Not Just for Kids: How to Improve Adult Vaccination Uptake in Canada

Abstract

Vaccinations and booster shots aren’t just for kids. Adult vaccination rates urgently need a booster shot in Canada. Better and more regular uptake of vaccines during adulthood and retirement could improve the well-being of older Canadians and offset some of the challenges associated with an aging society. Despite clinical evidence showing the value of immunization against infectious diseases in the adult population, insufficient attention to lifetime immunization policies persists. This Commentary suggests creating formal approaches, based on applied behavioural design concepts, for improved adult immunization uptake. Influenza should be a pivot point. Even though the seasonal influenza vaccine suffers from relatively lower clinical efficacy than other vaccines, the related lack of confidence in its usefulness is exacerbated by doubts among healthcare workers. Still, the routine nature of the seasonal influenza shot does make it a pivotal part of adult immunization schedules. It should be used to prompt healthcare providers to review a patient’s overall immunization status, helping to develop databases to monitor and encourage other adult vaccines. This Commentary utilizes behavioural economic policy design issues and suggests major changes to the way Canadian provinces and territories monitor and ensure uptake of vaccines among adults. Alongside a digital strategy to create databases to monitor coverage of all adult vaccines, policies should build upon many patients’ preference to get their annual influenza shot at their local pharmacy by expanding pharmacists access to immunization databases, building greater links to primary care, and expanding pharmacists’ ability to set up immunization reminders for patients upon pharmacy visits, plus encouraging the use of digital apps. Going forward, the focus should shift to overcoming complacency with more use of automatic scheduling and reminders. Pharmacies, often a very convenient location for most urban-dwelling Canadians, could act as important parts of multidisciplinary primary care efforts to gather data on publicly funded adult vaccines – likely through digital platforms – and create reminders and prompts to overcome complacency as well.