Generating Knowledge for the Future of Vaccination for Public Health

For the Chief Public Health Officer of Canada's Report on the State of Public Health in Canada 2024: Realizing the Future of Vaccination for Public Health

A Companion Report by the Public Health Agency of Canada’s Office of the Chief Science Officer

On this page

• Introduction
• Section 1: Vaccination science landscape
  • Canada's role in global vaccination science
  • Canada's domestic science, research, and surveillance activities
• Section 2: Science and research for the future of vaccination in Canada
  • Call to action for coordinated science and research for strengthened vaccination systems
  • Generating knowledge for informed vaccine decision making
• Appendix A: Glossary
• Appendix B: Methods
• Acknowledgments
• References

Introduction

Each year, Canada's Chief Public Health Officer (CPHO) releases a report on the state of public health in Canada. The 2024 CPHO report, Realizing the Future of Vaccination for Public Health, offers a vision and framework for realizing the full potential of vaccination in Canada, so everyone, at every stage of life, can experience the benefits of vaccination for individual and community health and well-being.^{Footnote 1}

The 2024 CPHO report identified that effective vaccination programs and policies require data and evidence that is timely, comprehensive, relevant, and accessible to decision-makers from health and other sectors, and communities. This data and evidence may come from new research and knowledge synthesis, as well as from mobilizing or adapting existing knowledge.

As the Public Health Agency of Canada's (PHAC) focal point for science excellence, science and policy integration, and science promotion, the Chief Science Officer has developed this companion document to encourage scientific activities and situate those activities within the national and international vaccine landscape. This can help to advance the generation of knowledge and research that may strengthen vaccination data and evidence systems to be responsive, inclusive, and connected.

This companion document to the 2024 CPHO report first provides an overview of key ongoing and planned vaccination-related science activities taking place globally and federally within Canada (Section 1). It then presents a call to action to scientists and researchers across sectors including government, academia, or industry, as well as funders and communities, to support coordinated scientific activities to help “strengthen vaccination systems to address knowledge gaps and research needs” as recommended in the 2024 CPHO report (Section 2).

Section 1: Vaccination science landscape

Science and research play critical roles in generating knowledge for Canada’s vaccination systems, with PHAC focusing on applied research, implementation, science, and innovation in public health practice. Listed below are a subset of international and federal strategies. These include research agendas and mechanisms that support science and research (e.g. research and development [R&D], national guidance, surveillance, and program evaluation), and span core scientific functions such as producing evidence, partnering, providing funding, and promoting and applying science.^{Footnote 2} There are opportunities for Canada to support coherence across the vaccination continuum, from development to deployment and program implementation, confidence, and uptake, both domestically and globally.

Canada's role in global vaccination science

Globally, there are numerous initiatives to enhance vaccination systems and promote collective scientific action in vaccine R&D for both public health emergency and non-emergency contexts.

Canada, through its active membership in global multi-lateral fora and institutes, demonstrates a commitment to guiding scientific innovation, building resilient public health and vaccination systems, and aligning its domestic priorities to global strategies such as the examples provided below. These efforts are supported by a science and research ecosystem comprised of players across Canada who conduct, fund, or collaborate on vaccination-related science and research initiatives. A detailed overview of the broader roles and responsibilities in Canada's vaccination system, including those relating to science and research, is provided in Appendix A of the 2024 CPHO report.

Examples of global vaccination strategies and related agreements include:

• The World Health Organization's (WHO) R&D Blueprint (2016) provides a research framework to accelerate the development of medical countermeasures, including vaccines, against diseases with epidemic and pandemic potential.^{Footnote 2}
• The Pandemic Agreement is being led by the WHO with member states to strengthen and coordinate national and international efforts for pandemic preparedness and response, and support equitable access to vaccines and treatments. The Pandemic Agreement was adopted in May 2025.^{Footnote 3}
• The WHO Immunization Agenda 2030 (IA2030) (2021 to 2030) is a global vision and strategy focused on strengthening immunization systems, including strategic priorities for research and innovation. As part of IA2030, the WHO recently released global priorities for new vaccine R&D for top endemic pathogens.^{Footnote 4Footnote 5}
• The Asia-Pacific Economic Cooperation Action Plan on Vaccination Across the Life Course (2021 to 2030) aims to bolster life course immunization programs, outlines areas for further research, and encourages collaboration among member economies to strengthen science capacity.^{Footnote 6}
• The Coalition for Epidemic Preparedness Innovations (CEPI) CEPI 2.0 (2022 to 2026) and the 100 Days Mission, assert the goal of having safe, effective, and affordable vaccines ready for production and global deployment within the first 100 days of detecting a disease threat.^{Footnote 7}
• Gavi, The Vaccine Alliance, Gavi 6.0 Strategy (2026 to 2030) aims to introduce and scale up vaccines, strengthen health systems to increase equity in immunization, improve sustainability of immunization programs, and ensure healthy markets for vaccine products. One of the enablers for this strategy includes harnessing new digital technologies and data to drive evidence-based outcomes.^{Footnote 8}

