The COVID-19 pandemic has disrupted major aspects of day-to-day life for Canadians and their families, including access to healthcare. Since this disruption, according to the World Health Organization (WHO) and UNICEF, there has been a decline in the number of children around the world receiving their immunizations.1 Physical distancing measures may have had an impact in Canada’s infant and toddler immunization programs, despite recommendations by Canadian government to maintain routine immunization visits as essential.2, 3
To get the full benefits of immunizations, which help protect against vaccine-preventable diseases, immunization schedules should be fully completed, with all doses administered in the appropriate time frame.4
An immunization schedule is designed to help protect children from vaccine-preventable diseases, such as measles, meningitis, and invasive pneumococcal disease. Children are immunized early in life because they are vulnerable to diseases and the consequences can be serious. But if vaccinated on time, they can have the best protection as early as possible.5
In Canada, the planning and delivery of immunization programming is undertaken by provincial and territory governments, along with local public health authorities.6 The National Advisory Committee on Immunization (NACI) works with the Public Health Agency of Canada (PHAC) to provide updated scientific evidence and public health advice in the form of recommendations for the use of vaccines currently or newly approved in Canada.7
The 2020 COVID-19 guidance from NACI emphasizes that routine immunizations in infants and toddlers are essential to continue even throughout physical distancing guidance and closures of non-essential businesses.3 Cancelling or postponing routine immunizations may inadvertently pave the way for outbreaks of vaccine-preventable diseases that infants and children are vulnerable to.8 There is also heightened concern that vaccine-preventable diseases may spread as physical distancing measures are relaxed and international travel is resumed.8 For the best possible health and safety of infants, children, and other vulnerable populations, it is important to continue routine immunizations.8
If your child’s immunizations are missing or delayed, start the conversation with your healthcare practitioner or local public health unit. If your healthcare practitioner’s office is not fully functioning due to COVID-19, ask them for guidance on where and how to proceed. If full maintenance of your child’s immunization schedule is not possible, emphasis should be put on the first set of recommended immunizations (i.e. the primary series) and booster shots for children under two years of age.3
As the pandemic has progressed your healthcare provider or any other form of immunizer has been given advice from their provincial/territorial jurisdiction and the Public Health Agency of Canada on how to resume the immunization programs. This guidance has helped them understand when and how to relax physical distancing measures and resume usual healthcare services in their local region.3 Parents can also assist in the safe administration of immunizations with some basic precautions to help protect themselves, their infants, their healthcare providers and the public. These include child and parent screenings prior to visits, non-medical masks for parents, physical distancing between patients at the clinic, and scheduling considerations.3
Consider these tips to help reduce the risk of infection at immunization visits:
Choose only one parent or guardian to accompany your child’s appointment.
Do not attend a clinic if you or your child is sick. Call to reschedule an appointment.
Bring your child’s immunization card or booklet to the appointment or download the CANImmunize app to record immunizations received.
Talk to your child about the visit so they know what to expect. Your child may feel a poke or pinch for a few seconds.
Have your child choose a blanket, stuffed toy or a book for distraction or comfort.
Wait outside the clinic until they are ready for your child, if feasible.
Sanitize your hands when entering the building.
If spending time in the waiting room with others, consider wearing a face mask.
Keep six feet of distance from others.
After vaccination, stay at the clinic for 15-minutes to monitor for any reactions.
Offer praise. Positive reinforcement works for children of all ages.
Sanitize your hands when leaving the building.
At home, monitor your child for any side effects. For minor reactions such as fever, irritability or a sore arm, use acetaminophen or ibuprofen as directed by your doctor.
If you notice any changes in your child’s health, such as unusual fussing, crying or low energy, call your doctor.
World Health Organization. “WHO and UNICEF warn of a decline in vaccinations during COVID-19.” Available at https://www.who.int/news-room/detail/15-07-2020-who-and-unicef-warn-of-a-decline-in-vaccinations-during-covid-19. Last accessed July 2020.
World Health Organization. Guiding principles for immunization activities during the COVID-19 pandemic. Available at https://apps.who.int/iris/bitstream/handle/10665/331590/WHO-2019-nCoV-immunization_services-2020.1-eng.pdf?sequence=1&isAllowed=y. Last accessed August 2020.
National Advisory Committee on Immunization (NACI). Interim guidance on continuity of immunization programs during the COVID-19 pandemic. Available at https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/interim-guidance-immunization-programs-during-covid-19-pandemic.html. Last accessed July 2020.
Government of Canada. Provincial and territorial routine and catch-up vaccination schedule for infants and children in Canada. Available at https://www.canada.ca/en/public-health/services/provincial-territorial-immunization-information/provincial-territorial-routine-vaccination-programs-infants-children.html. Last accessed July 2020.
Immunize BC. Why your child needs to get vaccinated on time. Available at https://immunizebc.ca/why-your-child-needs-get-vaccinated-on-time. Last accessed July 2020.
Government of Canada. Canadian Immunization Guide. Available at https://www.canada.ca/en/public-health/services/canadian-immunization-guide/introduction.html. Last accessed July 2020.
Immunize Canada. About us. Available at https://immunize.ca/about-us. Last accessed July 2020.
Immunize Canada. “Immunize Canada: Maintaining Immunization during the COVID-19 Pandemic.” Available at https://immunize.ca/sites/default/files/Resource and Product Uploads (PDFs)/Media and NewsReleases/2020/ic_smt_maintaining_imm_covid_e.pdf. Last accessed July 2020.
City of Toronto. COVID-19: Advice for Specific Needs. Available at https://www.toronto.ca/home/covid-19/covid-19-protect-yourself-others/covid-19-advice-for-those-with-unique-needs/. Last accessed July 2020.