and perceptions about acceptability, feasibility, and fidelity of CARD. Implementing CARD resulted in improved client experiences and reduced ISRRs during influenza vaccine pop-up clinics. CARD was positively received by immunizers.