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Posts Tagged ‘Vaccine Coverage Rates’

Measles outbreaks in the spring of 2019 in the American Pacific Northwest and British Columbia were part of a global revival of an infectious disease that had already affected thousands in Asia, Africa and Eastern Europe. In the wake of that outbreak, the BC Ministry of Health under Adrian Dix acted to require all parents to provide local public health units with their child’s immunization record before beginning school in September 2019. Twelve measles cases in Saint John, New Brunswick, in June 2019, prompted the Chief Medical Officer of Health Dr. Jennifer Russell to intervene to protect as many as 2,000 people exposed to the disease, ordering up 20,000 more doses of MMR vaccine, protection against measles, mumps and rubella.

Lagging childhood immunization rates are emerging as a major public health concern.  Periodic outbreaks of measles and mumps have alerted the public to the fact that childhood diseases, once virtually eradicated by vaccines, are reappearing in and around schools.

Vaccines remain one of the safest and most effective tools we have to protect ourselves, our families and our communities from infectious diseases. Those are not my words, but those of the Public Health Agency of Canada. The current reality is that we are not meeting our national immunization goals and too many children as well as adults remain unprotected and liable to experience illnesses from vaccine-preventable diseases that can cause serious health complications, some of which carry a risk of death.

Each year in April Health Canada raises the alarm during National Immunization Awareness Week and education programs are announced in an attempt to raise vaccination rates. Our Chief Medical Officer of Health, Dr. Robert Strang, makes regular appeals, most recently in August of 2019, to encourage parents to keep their children’s immunization records up-to- date.

The current strategy is not working in Nova Scotia where only 71 per cent of 7- year-olds are immunized for measles and mumps, some 15 per cent lower than the national provincial average and ranking last among the provinces. In New Brunswick, where it’s considered a “crisis,” the measles and mumps coverage rate at age 7 is 92.3 per cent.

While provincial health and school authorities in New Brunswick, British Columbia and Ontario are tackling it head on, Alberta and Nova Scotia are still vacillating on how to improve its abysmal childhood immunization rates. While Health Minister Randy Delorey dithered, PC Leader Tim Houston introduced a private member’s bill to try to force the government’s hand.

Sparked by the spring 2019 measles scare in the Saint John region, New Brunswick Education Minister Dominic Cardy has championed legislation that would make vaccinations mandatory for children without medical exemptions in provincial schools and day cares.

Taking a proactive approach to combating the resurgence of childhood diseases is becoming common right across Canada. Three years ago, Ontario introduced stricter childhood vaccination regulations and in British Columbia legislation requires the reporting of immunization records. Ontario has far higher rates of reported childhood immunization at age 7 than Nova Scotia. Yet, since 2016, that province has required student vaccinations be up to date unless a parent or guardian can provide medical, religious or philosophical reasons why their child has not received a vaccine. Even when exemptions are granted, families are required to watch a 30-minute video on the importance of vaccines and then sign a document saying they viewed the presentation.

Public health authorities hold sway in Nova Scotia, unlike in New Brunswick, where a proactive Education Minister is leading the charge to meet childhood immunization targets so schools do not become sources of contagion.

Nova Scotia Health Minister Delorey may be deterred by fears of stirring-up the radical anti-vaxxers and setting back the cause. He should be taking his cue from New Brunswick’s courageous Education Minister. Confronting a posse of opponents, Cardy called out the group as conspiracy theorists who “influence, mislead and deceive” parents into thinking their children are at risk if they are vaccinated.

Prominent among the N.B. protesters were former Halifax chiropractor Dena Churchill who recently lost her licence to practice because of her anti-vax campaigning, and California pediatrician Dr. Bob Sears, a well-known anti-vax advocate funded by Vaccine Choice Canada.

Vaccine adverse reactions do happen, but, on balance, immunizing children prevents far worse harms caused by the unchecked spread of childhood infectious diseases. School attendance is compulsory and, in that context, so should immunization aimed at safeguarding children’s health.

Minister Cardy stood his ground defending his legislative changes aimed at achieving the goal of 95 per cent coverage. Growing anti-vaccination sentiment, he claimed, was being fed by social media, and threatened to discourage parents from vaccinating their children, reducing immunization rates below a critical threshold that allows a community to resist an outbreak.

Playing nice does not seem to be working at raising childhood immunization rates. Scare stories spread by anti-vaxxers should not go unchallenged. Claims that vaccines are harmful, in Cardy’s words, are “not supported in fact.” “If you believe in evidence-based decision-making, you have to look at the evidence and the evidence is incontrovertible.”

Childhood diseases such as measles, mumps, diphtheria, pertussis, and rubella can do great harm if left unchecked by regular vaccination. With childhood infectious diseases making a comeback, is now the time to be vacillating on child immunization? Does the school system have some responsibility to ensure that immunization rates are high enough to prevent mass outbreaks in the community?  Should it all fall on provincial and local health authorities? 

  • An earlier version of this research commentary appeared in The Chronicle Herald, October 31, 2019.

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