Measles vaccination for Toronto school children on Dec. 13, 1965.James Lewcun/The Globe and Mail
Fewer Canadians believe in the importance of childhood vaccines compared to before the pandemic, according to a new Unicef report that warns about the growing threat of preventable infectious diseases because of lagging vaccination uptake.
While most Canadians – 82 per cent – still say vaccines are important during childhood, that number has dropped 8.2 percentage points since before the onset of COVID-19, the Unicef report found.
The reduced confidence in vaccines comes as 67 million children around the world missed out on vaccination during the pandemic, which is already being linked to an upswing in cases of measles and polio, according to the report.
“It’s a disturbing trend,” said David Morley, president and CEO of Unicef Canada. “There’s a risk that more children are going to die who don’t have to die because those levels of vaccine hesitancy are going up.”
Around the world, the spread of vaccine-preventable illness is on the rise and is leading to severe outcomes, particularly in low-income countries. The Unicef report found that in 2022, cases of measles around the world doubled from the year before. And there was an eight-fold increase in the number of children paralyzed from polio around the world from 2019 to 2021 compared with the previous three-year period
During the pandemic, regular access to vaccines has been disrupted around the world as a result of closings of health care facilities or need for staff to divert resources to COVID-19 responses. While many countries, including Canada, are now focusing efforts on catch-up programs to make up for lagging vaccine-coverage rates, protection against some infectious diseases remains too low.
For instance, data released from Public Health Ontario in February found that even after a catch-up program, only 23 per cent of 12-year-olds were fully vaccinated against human papillomavirus, which can cause cervical and other forms of cancer.
Mr. Morley said that the proliferation of disinformation around vaccines during the pandemic appears to be leading to lower levels of confidence and more hesitancy, which is an added challenge for bringing coverage rates back to pre-COVID levels.
“Catch-up programs, they don’t always work if people don’t want to be caught up,” he said.
Gilla Shapiro, member of the Centre for Vaccine Preventable Diseases at the University of Toronto’s Dalla Lana School of Public Health, said there are other factors that Canada needs to look at to improve vaccine uptake.
For instance, one long-standing issue has been the lack of a comprehensive vaccine registry that can help health officials understand where gaps in coverage exist and tailor programs accordingly, she said.
And in order to improve vaccine confidence, health officials need to develop a better understanding of why it may be waning in certain communities and develop programs that can work on a micro level for individual communities, she said. One such strategy that has appeared to work well during the pandemic is the use of mobile vaccination clinics that travel to COVID-19 hotspots, making the process of vaccination convenient for a wide variety of individuals.
“To increase confidence, it is vital to understand why, what works and for who,” said Dr. Shapiro, who is also a clinical and health psychologist at the Princess Margaret Cancer Centre.
The Unicef report found that while vaccination uptake has dropped around the world during the pandemic, the worst effects are being experienced in some of the poorest, marginalized areas.
Children who live in remote areas or in urban slums that are hard to reach by vaccination programs are typically least likely to have received a single vaccination dose. For many of those children, their mothers haven’t been able to go to school and aren’t given a say in family decisions.
Unicef is calling on governments around the world to redouble efforts to improve vaccine confidence and uptake by investing in a number of initiatives, including better funding for immunization delivery and primary care, and investment in more female health workers and local manufacturing.
Mr. Morley said that it will be hard work to improve vaccine uptake and that no one solution is the answer. But he added that trusted community leaders who can connect with marginalized individuals, including those who may not trust the medical system, represent one critical aspect to improving public confidence in vaccines.