Canada funds efforts to increase regional vaccine production capacity in low- and middle-income countries through initiatives like Canada's Global Initiative for Vaccine Equity (CanGIVE), which aims to provide sustained access to vaccinations beyond the COVID-19 pandemic response. Investments made through CanGIVE are part of Canada's $732 million commitment to the Access to COVID-19 Tools Accelerator, which is a global collaboration led by the WHO to accelerate the development and equitable distribution of COVID-19 vaccines, tests, and treatments.^{Footnote 9}

Global investments also address barriers to equitable access to medical countermeasures. For example, Canada has provided to Gavi more than $1.6 billion in core funding to date, including notional support for their African Vaccine Manufacturing Accelerator, and toward the CEPI 5-year strategic plan ($100 million; 2022 to 2026).^{Footnote 10} Global Affairs Canada built on this investment with renewed funding of $1 million to CEPI in 2023 to support the development of vaccines against emerging infectious diseases and continued efforts aligned with CEPI's 100 Days Mission.^{Footnote 11} Annual progress reviews of global efforts related to the 100 Days Mission are prepared by the International Pandemic Preparedness Secretariat, a time limited, independent entity that is led by a steering committee group chaired by Canada's Chief Science Advisor, Dr. Mona Nemer.^{Footnote 12}

Partnerships and collaborations between Canada and international organizations help to advance vaccination science and vaccine R&D. In 2024, Canada joined the International Vaccine Institute (IVI), an international nonprofit organization dedicated to vaccines and vaccination for global health.^{Footnote 13} Canadian representatives are included within IVI's Scientific Advisory Group. IVI also collaborates with Canadian research organizations and industry partners, including a partnership with the Vaccine and Infectious Disease Organization at the University of Saskatchewan to exchange knowledge and opportunities for the shared mission of advancing vaccine science.

These vaccine-specific investments are complemented by investments in broader international initiatives focused on health systems strengthening – a key dimension for supporting the vaccine development to deployment continuum.

Canada's domestic science, research, and surveillance activities

In 2021, Canada released its Biomanufacturing and Life Sciences Strategy with the interrelated objectives of growing the domestic biomanufacturing and life sciences sector and preparing Canada for future pandemics and health emergencies.^{Footnote 14} This strategy is supported by $2.2 billion from the 2021 federal budget for investments over 7 years. The strategy is enabling critical vaccine science and research through funding programs including the Canadian Institutes of Health Research's Clinical Trials Fund, the Social Sciences and Humanities Research Council's Canada Biomedical Research Fund (CBRF), and the Canada Foundation for Innovation's Biosciences Research Infrastructure Fund (BRIF). In 2023, the Government of Canada announced an investment of $10 million through the CBRF-BRIF competition to support the establishment of 5 research hubs intended to bolster research and talent development efforts in collaboration with partners.^{Footnote 15} An additional $575 million is funding innovative research, talent development, and research infrastructure projects endorsed by the hubs. In fall 2024, Canada announced the launch of Health Emergency Readiness Canada, a special operating agency within Innovation, Science and Economic Development Canada that is dedicated to protecting people in Canada against future health emergencies by supporting the development and production of medical countermeasures, such as vaccines, therapeutics, and diagnostics.^{Footnote 16}

Vaccination-related science and research activities at the Public Health Agency of Canada

Within the Canadian vaccination system, PHAC leads, partners, or invests in several initiatives that drive action in vaccine science and immunization programs. A sample of activities, described below, illustrate PHAC's role within the rapidly evolving vaccine landscape. This includes supporting a scientific foundation and guiding research to contribute to a strong evidence base for public health programs.

