Access to vaccines: A call to action

The World Health Organization, UNICEF and the World Bank released a report entitled “State of the World's Vaccines and Immunization” in November 2002 (1). Nelson Mandela, Chair of the Vaccine Fund Board, in a foreword to the report entitled “Call to Action” eloquently pleaded for a commitment for the equitable access to immunization for all of the world's children (2). He stated that immunization “is the most powerful of all preventive health measures for children and is central to human rights and poverty alleviation. It is the right of every child to be given this kind of protection.” Most countries find it very surprising that, in Canada, we have inequity of access to vaccines to protect our country's population. Canada is one of the few highly developed countries in the world without a national immunization strategy. Because of the provincial and territorial ‘patchwork quilt’ system of immunization provision, Canadian children and youth do not have an equal opportunity to be protected by all of the vaccines recommended by the National Advisory Committee on Immunization (NACI). Children residing in different provinces have different access to publicly funded vaccines (Table 1). For example, while children in Alberta receive varicella vaccine, conjugate meningococcal C vaccine and conjugate pneumococcal vaccine through publicly funded programs, no other province or territory provides all three of these newer vaccines. Also, only youth in Newfoundland and Labrador and the Northwest Territories have the opportunity to protect themselves from pertussis by receiving the acellular pertussis vaccine along with their adolescent tetanus and diphtheria toxoid booster in a funded program. While all of the vaccines are recommended by NACI, children in Canada who reside in provinces or territories where the newly licensed vaccines are not provided through a publicly funded system have access to them only if their parents have the funds available to pay for them (3). Why do these inequities exist? We do not have a strategy in place whereby new vaccines can be uniformly and quickly assimilated into the universal provincial and territorial programs across Canada. We do not have a national immunization strategy. Children's access to publicly funded vaccines in Canada Children's access to publicly funded vaccines in Canada The proposed National Immunization Strategy (4), which has been endorsed by the Canadian Paediatric Society and the Canadian Infectious Disease Society, seeks as its primary goal the equitable access to NACI recommended vaccines for all Canadian children and adults. In his report (5), Romanow recommends implementation of the National Immunization Strategy (Recommendation 24). The establishment of the National Immunization Strategy will not happen, however, without support from the governments of all the provinces and territories as well as that of the federal government. We, as health care providers, need to advocate now to ensure that the proposed National Immunization Strategy moves from being a vision to becoming a reality. To do this, we need to make certain that the politicians, who will decide the ultimate fate of the National Immunization Strategy, know how important it is to health. How can we do this? Each of us needs to educate all of our elected representatives (The Member of Parliament for your federal riding, the Member of the Legislative Assembly for your provincial or territorial riding, the Minister of Health for Canada, the Minister of Health for your province or territory, the Prime Minister of Canada and your Provincial or Territorial Premier) in person or by letter about the National Immunization Strategy and the importance of providing adequate funding for its successful implementation. The establishment of the National Immunization Strategy will significantly improve our ability to provide equitable access to optimal health care to all of the children, youth and adults of Canada.

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