Alberta doctors call for routine access to vaccines at children’s hospitals to combat low vaccination rates
Some pediatricians in Alberta say making childhood vaccinations routinely available in pediatric hospitals could help improve declining vaccination rates in the province.
But the Alberta government is closing the door on that idea, saying children’s hospitals are under too much pressure, and it is taking other steps to improve access.
Dr. Sam Wong, chair of the pediatric section of the Alberta Medical Association, said he and his colleagues have been advocating for this change for several years.
“The fact that we have lost our measles-free status should be a call to arms for us to do a better job,” he said, pointing to the recent decision. Pan American Health Organization To remove Canada’s measles eradication designation,
“We need to reform how we deliver vaccinations and how we administer vaccinations. And we need to look at all options, including vaccinating in hospitals where we have the capacity to do so. We just need to make administrative changes to allow us to do that.”
We just have to start thinking outside the box and stop doing the same things we used to do because, obviously, it’s not working.– Dr. Sam Wong, Alberta Medical Association
Alberta accounts for about 38 per cent of all measles cases in Canada. The outbreak is concentrated in communities low childhood vaccination rates,
“We don’t have enough people vaccinated against measles, and that allows community spread. It can happen with pertussis or whooping cough,” Wong said.
They’re concerned the province could see more infections, hospitalizations and potentially deaths.
He often sees children in emergency rooms or patients admitted to hospital wards who have not had routine childhood vaccinations, and their parents are eager to get them vaccinated.
But, according to Wong, the opportunity is missed because routine vaccines at Stollery Children’s Hospital, where he works, are only given one day a week, when a public health nurse comes to administer them. Most patients don’t live long enough to benefit from vaccination, he said.
Ideally, Wong would like to see routine vaccinations available 24 hours a day, seven days a week. But even less than that would help, he said.
“It’s a simple, short-lived product,” said Wong, who argues that nurses or pharmacists can administer the shots, which can be stocked in hospital pharmacies.
“Anything is possible. We just have to start thinking outside the box and stop doing the same things we used to do because, obviously, it’s not working.”
Concerns remain about declining childhood vaccination rates in Alberta.
publicly available provincial data Coverage rates for vaccinations including measles, whooping cough, polio and other diseases are below target rates.
For example, 68 per cent of Alberta children who turn two in 2024 will have received two doses of the measles vaccine. The lowest coverage rates were in the Northern Region (54.5 percent), Southern Region (55.8 percent) and Central Region (56.1 percent).
The target is 95 percent.
Vaccination rates for whooping cough (also known as pertussis) and polio are also falling.
Provincial data shows 68.9 per cent of Alberta children have received four doses of the vaccine that protects against pertussis, diphtheria, polio and other diseases by the age of two.
In 2016, coverage was 76.8 percent.
by provinceThe target of that vaccine is also 95 percent.
Hospitals under great pressure: Government
The Alberta government said it is continuing to expand access to vaccinations in community settings, but it is not considering pediatric hospitals as additional access points, given they are already strained.
“We are continuing to expand access through public health clinics, including walk-in and extended hours options, and strongly encourage families to keep vaccinations up to date,” a statement from the Ministry of Primary and Preventive Health Services said.
“Routine vaccinations are not offered in pediatric hospitals because these facilities care for extremely vulnerable children and are already under considerable pressure. Bringing greater patient volumes to services that can be safely and effectively provided in community settings will increase the workload on staff and could put vulnerable children at risk.”
If a child is hospitalized and needs vaccination because of increased risk or prolonged stay, public health outreach teams work to make that happen, the statement said.
The ministry also said that some vaccines require specific storage conditions and administration techniques, which are not available in hospitals.
‘Ridiculous’ delay
“This is a missed opportunity,” said Dr. Sidd Thakor, a pediatrician at Alberta Children’s Hospital in Calgary, where vaccines are also given once a week.
According to Thakor, whenever a patient is admitted, parents are asked if the child is up to date on his vaccinations. Often, they aren’t, he said.
“It still comes back to personal preference,” he said. “But personal choice means you have the opportunity to use it.”
Thakor said that just last week he had to postpone the start of treatment for a sick child who needed to be vaccinated ahead of schedule. Some medications can suppress the immune system, and doctors will want to make sure vaccines are up to date before starting those treatments. Treatment was delayed for about a week.
Thakor said, “Imagine how frustrating it is, not only for a family to wait for further treatment, but to spend time in the hospital, to mobilize resources, for the delays, to me, I think that’s ridiculous.”
Wong said he had recently seen a patient who had been exposed to measles and needed to be vaccinated (a preventive measure taken when known), and there were no arrangements to vaccinate the child at the hospital that day.
The hospital was eventually able to arrange for Public Health to provide vaccinations.
But Wong said it takes unnecessary time and is difficult to arrange.
“It shouldn’t be that hard,” he said.
The Ministry of Primary and Preventive Health Services said there were no active cases of measles as of Friday, and no one had been hospitalized due to the disease at that time.
“We are continuing to promote vaccination, and we hope that the numbers will continue to decline and remain low, allowing us to declare the measles outbreak officially ended, although the risk of new infections always remains,” the ministry statement said.
