Home » ‘We’re way behind’: How provinces are catching up with children on routine vaccines

‘We’re way behind’: How provinces are catching up with children on routine vaccines

by Naomi Parham

Some young learners struggle with early reading skills, while others stumble over mathematical concepts. Repeated pandemic pivots have left students unpractised with classroom learning, impacted their mental health and estranged them from their peers. CBC News’ Learning Curve series explores the ramifications of COVID-19 for Canadian students and what they will need to recover from pandemic-disrupted schooling.


Since 2017, Chantell Plunkett has worked on school-based vaccination programs in Brampton, Ontario, immunizing children against preventable diseases like HPV, hepatitis B and meningococcal disease.

Then the pandemic hit – and with schools closed, school vaccination programs were suspended across the country, leaving many children behind on their scheduled vaccinations.

In Ontario’s Peel Region, where Plunkett is a clinic supervisor for public health, those who missed scheduled injections in grade 7 have now gone on to high school. They “didn’t really finish their streak with us,” Plunkett said.

“We are way behind schedule,” she added.

Brampton nurse Chantell Plunkett says Peel Region is behind in catching up with children on HPV, hepatitis B and meningococcal vaccines. (Submitted by Chantell Plunkett)

Between school closures, staffing shortages and exhausted public health units, Canadian children and teens are falling behind when it comes to routine vaccinations that prevent various cancers and sexually transmitted diseases.

Public health units are now scrambling to catch up, but there is still work to be done, with several provinces reporting underuse of vaccines. Experts say improving access to routine vaccines will make all the difference.

School curriculum negatively affected, study finds

About two months into the pandemic in 2020, the National Advisory Committee on Immunization (NACI) advised that school-based vaccination programs, including those for adolescents, could be postponed until schools reopen.

But the intermittent nature of in-person learning in the 2020-21 school year — with some students learning virtually or in a hybrid format — meant that not everyone would be in school for a vaccine catch-up.

“School-based vaccines are a totally different animal,” said Shannon MacDonald, lead researcher on the study and associate professor in the Faculty of Nursing and School of Public Health at the University of Alberta at Edmonton.

“Then we had the COVID vaccination program which was rolled out in December [2020]. So public health was called upon again to try to provide COVID vaccines. So this whole 2020-2021 school year has also been a bit lost.”

Shannon MacDonald, an associate professor in the faculty of nursing at the University of Alberta, published a study with a group of other researchers that said routine school-based vaccination programs were most affected by pandemic. (John Ulan/Ulan Photography)

Dr. Meena Dawar, medical officer of health at Vancouver Coastal Health, said staff working in area schools to administer routine vaccines were reassigned when the pandemic hit.

“Our public health staff were brought back and diverted to the COVID case and contact tracing work, which was essentially more urgent at that time,” she said.

Children receive several routine injections to protect against diseases like HPV, meningococcal disease and hepatitis B, Canvax. Vaccines and schedules differ between provinces and territories, but most give them to students in grades 6, 7, 8, and 9.

“Our public health staff were brought back and diverted to the COVID case and contact tracing work, which was essentially more urgent at that time,” said Dr. Meena Dawar, medical officer of health at Vancouver Coastal Health. (Submitted by Meena Dawar)

In 2020, MacDonald and a team of researchers from universities across Canada conducted a pan-national study determine the impact of the pandemic on routine immunization programs.

School-based programs would have been the most negatively affected, according to the study, which is based on interviews with public health officials from 11 provinces and territories (representatives from New Brunswick and Yukon did not participated). School closures, limited resources and some public reluctance to attend health appointments were the main factors.

The Childhood National Immunization Survey, conducted by Statistics Canada every two years, is currently in progress – and these numbers will indicate how the pandemic has impacted routine immunization.

The results won’t be available to the public until 2024, the Public Health Agency of Canada told CBC News in an email.

Catch-up clinics underway as provinces report delays

As public health restrictions ease and schools across the country plan for a full return to in-person learning next year, regional health authorities are relaunching “catch-up” clinics for routine vaccines this summer and fall.

Ariella Zbar, medical officer of health at Fraser Health in British Columbia, said the health unit was waging a campaign to catch up with children after seeing a lag in vaccine coverage in several age groups.

“We are looking at lessons learned from COVID-19,” Zbar said. This includes scaling up services and partnering with the province’s education sector, as well as addressing misinformation and complacency among parents.

Ariella Zbar, medical officer of health at Fraser Health in British Columbia, said the health authority is “reviewing lessons learned from COVID-19.” (Submitted by Ariella Zbar)

In Nova Scotia, health protection officer Kim McGill explained that the province, while observing consistent immunization coverage, is experiencing high rates of absenteeism at school clinics.

“If we, for whatever reason, don’t vaccinate these children before the school year this year, we will follow up in the fall with them.”

Other provinces have a long way to go to catch up with their children.

  • Do you have a question about how children are recovering from pandemic-disrupted learning? Do you have an experience you want to share or ideas that could help get children back on track in school? Email ask@cbc.ca.

In Peel Region, Plunkett says efforts are underway to ensure current students — and graduates — are up to date on their vaccines. This includes extended access until 2023 to a school-based vaccination program for students who graduated this year or last year.

In April, thousands of Ontario students were reportedly behind on their routine vaccinations — those typically given in schools — by at least a single dose.

Additionally, a June poll found New Brunswickers were falling behind in their shots, with the province’s top doctor urging parents to keep their kids up to date.

Another study led by MacDonald showed that in 2019-20, comprehensive HPV coverage among Alberta students dropped from 66.4% to 5.6%, a figure that increased only slightly in during the 2020-2021 school year.

What is driving these low adoption numbers?

“Access, for sure, is the biggest determining factor for routine school-based vaccinations, and probably most other vaccinations as well,” said Dr. Jia Hu, co-chair and CEO of 19 to Zero, an organization of defense of vaccines.

Hu, a former medical officer of health with Alberta Health Services, added that misinformation and vaccine hesitancy played a relatively small role in low uptake compared to access issues.

In October 2021, 19 to Zero released the results of a survey with the University of Toronto which showed that 23% of school children had missed or delayed a routine vaccine during the pandemic.

19 to Zero Co-Chair and CEO Dr. Jia Hu said access is “the biggest driving factor” currently impacting routine school-based vaccinations. (Erin Collins/CBC)

Dr. Sloane Freeman, a Toronto physician and specialist in school medicine, said children living in the city’s marginalized communities were more likely to be learning remotely than others, facing significant barriers to access vaccines.

“They would have been even more affected by the loss of school vaccinations during this time,” she said.

Some marginalized members of the community may be suspicious of health services and providers because of a history of racism or systemic discrimination, CBC News reported last year.

Thus, schools are a crucial forum for vaccine awareness because they are “often seen as the heart of a community and a place where families, parents and students feel safe, based on relationships, trusting relationships with educators,” Freeman said.

“So it’s a great place to not only get vaccinations, but also…information about vaccinations.”


COVID-19 has affected the last three school years. How have your students fared amid pandemic schooling? What worries you the mostof approximately? Share your experiences and concerns with us at ask@cbc.ca (Be sure to include your name and location. They can be broadcast on CBC News Network.)

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