Abstract
Vaccination is considered to be one of the greatest public health achievements, contributing to a substantial decline in infectious disease mortality in Canada. However, a growing threat of vaccine hesitancy has led to an upsurge in the prevalence and incidence of vaccine-preventable diseases across the globe, including Canada. Vaccine hesitancy is on the rise in the province of Ontario. Parental vaccine hesitancy, vaccine misconceptions, rising non-medical vaccine exemption rates, and low childhood vaccination coverage has led to a resurgence in vaccine-preventable diseases, especially measles. Given the importance of achieving high vaccine coverage to avoid vaccine-preventable diseases and their dire consequences, vaccine hesitancy is an important issue that needs to be addressed. There is no perfect solution to address vaccine hesitancy. Understanding the complex mix of factors that determine individual and collective vaccination behaviour is vital to designing effective vaccination policies, programs, and targeted interventions. This article critiques current vaccine policy strategies and outlines a policy approach to address parental vaccine hesitancy and prevent future vaccine-preventable disease outbreaks, specifically in Ontario, and more broadly within Canada. Providing support to healthcare providers and primary care physicians; and empowering parents, schools, students, families, and communities in Ontario, will slowly but surely mitigate vaccine hesitancy and enable healthy vaccination behaviours. Healthcare system-based interventions seem to be the most comprehensive approach that requires coordinated efforts and partnerships between community-based organizations and vaccination providers to ensure inclusive and integrated service delivery.
Highlights
Vaccine hesitancy (VH) is the reluctance or refusal to vaccinate despite vaccine availability and is a leading risk factor resulting in low immunization uptake
Given the importance of achieving herd immunity [mandated vaccination coverage for attaining adequate disease-specific thresholds] to avoid vaccine preventable disease (VPD) outbreaks, VH is a critical public health issue that threatens to reverse the tremendous progress in combatting VPDs in the past
VH issue is centred around cultural orientation and predispositions involving certain individual and community beliefs and cognitive biases
Summary
Vaccine hesitancy (VH) is the reluctance or refusal to vaccinate despite vaccine availability and is a leading risk factor resulting in low immunization uptake. A growing threat of VH has compromised the herd immunity for VPDs [11], the nation-wide mandated vaccination coverage of 95% for measles [12] This negative trend has resulted in an upsurge in the prevalence and incidence of measles [5,13] in Ontario [14,15]. In Ontario, considering the issue of steadily rising non-medical exemption rates [22,36,37] and adiaphorous impact of mandatory VH education classes for parents [38], Toronto’s Board of Health passed a report in September 2019 [39,40,41], with request in keeping with the recommendations from The Ontario Ministry of Health and Long-term Care – Premier's Council on Improving Healthcare and Ending Hallway Medicine [42].
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