Preparing for the next pandemic: Harmonize vaccinations in Canada

To prepare for the next pandemic and provide a coordinated approach to vaccination across the country, Canada should create Canadian Immunization Services based on the Canadian Blood Services model, authors propose in CMAJ (Canadian Medical Association Journal).

The authors, including a leading health policy and immunization expert, a blood system expert and a former federal minister of health, are Dr. Kumanan Wilson, professor, Department of Medicine and member of the Centre for Health Law, Policy and Ethics, University of Ottawa; Dr. Graham Sher, CEO, Canadian Blood Services; and Dr. Jane Philpott, Dean, Faculty of Health Sciences, Queen's University.

"If we want to be better prepared for the next pandemic, it is time to chart a bold new path forward," said Dr. Kumanan Wilson. "We propose intergovernmental collaboration through an arms-length entity, which was successful after the tainted blood scandal, one of Canada's biggest public health crises. We have done this before, emerging stronger from a public health crisis and creating a world-class blood system. We can do it again."

Various reports, including from the federal auditor general, have documented the problems with how Canada's federal, provincial and territorial governments work together. Different vaccination schedules for each province and territory, different terminology and variations in immunization tracking have made Canada's system fragmented.

"It is challenging to coordinate pan-Canadian disease surveillance and mass immunization responses without harmonized data and systems," said Dr. Wilson. "Our response to COVID-19 has been plagued by many of the challenges facing public health over the last 20 years."

As the responsibility for managing public health threats is largely the responsibility of the provinces and territories, unilateral federal mandates are difficult to implement.

The authors propose an independent not-for-profit corporation—Canadian Immunization Services—funded by participating provinces and territories, and potentially the federal government, based on the Canadian Blood Services model.

"Twenty-three years ago, Canadian Blood Services assumed full responsibility for the operation of the national blood supply outside Quebec, taking over a system that was unquestionably broken," said Dr. Graham Sher. "We were founded to restore confidence in the blood system, and over the past two decades, our journey has been one from tragedy to trust. We now have one of the safest blood systems in the world. We believe that Canada can effectively prepare for the next pandemic by establishing a world-class vaccination system based on this model as well."

Canadian Immunization Services would provide:

• Ability to procure vaccines in bulk for Canada
• Vaccine surveillance and supply chain management by single entity versus many
• Common data standard to enable data sharing between provinces and territories
• Ability to access expertise rapidly without government barriers to hiring

"If we hope for public health to be better prepared for the next pandemic, now is the time to implement needed changes," the authors conclude.

"Preparing for the next pandemic by creating Canadian Immunization Services" is published July 19, 2021.