Abstracts
Keywords:
- professional education,
- public health,
- immunization
Mots-clés :
- formation professionelle,
- santé publique,
- immunisation
That’s the broad umbrella under which my research falls. It’s still important to look at issues around vaccine hesitancy, but my work tends to be more on the access side. That’s an intentional choice, because only about 5% of kids don’t get vaccinated at all because of vehement objection from the parents. About 25% of the population got some of their vaccines, didn’t finish the series, missed a preschool vaccine, missed a second dose of HPV. If that’s 25% of the population and we can get them caught up, we are at what you’d call community immunity. The other reason I focus on the 25% who are incompletely immunized is that it really puts the onus on the health care system to fix the problem. It’s not about changing an individual person’s mind. It’s not about educating an individual person. My focus is on the system-level strategies that make immunization as easy as possible. With regard to the main projects that we’re working on, we’re on the back end now of the COVID-19 pandemic. We know that vaccination with routine vaccines took a hit during the pandemic. Schools closed, kids were online. You can school online, but you can’t vaccinate online. We have lots of kids who missed school-based vaccines, like HPV and Hepatitis B in elementary or junior high school, and meningococcal vaccine and whooping cough booster closer to grade 9. We’d done some studies earlier in the pandemic that showed that, for instance, HPV coverage had dropped to about 5%. We wanted to understand, are we catching up? Because lots of provincial health systems were investing in catch-up programs to varying degrees and with different approaches. Within Alberta, we were able to look at this quite well because we have a province-wide immunization repository, so every vaccine record in the province goes into it. We’ve been looking at those kids who were affected in the first couple of years of the pandemic and then following them for about 4 years now. We’ve finished the analysis of vaccine coverage, and we’re now in the midst of understanding the strategies that were used to affect coverage. There’s value in saying, “Okay, we caught up with HPV,” which we did. We’re not where we want to be, but we’re back to about 70%–72% of kids getting their HPV vaccine, which is where we were pre-pandemic. But for other vaccines, not so much. For the meningococcal vaccine, which is typically given in grade 9, we didn’t get in touch with some of those kids before they graduated high school. They’re now off in colleges and universities, living in dorms where meningococcal vaccine would really be useful. It’s valuable to know where our gaps lie, but it’s also important to look at what we did to get there. What worked? What didn’t work? If we’re ever faced with this situation again, we don’t want to be reinventing the wheel. We want to say, “We had programs where we went into high schools and that seemed to work.” Or, “We were making phone calls to get people into the health centre and that didn’t work.” It’s figuring out what was working. There are policy documents about what was supposed to happen, but we wanted to actually talk to the frontline nurses about when they were told to go into the high schools. How did that happen? How did it work? In some cases, we found that what’s written in the plan is not what the nurses actually encountered. In some cases, going into high schools didn’t work because there were no pre-existing relationships …