Comment: B.C. finding a balanced approach to immunization

Re: “Take stronger action on vaccinations,” editorial, March 1.

There have been several confirmed cases of measles reported in B.C. this year, and this serious disease continues to cause illness and sometimes death — primarily in children — in countries around the world.

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In the face of this highly contagious disease, immunization is the safest, most effective and best way to protect our children and our communities.

I have been asked about the ideas of mandatory reporting of immunization records and mandatory immunization in B.C. Immunization is critical, and tracking those records is especially important for disease prevention, as well as control.

I strongly believe every child in B.C. should be protected by the safe, effective immunizations we have, and I support government policy that will require parents and guardians to report their children’s immunization records to school officials to provide to regional health authorities and be entered in our provincial registry.

Immunization is not strictly mandatory in any jurisdiction in Canada. Mandatory immunization would mean that children who are not immunized would not be able to attend school at all.

Evidence has shown that has downstream adverse effects on children and is likely against the Canadian Charter of Rights and Freedoms.

Based on the evidence available, I do not recommend mandatory immunization in British Columbia. Measles has been rare in B.C. and across Canada for many years, due to our effective immunization programs — indeed, measles is considered eliminated in Canada.

Recent outbreaks have all stemmed from imported cases, primarily from unimmunized people who have travelled to countries where this serious illness is still common.

In B.C. and Canada, immunization rates remain high compared with many other jurisdictions, and that has enabled us to control these imported outbreaks.

However, there are pockets in B.C. where immunization rates have fallen. This makes children vulnerable, as even small outbreaks can cause a great deal of disruption and sometimes lead to severe illness.

Very few people in B.C. are against all vaccinations (estimated at one to two per cent). For example, based on what we have heard from B.C. parents whose children are not up to date in their immunizations, most often, the reasons are: not realizing their child was due for a booster, challenges in scheduling and challenges going to appointments while juggling other family responsibilities.

For parents who are hesitant about immunization, having their questions answered and concerns addressed by their health-care provider in an open, non-judgmental way is also an important factor in their decision on immunization. This tells us that better understanding and public awareness can be as effective here as mandatory immunization.

My recommendation for B.C. is for a model similar to Ontario’s. One that allows for exemptions, with a formal process that parents must go through to register an exemption based on medical contraindication or on personal belief. There are consequences, such as excluding unimmunized children from school if there is an outbreak. That is the distinction between mandatory reporting and mandatory immunization — the ability to have an exemption based on medical contraindication or belief.

I am working with experts from the Ministry of Health and the B.C. Centre for Disease Control.

We will be consulting with partners across and outside government, including the Ministry of Education, the B.C. Pharmacy Association, Doctors of B.C. and education stakeholders to plan and implement a program that is tailored to B.C. — a balanced approach that allows us to raise immunization rates and address parents’ concerns, but will also ensure children are not negatively affected and prohibited from attending school because of their parents’ decision. The details of the B.C. program will be announced in the coming months.

My suggestion for parents now is to check your children’s immunization records to ensure they are up to date as we head into spring break when many families might be travelling. This is an opportunity to ensure your whole family has the immunizations they need to be protected, including from measles.

Check with your public-health office or family doctor for immunization records if you do not have them. Keep your records handy, so they are available to your local health unit for entry into the provincial immunization registry.

For adults, now is also a good time to check your immunization records to make sure your own vaccinations are current. For more information on immunization, visit ImmunizeBC’s website: immunizebc.ca

Dr. Bonnie Henry is B.C.’s provincial health officer.

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