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Canada Ontario immunization campaigns increasingly failing to reach some families, new data shows

The number of Ontario students with non-medical exemptions for vaccines has risen slightly in recent years, showing provincial immunization campaigns are failing to reach some families.

The figures, released on Tuesday by Public Health Ontario, show that in the 2017-18 school year, 2.5 per cent of seven-year-olds had a non-medical exemption for measles, up from 2 per cent in 2013-14. Non-medical exemptions can be filed by parents who have a religious or conscience objection to vaccination and allows students to attend school without the immunizations required by the province.

Similarly, 2.5 per cent of seven-year-olds had a tetanus exemption in 2017-18, up from 1.9 per cent in 2013-14.

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“It certainly does suggest that the proportion of children with non-medical exemptions appears to be increasing, slowly but steadily,” said Sarah Wilson, a physician with Public Health Ontario.

Non-medical exemptions are much higher in certain parts of the province, which could point to areas where vaccination rates are lower and disease outbreaks are more likely to occur. For instance, about 11 per cent of students in the Elgin St. Thomas Public Health and Oxford County Public Health catchment areas had a non-medical exemption to at least one of the vaccines required for school attendance in Ontario in 2017-18. Those two health units have since merged to form Southwestern Public Health.

Joyce Lock, Southwestern’s medical officer of health, said officials are aware that some communities in the area are wary of vaccination and that the health unit has created strategies to increase rates. For instance, public-health nurses will meet with community members to discuss the positive aspects of vaccination and dispel myths about vaccines, Dr. Lock said.

“We continue to build strong relationships with these communities through the personal one-on-one relationships that our front-line staff make with these individuals that have concerns about vaccines,” she said.

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Over all, vaccination rates across Ontario are relatively high, but are failing to reach national goals required for herd immunity. For instance, 87.6 per cent of seven-year-olds have up-to-date measles vaccines in Ontario. Nearly 86 per cent of those students are also up-to-date for the whooping-cough vaccine. But those diseases require 95-per-cent coverage for herd immunity.

Ontario and New Brunswick are the only provinces that currently require school-age vaccinations, providing the clearest picture of rates of vaccination.

It’s unclear if the rates reflect actual significant shortfalls in vaccination coverage, or if the record keeping is falling short, Dr. Wilson said.

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“We have no way of quantifying what that number is,” she said.

In Ontario, most students are vaccinated by a primary-care provider who operates outside of a public-health unit. Parents must notify health units of a child’s immunization status in order for them to attend school, but in some cases, this may not happen.

A report released by Ontario earlier this month helps shed more light on the issue. That study looked at the number of students who had no vaccinations on record and also had a non-medical exemption. Dr. Wilson said it’s fair to assume that cohort of students were the ones in the province who hadn’t been vaccinated. The overall numbers were low, but in certain pockets of Ontario, such as the southwestern part of the province, the rates were much higher.

The study found that unvaccinated students with non-medical exemptions were more likely to attend private or religious schools or be home-schooled.

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