Vaccine research and development

PHAC's National Microbiology Laboratory (NML) is Canada's only Containment Level 4 laboratory for human health and is essential to leading vaccine R&D, including the development of the world's first Ebola vaccine and vaccine candidates for COVID-19.^{Footnote 17Footnote 18Footnote 19} The NML has a unique capacity to conduct vaccine research using genomics, immunology, and animal models. Comprehensive surveillance and genomic analysis of emerging pathogens further informs vaccine development and aids in the identification of vaccine candidates. Capabilities in conducting immunological and serological animal studies allows for the study and differentiation of immunity induced by vaccines versus infection, as well as studies assessing the safety and efficacy of vaccine candidates. In addition, as a National Influenza Centre for the WHO, the NML receives and analyses influenza virus specimens which contribute to the formulation of WHO recommendations on the composition of annual influenza vaccines.

Immunization and vaccine-preventable disease surveillance

PHAC partners with provinces and territories, researchers, and institutions to conduct immunization-relevant surveillance to track trends in vaccine-preventable diseases, monitor vaccine effectiveness and safety, and detect signs and signals of vaccine escape, breakthrough infections, and waning immunity levels in populations living in situations of higher risk and in communities across Canada. Surveillance initiatives include surveys like the Childhood and Adult Immunization Coverage Surveys (cNICS and aNICS), surveillance reports like the Vaccine Preventable Disease Surveillance Report, and the development of the Standardized Reporting on Vaccination (STARVAX) system.^{Footnote 20Footnote 21Footnote 22Footnote 23} PHAC also plays a critical role in maintaining high standards of vaccine safety, including the ability to respond to serious adverse events following immunization that are identified through functions like the Canadian Adverse Event Following Immunization Surveillance System (CAEFISS), and by funding the Canadian Cardiovascular Society for the MYCOVACC surveillance study of myocarditis and pericarditis following mRNA COVID-19 vaccinations (2022 to March 2026).^{Footnote 24Footnote 25} PHAC also funds integrated sentinel surveillance networks in hospitals, like the Surveillance Program for the Rapid IdeNtification and Tracking of Infectious Diseases in KidS (SPRINT-KIDS).^{Footnote 26}

National guidance and science advice for immunization programs

To support the implementation of vaccination programs across Canada and promote the scientific evidence base for vaccination programs and recommendations, PHAC publishes national guidance through the National Advisory Committee on Immunization (NACI). NACI is an external advisory body that provides independent expert advice to PHAC on the optimal use of vaccines authorized for use in Canada. Their statements help to inform provincial and territorial decision-makers on vaccination programs and outline research priorities for specific vaccines.

PHAC leads collaborative efforts to identify research priorities for emerging public health issues, such as avian influenza A(H5Nx), including the development, evaluation and use of vaccines and therapeutics in the context of pandemic preparedness and response.^{Footnote 27} Several additional PHAC-led prioritization initiatives are underway that highlight pressing areas of research to continue guiding knowledge generation and refining future guidance in the rapidly evolving vaccination space. These include NACI identification of targeted knowledge gaps and research needs to inform immunization recommendations, vaccine research and development priorities for the context of endemic infectious diseases (planned to be updated for 2025), and a prioritization framework for infectious disease medical countermeasures for the context of pandemic preparedness and other unmet public health needs.^{Footnote 28}

The renewed interim National Immunization Strategy (NIS), planned for release in fall 2025, will outline goals and objectives for federal, provincial, and territorial governments and key immunization partners to catalyze action within 11 pillars—including vaccine innovation, research, and development; and program evaluation and research—to improve vaccination programs across Canada.^{Footnote 29} The NIS also fulfills Canada's commitment to the WHO's IA2030, which calls on countries to have immunization strategies as a “mechanism to ensure ownership and accountability and a monitoring and evaluation framework to guide country implementation”.^{Footnote 4}

Enabling evidence systems for vaccination

PHAC routinely conducts and commissions evidence syntheses, assessing the scientific literature to provide timely and comprehensive evidence to inform vaccination programs, and supports the generation of evidence through collaboration on studies as co-investigators or as knowledge users. In addition, PHAC and the Canadian Institutes of Health Research have provided a renewed investment of $15 million (2024 to 2029) to the Canadian Immunization Research Network, a body focused on vaccine safety, immunogenicity and effectiveness, and immunization program implementation and evaluation.^{Footnote 30} This renewed investment will target priority research areas and address diverse immunization research requirements in Canada.^{Footnote 31} Moreover, the Canadian Association for Immunization Research, Evaluation and Education, a professional organization dedicated to building the scientific foundation for optimal immunization programs, includes NACI liaisons and representatives in all of their working groups to foster 2-way communication on items related to vaccine research and evaluation.^{Footnote 32} PHAC also participates in and collaborates on the planning and delivery of the Canadian Immunization Conference, supporting scientific knowledge mobilization to help shape the future of Canada's vaccination research, policies, and programs.^{Footnote 33}

