Canadians, by and large, are extremely healthy. Across the developed world, life expectancies have been steadily increasing over the last century as infant mortality and the incidence of serious outbreaks of infectious disease have dropped. Among the many factors that have enabled this blessing of good public health, vaccination is second only to access to clean water in terms of impact.

Unfortunately, Canadians have become complacent about vaccination, particularly those recommended for adults rather than children. While the lack of a national vaccine registry makes it difficult to know exactly how many Canadians have received their recommended vaccinations, the National Immunization Coverage Survey by the Public Health Agency of Canada shows that vaccination rates in adults fall well below targets across the board. “We have a mentality that vaccines are for kids only,” says Dr. Susan Bowles, Chair of Immunize Canada. “In reality, vaccines are for everybody. The vaccines you receive as a child are very important, but the vaccines you receive as an adult are also vital.”

Much of this complacency can be attributed, ironically, to our good national health itself. A hundred years ago, the leading cause of death worldwide was infectious disease. Now, thanks largely to vaccination, infectious disease accounts for less than five percent of domestic deaths, according to the Canadian Public Health Association. That makes it all too easy to overlook the potential dangers. “Immunization programs have been a victim of their own success,” says Dr. Bowles. “We now have several generations of adults who didn’t live through polio outbreaks or diphtheria outbreaks. When vaccine programs are very successful and significantly combat or eradicate diseases, people don’t know what those outbreaks are like, and so the risks of the diseases are minimized in their minds and the risks of potential vaccine side effects are maximized.”

“People aren’t getting vaccines for a lot of reasons. But let me tell you, you wouldn’t want polio to come back. I was just a kid then, but boy was that scary.”

But, talking to experts and doctors from across the many disciplines that vaccines touch, one thing is clear: Immunization, particularly among adults, is as important an issue now as ever.

Herpes zoster (shingles), for example, is a painful condition with potentially severe complications that will affect 1 in 3 Canadians over the age of 60, and it is vaccine-preventable. And yet, very few Canadians receive the vaccine. Both Elaine Gareau of Eastern Ontario and her husband Larry have lived through shingles episodes, with Elaine’s case being particularly severe and resulting in postherpetic neuralgia that causes her substantial pain to this day. Elaine was unvaccinated because, though the shingles vaccine is approved and recommended nationally, it remains unfunded by provincial and territorial immunization programs.

Ambivalence about vaccines is extremely hazardous, and as we grow more complacent in our good health, we are at ever greater risk. Larry Gareau sums it up very succinctly: “People aren’t getting vaccines for a lot of reasons. But let me tell you, you wouldn’t want polio to come back. I was just a kid then, but boy was that scary.”

With millions of adult Canadians failing to get even the widely-available and effective flu shot, vaccine-preventable diseases remain a danger to us all. We need to do a better job, as a nation, to ensure that everyone is aware of their immunization options and empowered to make the most of them.