Booster shots for young Canadians may prevent preventable diseases but they might do little more than buy more time for doctors to sort the really serious cases out
Canada, the best country in the world at implementing government-directed drug coverage, just jumped into the business of making people jumbo-sized jabs to try to combat a tiny and tiny way of preventing deadly outbreaks like the one that hit when measles was reintroduced to the southern United States last year.
The measure is projected to save taxpayers millions, said Susan Jennings, the provincial minister of health and advanced education, and is more likely to result in fewer people getting the dire consequences of infection – even if it does not make a big difference for those who are already infected.
“There’s no harm in helping our kids,” said Jennings, “but if you really want to make a difference, what we should really be doing is giving every Canadian the chance to be protected against the whole range of potential infectious diseases.”
Bitter pill: a Canadian doctor on life as a volunteer in the US opioid epidemic Read more
Experts are not convinced this is such a sound policy.
Jennings should be working more closely with the US Centers for Disease Control and Prevention to set good and strategic policies on vaccine mandates, said the epidemiologist Bradley Katz, who works for Breakthrough, a California-based group that supports physician-led policies to reduce disease in underserved communities.
“This is not an issue that is all of a sudden emerging, or about compliance,” Katz said. “It is a … national health security crisis.”
The most effective way to protect the population, he said, is with lifelong, high-quality immunizations, including that made by the CDC.
“One hundred million booster shots for a vaccine to prevent a few cases of a disease is not an effective way to do it,” Katz said.
Experts on infectious diseases are generally critical of the Canada moves.
Physicians have an obligation, too, to deal with the rare cases where a vaccine-preventable disease strikes, said the emergency room physician and infectious disease specialist Dr Michael Gardam.
“There will always be people that fail to get the shot and therefore die,” said Gardam, president of the Ontario Association of Medical Officers of Health, but those rare circumstances should not be treated as a justification for low-income countries to pay for huge amounts of vaccinations for vulnerable populations.
“We shouldn’t be using vaccination as a first line of defence for preventing severe infectious diseases,” he said.
There is no evidence that Canada will save money by requiring kids to get more jabs; rather, it will cost billions of dollars, according to projections by the Canadian Institute for Health Information.
“And that’s before we even think about emergency room costs and the incidence of opportunistic infections,” said the expert in infectious diseases, Robert Armstrong, director of the Centre for Medical Humanities and Public Health at Queen’s University.
“There’s no point in just handing out these inflatable jabs.”
The CDC, he said, has generally done a good job of explaining how the vaccine works and who is most at risk of getting an infection if they get vaccinated.
Dr Benjamin Marzi, a medical infectious disease expert with the Centre for International Health, said the idea that noncompliance with vaccination is a meaningful factor in outbreaks is “absolutely absurd”.
With routine vaccination, he said, it’s hard to see how vaccine-preventable diseases can become endemic in a country that is often lauded around the world for achieving full coverage.
“Canada is a difficult case,” Marzi said. “The close proximity of people to other countries make infection by plane or by the epidemic’s contact vector difficult for Canada to get rid of. It’s very difficult to have that severe outbreak that Canada can afford.”
• This article was amended on 7 August 2018. An earlier version said toddlers and schoolchildren would be immune to vaccinations because the packages have a “spray cushion”. The foam cushion is included on the package but not in the spray.