New Brunswickers falling behind on routine vaccines, survey finds

New Brunswickers are falling behind on their "regular" vaccinations, particularly children, says the province's chief medical officer of health.

It's "concerning," said Dr. Jennifer Russell.

And getting people "up-to-date" is something the Department of Health plans to "spend some attention and time and energy promoting," she said.

The department recently conducted a survey "reviewing people's attitudes towards vaccines," said Russell.

She could not immediately provide any of the results but said it's "apparent" that "it's been hard to keep up-to-date" during the COVID-19 pandemic.

"There's been so many challenges for that," she said.

"So as of right now, I really encourage parents of young children to ensure their child's [routine] childhood vaccinations are up-to-date, again because so many might have been missed during the past two years."

Immunization is "a key public health measure to protect children from diseases such as measles, whooping cough (pertussis), mumps, Hepatitis B, polio, rotavirus and many more," said Department of Health spokesperson Valerie Kilfoil.

This includes any booster doses that are needed to continue to provide longer term protection, she said.

Impact on access

The pandemic "disrupted the delivery of some services, which may have impacted access for childhood immunizations," Kilfoil said in an emailed statement.

Public Health continued to offer clinics for pediatric (childhood) vaccines, but "often reported the number of vaccines given were lower than in the past," she said.

In addition, primary care providers may not have provided face-to-face office appointments for immunization.

"Both of these situations contributed to fewer vaccines being distributed in the province."

4% drop in mandatory school shots prior to pandemic

Annual statistics on school immunizations have also indicated a decline, said Kilfoil.

"Since 2018-2019 there has been a slight decrease in the percentage of school-aged children (76.8 per cent in 2018-2019 and 72.8 per cent in 2019-2020) who met immunization requirements with regards to the five mandatory vaccines" — Men-C-C (meningococcal conjugate-C), MMR (measles, mumps, rubella), Varicella (chicken pox), DTaP (diphtheria, tetanus and pertussis, also known as whooping cough), and IPV (polio), she said.

This shows the decline actually started prior to the pandemic.

The 2019-20 statistics are the most recent available. The newest school immunization report will be published this fall, Kilfoil said. "This annual report is the tool used to track vaccinations provided through the routine school immunization program."

Of the seven years of school immunization reports posted online, 2014-15 had the lowest proportion of children meeting the school immunization requirements, at 69.1 per cent.

"There has been a steady increase in children not immunized due to parental objection from [two per cent] in 2012/13 to 2.8 [per cent] in 2014/15," the September 2015 report states.

Education Minister Dominic Cardy's bill to eliminate some exemptions from the mandatory vaccination policy for school children was defeated 22-20 in a free vote in the legislature in June 2020.

Under Cardy's bill, religious and philosophical exemptions would have been eliminated. Only medical exemptions would have been allowed.

Cardy had argued that 95 per cent of children need to be vaccinated to achieve herd immunity, in which there's enough resistance to a disease that it's unlikely to spread in a school.

About one per cent of school children were exempt at that time, but Cardy argued that with three per cent of vaccinations not working, the province was perilously close to slipping below the herd immunity threshold.

In 2019-20, 1.7 per cent of students — about one in 60 — had medical exemptions, up from zero the previous year, the annual school immunization reports show. In prior years, the highest medical exemption rate was about one in 500.

2019 measles outbreak

In New Brunswick, one of the routine childhood immunizations is the measles, mumps, rubella (German measles) and Varicella vaccine (MMRV).

The Saint John region had a measles outbreak in 2019, before the pandemic. It lasted more than two months, with a total of 12 cases confirmed.

"This can happen again," Russell warned at the time, advising people who were travelling to check their immunization records and ensure they had received two doses of the vaccine. A second dose raises the effectiveness of the vaccine to 97 per cent, she said.

Some of the other routine childhood immunizations include the diphtheria, tetanus, pertussis and polio vaccine; the meningococcal conjugate-C vaccine, Hepatitis A and Hepatitis B.

Some of the routine adult immunizations in New Brunswick include influenza; tetanus, diphtheria and pertussis; and pneumococcal polysaccharide.

Routine immunization services are available at Public Health offices and from medical and nurse practitioners, according to the department's website.

Public Health nurses also provide routine immunizations for children and adolescents at pediatric immunization clinics and through school-based immunization programs, it states. Parents of adolescents who are not enrolled in a public school may contact their local Public Health office for further information.

Campaigns in the works

The Department of Health conducted the survey about "vaccines in general" to help guide the development of vaccine campaigns, "one of which will be around childhood vaccines," said Kilfoil.

"Details have not been worked out yet but we do want parents to start thinking about whether their children have missed out on any of the childhood vaccinations due to the pandemic," she said.