As Ontario grapples with the largest measles outbreak in decades, experts are calling on the Ford government to create an electronic immunization registry that would make it easier for people to get vaccinated and reduce the burden of vaccine-preventable diseases.
Members of the Ontario Immunization Advisory Committee (OIAC) are “strongly urging” the government to create an immunization registry that would include vaccination records from infancy to old age for everyone in the province.
The electronic system would replace the yellow paper immunization cards that Ontarians now use to track their vaccinations and would allow individuals and health-care providers to have real-time access to immunization records.
Currently, the province lacks 鈥渁 reliable, complete or timely鈥 system to record vaccinations, according to a , tasked with providing evidence-based advice to Public Health Ontario.
鈥淚mmunization registries are vital tools to make sure that Ontario鈥檚 immunization programs provide the most benefit for individuals and communities,鈥 the committee states.
Dr. Jeff Pernica, the committee鈥檚 co-chair and a pediatric infectious disease specialist at McMaster Children鈥檚 Hospital, called the creation of an immunization registry a 鈥渟lam dunk鈥 for its ability to improve Ontarians’ health. He said the committee鈥檚 call for a registry is especially timely amid the ongoing outbreak.
鈥淭here are multiple ways in which a registry would be helping right now,鈥 Pernica said. A real-time, electronic system would not only help individuals 鈥 and their doctors 鈥 know their vaccination status, it would also assist public health officials in managing their outbreak response, he said.
鈥淚 know a lot of pediatricians at McMaster (Children’s Hospital) who are fielding calls from frantic parents wondering if their children are up to date and whether they need a measles vaccination,鈥 Pernica said.听
鈥淭he number of ways in which a vaccine registry could improve care to Ontarians is almost too numerous to list.鈥
Ontario鈥檚 measles outbreak started in mid-October following the arrival of an infected traveller from New Brunswick. As of April 2, the outbreak has sickened 661 people, mostly unvaccinated infants, children and teens.
The U.S. is also experiencing a measles outbreak, with nearly 500 cases at its epicentre in Texas and cases spreading to New Mexico, Oklahoma and Kansas, The Associated Press reports. On Thursday, a second young child in Texas died of measles-related complications, the third death tied to the outbreak. An adult in New Mexico also died of the infection. All three people who died were unvaccinated, according to AP.听
Dr. Vinita Dubey, associate medical officer of health for 海角社区官网Public Health, said Ontario’s 鈥渧ery large outbreak of measles鈥 is a compelling reason for the province to create an immunization registry.
鈥淥ne of the top rationales for why we need a registry is for when we have outbreaks of infectious diseases where vaccines are part of the control to prevent the spread and save lives,鈥 said Dubey, a member of the OIAC. 鈥淲e need to urgently be able to assess who is vaccinated and who is not, and to act quickly to prevent the spread.鈥
She said 海角社区官网Public Health has been calling on the province to create an immunization registry for more than 10 years. She also noted Canada’s聽 recommends comprehensive vaccine registries.
Ontario鈥檚 current system to record and track immunizations is fragmented.
Individuals are meant to keep track of their own immunizations, including those administered at pharmacies. Though primary care providers administer immunizations, they do not submit records to public health.
Parents of school-aged children are required to submit records to local public health units, which then store records, including for vaccinations administered through school-based programs, in the Digital Health Immunization Repository. But this repository only captures some vaccines for school-aged children and isn鈥檛 accessible to health-care providers outside public health.
鈥淭here are no seamless ways for vaccines to be reported,鈥 Dubey said, adding that a registry needs to be updated in real time and that individuals need to be able to access their own records. 鈥淓veryone has a story of not being able to find their yellow paper record.鈥
In its recommendations, the OIAC noted that Manitoba has a centralized immunization registry that was implemented between 2015-18. The OIAC also pointed to Ontario鈥檚 COVID-19 vaccine registry, COVaxON, as evidence of the province already implementing an electronic system used by all health-care providers.
Dr. Kieran Moore, Ontario鈥檚 chief medical officer of health, told the Star in March 鈥渨e all want to see one immunization record for all Ontarians that individuals can access seamlessly and electronically to know if they鈥檙e up to date.鈥
鈥淚 think that is a gap,鈥 Moore said, adding the government has been briefed on the need for such a registry and is 鈥渋nterested.鈥
鈥淭here are many competing interests within the Ministry of Health and we have to prioritize (a registry) amongst all those competing interests.鈥
A spokesperson for Health Minister Sylvia Jones said the government is 鈥渕odernizing the provincial electronic health record to provide Ontario residents with safe digital access to their personal health information and better access to care.鈥
鈥淲e are working with our partners to make vaccination records digitized, secure, and directly available for those searching,鈥 Ema Popovic said.
Popovic noted public health units collect immunization information to ensure children are up to date and to manage vaccine-preventable diseases in schools. She did not directly say whether these measures address the recommendations laid out by the OIAC.
Maxwell Smith, an assistant professor and Canadian Institutes of Health Research Applied Public Health Chair at Western University, said an immunization registry would aid public health efforts, ensure the easy transfer of vaccine records and help track safety and effectiveness.
He stressed the importance of addressing concerns over privacy and potential government surveillance, especially as these worries are heightened following the pandemic.
Smith said Ontario鈥檚 health system already collects and stores individuals鈥 sensitive health information, and the same privacy protections would apply to an immunization registry.
He said officials need to be 鈥渦pfront鈥 about how the information will be used to preserve trust, noting 鈥渟ome proportion of the population鈥 is skeptical of government intrusion when it comes to vaccines.
鈥淣ot to say that prevents us from having a centralized registry of everyone鈥檚 immunization status. We just need to know there will be that sort of reaction and proactively address it.鈥
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