Measles outbreak in N.B. renews interest in national vaccination registry
Central database could let people look up their immunization records, health officials monitor coverage
A measles outbreak in New Brunswick and a surge of cases across Canada has renewed calls for a national vaccination registry.
New Brunswick has 50 confirmed cases of the highly infectious respiratory disease, as of Wednesday — all in health Zone 3, which includes Fredericton and parts of the Upper St. John River Valley area, and all linked to an initial travel-related case reported on Oct. 24.
The province's outbreak has pushed Canada's annual case count to 131, including the death of child under five in Hamilton, the highest number of cases the country has seen in a decade.
"It's definitely scary," said Dr. Joanne Langley, a pediatric infectious disease specialist at the IWK Health Centre in Halifax and a member of the Canadian Center for Vaccinology.
She believes creating a national registry where people could access their immunization records would help increase vaccine uptake, and reduce the incidence of measles and other vaccine-preventable diseases, along with the associated health-care costs. It would also allow health officials to assess coverage, effectiveness and safety.
Dr. Joanne Langley says Canada is behind the rest of the world when it comes to a national vaccination registry. (Submitted by Joanne Langley)
"Lots of folks" have been working on the concept since the last measles outbreak in New Brunswick in 2019, during the COVID-19 pandemic and subsequent outbreaks of pneumococcal disease and respiratory syncytial virus, or RSV, said Langley, who is also a professor at Dalhousie University.
While individual provinces and territories have improved their registries, Canada's ability to integrate that data to get a national picture "is still quite far behind," she said.
"And that puts us at a deficit compared to other countries that have national vaccine programs where you can rapidly assess where the problems are, where you need to direct efforts and remediate those so that we're prepared for any infectious disease outbreak that's preventable by a vaccine."
Many European countries have such a system, said Tim Sly, an epidemiologist and professor emeritus in the School of Occupational and Public Health at Toronto Metropolitan University.
But in Canada, "We're rummaging in the kitchen drawer looking for a little yellow card" for information about vaccines we might have received decades ago, when we may have been living in another province.
"That's no good," said Sly. "In this day of information technology, we need a national database to see who's been vaccinated."
This is particularly important for measles, which is highly contagious. At least 95 per cent of the population needs to be immunized with two doses of the measles, mumps and rubella, or MMR, vaccine to prevent spread, said Sly.
"We've let that drop to … 80 per cent in Canada, and this is why we're going to see more of these little sprouting outbreaks."
Of the 50 New Brunswick cases, 90 per cent were unvaccinated and the remaining 10 per cent could not provide evidence of vaccination or immunity, said Department of Health spokesperson Tara Chislett.
Crucial 1st step to saving health-care system
Ian Culbert, executive director of the Canadian Public Health Association, an independent advocate for public health based in Ottawa, contends a national vaccine database is "a crucial first step to saving our health-care system."
Immunization is one of the most valuable tools public health has to prevent diseases, said Culbert, but as it stands, officials don't know who in the country is vaccinated.
"Without a national registry — or even provincial registries — we can't pinpoint our efforts to get under-immunized communities up to speed with their vaccinations," he said.
Ian
Culbert, executive director of the Canadian Public Health Association,
says investing in a centralized system would be money well-spent. (Google Meet/CBC)
Meanwhile, every jurisdiction is struggling with doctor shortages and long emergency room wait times, said Culbert.
"The simplest thing that we can do and the most cost-effective thing we can do is prevent those diseases in the first place. Vaccines give us the power to do that."
He pointed out how quickly every province and territory managed to develop a registry for COVID-19 vaccines, when people had to prove they had been vaccinated.
But there hasn't been the "political will" to make the necessary investments in a national registry for all vaccines, according to Culbert. Governments appear to be "much more interested" in investing in acute care than public health, he said, which he attributes to the backlash faced over vaccine mandates and restrictions during the pandemic.
Privacy concerns could be a factor
Langley thinks privacy concerns could be holding some provinces and territories back, but she described those as "not substantiated." There are "rigorous" systems to ensure individual citizens are not identifiable, such as assigning each person a number, she said.