Behavioural science for vaccination

PHAC contributes to and conducts behavioural science research on topics relevant to Canada's public health priorities to support better understanding of what influences individuals' health-related attitudes and behaviours.^{Footnote 34} PHAC conducts and leverages a variety of research methods to better understand vaccination knowledge, beliefs and behaviours, vaccine intentions and uptake, news consumption and information sources, and other relevant topics. Currently, PHAC is working to fill a key evidence gap highlighted in the 2024 CPHO report through the Vaccine Access Project (Vaxxess), which aims to better understand the link between people's access to material health resources and information, and their attitudes and behaviours surrounding vaccination, an underexplored, but essential topic for enhancing vaccination in Canada.

Indigenous, First Nations, Inuit, and Métis knowledge, expertise, and advice for vaccination

At the time of writing, PHAC is actively working on integrating Indigenous expertise, evidence, and considerations in the development of immunization guidance issued by NACI for the renewed NIS, in partnership with the Indigenous Services Canada (ISC) First Nations and Inuit Health Branch (FNIHB). For example, updates to respiratory syncytial virus (RSV) vaccine guidance for infants and adults, and the 2025 to 26 Seasonal Influenza Statement. As members or liaisons to NACI, ISC, including FNIHB, the Indigenous Physicians Association of Canada, and Canadian Indigenous Nurses Association, are contributing to immunization guidance.

Section 2: Science and research for the future of vaccination in Canada

Call to action for coordinated science and research for strengthened vaccination systems

As the vaccination and public health landscape adapts to changes in disease patterns, information environments, and technology, health systems must also evolve to advance sustainable and equitable access to priority vaccines.

Science and research are integral to this mission. There are opportunities for cohesive and collaborative scientific action, including domestic alignment with global strategies that can strengthen multidisciplinary science, R&D investments, and networks while leveraging Canadian expertise.

Research funding and collaboration mechanisms must be responsive to support rapid research and the amplified need for scientific coordination related to vaccination during public health emergencies; support systems-level research to better understand and address factors affecting vaccine policy and programs; and promote diverse interdisciplinary and cross-sectoral collaboration. Non-health sectors play an important role in the vaccination system, as well as in the generation of evidence using a One Health approach for issues at the interface of human, animal, and environmental health.

Essential to this call for collective research action are cross-cutting principles and Indigenous rights-based frameworks, as identified in the 2024 CPHO report (see text boxes “Cross-cutting principles for vaccination-related science and research” and “Extending an Indigenous rights-based approach to vaccination-related science and research”).

Generating knowledge for informed vaccine decision making

Science and research activities to address these knowledge gaps may be achieved through a diversity of approaches across sectors and disciplines. While these areas are not intended to privilege specific research areas, designs, or methodological approaches, researchers can consider the importance of implementation research and evaluation, participatory and community-led research, interdisciplinary research, and the integration of First Nations, Inuit, and Métis research principles.

Understand the impacts of vaccine-related mis- and disinformation and identify effective system-level interventions to address them.

Specific topics include:

• Exploring the effectiveness of strategies to improve science and digital health literacy and to address vaccine related mis- and disinformation in various populations, contexts, and environments (e.g., strategies to improve the public's ability to find and appraise online information, including to how mitigate information overload and mixed messaging during public health emergencies).
• Exploring the differential impacts of mis- and disinformation across populations (e.g. younger adults, new parents, men, and populations experiencing inequities), which may arise from systemic, technological, and cultural factors, including social media use, and access to a trusted and credible information source, like a healthcare provider.

Explore individual, societal, and structural factors and how they intersect to impact differential vaccine access, acceptance, and uptake across the life course.

Specific topics include:

• Exploring how factors that impact the acceptance of vaccines and other relevant public health measures are interconnected, and the effects of interventions to modify these factors. These may include social and structural factors such as systemic racism, institutional practices, public policies, and dominant social norms; geographic and sociodemographic factors; knowledge, attitudes, and beliefs about vaccination across different locations and populations throughout the life course.
• Understanding the prevalence and interplay of attitudinal, behavioural, and access factors, including the role of non-health partners (e.g., education sector, workplaces) and policies, in influencing public confidence and uptake for different vaccines.

Explore how data and vaccine surveillance systems or networks can be integrated across jurisdictions to identify differential vaccine coverage and the impacts of vaccination across various sub-populations and across the life course.

