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Immunizations  --Article One

CMA calls for proof of vaccinations before children can be enrolled in school


HALIFAX — Every elementary and high school in the country should require parents to provide proof their child has received up-to-date immunizations for school entry, Canada’s doctors say.But in a move that could fuel the anti-vaccination movement, delegates to the Canadian Medical Association’s annual general council meeting Wednesday overwhelmingly rejected a call for a national program to compensate those who suffer the extremely rare injuries that can be caused by vaccines.That proposal was among a raft of motions aimed at combatting “vaccine hesitancy,” a growing phenomenon public health experts fear is driving immunization rates for key diseases below target in many regions of the country.

A critical resolution calls for governments to authorize schools to require parents show proof of vaccination. Those whose children have been “inadequately vaccinated” would be required to meet with public health officials to discuss why.The proposal doesn’t call for mandatory vaccinations, CMA president Dr. Cindy Forbes stressed. The goal, said Forbes, a Halifax family doctor, is to improve vaccination rates and not inflame the situation by calling for compulsory shots. “We’re looking to have a very reasoned, rational conversation with our patients, and not have a situation where someone is telling them what to do,” she said.

“It’s a way, a checkpoint, where we can take a toll, and say: ‘Has your child been immunized?’ And if they haven’t, it’s an opportunity to provide the immunization” or information to address concerns or fears, she said.

Studies suggest more than a third of Canadian parents wrongly believevaccines can cause the very diseases they are designed to prevent.While fewer than five to 10 per cent of parents have strong, anti-vaccination views, “many more parents have doubts and concerns,” said CMA past president Dr. Chris Simpson.The issue has come under sharp focus following alarming outbreaks ofmeasles — a highly infectious disease that can cause blindness, brain swelling and severe respiratory disease, even death, in severe cases — in the U.S. and parts of Canada.

In June, California signed a bill into law requiring nearly every schoolchild in the state to be vaccinated and abolishing exemptions on religious grounds.Doctors in Canada worry parents are rejecting vaccines out of misplaced fears and deep suspicions of science and Big Pharma.

Simpson said that a declaration of immunization, “coupled with a requirement to meet with public health if it’s not up to date, provides the opportunity to understand why the parent hasn’t fully vaccinated the child.”It’s an opportunity, he said, “to fully inform those (parents) who may be hesitant.”Only Ontario and New Brunswick have laws mandating children receive the full schedule of recommended shots, although exemptions are allowed for medical reasons, or on religious grounds.“We want to see it done on a national level,” Forbes said.

Delegates rejected a motion for a compensation plan for people who suffer grave injuries associated with vaccinations — a motion partly designed to help allay parents’ fears about vaccine safety.Should someone suffer the rare occurrence of a severe side effect resulting in a permanent handicap, “we thought they should know they would be compensated for the rest of their lives,” said Quebec physician Dr. Pierre Harvey, a member of the CMA board and seconder of the motion.

The motion was rejected partly due to fear it would send the wrong message to the public that vaccines are dangerous, Harvey said.“Statistically the risks are very low,” he said. While vaccines are overwhelmingly safe, “we have to be honest. There are side effects to vaccines.”When his own children were vaccinated against MMR, “I was worried as a parent, ‘Will my kid be the victim — the one in 10 million or six million (who develops) severe encephalitis with this vaccine?“But if everyone decided not to vaccine their children, we would be back to a situation where we would have tens, and maybe hundreds of deaths yearly in Canada from measles.”Canada is among just two G8 nations (the other is Russia) without a national compensation system for vaccine injuries (although Quebec has its own program.)

Dr. Jane Brooks, from Middleton, N.S., said her brother became deaf after receiving the measles, mumps and rubella (MMR) vaccine. Her parents couldn’t afford hearing aids for three years. Brooks said her brother could have benefitted from a national compensation plan and urged the nearly 300 delegates to support it.Other doctors questioned who would pay for it. “If this is the right thing to do is everybody in the room ready to put in a few hundred dollars a year to make sure we have a national compensation package?” asked Dr. Margaret Burnett, president of the Society of Obstetricians and Gynaecologists of Canada.

The Quebec system has paid out about $4.3 million to claimants since 1988, delegates heard.•

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