Many people already voluntarily give "way more" private information to companies, such as when using smartphones, or joining social media platforms, than a vaccine registry would require, she noted.
Public Health Agency of Canada spokesperson Nicholas Janveau said there are a number of significant challenges to creating a centralized national registry, which are "rooted in the structural, legal, and operational realities of the country's decentralized health-care system." Privacy is among them, he said, given different rules and approaches to privacy management.
A centralized system also presents an increased risk of data breaches "due to the concentration of personal health information and … broader access," Janveau said in an emailed statement.
Incomplete data reduces effectiveness
In addition, unlike some other countries, Canada's federal government does not oversee a national immunization program or have national legislation mandating health-care providers to report or track immunizations in a centralized system, he said.
Health care, including vaccination, falls under provincial and territorial jurisdiction. Only provincial governments can mandate the recording of immunization events in a registry.
Without uniform mandates, many immunizations, such as those given in pharmacies and doctors' offices, could go unrecorded, particularly if they still use paper records, said Janveau. That risks incomplete data and reduces the effectiveness of a national registry.
"A more pragmatic approach," he said, is to focus instead on improving interoperability between existing provincial and territorial systems to enable data sharing and support public health monitoring.
That work is underway, building upon the success of COVID vaccine registries, he said.
Langley believes with dedicated resources, a registry that links 13 jurisdictions could be up and running within a year.
Doctors busy fielding questions
Meanwhile, New Brunswick doctors are fielding questions about measles vaccines from concerned patients and parents, said Dr. Lise Babin, president of the province's medical society, who works as a family doctor in Dieppe.
"They're asking if they should be vaccinated. … They're unsure of their vaccination status," or whether they need a booster, she said, noting electronic records have made it easier for doctors to track and share information with Public Health.
She said it's "surprising" and "concerning" that 28 per cent of kindergarten students last year failed to provide proof of full immunization against nine diseases, including measles, as required under the Public Health Act.
"Measles is one of the most contagious diseases that we know of, so it doesn't take that many unvaccinated people to see a real outbreak," she said. "And we know the best protection for the measles is the vaccine."
With files from Information Morning Fredericton
David Amos
Content Deactivated
The support of the Nanny State never ceases to surprise me
Margie Anderson
Reply to David Amos
I am not understanding what mean in regards to this article.
Margie Anderson
Reply to David Amos
*what you mean
Margie Anderson
There is a valid reason that some comments are not visible to me. Thank you
Carly Wattson
Reply to Margie Anderson
Because you muted them? Who are you thanking?
serge montague
Reply to Margie Anderson
Most people have a valid reason for not caring what is visible to you
Margie Anderson
Reply to Carly Wattson
I have no need to hear what he has to say and likely haven't for a year.
I'm thanking whoever came up with the little button of course.
Carly Wattson
Reply to Margie Anderson
Don’t go to a public forum if you don’t like the public.
But yes, I see what you meant by thank you.
Margie Anderson
Reply to Carly Wattson
I like to see reasonable sides to every story.
Ralph Linwood
Reply to Margie Anderson
The mute button is a nice feature. There is just no talking to some people unfortunately.
Margie Anderson
Reply to Ralph Linwood
Or listening, reading.
David Amos
Reply to Margie Anderson
Nope
serge montague
Reply to Ralph Linwood
No it's not. It means you don't have to put up with the muted person's opinions. everyone else gets to make their own decisions
Federal government has set vaccination campaigns backward severely with their backwards mandates and invasion of medical privacy based on promises from an unnecessary election. Also their immigration numbers are much too high, and other countries don’t have strong vaccine programs like we used to have in Canada. Federal Liberals and NDP should step down, and we don’t need any more national money wasting bureaucratic programs.
Pat McGregor
Reply to Frank Blacklock
Disinformation has set vaccination campaigns backward severely.
The majority of vaccine mandates were provincial, such as a health care requirement and a requirement to enter high-risk venues. There were also mandates from private companies.
