SASKATOON Four in five Saskatchewan residents think vaccinations for children and youth under the age of 18 should be mandatory, new public opinion research suggests.However, Dr. Saqib Shahab, Saskatchewan’s chief medical health officer, says such a move wouldn’t be of much value because the existing system is doing a good job of ensuring as many people as possible are vaccinated on time.Eighty-three per cent of the 400 Saskatchewan residents who participated in a telephone survey this month agreed that immunizations should be mandatory for children and youth under the age of 18.Fourteen per cent disagreed. The remaining respondents were unsure or refused to answer.Men were more likely than women to agree that immunizations should be mandatory.The research was done by the University of Saskatchewan’s Social Sciences Research Laboratories (SSRL) as part of the Taking the Pulse initiative, which involves SSRL researchers calling a representative sample of Saskatchewan residents four times a year and asking for their views on hot-button topics in the province. The results are published by Postmedia News.Ontario and New Brunswick are the only provinces in Canada with legislation in place requiring children to be immunized against diseases including diphtheria, tetanus, polio, measles, mumps, rubella, meningococcal disease and pertussis (whooping cough) in order to attend school.However, both provinces have exemption clauses that allow parents to refuse vaccinations for medical reasons or because of conscience or religious beliefs.Shahab estimates that fewer than one per cent of parents in Saskatchewan actively refuse to have their children vaccinated.In the majority of cases when children are not up to date on vaccinations it’s because parents don’t understand the immunization schedule, have questions about vaccinations they want answered before getting the shots, or face challenges in making it to a clinic on time.Cory Neudorf, a professor in community health and epidemiology at the U of S, said he wasn’t surprised to see high support for mandatory immunization in the survey results.“People think that immunization is very important and, not just important for them, but they want to make sure that their friends and neighbours have their kids immunized as well,” Neudorf said.Despite the apparent support for mandatory vaccinations, “we probably haven’t met the bar in this province for needing that,” Neudorf said.“I think we’re already getting the same kind of results here without needing the legislation … I doubt very much whether there would be a perceived need for going that way.”According to the Immunization Coverage Report for School Pupils in Ontario, which looked at immunization rates of sevenyear-old students for the 2016-17 school year, coverage was 91 per cent for measles and 85 per cent for pertussis.Reports published by the Saskatchewan Ministry of Health show that immunization rates for measles and pertussis were 91 and 76 per cent, respectively, for the province’s seven-year-old children in September 2018.The national goal for coverage is 95 per cent.“The herd effect really starts kicking in above 80 per cent, and the herd effect of community immunity is better the higher the immunization rate,” Shahab said. “Aspirationally, we would want to go to 95 per cent.”The herd effect refers to the fact that, when a significant portion of a population is immune to a disease, it reduces the likelihood of disease outbreak and also provides a measure of protection for those who are not immune to it.The most recent outbreak of a vaccine-preventable disease in Saskatchewan happened this fall when at least two-dozen cases of whooping cough were reported in children and youth in Rosthern, Hague, Wakaw, Hepburn and Waldheim. The majority of the children were not up to date on their whooping-cough immunizations.While whooping cough causes a bad cough in most people, the disease can be fatal for infants.Children need six doses of pertussis vaccine by the time they reach Grade 8 to be fully immunized. The first three doses are done at ages two, four and six months.Shahab says it can be easy for parents to fall behind this schedule.A big misconception is that parents think they should delay vaccinations for premature babies — but they shouldn’t, he says.The health region has recently started recommending pertussis vaccinations in pregnant women to protect their newborns before they are old enough to be immunized, and the health region continues to do public education around the need for vaccinations, Shahab says.In Saskatchewan, public health nurses work with pregnant women to ensure they understand the province’s vaccination schedule before their children are born.As of February 2015, no matter where a child is immunized in Saskatchewan, their information is entered into a common database so their immunization records are easily accessible by other public health professionals, even if they move.Shahab says this has helped improve immunization rates in centres such as Prince Albert and North Battleford — where people often move around — because families can now get the appropriate immunizations, regardless of where in the province they go to gain access to health-care services.Public health nurses do vaccination checks in Saskatchewan schools at grades 1, 6 and 8. If children are not up to date on vaccinations, arrangements are made to catch them up.Shahab says immunization rates tend to lag the most in centres with large newcomer populations, because parents may not understand the Saskatchewan immunization schedule.A decade ago, Neudorf was part of efforts to narrow the immunization rate gap between different areas of Saskatoon.When he started his work, some neighbourhoods had 100 per cent immunization rates while other neighbourhoods had rates below 50 per cent.Neudorf and his team worked to understand why, and they learned that some families were struggling to get to clinics for appointments on time.The former Saskatoon Health Region then made changes to drive numbers up in neighbourhoods where immunization rates were lower, including changing where clinics were located and when they were open.The health region has credited his work for bringing measles immunization rates in two-year-old inner-city children to 80 per cent in 2016 from just 46 per cent in 2007.Neudorf said it’s efforts like this — not laws on mandatory immunization — that make the most difference in immunization rates.“Essentially, it’s not an issue with the parents’ level of support. It’s a question of the rest of the delivery system: Are we able to respond according to those patients’ needs?” Neudorf said.Each iteration of Taking the Pulse has an overall margin of error of plus or minus 4.9 per cent, 19 times out of 20, which means researchers expect their results to reflect the opinions of Saskatchewan adults to within 4.9 per cent, 95 times out of 100.
A Postmedia poll suggests that more than 80 per cent of Saskatchewan residents favour mandatory vaccinations for children and youth.
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