Continuity of routine immunization programs in Canada during the COVID-19 pandemic

Hannah Sell; Ali Assi; S Michelle Driedger; Ève Dubé; Arnaud Gagneur; Samantha B Meyer; Joan Robinson; Manish Sadarangani; Matthew Tunis; Shannon E MacDonald

doi:10.1016/j.vaccine.2021.08.044

Continuity of routine immunization programs in Canada during the COVID-19 pandemic

Vaccine. 2021 Sep 15;39(39):5532-5537. doi: 10.1016/j.vaccine.2021.08.044. Epub 2021 Aug 16.

Authors

Affiliations

¹ School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
² Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
³ Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
⁴ Faculty of Social Sciences, Université Laval, Quebec City, Quebec, Canada.
⁵ Département de pédiatrie, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, Quebec, Canada.
⁶ School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
⁷ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
⁸ University of British Columbia, Vancouver, British Columbia, Canada.
⁹ Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Ottawa, Ontario, Canada.
¹⁰ Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Electronic address: smacdon@ualberta.ca.

Abstract

Introduction: In Canada, the COVID-19 pandemic has interrupted many routine health services, placed additional strain on the health care system, and resulted in many Canadians being either unable or unwilling to attend routine immunization appointments. We sought to capture and synthesize information about changes to routine immunization programs in response to the pandemic and plans to catch-up any missed immunizations.

Methods: Provincial/territorial (P/T) public health leaders were interviewed via teleconference between August-October 2020 to collect information on the following topics: how routine immunization delivery was affected during and after initial lockdown periods, plans to catch-up missed doses, and major challenges and achievements in continuing routine immunization programs. Data were coded and categorized according to common responses and descriptive analysis was performed.

Results: Interviews occurred with participants from 11 of 13 P/Ts. School immunization programs were reported to be most negatively affected by the pandemic (n = 9). In the early pandemic period, infant, preschool, and maternal/prenatal programs were prioritized, with most P/Ts continuing these services with adaptations for COVID-19. After the initial lockdown period, all routine programs were continuing with adaptations in most P/Ts. Infant, preschool, and school programs were most often targeted for catch-up through measures such as appointment rebooking and making additional clinics and/or providers available. Major challenges included resource limitations (e.g., staff shortages, PPE shortages, limited infrastructure) (n = 11), public health restrictions (n = 8), and public hesitancy to attend appointments (n = 5).

Conclusions: Canadian routine immunization programs faced some disruptions due to the COVID-19 pandemic, particularly the school, adult, and older adult programs. Further research is needed to determine the measurable impact of the pandemic on routine vaccine coverage levels.

Keywords: COVID-19; Immunization; Pandemic; Routine; Vaccination; Vaccine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
COVID-19*
Canada
Child, Preschool
Communicable Disease Control
Humans
Immunization
Immunization Programs
Infant
Pandemics* / prevention & control
SARS-CoV-2
Vaccination