The spread of misinformation on the safety of vaccines has some parents asking the courts to be the final arbiter over whether their children should be immunized. But experts say using the legal system in this way could create the false impression that science can be up for debate.
In Salmon Arm, B.C., a judge has ruled that, despite the objections of their mother, two children must be vaccinated according to the province’s immunization schedule. The ruling, which became public this week, also granted the children’s father full responsibility for decisions regarding their medical and dental treatment.
Other parents in recent years have also have taken vaccination disputes to court. Last year, an Ontario arbitrator ruled in favour of a mother who refused to vaccinate her two children. The mother brought a well-known anti-vaccination advocate to testify. The father’s appeal of the decision will be heard later this year.
When judges hear a vaccination-related case, they are often asked to weigh legitimate scientific evidence against testimony from vaccination opponents who are skilled at making their arguments sound credible.
Justice Adèle Kent, chief judicial officer of the National Judicial Institute, which provides education and training for judges across Canada, said cases involving medicine and science are often challenging. Judges play a gatekeeper role, meaning they must decide when scientific evidence is valid, and when it is not. Those decisions aren’t always easy, especially as the science is complex and some witnesses who oppose vaccines can be very persuasive about their medical credibility.
“That’s why judges have to be so careful,” Justice Kent said. “The consequences are so significant. They’re life-altering.”
The National Judicial Institute has been doing more training to help judges navigate the increasingly complicated issues involving medicine and science, she said. The institute has also created a 220-page manual to help judges evaluate the validity of scientific and medical evidence being presented in court. The manual includes a detailed guide to understanding scientific evidence, and how to tell whether an expert witness may be biased, such as testifying frequently on the same position.
Louise Mimnagh, a family lawyer in London, Ont., said she has been involved in two vaccination cases. They were settled before they reached a trial, as most are, she said. But Ms. Mimnagh said that because the Canadian judicial system requires judges to evaluate and weigh evidence from a variety of experts, she believes it’s unlikely purveyors of pseudoscience would be taken seriously.
“There’s a lot of safeguards that have been developed in Canadian law to prevent shopping around for someone who’s going to say what you like.”
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Yet, one of the problems with using the legal system this way is that it could give the false impression the debate over vaccines is legitimate, said Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital. “We already have overwhelming answers to those questions,” Dr. Bogoch said.
Timothy Caulfield, Canada Research Chair in health law and policy at the University of Alberta, said he’s also concerned about using the courts to make decisions in vaccination disputes. “It can create an impression of false balance, that there’s two equal sides,” he said.
The anti-vaccination movement promotes many falsehoods about vaccines that cause people to question their safety, such as the debunked ideas they are linked to autism or have a high risk of serious side effects.
One way to keep vaccine disputes out of court is to focus on better education and stopping misinformation from spreading, Dr. Bogoch said. The medical community, governments, communication experts and other stakeholders must do more to combat the rise of anti-vaccination sentiments and misinformation about health, which can be disseminated quickly on social media, he said.
While organizations such as the Public Health Agency of Canada have started campaigns aimed at dispelling myths, experts say much more is needed to counter false information, including better oversight of regulated health professionals who profit by promoting that misinformation.
In the recent B.C. court case, Justice Stella Frame noted in her ruling that the mother said she became “uncomfortable” with vaccines after speaking to a naturopath ABOUT the risk of side effects. The naturopath offered to conduct tests to determine whether her children would be at risk, but the mother couldn’t afford them. The children’s father asked the court to order the children to be vaccinated.
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The naturopath, Chris Spooner, said in an e-mail that he wasn’t at the court proceeding and can’t comment on it. But he added that he is pro-vaccination and adheres to all college policies on issues of immunization.
In a statement posted online, the College of Naturopathic Physicians of B.C. said naturopaths are not allowed to share anti-vaccination information with patients, and that anyone doing so will be investigated. The college did not respond to a request for comment.
Justice Frame’s ruling relied heavily on cases that went in favour of the parent that wanted to immunize their children. She also highlighted the mother’s attempts to use testimony from Toni Bark, an anti-vaccination advocate, writing that Dr. Bark’s views read like “a conspiracy theory.”
The case arose because of new immunization reporting requirements in B.C. Under the new rules, unvaccinated children can be kept home from school during outbreaks, a situation the father wanted to avoid. A letter from the provincial health authority stated that the father would need to get a letter of consent from the mother to have the children vaccinated, or obtain a court order.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
