We Canadians have historically been very good at ensuring that our children receive their recommended immunizations, but we do quite a bit worse when it comes to vaccines recommended for adults. It’s important for all Canadians to know that the responsibility for immunization does not begin and end with children.

A large part of the problem simply comes down to awareness. “Most people, even if they understand that there are some vaccines adults are supposed to get,  don’t really know which ones they are,” says Dr. Shelly McNeil, Vice Chair of Immunize Canada. “They don’t know if they are personally at risk. They don’t know if they are supposed to get the vaccine.”

Looking beyond tetanus and the flu

Most Canadians are aware of the annual influenza vaccine and may know that they are supposed to get periodic tetanus boosters but, for too many, their knowledge of adult vaccines ends there. In truth, there are a wide range of infectious diseases for which adults have access to immunization, and for which vaccination is recommended by the National Advisory Committee on Immunization (NACI).

“They don’t know if they are personally at risk. They don’t know if they are supposed to get the vaccine.”

Children in Canada receive a vaccination against acellular pertussis (whooping cough) as part of their regular vaccine program, but immunity wanes over time and all adults are recommended to receive a second booster, yet only about seven percent do. Similarly, adults can and should be vaccinated against pneumococcal disease (the major cause of pneumonia), hepatitis A, and herpes zoster (shingles), depending on their age. Unfortunately, too few adults are getting these recommended immunizations. For adults born after hepatitis B vaccination, measles/mumps/rubella (MMR) vaccination, and human papillomavirus (HPV) vaccination became standard for children, you can add those to the list as well.

Taking HPV as an example, despite the fact that it is dangerous and ubiquitous, causing almost all cases of cervical cancer, only about 12 percent of Canadians over the age of 20 have received immunization. “The HPV vaccine is routinely given to school age children, and many provinces are expanding that to include boys,” says Dr. Susan Bowles, Chair of Immunize Canada. “But, for all men and women at ongoing risk of exposure, it’s something you definitely want to consider.”

Awareness and access

The two big challenges in working towards a more thoroughly immunized Canada are public education and access. “People don’t want to take time out of their day to make an appointment to go get their vaccine, and they may not even be aware they need a vaccine,” says Dr. Bowles. “Family doctors are very busy and, if they are seeing a patient for an acute condition, the vaccine conversation may not even come up.”

One big step towards making vaccination programs more visible and accessible is the move towards giving vaccines directly in pharmacies, an initiative that has already shown success for flu vaccine compliance in several provinces. “I think that over the next five to ten years we are going to see an increase in the number of vaccines that are available at pharmacies,” says Dr. Bowles.

Whether they get their shot at a pharmacy, a clinic, or their family doctor’s office, however, all Canadian adults should be speaking to their physician about the range of adult vaccinations available to and recommended for them.