Can Canada’s immunization programs be stopped now?

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November 3, 2016

By Dr. Lillian Lum

Toronto’s top doctor says she expects vaccines, approved and offered for young children within weeks.

Dr. Lillian Lum, editor of the Canadian Medical Association Journal and president-elect of the CMAJ, comments on a recent decision by Health Canada to ban vaccines for infants under six months of age based on a small but vocal minority who claim they can cause autism.

Since September 2013, those labels have applied to three vaccines provided to Canadian infants and toddlers who require the DTaP (diphtheria, tetanus, pertussis) booster. (Those vaccinations are in addition to oral-meningococcal vaccines given to nine-month-olds.) Some pediatricians began offering these vaccines for infants in 2014 after Health Canada decided to suspend further clinical studies on babies under six months of age.

But as the controversy picked up steam over the past several months, the government relented and said the vaccines would be covered for infants beginning October 26, 2017.

“The recent decision by Health Canada means that children who have been immunized against these vaccines will now be able to receive them at earlier ages and keep their most efficient immunity,” Dr. Lum said in an e-mail statement. “Most physicians look forward to offering these vaccines to their patients within the coming weeks.”

The flurry of activity followed what was thought to be a decision by The Advisory Committee on Immunization Practices, a group of medical specialists at The U.S. Centers for Disease Control and Prevention (CDC), to stop recommending the vaccine for infants.

Yet the committee’s website shows it voted to recommend the vaccines for infants in February, after review of the randomized controlled trials supporting their safety and effectiveness, said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. The CDC reassessed the committee’s decision and “approved their request to resume the recommendation,” Hotez said.

A press release from Health Canada explained that it’s no longer recommending the vaccine for infants because of safety concerns that were proven to be unfounded following Health Canada’s review of the available data. But it reminded the public that health care professionals can request immunization for infants under six months of age if they have a medical reason.

Dr. Elizabeth Bradley, a pediatrician and spokeswoman for the Canadian Association of Pediatrics, agrees.

“Those who claim that there’s a connection between the vaccines and autism face a population that is just unreasonable and often belligerent,” Bradley said. “That’s just how it is. It’s just life in a public health system.”

But at the very least, the decision to stop vaccinating against pertussis (whooping cough) in infants was a mistake, she added.

“Really, now it’s very clear. We should have held on until everybody had the opportunity to realize, ‘Maybe what we’re saying isn’t quite correct,’ ” she said. “If those of us who have recognized the wisdom of treating the children in the strongest possible manner before we provide them a vaccine in a child’s early life are wrong, then I feel that there should have been that consequence.”

“I hope that we will provide certainty to the public,” Bradley said. “It’s reassuring to be able to say that there are the science and data to support children in the first six months having been immunized against pertussis. There’s no reason for these vaccinations to be suspended.”

Lum, meanwhile, shares that hope, and doesn’t blame baby boomers like herself who received vaccines.

“I’m always dismayed when we hear comments that go against science,” she said. “It’s always hard for me to hear people attributing cause to a vaccine, as if they just won the lotto and they know what will happen in the future.”

“I don’t think it’s realistic to assume science always supports a particular theory or vaccine,” she said. “There is a great deal of uncertainty and many gaps in the research. And I think we’re all aware of that.

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