"other countries don’t have strong vaccine programs like we used to have in Canada. " Sounds like you want your cake and eat it, too.
Immigrants to Canada are advised of vaccinations that they may need.
Mike Hayley
Reply to Frank Blacklock
What federal mandates?
Frank Blacklock
Reply to Pat McGregor
Disinformation was mostly from the federal government during their lockdown election, and also from their subsidized and paid news and reporters.
Pat McGregor
Reply to Frank Blacklock
What, specifically, was disinformation from the federal government?
Frank Blacklock
Reply to Mike Hayley
Liberals and NDP ran a whole unnecessary election during lockdowns, pushing the idea of job, travel. and school mandates.
Pat McGregor
Reply to Mike Hayley
I don't think Frank wants to play anymore.
Mike Hayley
Reply to Frank Blacklock
The idea of mandates? But what federal mandates specifically?
Frank Blacklock
Reply to Pat McGregor
Too long to list. Read news stories from 2020.
Frank Blacklock
Reply to Mike Hayley
Travel mandates, employee mandates, military mandates.
Frank Blacklock
Reply to Pat McGregor
95% effective, lasts for one year at least, stops the spread, need over 90% uptake, Canada isn’t a country that mandates vaccines, protesters were mostly foreign funded, protesters started fires in apartment buildings, on and on and on.
serge montague
Reply to Frank Blacklock
"protesters started fires in apartment buildings" where did that happen?.
"mostly foreign funded"...debunked long ago
Don Corey
Reply to Frank Blacklock
The icing on the cake was the trucker vaccine mandate, and at a time when the provinces were lifting their pandemic restrictions.
Al Clark
Reply to Frank Blacklock
Too short to list you mean. Name ONE, just one ;-)
David Amos
Content Deactivated
Reply to Al Clark
I trust that you know why I ran Quispamsis
Frank Blacklock
Reply to Don Corey
No reason ever given for the Emergencies Act. Disinformation and no good answer on that one.
David Amos
Content Deactivated
Reply to Frank Blacklock
C'est Vrai
David Amos
Content Deactivated
Reply to Don Corey
I am impressed to see so many comments posted by you
David Amos
Reply to Don Corey
Oh My My
Anne Lacourt
Reply to Don Corey
And at the time the US had the borders closed.
Pa Ess
A lot of bad decisions re vaccinations since Covid.
Don Corey
Reply to Pa Ess
There were more bad decisions during Covid.
Eddy Geek
Reply to Don Corey
Yes - Like some who refused to get vaccinated
Steph Roche
Reply to Don Corey
we should be ashamed of our inability to get the anti-intellectuals to understand the facts and take the protective action to mitigate illness and worse
Don Corey
Reply to Eddy Geek
That's your take. Mine is the misinformation we were fed by chief medical officers, political leaders and mainstream media.
Don Corey
Reply to Steph Roche
You should be ashamed of your inability to understand why so many people were reluctant to get the Covid vaccines, and how the misinformation we were provided during the pandemic led to a subsequent increase, unfortunately, in numbers now very skeptical of all vaccines. And no, the misinformation I refer to was not from internet anti-vaxxers.
Carly Wattson
Reply to Don Corey
And before
Carly Wattson
Reply to Steph Roche
Also before
David Amos
Content Deactivated
Reply to Carly Wattson
I trust that you know why I ran Quispamsis
Carly Wattson
Reply to David Amos
I know you have a history of politics in NB, but not the whole story.
Al Clark
Facebook dokters will have a field day on this one. Pet meds anyone?
SarahRose Werner
Reply to Al Clark
I'm all in favour of pet meds. My cat goes to the vet for his vaccinations annually - rabies, FLV, etc. Pet meds are great! For pets, that is.
Peter Hill
Reply to SarahRose Werner
Sadly, some people will vaccinate their pets before they vaccinate their kids.
David Amos.
Content Deactivated
Reply to Al Clark
Welcome back to the circus
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