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Anna Taddio is professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto

Noni MacDonald is Professor of Pediatrics and Dalhousie University and IWK Health Centre in Halifax.

The COVID-19 pandemic has exposed how inadequate our collective knowledge and confidence in immunization is. A significant percent of the population is reluctant about getting vaccinated, including COVID-19 vaccination, even in the face of the pandemic. People have a lot of questions about COVID-19 vaccination in particular, and about immunization more generally. This includes concerns about how vaccines work, how quickly they were developed, how effective they are and about their safety.

While public health experts have been talking openly and often about COVID-19 vaccination, what they are saying has not been easy for everyone to understand. For many, terms they are using, such as clinical trials, viral mutations, immunogenicity, community immunity, are new. At present, immunization is not part of the grade school curriculum and people learn about these concepts haphazardly - from health providers, family members, friends, media, and the internet. This may result in little common understanding of how and why vaccines effectively control many diseases and what steps ensure our vaccines are safe. Based on an individual’s knowledge, comfort level, and sources of information, there is the potential for significant confusion and misunderstanding that may affect vaccine acceptance.

Several communication strategies on the “basics” of vaccines are being employed to help us through the COVID-19 pandemic. Public health officials and other experts are working to ensure everyone has access to online information that address questions about vaccination. Health providers across the country are receiving up to date information that they can share with patients. Going forward, however, we really need a national plan for immunization education, so that everyone understands the immunization process and how it can contain a serious preventable disease - where the alternative is illness or death and extreme disruption to our usual way of life.

One important step would be to educate the next generation - and the ideal place to do this is at school. Nationally public health agencies have strong relationships with school officials and can work with educators to develop curriculum content and act as information resources. Some public health leaders have already created online resources to help children learn about immunization and self-coping skills, but more is needed. Immunization is a topic that can be integrated into many courses, in health (learning about diseases and how to keep your body healthy), science (learning about how vaccines work and clinical trials), math (understanding risks of disease and risks of vaccination), mental health (learning how to cope with fear and pain from needles) and history (learning how vaccines and vaccine preventable diseases have shaped history). Teaching children about immunization can shape their understanding and thus support vaccine acceptance, by them and their families, as they share what they learn.

Education for health providers should also be strengthened. This will empower them to be advocates for vaccination and engage patients in more conversations about the subject. It will also lead to more consistent information being provided, which will reduce confusion. For health professions that have national licensing examinations, ensuring they include questions about immunization is an important step.

Immunization is a subject we all need to know and care about, just like diet and exercise, so it is time to include it in our school curriculum. Being informed allows one to focus on the relevant questions with respect to decision-making, including about receiving the COVID-19 vaccine.