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Opinion

Vaccine hesitancy: individual choice, public threats

By Senator Rosemary Moodie      

Canadians need a vaccination policy that is consistent across all provinces and territories, as well as a national database that allows for vaccination rates to be collected, recorded and monitored from coast to coast to coast.

Due to significant data gaps, Canada’s overall vaccine coverage is unclear, making the process of identifying and addressing problem areas very difficult.
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More Canadians contracted the measles by March 30 of this year than in all of 2018.

Globally, incidence of measles infection jumped by 50 per cent last year. Europe, alone, experienced more than 83,000 cases and just south of the border, the United States saw a 500 per cent increase from 2017 levels.

At the root of this problem is vaccine hesitancy.

Vaccine hesitancy refers to a reluctance or refusal to vaccinate, despite the availability of vaccines. Around the globe, and especially in the developed world, vaccine hesitancy has been on the rise, fueling concerns amongst public health agencies—such as the World Health Organization—about a resurgence of the threat once posed by infectious disease.

The dangers of infectious diseases, such as measles, slowly faded from public consciousness as effective vaccines became widely available and rates of infection dropped. More recently though, false information shared via traditional media and social media has led some to fear the vaccine more than the disease.

While only two per cent to five per cent of Canadians are strongly opposed to vaccination, as many as 20 per cent to 30 per cent of Canadians could be classified as vaccine hesitant. It is that hesitancy—which may manifest in delayed immunization or outright refusal to vaccinate—that threatens to reverse decades of progress.

In the face of the World Health Organization listing vaccine hesitancy as one of the top-ten threats to global health in 2019, it is important to appreciate how a small decrease in vaccination rates can have major implications for public health.

Vaccination protects the individual as well as the community due to a process called herd immunity. In order to create a herd immunity toward measles, vaccination rates must be at or above 95 per cent. Falling too far below the 95 per cent threshold allows the disease to more easily spread through the population and infect those who cannot be vaccinated for health reasons; think cancer patients or newborn children.

Unfortunately, the vaccination rate for Canadian children sits at about 90 per cent, which amounts to one of the lowest rates in the developed world—this is a serious cause for concern.

Patient advocates and physicians’ associations are calling on the government to do more to support doctors and clinicians as they work to correct misinformation and change minds. Better training and tools beget better intervention and education outcomes. Experts agree that increasing public trust in health professionals is integral to overcoming the misinformation that fuels vaccine hesitancy.

It is equally important to use available regulatory and legislative tools to address individuals who—outside the scope of their expertise or in contravention of their professional designations—are perpetuating false claims and disseminating misinformation through private practice, traditional avenues or social media.

Vaccine hesitancy is a threat that must be addressed but cannot be corrected overnight.

In the near-term, we must understand where threats exist to address the possibility of outbreaks, which means better understanding areas of under vaccination, increasing targeted support and preparing health workers to respond to emergency situations in high-risk regions and demographics.

This is easier said than done.

Canada does not have a national framework to collect, record, and monitor vaccination rates. With health-care being primarily a provincial and territorial responsibility there are inconsistent vaccination policies across the country.

In most Canadian provinces and territories, parents are not required to provide schools with their children’s immunization records. Moreover, there’s no national online registry of vaccinations; records don’t carry over when people move or travel across provincial boundaries; and paper records are still being used to varying degrees in some regions. Researchers found that in one province it can take as many as four data sources to get a complete record of a child’s immunization status.

Due to significant data gaps, Canada’s overall vaccine coverage is unclear, making the process of identifying and addressing problem areas very difficult.

Vaccine hesitancy has existed in our society for decades, even with our best efforts, it will take time to weed out. Individual choices will continue to put the public at risk, and as such, we must improve our ability to collect, monitor and respond to data on vaccination rates.

Canadians need a vaccination policy that is consistent across all provinces and territories, as well as a national database that allows for vaccination rates to be collected, recorded and monitored from coast to coast to coast. It takes time to rebuild trust, change minds, and stamp out sources of misinformation, but preparing for the next outbreak can start today.

Ontario Senator Rosemary Moodie is a member of the Independent Senators Group. 

The Hill Times 

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