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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: 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 Page 3 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