Ontario Doctor Advocates for National Vaccine Registry Amid Measles Resurgence

Ontario’s Chief Medical Officer, Dr. Kieran Moore, has called for a national immunization schedule and registry to address the gaps highlighted by the recent resurgence of measles in Canada. In his annual report submitted to the provincial legislature, he emphasized that a centralized digital vaccine system is essential for Ontario to effectively manage vaccine-preventable diseases, especially amid rising vaccine hesitancy.

The report highlighted a fragmented approach to vaccination across Canada, where each province and territory operates its own immunization schedule and data system. For over two decades, health care providers and public health experts have pushed for a cohesive national vaccine registry. The Canadian Paediatric Society has advocated for harmonized vaccine schedules since 1997, yet the situation remains largely unchanged.

Need for Modernization in Ontario

According to Moore, Ontario is falling behind other provinces such as British Columbia, Quebec, Alberta, Manitoba, and Nova Scotia, which have already modernized their vaccine records. This disjointed approach has led to confusion among parents, who often take on the role of record-keepers, and has hindered public health officials from identifying coverage gaps and inequities in access. Such challenges complicate efforts to respond to outbreaks effectively.

Moore pointed out that monitoring vaccine effectiveness and safety has become increasingly difficult, especially considering that parental skepticism towards routine immunizations has doubled in Canada from 2019 to 2024. He stated, “Vaccine-preventable diseases are an ongoing threat that can and will re-emerge if we let our guard down. A recent outbreak of measles in Ontario has unfortunately highlighted how quickly previously controlled diseases can spread.”

In an interview last month, Dr. Vinita Dubey, Toronto’s associate medical officer of health, described the outdated processes in her jurisdiction. Parents are required to track their children’s immunization records and submit them to public school boards in Toronto. This information is then manually entered into the system by Toronto Public Health, which also sends out letters to households that have not provided vaccination records. “It’s a very, very manual process. Our system itself doesn’t speak to a lot of other systems,” Dubey explained.

Efforts Toward a Unified System

Moore’s report noted that the Public Health Agency of Canada is collaborating with provinces and territories to connect existing immunization registries and develop a comprehensive surveillance system for vaccine coverage. As of October 2024, six regions, including Alberta, Saskatchewan, Manitoba, New Brunswick, Nova Scotia, and Yukon, have submitted vaccine records to the federal government.

Currently, Ontario maintains vaccine records in three separate systems: one for schools and child care centres, another for COVID-19 vaccinations, and a third for billing claims under the Ontario Health Insurance Plan. Moore acknowledged the Ministry of Health’s ongoing efforts to connect these systems, which he described as encouraging.

A spokesperson for the ministry indicated that Ontario is working towards providing patients with a digital identity tool that would give them access to their personal health information, including vaccination records. This step is vital, as integrating data from various health care providers without duplicating entries has proven to be a significant challenge.

Routine childhood immunizations are typically administered by family doctors in Ontario, contrasting with other provinces where public health nurses play a more prominent role, facilitating easier data consolidation. Additionally, Moore highlighted the economic benefits of a national vaccine schedule, explaining that centralized procurement could lead to cost reductions through bulk purchasing, prevent duplicate vaccinations, and ultimately decrease preventable hospitalizations.

The need for a robust and modern vaccination system in Ontario is clear, as the province navigates the complexities of public health amid growing skepticism towards vaccines. The recommendations put forth by Dr. Kieran Moore could serve as a crucial step toward ensuring better health outcomes for children and communities across Canada.