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Immunization Competency Course - version 1.0
Module 16 - Canadian Immunization System
February 2011
Module 16
Canadian Immunization System
1.
Competency ............................................................................................................. 1
2.
Learning Objectives.................................................................................................. 1
3.
Introduction .............................................................................................................. 1
4.
National Responsibilities .......................................................................................... 1
5.
Provincial/Territorial Responsibilities ........................................................................ 2
6.
Summary.................................................................................................................. 3
7.
References............................................................................................................... 3
Immunization Competency Course - version 1.0
Module 16 - Canadian Immunization
February 2011
Page 1
1. Competency
Demonstrate an understanding of the immunization system in Canada and its impact
on his/her own practice.
2. Learning Objectives
By the end of this module you will be able to:
 Describe how the National Immunization Strategy (NIS) is relevant to practice.
 Distinguish between federal and provincial/territorial responsibilities as related
to immunization programs in Canada.
 Explain the reasons for the variable immunization schedules among the
provinces and territories.
 List who can administer immunizations in Nova Scotia.
3. Introduction
In Canada, immunization is a shared responsibility between federal, provincial and
territorial governments. National, provincial and territorial immunization strategic
frameworks guide current and future immunization practices.
4. National Responsibilities
4.1 National Immunization Strategy (NIS)
The National Immunization Strategy (NIS) is a means for Federal/Provincial/Territorial
jurisdictions to work in partnership to improve the effectiveness and efficiency of
immunization programs in Canada. Initiated in 2003, the NIS is a comprehensive
strategy to meet the current and future immunization needs of all Canadians. The
following are the NIS goals:
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Ensure equitable and timely access to recommended vaccines
Optimize program safety and effectiveness
Improve co-ordination and cost-effectiveness of immunization programs
Ensure the security of vaccine supply
Provide rapid and effective national interventions in emergency situations and
in response to international requests when required
 Promote professional and public acceptance of recommended programs.
For further information on the NIS, click on the following link: http://www.phacaspc.gc.ca/publicat/nis-sni-03/pdf/nat_imm_strat_e.pdf
4.2 National Advisory Committee on Immunization (NACI)
NACI is a national committee of recognized experts in the fields of pediatrics,
infectious diseases, immunology, medical microbiology, internal medicine and public
health. NACI makes recommendations for the use of vaccines currently or newly
approved for use in humans in Canada, including the identification of groups at risk
for vaccine-preventable disease for whom vaccine programs should be targeted.
NACI recommendations are published in the Canadian Communicable Disease
Report: http://www.phac-aspc.gc.ca/naci-ccni/
Immunization Competency Course - version 1.0
Module 16 - Canadian Immunization
February 2011
Page 2
5. Provincial/Territorial Responsibilities
In Canada, immunization is a shared responsibility between federal, provincial and
territorial governments. The large majority of costs are borne by the provinces and
territories, as each province and territory plans, funds, and delivers their respective
immunization programs to their populations.
In planning their immunization programs, provinces and territories adjust their
recommended schedules and selection of vaccines based on the National Advisory
Committee on Immunization (NACI) recommendations, other expert advisory
committee recommendations, and on local epidemiological, program, and financial
considerations.
Therefore, publicly funded immunization schedules may vary from province or
territory resulting in diversity within consensus.
 Provincial programs can differ in details even when all agree to provide a new
vaccine
 Product-specific schedules may differ
 Chosen target age (and dosing requirement) may differ
 Catch-up programs (if any) may differ
 Other influences may apply. e.g., school curricula
As well, situations arise when new vaccines are licensed and recommended for
universal programs but provinces chose not to implement them. However, the CMPA
(Canadian Medical Protective Association) has stated that the standard of care in this
situation requires physicians to inform parents of the recommendation for routine
immunization and how to obtain it at their own expense. E.g., Varicella Zoster vaccine
Click on the following link to view the provincial and territorial immunization
schedules: http://www.phac-aspc.gc.ca/im/ptimprog-progimpt/table-1-eng.php
5.1 NS Immunization Programs
In Nova Scotia, proposals for new publicly funded immunizations or changes to
existing programs are brought forward to the provincial immunization sub-committee
(ISC) of the provincial Communicable Disease Prevention and Control Committee
(PCDPCC). There is also consultation with provincial vaccine and infectious disease
experts. The following issues are examined: burden of disease, vaccine
characteristics, immunization strategy, cost-effectiveness and acceptability.
The ISC and PCDPCC recommendations for immunization programs are made to the
Chief Public Health Officer, the Deputy Minister and the Minister of the N.S. Dept of
Health and Wellness. When recommendations are approved then guidelines for
immunization services in the province are developed. These guidelines are posted on
the DHW website as part of the NS Immunization Manual. DHW purchases the
vaccine, and the provincial Bio Depot distributes to district Public Health Offices who
in turn supply vaccines to other providers such as family physicians, long term care
facilities and/or hospitals.
Immunization Competency Course - version 1.0
Module 16 - Canadian Immunization
February 2011
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5.2 Who can administer immunizations in NS
In Nova Scotia, the following professions may administer immunizations:
 Registered nurses
 Licensed practical nurses
 Pharmacists
 Physicians
6. Summary
In Canada, immunization programs are a shared responsibility between federal,
provincial and territorial governments.
7. References
 NS Department of Health and Wellness
www.gov.ns.ca/hpp
 Minister of Health (2004). National Immunization Strategy: Final report 2003.
http://www.phac-aspc.gc.ca/publicat/nis-sni-03/pdf/nat_imm_strat_e.pdf
 Public Health Agency of Canada. National Advisory Committee on
Immunizations. retrieved December, 2010 from http://www.phacaspc.gc.ca/naci-ccni/
 Public Health Agency of Canada. Publicly funded Immunization Programs in
Canada, retrieved December, 2010 from: http://www.phacaspc.gc.ca/im/ptimprog-progimpt/table-1-eng.php