After two years of intermittent school closures, changes in models of health care, and a redirection of public health resources, paediatricians and public health experts are working to address interruptions to routine childhood vaccinations.
According to Dr. Sloane Freeman, a paediatrician at St. Michaels Hospital and assistant professor of medicine at the University of Toronto, many children across Ontario are unvaccinated or under vaccinated leaving them vulnerable to vaccine preventable diseases.
“Children and families are not accessing health care in the same way they did before the pandemic. As a result, we are seeing that children are falling behind in their routine immunizations that would normally be given in infancy or early childhood. These series are not being completed or not being started, and so children are being under vaccinated or unvaccinated,” Freeman said in a media call with the Ontario Medical Association on Wednesday.
With vaccine coverage lagging, there is a growing risk of a re-emergence of infectious disease that were not previously an issue. Freeman points to the detection of the polio virus in wastewater in New York City, London and Jerusalem, which poses a significant risk for those who are unvaccinated or under vaccinated.
In Ontario, the Immunization of School Pupils Act requires that children attending school are vaccinated against diseases such as polio, but Freeman is concerned about children who are not yet school age.
In Kingston, Frontenac and Lennox and Addington, coverage for IPSA mandated vaccines reached a record low as a result of the pandemic.
“In January we were sitting between 75 to 80% (coverage), which is our lowest, we would normally (have coverage) in the low 90s,” said Brian Larkin, program manager of vaccine preventable disease at KFL&A Public Health, in an interview with the Whig-Standard.
In order to address this, Larkin says that public health staff increased messaging directed at families of young children and utilized the COVID-19 vaccination infrastructure to increase access to routine vaccinations.
“We tried to use the infrastructure like mass immunization clinics for COVID vaccines to target ISPA vaccines, and worked closely with our schools in the area and with primary care (physicians) to get messaging out to students and offer (vaccination) clinics to get kids up to speed with ISPA related programming,” Larkin said.
Since January, coverage has increased significantly, with around 90% coverage for routine vaccinations—lower than pre-pandemic but still above the record low seen in January.
While mandatory vaccine coverage is rising locally, Larkin said he and his team are now working to increase coverage for Hep B and HPV vaccines, which are usually offered in school to Grade 7 students.
Though school-based vaccine clinics for Hep B and HPV have resumed, kids who were in Grade 7 for the 2020-2021 school year, or the 2021-2022 school year, the frequent school closures mean that many students did not have access to those vaccinations.
“There’s a whole group of kids who are now in high school who have not had the same opportunity to get their Hep B and HPV vaccines during the school program,” Larkin said. “We’re reaching out in a similar process (to the IPSA strategy) and sending reminder letters to parents and family to let them know that they are overdue and eligible for vaccines like Hepatitis B and HPV. We currently have clinic opportunities here to be able to get those vaccines, and we are continuing our regular programming.”
Both the Hep B and HPV are sexually transmitted viruses that can cause long-term and serious health issues, so providing vaccinations before youth are at risk of contracting these viruses is highly effective in reducing both individual risk and the rates of virus in the community.
According to Larkin, Hep B, which is an infection of the liver, can cause issues like liver cancer, while HPV, can cause issues like cervical cancer, penile cancer, head and neck cancers, and genital warts.
“The current HPV vaccine immunizes against nine types of high-risk HPV, and can prevent approximately 70 per cent of cervical cancers and 60 per cent of high-risk precancerous cervical lesions,” Larkin said. “Getting people vaccinated before they’re at risk is really important to help reduce their overall risk and, of course, reducing the risk of spreading it to others.”
Larkin is thankful to all those who have already gone in and caught up on their routine vaccinations, and encourages anyone who has not yet caught up or is unsure if they are caught up to contact KFL&A Public Health and to take advantage of community and school-based vaccine clinics.
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.
The Canadian Press. All rights reserved.
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.
The Canadian Press. All rights reserved.
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.
The Canadian Press. All rights reserved.
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