Immunization week addresses declining rates

In 2004, the Government of Canada established the Public Health Agency of Canada (PHAC), a branch of Health Canada with the mandate "to protect the health and safety of all Canadians."

At the forefront of that mandate is promoting vaccinations for preventable infectious diseases.

"In Canada, immunization programs have saved more lives than any other health intervention, making immunization the single-most cost-effective health investment and a cornerstone in the effort to promote health," wrote Lucie Marisa Bucci, a senior manager with Immunize Canada, in a media release promoting Immunization Awareness Week.

Last week, the Sunrise Health Region's Employee Health Group participated in the April 20-27 campaign by distributing educational resources to staff.

Generally speaking, efforts to promote immunization focus on parents of young children.

"It is critically important that parents make sure their children receive all doses of the recommended vaccines," said Dr. Susan Bowles, chair of Immunize Canada.

"Infants are particularly vulnerable to many diseases that vaccines prevent since they have not yet developed immunity to the bacteria and viruses that cause them. Immunization triggers their immune systems to be prepared to protect them from these serious diseases."

That doesn't mean adults are exempt.

"Under-immunized adults may be at risk of infection from vaccine-preventable diseases and can infect others," said Dr. Shelly McNeil, Immunize Canada vice-chair. "For example, adults who contract measles, mumps or pertussis (whooping cough) can infect infants who may not yet be fully immunized."

Both doctors' points underscore the concept that vaccines do not merely protect the individuals who are immunized, but all of society through a process known as "herd immunity." Herd immunity occurs when a high enough percentage of a population has been immunized that susceptible individuals' risks are also effectively reduced.

This is important because some people simply cannot be immunized because they are too young or allergic.

Experts estimate the herd immunity threshold for the common vaccine-preventable diseases is approximately 95 per cent.

A recent UNICEF report puts Canada almost at the bottom of a list of developed countries with a rate of just 84 per cent for children 12 to 23 months old, well under the herd immunity threshold.

Critics of the UNICEF report, including Dr. John Spika, PHAC general director, say neither Canada nor the provinces collect vaccination-uptake data so the report relies on telephone surveys to estimate the percentages. He believes Canada is doing much better than 84 per cent based on recent StatsCan data, but was not willing to reveal a number.

Spika also said he doesn't trust data from some countries that scored higher than Canada, such as Romania, France, the U.K., Germany and Switzerland, that have had major measles outbreaks over the last couple of years.

Others, such as Michael Kruse, an evidence-based medicine activist and co-founder of the consumer advocacy group Bad Science Watch, say vaccination rates are clearly declining and lay the blame squarely on the proliferation of alternative medicine in Canada.

"there is a concerted effort on the part of those left out of the medical establishment to twist, misinterpret or out[right] make up facts about immunizations and vaccines," Kruse wrote in his blog for the Huffington Post. "The alternative medical community-naturopaths, homeopaths, chiropractors-has made a considerable effort over the past three decades to spread fear and mistrust about vaccines and we have to recognize that they are part of the problem, no matter how well-intentioned."

For Immunize Canada, the bottom line of Immunization Awareness Week is to get vaccination information into the hands of as many people as possible.

"Whether you are a parent, a young adult or a senior, talk to your doctor, nurse, pharmacist or local public health office about being up to date on your immunizations," Bucci wrote.