Specific topics include:

• Exploring ways to enhance the completeness of sociodemographic information and interoperability of electronic medical records, vaccine registries, laboratory results, and other vaccine-preventable disease surveillance systems to monitor the population-level findings of vaccination across the life course.
• Exploring how interoperable vaccine registries and linkages to medical records influence data accessibility for patients, healthcare providers, and public health practitioners.
• Evaluating how innovative methodologies and advanced analytical approaches (e.g., machine learning, big data approaches, artificial intelligence) can complement vaccination safety and coverage monitoring, and vaccine-preventable disease surveillance.
• Developing, validating, and applying systematic and equity-informed methods and public health indicators that can consistently measure vaccine access and uptake as well as knowledge, attitudes, and beliefs about vaccination across the life course.

Explore approaches to systematically integrate community perspectives into interdisciplinary vaccination evidence systems and decision making for vaccination program and policy.

Specific topics include:

• Exploring how community-based learnings can inform vaccination program and policy. For example, to inform culturally relevant and needs-specific healthcare for vaccination (i.e., vaccination sites and services; tailored resources) for populations who are generally not well-served by traditional vaccination services. Populations may include Indigenous Peoples, some racialized populations, people from the 2SLGBTQI+ community, persons with disabilities, people experiencing homelessness, people who use drugs, and people involved in the criminal justice system.

Innovate and evaluate digital health and vaccine technologies and interventions for supporting equitable access to vaccines.

Specific topics include:

• Exploring vaccine technologies that could impact acceptability of vaccine (e.g., oral vaccines, nasal vaccines, microneedle array patches) and accessibility (e.g., vaccines with long shelf-life, vaccines with less stringent storage requirements) and the potential impact of these technologies for different populations throughout the life course.
• Evaluating the impact of digital health technologies and interventions on uptake of vaccines and efficiency of the vaccination process, and how they can be tailored for different populations or contexts (e.g., reminder/recall systems, electronic consent for school-based vaccinations, clinical decision support alerts for healthcare professionals, and educational interventions that share materials about mis- and disinformation).

Explore and evaluate the economic, social, and public health impacts of vaccination policies and programs across sub-populations and the life course.

Specific topics include:

• Evaluating whether and how vaccination programs and policies contribute to achieving public health objectives in the short- and long-term.
• Conducting equity-informed economic analyses on vaccination policies and programs to understand differential impacts on health, and the broader social and economic impacts of vaccination.
• Evaluating the comparative cost-effectiveness of multiple vaccinations and delivery approaches within publicly funded vaccination programs and in varying scenarios, including studying entire vaccination programs or schedules.

Appendix A: Glossary

Applied Research: Research activities conducted for the advancement of scientific knowledge with a specific practical application.^{Footnote 35}

Equity: The principle of considering people's unique experiences and differing situations and ensuring they have access to the resources and opportunities that are necessary for them to attain just outcomes.^{Footnote 34}

Evidence: Factual knowledge gained through observation or experimentation in support of a conclusion.^{Footnote 36}

Implementation science: The study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies into routine healthcare and public health settings. Its goal is to identify factors and processes that facilitate or hinder the successful implementation of these interventions, ultimately improving population health outcomes.^{Footnote 37}

Indigenous data sovereignty: Ensures that First Nations, Inuit, and Métis communities lead and have ownership of the data collection and analysis process and dissemination of research findings and results. Communities have the right to hold ownership over their knowledge, including traditions, cultures, and histories and traditional Western evidence sources, like quantitative and qualitative research data, that relates to First Nations, Inuit, and Métis Peoples.^{Footnote 1}

Mis- and disinformation: Misinformation is a broad term used to refer to many types of false or misleading information, some of which may exist without malicious intent. Disinformation is incorrect information that is created or spread specifically to deceive or mislead. There are a variety of reasons for the creation and spread of disinformation, including financial motives (e.g., advertising revenue, sale of supplements or natural health products) or the promotion of polarization for personal or political gain. Vaccine mis- or disinformation may be about vaccines or the vaccination system, including vaccine safety or efficacy and conspiracies about vaccine development and promotion.^{Footnote 1}

Research: An undertaking intended to extend knowledge through a disciplined inquiry and/or systematic investigation.^{Footnote 36}

Science: A systematic and iterative process of inquiry and investigation that seeks to understand the natural and social world through the collection and analysis of empirical evidence, the formulation of testable hypotheses, and the development of theoretical frameworks. It encompasses various epistemological approaches, including but not limited to positivism, constructivism, and traditional, including Indigenous, Afrocentric, or other cultural knowledge systems, recognizing that different cultures and communities may have unique ways of understanding and interpreting the world.^{Footnote 34}

