Fewer B.C. children are being immunized against diseases in the wake of the COVID-19 pandemic, according to updated data from the B.C. Centre for Disease Control, which had delayed publishing provincewide figures for the past three years.
This week, the centre publicly released four new reports for 2021 through 2023 that collectively show a slight downturn in immunization coverage, effectively halting the progress that was being made leading up to 2020.
Coverage for two-year-old children reached a recorded all-time high of 74 per cent in 2019 but now rests at 69 per cent. Minus the booster, coverage went from 84 per cent to 77 per cent in the same period.
B.C. is a signatory to a federal preventable disease reduction program with a goal of reaching a 95 per cent immunization rate by 2025 for diphtheria, tetanus, pertussis and Hib, polio, hepatitis B, MMR, varicella, pneumococcal conjugate, and meningococcal C conjugate — what now appears to be a lofty goal at this point, with the centre acknowledging it is “well below” the target.
“These declines in coverage coincide with the COVID-19 pandemic as the 2019 birth cohort (2021 report) was scheduled to receive their 12- and 18-month vaccine doses starting in 2020,” the centre stated in its 2023 Immunization Coverage in Children by the Second Birthday report.
“BC initially implemented a provincewide shutdown which impacted the provision of public health services as well as in-person clinical services by physician providers. The pandemic response continued through 2022; routine childhood immunization may have been affected in some regions due to rescheduled appointments or longer wait times,” the report added.
One important caveat among the reports is that immunizations occurring in family physician offices are not required to be reported to the centre. Furthermore, Vancouver Coastal Health (VCH) did not contribute to the two-year-old report and it typically has higher coverage rates than the other four health authorities (regions).
The authority with the highest booster rate was Island Health, at 81 per cent whereas Northern Health struggled at 69 per cent.
Overall vaccine refusal rates were one per cent with the outlier East Kootenay health area (of Interior Health) coming in at five per cent.
The second report is for seven-year-old children (Grade 2) and shows a coverage rate of 66 per cent, not seen since 2015. Coverage actually spiked to 73 per cent in 2021 until declining over the following two years.
Vaccination against measles and mumps declined more than for any other disease, reaching just 72 per cent and accelerating a trend since 2014 when the rate was 90 per cent.
The earliest date the centre has tracked polio coverage was 2019 when the coverage rate was 77 per cent. Last year, the rate was only 72 per cent.
Interior Health had the highest proportion (2.3 per cent) of seven-year-olds with documented refusals to all vaccines, as compared to 0.9 per cent for VCH.
The report for Grade 6 students outlines coverage rates for hepatitis B, varicella and Human Papillomavirus (HPV).
The Grade 6 report shows hepatitis B coverage at 88.8 per cent; varicella coverage at 86.4 per cent; and HPV coverage at 57.7 per cent.
This report states coverage for hepatitis B and varicella remained comparable to pre-pandemic years, although coverage for HPV was approximately six per cent lower for females and males compared to 2018 and 2019.
The centre cautions, again, that “doses administered by providers other than public health, including doses administered outside of B.C. to newly arrived students whose records have not yet been received by public health, may not be reported in the registry.”
About 15 per cent of B.C. children this age initiated an HPV vaccine series but did not complete it.
Once again, for HPV, Interior Health and in particular the East Kootenay region led in outright recorded refusals, at 16 per cent.
The final report is for Grade 9 students, showing coverage rates for tetanus/diphtheria, pertussis, meningococcal quadrivalent, and HPV.
The report states: “Overall, provincial coverage was relatively similar across all four antigens, but was highest for meningococcal quadrivalent (74.3%), followed by tetanus/diphtheria (74.1%), pertussis (73.9%), and HPV (72.1%). Coverage for tetanus/diphtheria and pertussis in 2023 increased compared to 2021 and 2022, and was higher than 2018 and 2019, but remained below the maximum of 74.9% in 2020. Meningococcal quadrivalent also increased compared to 2021 and 2022, but remained below pre-pandemic years (2018-2019) and 2020. Coverage for HPV has been increasing since 2018 in both females and males, with the exception of males in 2023, which had a 0.3% decline compared to 2022.”
