Contextual Issues Relevant to Immunization

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12. The Canadian Immunization System

Competency: Demonstrates an understanding of the immunization system in Canada and its impact on his/her own practice.

Learning Objectives

The health professional will be able to perform the following:

1. Describe how the National Immunization Strategy (NIS) is relevant to practice.
2. Distinguish between federal and provincial/territorial responsibilities as related to immunization programs in Canada.
3. List who can administer immunizations in Canada.
4. Describe the current status of immunization registries in the province or territory where practice is based.
5. Describe the process required to introduce a new publicly funded vaccine in a province or territory.
6. Explain the reasons for the variable immunization schedules among the provinces and territories.
7. Locate the current immunization schedule for the province or territory of practice.
8. Identify laws and regulations that may affect immunization delivery programs in provinces and territories.

Key Terms: Canadian Immunization Guide (CIG), immunization schedule.

Suggested Content for Training

• Goals of the NIS
• How the number, timing, and spacing of doses is decided upon
• The role of the National Advisory Committee on Immunization and how vaccine recommendation is decided upon
• Current published recommendations in the CIG
• The role and responsibilities of the federal, provincial, and territorial governments in publicly funded immunization programs and vaccine purchase
• Provincial and territorial resources available to consult about immunization issues

13. Immunization Issues

Competency: Addresses immunization issues using an evidence-based approach.

Learning Objectives

The health professional will be able to perform the following:

1. Describe factors which lead to scepticism regarding immunization for both health professionals and the general public.
2. Describe the impact that misperceptions regarding immunizing agents have on immunization programs and on the population.
3. Address misperceptions regarding immunizing agents using an evidence-based approach.
4. Locate evidence-based sources of information on current issues relating to immunization.
5. Use evidence-based scientific knowledge to develop clear, concise key messages regarding true immunization benefits and risks.

Key Terms: Canadian Immunization Guide (CIG), immunization schedule.

Suggested Content for Training

• Importance of keeping up to date
• Anti-immunization messages on social media
• Multiple injections
• Thimerosal
• How and where to find information (local and national sources of advice) and assessing the reliability of sources
• Media portrayal of vaccine news stories
• The critical importance of professional confidence in immunization

14. Legal and Ethical Aspects of Immunization

Competency: Acts in accordance with legal and high ethical standards in all aspects of immunization practice

Learning Objectives

The health professional will be able to perform the following:

1. Discuss the implications of basic ethical principles, including individual's right, confidentiality, privacy, informed consent, and informed refusal.
2. Describe the legal requirements relevant to immunization administration, documentation, recording, and reporting.
3. Describe the legal requirements in the province/territory of immunization practice that relate to immunization status and exclusion from daycare, school, workplace, or other settings.
4. Identify his/her own professional scope of practice as it relates to immunization (jurisdiction, organization, practice setting – institutions, etc.).
5. Discuss the ethical issues arising from:
   • mandatory versus voluntary immunization; and
   • targeted versus universal immunization.
6. Discuss the responsibility of health professionals to inform patients regarding the availability of all recommended vaccines regardless of whether they are publicly funded or not.
7. Describe the ethical implications when a provider's beliefs conflict with evidence-based recommendations for immunization.

Key Terms: Assent, benefit, conflict of interest (real and perceived), disclosure, harm, informed consent for immunization, informed consent for registry, mandatory immunization, prejudices, risks, medicolegal, targeted immunization, universal immunization, voluntary immunization.

Suggested Content for Training

• Current legal requirements for informed consent
• Data protection
• Documentation
• Professional accountability

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