Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
  • LinkedIn
  • Instagram
OtherPractice

Does Canada need to improve its immunization rates?

Canadian Family Physician January 2017; 63 (1) e18;
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

Case scenario

You are at a continuing professional development event in your area listening to a presentation on immunization. “Where do you think Canada sits compared with other high-income countries with respect to immunization rates? Are we in the top 25%, about the middle, or near the bottom?” Someone identified the top 25%; you would have guessed the same. The speaker responds: “Unfortunately a 2013 UNICEF study found that Canada’s rate of 84% was 28th out of 29 countries. Finland, for example, had a rate of more than 95%.”1 You are surprised and wonder how Canada can be ranked so low.

Evidence

For most health care workers, the case for vaccination is self-evident—it is one of the top 10 public health interventions. However, this is often not appreciated by the general public. Parents of young children today have not seen measles, mumps, or rubella, let alone diphtheria or smallpox, so the protective effect of vaccines can seem theoretical. Is it surprising then that they hesitate to submit their happy, healthy infant to the pain of a needle? Or that they feel guilty when they see their child with a red, swollen arm after vaccination? In Canada’s most recent Childhood National Immunization Coverage Survey, 70% of parents indicated that they were concerned about vaccine side effects, 37% believed that a vaccine could cause the same disease it was meant to prevent, and a small proportion believed that homeopathy and chiropractic care could eliminate the need for vaccines.2 Some hesitate over the idea of 5 vaccines all in one shot. Further, there is a lot of misinformation out there. For example, most parents have heard that vaccines can cause autism, but not all now realize this spurious association has long been debunked.3

Although our calculated immunization rate of 84% might be an underestimate because we do not have a national registry, Canada does need to improve its immunization rate. Our elimination status for measles is not assured in the long term, and pertussis continues to circulate and cause outbreaks. With the spectre of antimicrobial resistance,4 preventing infections in the first place is now more important than ever. Fortunately, there is a growing body of research on vaccine hesitancy to inform a constructive approach to addressing it. For example, it is not a good idea to advocate too strongly for vaccines, as research has shown this can actually increase vaccine hesitancy.5 A best practice is to routinely explore the perspectives your patients or their parents have on vaccines, and tailor your communications accordingly.6 If they are accepting of vaccination, reinforce how this promotes resiliency and discuss common side effects to maintain trust. If they are vaccine hesitant, build rapport, accept questions and concerns, and provide risk-benefit information. For the few adamant vaccine refusers, avoid debating back and forth; keep discussion brief but leave the door open—and know where to find resources that will help dispel misinformation.

Bottom line

Canada is fortunate to have a large number of publicly funded vaccines. However, we have some progress to make before we can be proud of our national immunization rates. The good news is that, increasingly, Canadian health care providers can access the evidence base and resources needed to help make this happen.7

Notes

CCDR CANADA COMMUNICABLE DISEASE REPORT

CCDR Highlights summarize the latest evidence on infectious diseases from recent articles in the Canada Communicable Disease Report, a peer-reviewed online journal published by the Public Health Agency of Canada. This highlight was prepared by Dr Patricia Huston, a family physician, public health physician, and Editor-in-Chief of the Canada Communicable Disease Report.

Footnotes

  • La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro de janvier 2017 à la page e19.

  • Copyright© the College of Family Physicians of Canada

References

  1. 1.↵
    1. UNICEF Office of Research
    . Child well-being in rich countries: a comparative overview. Innocenti report card 11. Florence, Italy: UNICEF; 2013. Available from: www.unicef-irc.org/publications/pdf/rc11_eng.pdf. Accessed 2016 Oct 24.
  2. 2.↵
    1. Public Health Agency of Canada
    . Vaccine coverage in Canadian children: results from the 2013 Childhood National Immunization Coverage Survey (CNICS). Ottawa, ON: Public Health Agency of Canada; 2016. Available from: http://publications.gc.ca/collections/collection_2016/aspc-phac/HP40-156-2016-eng.pdf. Accessed 2016 Oct 26.
  3. 3.↵
    1. Dyer C
    . Lancet retracts Wakefield’s MMR paper. BMJ 2010;340:c696.
    OpenUrlFREE Full Text
  4. 4.↵
    Antimicrobial resistance: international health threat. Can Fam Physician 2016;62:903, e659. (Eng). (Fr).
    OpenUrlFREE Full Text
  5. 5.↵
    1. Nyhan B,
    2. Reifler J
    . Does correcting myths about the flu vaccine work? An experimental evaluation of the effects of corrective information. Vaccine 2015;33(3):459-64.
    OpenUrlCrossRefPubMed
  6. 6.↵
    1. Dubé E,
    2. Bettinger JA,
    3. Fisher WA,
    4. Naus M,
    5. Mahmud SM,
    6. Hilderman T
    . Vaccine acceptance, hesitancy and refusal in Canada: challenges and potential approaches. Can Comm Dis Rep 2016;42(12):246-51.
    OpenUrl
  7. 7.↵
    1. MacDonald NE
    . The long and winding road to improving immunization rates: sharing best practices in Canada. Can Comm Dis Rep 2016;42(12):243-5.
    OpenUrl
PreviousNext
Back to top

In this issue

Canadian Family Physician: 63 (1)
Canadian Family Physician
Vol. 63, Issue 1
1 Jan 2017
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Does Canada need to improve its immunization rates?
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Does Canada need to improve its immunization rates?
Canadian Family Physician Jan 2017, 63 (1) e18;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Does Canada need to improve its immunization rates?
Canadian Family Physician Jan 2017, 63 (1) e18;
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Evidence
    • Bottom line
    • Notes
    • Footnotes
    • References
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • Le Canada doit-il améliorer ses taux de vaccination?
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

Practice

  • Managing type 2 diabetes in primary care during COVID-19
  • Effectiveness of dermoscopy in skin cancer diagnosis
  • Spontaneous pneumothorax in children
Show more Practice

CCDR Highlights

  • Should we screen people at increased risk of hepatitis C virus infection?
  • Are we losing the battle against sexually transmitted diseases in Canada?
  • Can we eliminate HIV?
Show more CCDR Highlights

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • LinkedIn
  • Instagram
  • RSS Feeds

Copyright © 2025 by The College of Family Physicians of Canada

Powered by HighWire