Canadian doctors are warning that a new U.S. policy which slashes the number of vaccines universally recommended to all children could have devastating, and potentially deadly effects in Canada, including increasing disease spread through American travellers visiting north of the border.
“This was just incomprehensibly stupid. I was horrified,” said family doctor and former president of the Ontario Medical Association, Dr. Sohail Gandhi in an interview with CTV News Saturday. “Children in the U.S. are going to die as a result of this move – and, worse, some children are going to have lifelong complications as a result of this move."
On Monday, the U.S. Centre for Disease Control (CDC) announced it will slash routine vaccine recommendations for all children from 17 down to 11, no longer suggesting protection against diseases like COVID-19, hepatitis A, Hepatitis B, influenza, rotavirus, respiratory syncytial virus (RSV) and meningococcal disease.
CTV News spoke to several health professionals who say this will have a compounding effect, with vaccine hesitancy on the rise in Canada and immunization numbers dwindling.
In combination with an expected increase in the disease spread in the U.S., because of the new CDC policy, and American travellers crossing the border, it could result in increased spread of those diseases in Canada, they said.
“We’re going to see upticks of these diseases,” Gandhi said.
“We still have people coming from the U.S., and we still have Canadians going to the U.S… Going into areas where there’s not as much immunization as there should be, and there’s not enough herd immunization. So, I wouldn’t call it the possibility, I would say it is definitely going to happen.
Vaccine hesitancy
The worry is that American tourists, who aren’t inoculated against those diseases because it’s no longer recommended, are stepping into a situation that is ripe for disease spread due to dropping vaccination numbers.
Health professionals say they’re seeing more vaccine hesitancy among their patients, which is supported by a recent Leger poll that showed more than a quarter of those surveyed had lost confidence in vaccines.
“We always worry about vaccine hesitancy,” said Dr. Allan Grill, chief of family medicine at Markham-Stouffville Hospital. “We’re so closely tied to the U.S., information is shared freely, people can travel freely. Any time something happens where the rate of getting a vaccine goes down, it could result in more cases in both countries.”
Grill says he’s especially concerned about rotavirus and meningitis diseases spreading here in Canada, for which inoculation targets are not being met. They are worried they may increase in cases the same way measles did.
“It’s definitely worrisome,” said Grill. “We’ve seen rates of vaccination of measles drop both here and, in the U.S., and that’s resulted in increased cases. When I trained 20 years ago, we didn’t even think about measles, especially being in Canada, but when rates go down, people can get the diseases.”
Doctors also warn that eliminating roughly a third of the vaccines on the U.S. CDC’s recommended list will confuse most Canadians, who may question the efficacy of the other remaining vaccines on the list.
“It basically causes people to question how safe and how necessary all the vaccines are, seeing a drop from 17 to 11 and knowing that the ones they dropped are actually still very important as well,” said the current president of the Ontario Medical Association, Dr. Zainab Abdurrahman. ”They start to question the ones that are even on that 11, and they’re wondering which ones are necessary or how well studied they are.”
“In the past, we have also referred to some of these U.S. based guidelines as a trusted source. And now that’s going to cause confusion because people are going to see that it’s no longer that (trusted) from a Canadian perspective,” Abdurrahman added.
Canada to keep its recommendations
Canadian physicians also question how many more patients the already overburdened healthcare system can handle, with having to potentially treat more unvaccinated Canadians and American travellers.
“We’re going to see our health care system be further over capacity at this point. We’ve seen with the influenza season, we’ve already seen an overwhelming of some of our children’s hospitals and several of our hospitals in the province,” Abdurrahman said.
“Now, if you add on other things that are being held back because of vaccines like RSV, like COVID-19, if we have all of this layered on top, our health care system actually cannot accommodate much more.”
However, doctors add that Canada will not follow the U.S.’s lead and will continue to recommend vaccines for all six diseases taken off the U.S. CDC’s list.
“There’s no reason to believe that the recommendations in Canada are going to change,” said Grill. “The recommendations that we have here in Canada are based on strong evidence and I’m very confident that our vaccines are safe and effective.”
“Changes to vaccine recommendations by the U.S. do not affect evidence-based decision-making about vaccine use in Canada. Childhood vaccination continues to remain one of our most powerful preventive tools to support child health in Canada,” a spokesperson for Health Canada and the Public Health Agency of Canada, André Gagnon, told CTV News in an email.
Gagnon added that there is a need for targeted interventions “to improve childhood vaccine series completion in Canada, including strengthened follow-up and reminder systems, as well as improved access to and uptake of publicly funded adult vaccines.”
