Abstract
BackgroundInfluenza is a serious public health concern, resulting in morbidity, mortality and significant expense to healthcare systems worldwide. Annual vaccination is the most effective way to prevent influenza. The National Advisory Committee on Immunization in Canada recommends that everyone six months of age and older without contraindications should be vaccinated. The Canadian province of Nova Scotia implemented a publicly-funded universal influenza vaccination program in the 2010–2011 influenza season. In 2013, pharmacists in Nova Scotia gained the authority to provide a variety of vaccinations, including the publicly-funded influenza vaccine. This study aimed to investigate any changes in influenza vaccine coverage following the implementation of each policy change: 1) universal publicly-funded program and 2) universal publicly-funded program with the addition of pharmacists.MethodsInfluenza seasons evaluated were from 2006-2007 to 2015–2016. Coverage was estimated by examining Nova Scotia census data with aggregate immunization administration data, including the total number of vaccinations administered according to vaccine provider (physician, public health or pharmacist), geographic region, vaccine recipient age and year.ResultsThe analysis showed an increase in influenza vaccine coverage immediately following the implementation of the two studied policy changes. Vaccine coverage increased from 36.4 to 38% following the implementation of the universally funded vaccine policy. Following the implementation of pharmacists as immunizers, coverage increased from 35.7 to 41.7%. Vaccine coverage was highest in those 65 years of age and older during all years evaluated. Physicians provided the highest proportion of vaccines during all study periods, however a decreasing trend through all periods was observed. Physicians proportionately provided more vaccines in urban areas; whereas pharmacist and public health immunization providers in rural areas provided proportionately more vaccinations than their urban counterparts.ConclusionsThe addition of a universally funded vaccination policy and the addition of pharmacists as providers of the influenza vaccine resulted in increases in vaccine coverage initially. Additional research is needed to determine the long-term impacts of the policy changes on vaccination coverage and to identify other important factors affecting vaccine uptake.
Highlights
Influenza is a serious public health concern, resulting in morbidity, mortality and significant expense to healthcare systems worldwide
This study aims to compare influenza vaccine coverage between three different policy periods: 1) pre-universal influenza vaccination program; 2) universal publicly funded program; and 3) universal publicly funded program with the addition of pharmacists
Following the addition of the universal funding policy, coverage increased to 38% from a previous high of 36.4%
Summary
Influenza is a serious public health concern, resulting in morbidity, mortality and significant expense to healthcare systems worldwide. Influenza is a serious public health concern, associated with severe illness and death, in high-risk populations [1]. Within Canada, it is estimated that 10 to 20% of the population is infected with influenza each year, resulting in an average of 12,000 hospitalizations and 3500 deaths annually [2, 3]. The Canadian National Consensus Conference for Vaccine Preventable Diseases in Canada proposed targets for influenza vaccine coverage, ranging from 80 to 95%, for high-risk individuals and healthcare professionals, respectively [3, 4]. As significant illness and high societal costs can occur in those even without high-risk complications, the National Advisory Committee on Immunization (NACI) recommends the influenza vaccine for all Canadians six months of age and older [3]
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