Immunization in Canada: An issue of Equality
By Stacia Sahi
Most of us don’t even remember getting our first vaccination shot, or even our second or third. But even if we don’t remember getting it, most of us can confirm that we’ve received our shots by checking our vaccination booklet and medical records. But some children in Canada are not fully vaccinated and understanding how well Canada’s children are vaccinated is challenging for health providers, because Canada lacks a system to accurately track vaccination rates and flag which segments of our population are left out. But that is soon to change, and rightly so.
What the Canadian government is doing to improve its vaccination program
The recent federal budget promises $25 million over five years to accomplish three immunization-related goals in Canada:
- Update the national immunization coverage goals and disease reduction targets
- Improve Canada's ability to identify under- and un-immunized Canadians
- Develop a focused program to improve vaccine access and uptake
Canada’s global rank in immunization
This is an important priority for the government to take on. The findings of UNICEF’s Report Card 11 released in 2013 estimated that Canada’s rates of coverage for childhood immunization ranked in second-to-last place compared to 28 of the world’s richest nations. We were one of only three wealthy countries whose immunization rate fell below 90 per cent; significantly short of what’s required to provide the relative safety of ‘herd immunity.’
Our current immunization monitoring mechanism relies on patient survey data, which is less reliable and more susceptible to inaccuracy than a mechanism based on medical records. It tends to leave out certain demographic groups, such as indigenous and immigrant children. This means that health providers can’t tell which groups of children are most in need of targeted intervention. These gaps in knowledge can prove dangerous. This reality came to light in 2015 when we saw outbreaks of measles in parts of Ontario, Quebec, Alberta and British Columbia.
UNICEF’s Report Card 13: not all children receive their vaccinations
UNICEF’s Report Card 13: Fairness for Children, released in April 2016, highlighted the fact that Canada as a society is highly unequal for children. Using the UNICEF Index of Child Inequality, we discovered that Canada ranks in the bottom third, at 26th of 35 industrialized countries, when it comes to equality gaps between children in the middle and those at the bottom of a range of well-being indicators. There are wide gaps in health inequality in particular; and an overall improvement in health will be difficult to achieve without closing these gaps. By better understanding which children are being left behind in different areas of health and well-being, we can determine which children we need to try harder to reach – with vaccinations and other important services.
Improvements are underway in Canada
We know that we can achieve positive results on health-related issues. One of the good news stories in Report Card 13 showed a decline in children’s consumption of unhealthy snacks and beverages. Greater awareness of healthy behaviours and targeted efforts to reach those most at-risk can have an impact; and this is true for immunization too. With new investments in Canada’s immunization program we can re-invest in our commitment to reach every single child with the essential health services they deserve.
Keep on Track with your Family’s Vaccinations
The Public Health Agency of Canada is responsible for Canada’s immunization program. Visit their website at www.phac-aspc.gc.ca to view immunization schedules and learn more about the issues discussed here. You can also download their app, ImmunizeCA, to help keep track of your family’s vaccinations.
Header Photo © UNICEF/UNI199235/Foucher.