Get your shots: Canada is failing to meet adult vaccination coverage goals

Canada has failed to meet all vaccination coverage goals for adults as per the 2023 national survey. During World Immunization Week, Dilshad Burman speaks to a family doctor about which vaccines adults are advised to take and why.

None of Canada’s national vaccination coverage goals are being met, according to the government’s Adult National Immunization Coverage Survey (aNICS) published in 2023 — which means many Canadians are likely missing some important shots.

During World Immunization Week, doctors are reminding people that regular vaccinations aren’t just for children.

“When speaking about adults, I landmark a vaccine milestone at 50. We often focus on children and make sure they’re getting updates, but adults need immunizations too” says family doctor Christine Palmay. “I think that once you become an adult, you forget that immunizations are still essential and important.”

Palmay says there are several vaccines that should be taken regularly.

“At a basic level, an adult needs a tetanus shot every 10 years. And while that seems so insignificant, you know, during COVID, I saw plenty of patients virtually who had cut themselves baking sourdough bread or doing renovations. And that simple laceration that may not have needed medical attention became really, really complicated if their tetanus wasn’t updated,” she says.

For those over 50, she advises that the shingles vaccine should be top of mind.

“Nobody wants a shingles episode, but there’s also long-term complications that we can’t forget. So shingles can lead to chronic pain, it can increase your risk of stroke and heart attacks. So when I talk to people about shingles, I’m like, ‘look, that rash is horrible. You’ll be miserable.’ But I’m also talking about vaccines to prevent potential long-term consequences,” she says.

She adds that annual influenza vaccines and COVID-19 vaccines should also be kept in mind and travel vaccines should not be overlooked.

“I often tell people that, ‘you know, it’s a precious time. We hadn’t been able to travel for such a long time. You don’t wanna ruin your vacation, so make sure your travel vaccines are up to date.’ Hepatitis A, we have an oral vaccine for travels, diarrhea, e-coli, and cholera. The list goes on and it’s really contingent on the location you’re going to,” she says.

The Canadian Immunization Guide recommends 10 other routine vaccines for healthy adults at low risk:

  • Diptheria (usually given along with Tetanus)
  • Human papillomavirus (HPV)
  • Influenza
  • Measles, mumps
  • Meningococcal conjugate
  • Pertussis
  • Pneumococcal polysaccharide 23-valent
  • Polio
  • Rubella
  • Varicella (chickenpox)

Palmay says in her experience, the reason many adults aren’t regularly vaccinated is simply a lack of awareness.

“I think that hesitancy or being against vaccines is less of a problem than patients simply not knowing what they are due for. Based on their age or their risk factors, that information also evolves,” she says.

“So I think constant discussions with your healthcare provider is absolutely essential. The problem is that many Ontario residents don’t have a family doctor. So speaking to pharmacists, nurse practitioners — the scope of primary care has expanded – there’s some wonderful credible websites like ‘Immunize Canada.’ So by far I think education and awareness is what we need to target as a public health system.”

In addition, as different countries have their own vaccine recommendations, many Canadian immigrants may not have received the ones recommended in Canada or may not know if they have.

“Some vaccines we can do serological testing for … if an immunization is not known, generally speaking, I provide that immunization to the patients to ensure that they are protected,” says Palmay.

She adds that another reason people might not know or forget about adult vaccinations is because of the success of the vaccines themselves.

“We have the luxury of being so far removed from these vaccine preventable diseases that they’ve become a distant memory, that luxury is unfortunately I think a bit of harm as well. And I think we have to remind ourselves that these vaccines protect against serious disease,” she says.

“It’s not just a chicken pox that goes away. It’s chicken pox that may lead to pneumonia, may lead to meningitis, may lead to hearing loss. It’s not just a shingles shot, it’s a shingles shot to prevent, not only the acute phase, but in a patient perhaps who has comorbidities, who has a cardiac history, [they could] end up in the hospital, end up having a stroke, a heart attack and then doesn’t leave the hospital in the same way he or she entered and requires long-term care … that sounds like a catastrophic rare outcome, but they really aren’t. And I think as a community, we have a public health duty to protect those at risk [by taking our vaccines.]”

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