Peel Region has a massive childhood vaccination backlog, with more than half of children missing at least one mandated vaccine dose.
That’s the warning from Peel’s acting medical officer of health, who says the lack of school immunizations is spelling trouble for communicable diseases.
“Without significant dedicated resources, we estimate it will take seven years to complete screening catch up and achieve pre-pandemic coverage rates,” said Dr. Katherine Bingham in a presentation to Peel council on April 11.
She says low immunization coverage among students significantly increases the risk for the re-emergence of vaccine-preventable diseases such as measles.
Unless children have a valid exception, the following vaccines are mandatory for Ontario school children: diphtheria, tetanus, polio, measles, mumps, rubella, meningitis, whooping cough and chicken pox. Several other vaccines are strongly recommended by public health units and doctors.
Advocates, doctors and Peel public health are advocating for more attention to the issue, more money from the province for public health and the formation of an action plan to quickly address the currently low vaccination rates.
Peel stacks lower than the provincial average on a number of vaccinations. For example, just over 37 per cent of seven-year-olds had been vaccinated against measles compared to more than 52 per cent province-wide as of August 31, 2022.
Peel Public Health says many children missed vaccinations they would have received at school or a doctor’s offices. Reporting of vaccines and enforcement also fell behind in the pandemic. To tackle the backlog more quickly, Peel Public Health opened public clinics for mandatory vaccines as of April 1 of this year.
‘We never thought it would be us’: mother
Jill Promoli, a Mississauga mother, lost her son, Jude, to a school flu outbreak eight years ago even though he was vaccinated. She’s now an illness prevention advocate championing immunizations and said the low vaccination rates in Peel children are “very concerning.”
“We never thought it would be us, but it is going to be someone,” said Promoli, who’s also a Peel District School Board Trustee, but did not speak to CBC Toronto in that capacity.
“The reason that we do vaccinate against these diseases is not because they’re inconvenient or uncomfortable, but it’s because people do die from them,” she said.
Jill Promoli, second from right, a Mississauga mother, says 50 per cent of Peel children missing a mandatory vaccine dose right now is “very concerning”. The Promoli family had this portrait taken before Jude, right, passed away eight years ago due to a school flu outbreak. (Submitted by Jill Promoli)
Promoli says she’s also concerned about children who are vaccinated being exposed, given vaccines do not provide complete immunity.
Pediatric and infectious disease specialist, Dr. Anna Banerji, called the proportion of Peel students missing a mandated dose “very high.”
“It needs to be addressed,” she said.
She says part of the problem in the region is access, including to family doctors, but the region also has a diverse population, which can mean additional challenges.
“I think that language and cultural support and trying to get these kids vaccinated will be very important,” she said.
Banerji also pointed to vaccine hesitancy being higher for some coming out of the pandemic.
She says seven years is far too long to have school-aged children not protected against such concerning diseases.
Needs will only grow, says Caledon mayor
The public health unit says they have less money than several nearby health units to try and tackle the issue, receiving one of the lowest provincial per capita funding rates in the province.
For cost-shared programs, in Peel, public health was funded by the province at approximately $34 per capita in 2022, while Toronto and Hamilton each received $49 per capita, according to the health authority’s report.
Caledon Mayor Annette Groves says the funding needs to change now to address problems that will continue to climb for Peel Public Health.
“Peel is a growing region and there will be greater need for funding as our resident population increases,” she said in a statement.
Caledon Mayor Annette Groves says Peel needs to receive more money from the province to handle public health in a growing population. (Evan Mitsui/CBC)
Province says funding has been increasing
Asked why Peel Public Health gets fewer dollars per capita, Ministry of Health spokesperson Hannah Jensen didn’t dispute Toronto and Hamilton received more funding per capita.
“Since 2018, our government has increased our investment into Peel Public Health by nearly 20 per cent,” she said in a statement.
Jensen said that’s in addition to the $100 million the provincial government invested into public health units across the province to provide support throughout the COVID-19 pandemic.
The government has restored a funding model where the province pays 75 percent of cost sharing for public health units and municipalities including Peel pay 25 percent, she said, noting the province had been paying 70 per cent for some time, so this represented an increase.
The province also increased base funding by one per cent per year, over the next three years, starting this year for public health units and municipalities including Peel, she added.
Asked why Peel would still receive a lower per capita rate that some of its neighbours, the province did not respond directly.
She says the government is working closely with its partners to get children caught up on vaccines.
A spokesperson for the Ministry of Health says since 2018, the provincial government has increased investment into Peel Public Health by nearly 20 per cent. Peel Public Health says it receives significantly less from the province per capita than nearby Toronto or Hamilton and is advocating for more money. (Evan Mitsui/CBC)
Promoli says the per capita discrepancy in funding between regions is “shocking” and diverse populations need more, not less.
“It’s always important to try to meet people where they are,” she said. “To hear those questions, to hear the reasons why people are hesitant or even refusing and to try to understand…and then find the best ways to help people make decisions that will best protect their families.”
Peel Public Health says it plans to return to council soon with more details about the challenges and its plans to address them.
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.
