Peel Region has major childhood vaccination backlog

Peel Region has a massive childhood vaccination backlog, with more than half of children missing at least one mandated vaccine dose.

That's the warning from Peel's acting medical officer of health, who says the lack of school immunizations is spelling trouble for communicable diseases.

"Without significant dedicated resources, we estimate it will take seven years to complete screening catch up and achieve pre-pandemic coverage rates," said Dr. Katherine Bingham in a presentation to Peel council on April 11.

She says low immunization coverage among students significantly increases the risk for the re-emergence of vaccine-preventable diseases such as measles.

Unless children have a valid exception, the following vaccines are mandatory for Ontario school children: diphtheria, tetanus, polio, measles, mumps, rubella, meningitis, whooping cough and chicken pox. Several other vaccines are strongly recommended by public health units and doctors. 

Advocates, doctors and Peel public health are advocating for more attention to the issue, more money from the province for public health and the formation of an action plan to quickly address the currently low vaccination rates.

Peel stacks lower than the provincial average on a number of vaccinations. For example, just over 37 per cent of seven-year-olds had been vaccinated against measles compared to more than 52 per cent province-wide as of August 31, 2022.

Peel Public Health says many children missed vaccinations they would have received at school or a doctor's offices. Reporting of vaccines and enforcement also fell behind in the pandemic. To tackle the backlog more quickly, Peel Public Health opened public clinics for mandatory vaccines as of April 1 of this year.

'We never thought it would be us': mother

Jill Promoli, a Mississauga mother, lost her son, Jude, to a school flu outbreak eight years ago even though he was vaccinated. She's now an illness prevention advocate championing immunizations and said the low vaccination rates in Peel children are "very concerning."

"We never thought it would be us, but it is going to be someone," said Promoli, who's also a Peel District School Board Trustee, but did not speak to CBC Toronto in that capacity.

"The reason that we do vaccinate against these diseases is not because they're inconvenient or uncomfortable, but it's because people do die from them," she said.

Promoli says she's also concerned about children who are vaccinated being exposed, given vaccines do not provide complete immunity.

Pediatric and infectious disease specialist, Dr. Anna Banerji, called the proportion of Peel students missing a mandated dose "very high."

"It needs to be addressed," she said.

She says part of the problem in the region is access, including to family doctors, but the region also has a diverse population, which can mean additional challenges.

"I think that language and cultural support and trying to get these kids vaccinated will be very important," she said.

Banerji also pointed to vaccine hesitancy being higher for some coming out of the pandemic.

She says seven years is far too long to have school-aged children not protected against such concerning diseases.

Needs will only grow, says Caledon mayor

The public health unit says they have less money than several nearby health units to try and tackle the issue, receiving one of the lowest provincial per capita funding rates in the province. 

For cost-shared programs, in Peel, public health was funded by the province at approximately $34 per capita in 2022, while Toronto and Hamilton each received $49 per capita, according to the health authority's report. 

Caledon Mayor Annette Groves says the funding needs to change now to address problems that will continue to climb for Peel Public Health.

"Peel is a growing region and there will be greater need for funding as our resident population increases," she said in a statement.

Province says funding has been increasing

Asked why Peel Public Health gets fewer dollars per capita, Ministry of Health spokesperson Hannah Jensen didn't dispute Toronto and Hamilton received more funding per capita.

"Since 2018, our government has increased our investment into Peel Public Health by nearly 20 per cent," she said in a statement.

Jensen said that's in addition to the $100 million the provincial government invested into public health units across the province to provide support throughout the COVID-19 pandemic.

The government has restored a funding model where the province pays 75 percent of cost sharing for public health units and municipalities including Peel pay 25 percent, she said, noting the province had been paying 70 per cent for some time, so this represented an increase.

The province also increased base funding by one per cent per year, over the next three years, starting this year for public health units and municipalities including Peel, she added. 

Asked why Peel would still receive a lower per capita rate that some of its neighbours, the province did not respond directly. 

She says the government is working closely with its partners to get children caught up on vaccines.

Promoli says the per capita discrepancy in funding between regions is "shocking" and diverse populations need more, not less.

"It's always important to try to meet people where they are," she said. "To hear those questions, to hear the reasons why people are hesitant or even refusing and to try to understand…and then find the best ways to help people make decisions that will best protect their families."

Peel Public Health says it plans to return to council soon with more details about the challenges and its plans to address them.