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Education
Parents and immunization providers need to be aware of how important it is to keep children and patients on track with their immunizations. The very success of childhood vaccination, however, brings the challenge of communicating to parents the importance of protecting their children when the diseases prevented through vaccination are no longer seen. Therefore, immunization programs need to pay more attention to educating and reassuring parents about diseases and vaccines, by providing parents with evidence-based information that will enable them to make informed decisions about their children’s immunization.
Research has shown that a number of factors can enhance vaccine uptake, including timely reminders, quality parent education materials, after-hours and weekend clinics, vaccine uptake monitoring, multiple vaccines given during one visit, standing orders for vaccines, multi-component provider education, and the elimination of financial barriers to immunization. Evidence-based interventions range from simple recall and reminder systems to quality improvement activities undertaken by provider offices. Parents also now have access to informative books and Internet Web sites devoted to education about vaccines and vaccine-preventable diseases.
In the United Kingdom, routine surveys are conducted to ascertain the attitudes of parents and health-care professionals, and all immunization promotion materials are extensively pre-tested and the impacts of such materials evaluated. These forms of operational immunization research are going to become more important as immunization programs face increasing pressures, especially with respect to doubts about the need for immunizations and their safety.
Improving access
In Canada, health is a provincial responsibility. Each province and territory decides which vaccines it will fund, which creates confusion and inequities across the country. Consequently, not all children and infants have access to all NACI-recommended vaccines, putting them at risk for problems such as acquired deafness from meningitis due to pneumococal infection. A national immunization program is therefore needed to improve equity of access to all of the NACI-recommended vaccines in order to be able to protect all Canadian children from the potential damage incurred by vaccine-preventable diseases.
Monitoring vaccine safety
To optimize children’s protection, immunization providers need to ensure that the safest and most effective vaccines are administered to children in as timely and efficient a manner as feasible. In 1994, Health Canada set up the Advisory Committee on Causality Assessment (ACCA), an expert committee charged with the task of monitoring vaccine safety by evaluating reported serious vaccine events in Canada. Health Canada also funds IMPACT (Immunization Monitoring Program, ACTive), an active surveillance system for vaccine-associated adverse events. Run by the Canadian Paediatric Society, this network involves 12 paediatric hospitals across Canada, which account for over 90% of the tertiary-care paediatric beds in Canada and serve as the local hospital for 45% of Canada’s paediatric population.
On the international level, the World Health Organization created the Global Advisory Committee on Vaccine Safety in 1999. Its task is to respond promptly, efficiently and with scientific rigor to vaccine safety issues of potential global importance.
Policy and infrastructure
The potential for vaccines to prevent suffering and death among children is great and will continue to increase as new vaccines are developed and traditional vaccines are improved. Realizing this potential, however, requires carefully developed vaccination policy recommendations and a delivery infrastructure that is able to conduct the essential roles of immunization programs: financing the purchase of vaccines, ensuring that evidence-based strategies are used to raise coverage levels, monitoring coverage levels and vaccine safety, and conducting surveillance of vaccine-preventable diseases.
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