Vaccination across the life course: A life course approach to vaccination aims to maximize the benefits of vaccines for health and well-being throughout the life span and integrate vaccination with other age-related health interventions, from infancy to older adulthood.^{Footnote 1}

Vaccination and immunization: While often used interchangeably, vaccination refers to the act of introducing a vaccine into the body, while immunization is the process of becoming protected against a disease. This protection can result from vaccination or exposure to pathogens, which are microorganisms, such as viruses, bacteria, and parasites that cause disease. Within this companion document, the terms vaccination and immunization are largely used interchangeably to refer to immunization via vaccines.^{Footnote 1}

Vaccination surveillance: Public health surveillance involves the ongoing and systematic collection, analysis, and application of data to understand and work to improve the health of populations. This includes various surveillance data sources, such as traditional public health, healthcare, and laboratory information systems, cross-sectional surveys, media and internet monitoring, and other methods, such as wastewater surveillance. Comprehensive vaccination surveillance systems incorporate data and analysis of vaccine-preventable diseases, vaccine coverage, and vaccine safety.^{Footnote 1}

Vaccine acceptance: The willingness or intent to receive a vaccine.^{Footnote 1}

Vaccination system: Vaccines and vaccination rely on interconnected systems for research and development, manufacturing, regulatory approval, recommendations for use, program implementation, procurement, delivery, uptake, and surveillance. The network of organizations, processes, and resources involved in these components is referred to as the vaccination system. Key players include research institutions and academia, pharmaceutical and biotechnology companies, international partners, governments (federal, provincial, territorial, Indigenous, and local), non-governmental and public health organizations, healthcare providers, and communities, among many others.^{Footnote 1}

Appendix B: Methods

Scoping and literature review

The science and research initiatives in Section 1 were identified by reviewing grey literature and activities that the Public Health Agency of Canada and other federal departments are engaged in for vaccination-related science. Each activity was reviewed to determine if it met 2 criteria: 1) it includes a science or research component; and, 2) the Government of Canada is involved in producing, partnering, funding, promoting, and/or applying science and research. The document presents a selection of these activities to highlight key initiatives and show the full range of efforts.

Synthesis of knowledge gaps and research needs

The knowledge gaps and research needs outlined in Section 2 were identified from the 2024 CPHO report. Both inferred or directly stated knowledge gaps and research needs were extracted, synthesized, and refined for clarity. The resulting list is presented to match the report's scope, language, and structure at a high level.

Validation

A full draft of the document was validated for scientific and public health resonance by experts in topics intersecting with vaccination and public health systems who collaborated and contributed to the development of the 2024 CPHO report. Section 1 was validated to ensure the accuracy of the vaccination-related science and research activities described, and to identify Indigenous-specific initiatives for inclusion. Section 2 was validated to assess whether each knowledge gap and research need: 1) represented a true gap in the evidence base, methods, or tools; and, 2) contributed toward achieving the report's vision, objectives, and recommendations. Reviewers were also invited to identify additional knowledge gaps or research needs considered critical to advancing the vision, objectives, and recommendations of the report.

Limitations

The framing and inclusion of First Nations, Inuit, and Métis science considerations included in this companion document are derived from the 2024 CPHO report, and do not represent Indigenous-validated science and research initiatives, knowledge gaps, or research needs. Indigenous research priorities should be identified through Indigenous-led approaches.

Acknowledgments

I would first like to acknowledge Canada's Chief Public Health Officer, Dr. Theresa Tam, and her team for the 2024 CPHO report on Realizing the Future of Vaccination. This report lays out a detailed pathway to strengthen the public health vaccination system to realize equitable and sustainable access to priority vaccines for all.

Thank you to CPHO report advisors, Dr. Noni MacDonald and Dr. Shannon MacDonald, for their contributions to the validation of this document.

In addition, I wish to thank colleagues across PHAC's Infectious Disease and Vaccination Programs Branch, including intramural experts from the Centres for Immunization Surveillance and Vaccine and Therapeutics Readiness, and Dr. Kerry Robinson, whose inputs and recommendations were integral to the development, validation, and technical review of this document.

In closing, I am thankful for the work of my team, in PHAC's Office of the Chief Science Officer, who supported the development of this report including Anna Bellos, Sydney Jennings, Dr. Kathryn Asher, and Mette Cornelisse.