ARCHIVED: Section C: National Immunization Strategy (NIS): Final report 2003 – Description of supporting activities
There are certain activities that cut across, and support, the five components of the NIS. There is potential to incorporate these activities into the overall NIS; however, further work is required to determine how these activities could best be integrated. These supporting activities are as follows:
C.1 Immunization Research
The objectives of this supporting NIS activity would be to:
- Improve the immunization research capacity in Canada, including surge capacity to deal with urgent issues (e.g., vaccine safety).
- Improve coordination of current and future immunization research activities in Canada, to support governmental needs and NIS goals.
- Facilitate the availability of timely, reliable information and evidence to support informed decision-making in all jurisdictions.
The current immunization research community in Canada is better established for the development and pre-licensure testing of new products, with funding predominantly coming from government grants or private industry. Research on effective program implementation and monitoring once vaccines are licensed (e.g., models to predict the effect of the new program, determining the most effective uptake measures, assessing cost-effectiveness, evaluation of education needs of professionals/the public) could be enhanced. Furthermore, the immunization research community in Canada is small, consisting mainly of senior specialists with multiple commitments, clustered in "pockets" across Canada.
There is a need to identify, document, and prioritize immunization research needs in Canada, as well as to pro-actively identify gaps in research funding envelopes and discuss strategies for prioritizing future needs. In doing this, strong partnerships must be established with research groups, industry, and funding agencies, such as the Canadian Institutes of Health Research (CIHR), the Canadian Association for Immunization Research and Evaluation (CAIRE), Canadian Population Health Institute (CPHI), and the Canadian Network for Vaccines and Immunotherapeutics (CANVAC). A preliminary list of immunization research priorities was developed using information from a meeting of key stakeholders held in February 2002, and could serve as a basis for further work on this topic.
C.2 Public and Professional Education
National organizations, such as the Canadian Immunization Awareness Program (CIAP), are currently the main sources of national information on immunization and vaccine safety issues and educational materials. There are also local, P/T, federal and professional organizations that provide information on these issues through existing websites. Messages are not always coordinated or consistent. International sources of information may not be relevant as licensed vaccines differ from those in Canada.
A national communication strategy for immunization (including vaccine safety issues) to develop national communication and educational tools/materials, and to disseminate immunization information in a coordinated, consistent way would be valuable. Strong partnerships with existing national organizations, such as CIAP, would be important. Consideration could also be given to establishing a communications network of key stakeholders, including F/P/T governments, which would be capable of disseminating pertinent information on immunization and immunization safety issues in a timely manner.
C.3 Approaches to Special Populations
The Aboriginal peoples require partnership in the NIS. It is proposed that Aboriginal organizations be linked into the NIS and that linkages be developed with the First Nations and Inuit Health Branch.
Other special populations, such as immigrants, refugees, travelers, certain religious groups, populations with low socio-economic status, and the elderly, will also require specific program attention as part of the NIS.
C.4 Vaccine-Preventable Disease Surveillance
Currently, Health Canada administers the Notifiable Diseases Reporting System (NDRS), in which reports of "notifiable diseases" are submitted by the provinces and territories across Canada based on a general agreement and recognition of the importance of a centralized data source. Health Canada uses these data to monitor national vaccine-preventable disease trends and provides summary reports through the Health Canada website. Health Canada also facilitates the development and implementation of national standards, such as case definitions and data models, and provides some support for P/T surveillance through material resources (e.g., computer tools), financial resources (e.g., CIPHS collaborative), and human resources (e.g., gap analysis, field epidemiologist support).
Other surveillance initiatives include the Canadian Paediatric Surveillance Program (CPSP), sentinel and targeted surveillance for viral hepatitis and influenza, and international circumpolar surveillance for specific vaccine-preventable diseases.
There are a number of important limitations to the current vaccine-preventable disease surveillance system, which fall generally into the following categories:
- Data quality and comprehensiveness could be improved, as variations exist between jurisdictions.
- Data analysis is mostly basic.
- Feedback/reporting could be more timely.
- Coordination and priority-setting could be improved.
A national mechanism for working with stakeholders to improve the current vaccine-preventable diseases surveillance system would be beneficial.
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