By Dr. Christine Palmay

COVID-19 has permeated every facet of our lives. Given the breadth of these impacts, it’s no surprise that efforts to combat the COVID-19 virus have led to a myriad of unintended negative health care consequences.

At a time when we were more conscious of the value of vaccines than ever, as a society we have dropped the ball on ensuring the most vulnerable in our society are protected against other major viruses. What used to be considered “routine” immunization is now anything but. Most of us will now know someone – a grandparent, parent, child or friend – who has missed a critical vaccination in the last 20 months, putting them at risk of clearly preventable disease.

In our efforts to deal with one health crisis, have we unwittingly laid the groundwork for the next?

A recent study completed by 19-Zero and the Neighbourhood Pharmacy Association of Canada confirmed that as many as one in four adults has missed, or is unsure if they have missed, a routine vaccination for themself or their child. Additionally, the data collected suggests that up to 35 per cent of children may have missed a critical routine vaccination. There is no doubt that these numbers are under-reported, since most patients are not aware of the full list of immunizations recommended for their age group by the Public Health Agency of Canada.

Decreased vaccination rates in pediatric patients leave them vulnerable to outbreaks of vaccine-preventable diseases during a time when our health care systems is already overextended.

Older adults have also seen a sharp drop in immunization coverage since the advent of COVID-19 – a population already suffering from the low uptake in adult immunizations. There was a 48 per cent decline in shingles vaccine uptake during the pandemic and although there was a slight uptick in influenza vaccine coverage, overall coverage remains abysmally low with less than 50 per cent of Canadians getting this vaccine even in the midst of a respiratory virus pandemic.

How did this happen? This list of reasons are complex and interrelated:

Closure of school-based immunization programs (including Hepatitis B, HPV and MMR)
Lack of access to primary care offices
Public fear of medical institutions
A lack of awareness that vaccines are essential
Mental health disease that has affected patients’ ability to attend to self-care

We need to do better. We need to pause, reflect and accept that amidst the chaos and harrowing moments during this pandemic, an opportunity for change exists.

Collaboration is part of the solution.

Unlike the antiquated and siloed structure of current medical practices, opening up access and collaboration amongst primary care (physicians, pharmacists, nurses and public health) will be essential. Studies also show that Canadians trust pharmacists as much as doctors and nurses when it comes to their preference of who delivers their vaccination.

Now, as the health system and governments across the country begin to focus on the danger posed by this secondary, preventable public health crisis, pharmacists stand ready and willing to once again form part of the solution.

There is strength in numbers.

Looking forward, we must acknowledge that health care burnout exists and thus, increase our efforts to collaborate and pool resources. The pandemic has shown us that management of extremely difficult and highly complex public health challenges is virtually impossible without the active engagement of the entire health care system. This includes policymakers and physicians, pharmacists and public health workers and patients themselves.

Good health care treats disease. Excellent health care prevents disease.

Let us use the lessons learned during COVID and proactively rebuild a health care system that expands access, increases convenience and champions collaboration to ensure immunizations are received safely, timely and in the spirit of preventative health care.

If our goal is to return to something resembling normal, then surely we should be ensuring that was once considered routine, will become routine again?

Dr. Christine Palmay is a physician currently managing a busy family medical practice in midtown Toronto, with a passion for preventative healthcare, and regularly speaks on the importance of routine immunization.

While funding for publication of the article was provided by GlaxoSmithKline Inc., the article was independently written by the author and the opinions expressed are the author’s own. The author was not compensated by GlaxoSmithKline Inc.

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