The steep decline in routine childhood immunization may be further complicated by uncertainty about whether COVID vaccines may overlap with other jabs, and which ones should be prioritized.
Routine shots for children — including those for measles, mumps, rubella, hepatitis B, meningococcal disease and human papillomavirus — have been derailed by school closures and public health measures, a new report from researchers at the University of Toronto and McMaster University suggests. Is. .
While parents scramble to catch up, flu shot clinics begin in October, and COVID jabs can be started in four to six weeks. But guidance from health agencies on whether there is a need to separate routine and COVID vaccines for children under 12 is yet to come.
Ideally, there should be no conflict between the routine and the timeline of when to receive the COVID vaccination. But when they do, and parents are forced to prioritize each other, family therapist Dr. Jeff Kwang suggests getting the COVID jab first.
“Get the COVID vaccine first, because that’s the most imminent threat,” said Kwang, who is also a Public Health Ontario scientist, lead in ICES’s Population and Public Health Research Program, and a co-author of the report.
While exactly how routine vaccines have been affected by the pandemic is still unclear, researchers from the U of T. Center for Vaccine Preventable Diseaseshandjob from Lana School of Public Health And McMaster’s Faculty of Health Sciences is calling on the province to develop a catch-up strategy to urgently close gaps in vaccine coverage, to prevent another health crisis.
The report’s authors advise the government to take three important steps, first investing in and developing a centralized electronic vaccination registry that catalogs people’s sociodemographic data and vaccine status, which can be accessed by health workers. Provide jobs and caregivers in the province.
Kate Allen, a postdoctoral fellow at the Center for Vaccine Preventable Diseases, said, “There has been a patchwork approach to vaccine delivery in the past…. “A centralized registry would really help us detect missed doses more efficiently. “
A health ministry spokesman said the province has focused on increasing vaccination levels over the past several months on COVID vaccination to support the reopening of Ontario. Other repositories support data sharing by the province’s 34 health units, and allow the public to access and update their vaccination records.
Because measles is so contagious, and preventing outbreaks requires a high percentage of vaccine coverage, researchers often view it as “a canary in a coal mine” or as an early indicator of potential danger or failure, Allen said.
Disruptions in the administration of routine vaccinations have already led to an increase in measles cases in Nigeria, Pakistan and Afghanistan.
“The last thing we need is an outbreak of anything in the middle of an epidemic that isn’t over,” said Dr. Hirotaka Yamashiro, a community-based pediatrician in Toronto and board director of the Ontario Medical Association. report good.
Last year, Toronto Public Health stopped School-based routine immunization clinics for grades 7 and 8 leave teens resorting to clinics like Yamashiro because of COVID restrictions. He said he would have been a little older if he had gotten jobs in school.
When there appears to be disruption to school-based clinic programs, Allen said it hurts families who are disconnected from the health care system, who may not have a primary care physician, can’t take time off from work. are, lack transportation or child care, are experiencing poverty or other barriers that advance vaccines. The researchers also recommend a multi-pronged approach, in which catch-up vaccinations are delivered in a variety of settings — including schools, communities, pharmacies, family doctors’ offices and short-term mass clinics — to help break down barriers. for.
“There are some students who are still struggling with distance learning so they can’t be in schools,” Allen said. “We want to accommodate needs that families may need to be really convenient.”
Toronto Public Health updated its website on September 21 to indicate the resumption of publicly funded school vaccination programs. 14, students in grades 7 and above have been able to book appointments for routine jabs at immunization sites running in the city, some also used for delivery of COVID jabs, such as the Metro Toronto Convention Center.
For the first time since the pandemic began, the 4-11 age group recorded the highest COVID case rate in the city, said Dr Eileen de Villa, medical officer for health at the Toronto Public Health Board. meeting Monday. He said the rate of cases among children in that group had risen over the past three weeks, reaching 64 per 100,000 by September 23.
A spokesperson for Health Canada said Monday that the National Advisory Committee on Immunization does not provide guidance for administering doses for a certain age group until vaccines have been approved for that age range. The spokesperson said Health Canada has not yet received any submissions from the vaccine manufacturer for a vaccine that can be distributed to children.
However, current guidance The NACI strongly recommends that the COVID-19 vaccine should not be given together with other vaccines for adults 18 years of age and older. The agency advises that it is best to wait at least 28 days after a dose of any COVID vaccine before receiving a non-COVID jab. If someone has already been given a non-Covid vaccine, they should wait at least 14 days before getting a COVID jab.
“It’s not because we think something would be unsafe. It’s actually because we don’t know,” Yamashiro said. According to the Health Canada website, no one on the simultaneous administration of the COVID-19 vaccine with other vaccines There is no data, although several studies are underway.
They estimate that the COVID vaccine for children under the age of 12 would need to be given at least one month apart from any other jabs.
Kwang notes that in the US, the Centers for Disease Control and Prevention are very different. recommendations. The agency says COVID vaccines and other routine vaccines can be administered on the same day “regardless of timing”.
He said he expects NACI to regularly update its recommendation to indicate as well as COVID jabs can be given.
“Now, children need to get vaccinated against COVID at the earliest. There is also the issue that they may have missed out on routine childhood vaccines,” Kwang said. “The bottom line is that we should use every opportunity to make as many vaccines available as possible.”
The third recommendation from the report’s researchers emphasizes the importance of a clear, unified government message led by the health ministry to unify the province in catch-up vaccination plans.
A ministry spokesman said the province is awaiting Health Canada’s approval for children ages 5 to 11, the current Ontario guidelines For people in more than 12 states, who have received another vaccine within the last 14 days, they should delay their COVID jab. Also, anyone who receives a single dose of the COVID-19 vaccine should usually wait 28 days before receiving a second vaccine.