Toronto board of health approves plan to combat ‘vaccine hesitancy’

Safia Ibrahim walked with difficulty to the speaker’s chair in a committee room at city hall on Monday to explain why she supports vaccination programs.

Safia Ibrahim, a Toronto mother who contracted polio as a small child in Somalia, told the health board Monday about her health struggles and spoke about importance of vaccinations.  (TORONTO CITY COUNCIL / YOUTUBE)

As a 1-year-old child, taking her first steps in Somalia, she contracted polio, which left her unable to walk. It wasn’t until she came to Canada when she was 8 that she was fitted with braces that increased her mobility. But the damage didn’t stop there. As an adult, polio returned with a vengeance and she had to undergo hip replacement surgery. She has arthritis in her elbows from prolonged use of crutches. She falls often, which is humiliating to her.

I believe that we have forgotten the ramifications and effects of these diseases,” said Ibrahim, who has ensured her own children received their vaccinations.

She said that before vaccination eradicated polio in Canada, it was not unusual to meet people who had been crippled by the disease. That’s not the case today.

“If you don’t see it, then it’s out-of-sight, out-of-mind,” said Ibrahim.

Ibrahim was speaking at a meeting of the city’s board of health on Monday. Members voted unanimously to take steps to push back against a phenomenon that has been dubbed “vaccine hesitancy” — a reluctance or refusal to vaccinate.

About 20 per cent of Canadian parents are vaccine hesitant, according to Toronto Public Health.

In 2019 we should not have to reprove science,” said board chair Councillor Joe Cressy (Ward 10 Spadina Fort-York).

The board was unmoved by several presenters Monday who spoke out against vaccines.

Vaccine hesitancy has been identified as a top-10 threat to global health by the World Health Organization (WHO). A recent investigation by the Toronto Star found that nearly 30 per cent of all schoolchildren in Greater Toronto at age 7 are not fully immunized.

Vaccination rates lower than 95 per cent create the potential for an outbreak among those who aren’t vaccinated, including infants.

Councillor Gord Perks (Ward 4 Parkdale High-Park), said that one of his most vivid memories as a child was his infant sister suffering from pertussis, also known as whooping cough, and listening to her cough and struggle to breathe, not knowing if she would survive. He pointed out that graveyards are filled with the headstones of children who died before immunization was widely practised.

I don’t want to live in that world again, said Perks.

Associate medical officer of health Vinita Dubey told the board that 70 per cent of parents have concerns about the side effects of vaccines and 38 per cent believe vaccines cause disease. Other reasons parents don’t vaccinate their children include lack of convenience in accessing vaccines and complacency and also, the perceived risks of disease are regarded as low.

Dubey said that Toronto Public Health already does work to address vaccine hesitancy, by providing vaccines in schools and in community settings, including to those who do not have health coverage.

She said Toronto Public Health plans to work further on a province-wide, real-time electronic vaccine registry that contains reports of vaccines administered by doctors at the time of vaccination — current provincial legislation mandating health care providers to report vaccinations directly to public health is on pause.

A registry will allow for assessment of vaccination rates and make it possible to find hot spots and develop targeted interventions, Dubey said.

As of September, 2017, parents seeking a philosophical or religious exemption from vaccinating their children are required to attend in-person immunization education sessions.

Dubey reported that from January to June 2018, out of 360 participants, 110 completed a survey following the education session. Opposition to immunization declined only eight per cent. Of that number, 79 per cent still intended to seek an exemption for their child.

We have to keep reminding people that vaccines are necessary,” said Dubey.

The measures approved Monday include requesting Health Canada explore avenues to reduce the spread of misinformation and false claims about vaccines and requesting that WHO consider global recommendations, similar to the WHO Framework Convention on Tobacco Control, regulating direct and indirect advertising, promotion, and sponsorship by anti-vaccine groups and anti-vaccine messages in print, audio, video and online advertisements.

Toronto’s medical officer of health was asked to report back in September with a strategy to address vaccine hesitancy which includes investigating the potential to restrict misleading advertising regarding vaccinations on city-owned land and infrastructure.

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