Executive Summary

The development of a national immunization strategy (NIS) was first endorsed by the F/P/T Deputy Ministers of Health (CDMH) in June 1999. In June 2001, the CDMH approved the development of an NIS, with the following five components:

• National Goals and Objectives
• Immunization Program Planning
• Vaccine Safety
• Vaccine Procurement
• Immunization Registry Network

The purpose of this paper is to present a final report on a comprehensive strategy to address immunization issues in Canada.

The development of this strategy has been conducted through the Federal Provincial/Territorial (F/P/T) Advisory Committee on Population Health and Health Security (ACPHHS). In developing the strategy, input was received from various officials, experts, and stakeholders across Canada, including provincial and territorial jurisdictions, Health Canada, the Council of Chief Medical Officers of Health (CCMOH), the Canadian Institutes of Health Research (CIHR), the Canadian Paediatric Society (CPS), the Canadian Immunization Awareness Program (CIAP), vaccine manufacturers, and others.

The strategy has been designed to address a number of challenges to immunization, which are currently being faced by all jurisdictions in Canada. For instance, expensive new vaccines will be coming onto the Canadian market in both the immediate and long-term horizon, and decisions will be required regarding their use in publicly-funded vaccine programs. In addition, provincial/territorial (P/T) vaccine expenditures have been increasing substantially in recent years (due to both the introduction of new vaccines and escalating prices of existing vaccines) and concerns have been raised regarding security of supply, particularly given the supply shortages recently experienced in the United States. Public attitudes about immunization, which can include complacency, concerns regarding vaccine safety, and fear of outbreaks, are also important considerations.

These issues and challenges reinforce the need for national collaboration. A national strategy is a means for F/P/T jurisdictions to work in partnership to improve the effectiveness and efficiency of immunization programs in Canada. The benefits of strengthening collaboration are anticipated to include the following:

• Reduction in vaccine-preventable diseases
• Improved access to timely immunization programs
• Improved efficiencies of immunization programs
• Better vaccine safety monitoring and response
• Enhanced affordability of vaccines
• Improved security of vaccine supply
• Public confidence in vaccines/response to growing anti-immunization concerns

The specific objectives and activities to be addressed by each component of the strategy are listed below:

National goals and objectives - to reduce vaccine preventable diseases and improve vaccine coverage rates by developing national goals and objectives for immunization programs, leading to recommendations for endorsement by all F/P/T governments, where appropriate.

Immunization program planning - to reduce duplication of effort, improve access to vaccines, and facilitate policy analysis of new vaccines, through national collaboration on the assessment and prioritization of new vaccines using common criteria.

Vaccine safety - to improve vaccine safety monitoring and public health response, by setting up a network of F/P/T vaccine safety contacts in all jurisdictions, establishing a clinical assessment/ referral system, and addressing potential vaccine safety issues (e.g., through improved data analysis, feedback/ risk communication, and development of national guidelines).

Vaccine procurement - to achieve best value for vaccines, long-term security of supply, quality of supply, and improved accountability, by making enhancements to the existing F/P/T procurement process, such as use of multi-year contracts, inclusion of value-added products/services as part of procurement process, collaboration with the vaccine regulator to ensure timely communication, and improvements in the administrative processes.

Immunization registry network - to improve national surveillance and the transfer of (and access to) individual immunization records, by establishing and maintaining a comprehensive, compatible national immunization registry network, with a core data set and minimum standards.

In addition, there are a number of activities which cut across, and support, the five components of the strategy. These are: immunization research, public and professional education, approaches to special populations and vaccine preventable disease surveillance.