Office of Audit and Evaluation, Health Canada and Public Health Agency of Canada - Results at a glance

Evaluation of Immunization and Respiratory Infectious Disease Activities at PHAC

Immunization Activities at PHAC

• Immunization is one of the most successful ways to prevent illness caused by infectious diseases. Vaccines help your body develop the defences it needs to fight diseases like measles, polio, chickenpox, HPV, shingles and the flu. These are called vaccine preventable diseases or VPDs.
• Preventing and controlling VPDs is a priority for the government. That's why the Public Health Agency of Canada (PHAC) works with partners like the provinces and territories and public health experts to track rates of VPDs and immunization coverage in Canada, share information, provide advice and guidance on immunization and prepare for outbreaks.

What the evaluation found

• While immunization coverage in Canada is good, it could be better. It remains difficult to identify the populations in Canada who have not been vaccinated and why.
• Some of PHAC's roles in immunization were clear: provide advice and guidance on immunization, coordinate the purchasing of vaccines, track VPDs, monitor vaccine safety issues and prepare for the event of an outbreak.
• Because many levels of government and other partners work in these areas, PHAC's role was less clear regarding immunization research immunization registries and health promotion.
• The Bulk Purchasing Program for vaccines is working well. PHAC and its partners have the tools to deal well with vaccine shortages when they occur.
• Canadians and people working in health care use PHAC's website as a source of information on immunization, particularly when there is an outbreak.
• Many adult Canadians don't know what vaccinations they should have and often think they are up-to-date, when really they are not.
• Because the rates of most VPDs have been significantly reduced through immunization programs, some Canadians don't see them as posing a significant threat to their health. There is also a lot of mis-information that is available online, which can cause confusion. This is not unique to Canada – many public health officials talk about this as a challenge in other countries as well.
• When vaccines are publically funded, provinces and territories are responsible for making them available to Canadians. Depending on where you live, you may not get access to a vaccine at the same time as another person in a different province or territory.
• There are many different government groups working on immunization issues. Sometimes this has led to confusion, because these groups are not always well coordinated and duplication of effort can result.

Recommendations and responses

1. Strengthen evidence base to address current information gaps on the under- and un-immunized in Canada.
   Response: PHAC will look for ways to obtain a more thorough national immunization coverage picture and get a better sense of why some people are not getting vaccinated.
2. Ensure timely availability of programmatic information regarding immunization for provincial/territorial use.
   Response: PHAC will expand the role and responsibilities of its National Advisory Committee on Immunization so that it can also provide timely and more thorough advice that takes provincial/territorial immunization program realities into account.
3. Determine and implement strategies to influence Canadians' knowledge, attitudes and beliefs related to immunization and respiratory infectious diseases.
   Response: PHAC will develop a social media plan and fund projects to try and increase the number of people getting vaccinated and reduce the number of cases of VPDs.
4. Review governance to enhance efficiencies.
   Response: PHAC will clarify the roles of government-led groups that work on immunization issues, so that groups who work in this area have a good idea of what they should be concentrating on and why.
5. Enhance efficiencies in response activities (including medical case reviews).
   Response: PHAC will clarify what activities take place when there is an outbreak of a VPD to help them plan better for future outbreaks and to get a better sense of what activities are needed and when. PHAC will also determine the best and most efficient process for medical case file review related to vaccine safety.

December 2016