Some Alberta pediatricians say making childhood immunizations routinely available in pediatric hospitals could help improve slumping vaccination rates in the province.
But the Alberta government is closing the door on that idea, saying children’s hospitals are under significant pressure, and it’s taking other steps to improve access.
Dr. Sam Wong, president of the section of pediatrics with the Alberta Medical Association, said he and his colleagues have been advocating for this change for several years.
“The fact that we lost our measles-free status should be a call to arms for us to do a better job,” he said, pointing to the recent decision by the Pan American Health Organization to pull Canada’s measles elimination designation.
“We need to improve the way we deliver vaccinations and how we deliver vaccinations. And we have to look at all options, including delivering vaccinations in the hospital where we have the ability to do so. We just need to make the administrative changes to allow us to do that.”
We just have to start thinking outside the box and stop doing the same thing we did before because, obviously, it’s not working.– Dr. Sam Wong, Alberta Medical Association
Alberta accounts for about 38 per cent of Canada’s total measles cases. Its outbreaks have been concentrated in communities with low childhood immunization rates.
“We just don’t have enough numbers of people vaccinated against measles, and it allows for community spread. It could happen with pertussis or whooping cough,” said Wong.
He worries the province could start seeing more infections, hospitalizations and potentially deaths.
He often sees children in the emergency room or patients admitted onto hospital wards who haven’t had their routine childhood vaccines, and their parents are willing to get them immunized.
But, according to Wong, the opportunity passes because routine vaccines are only given out one day a week at the Stollery Children’s Hospital, where he works, when a public health nurse comes in to administer them. Most patients don’t stay long enough to take advantage of the immunizations, he said.
Ideally, Wong would like to see the routine immunizations available 24 hours a day, seven days a week. But even less than that would help, he said.
“It’s simple, low-hanging fruit,” said Wong, who argues nurses or pharmacists could administer the shots, which could be stored in hospital pharmacies.
“Anything is possible. We just have to start thinking outside the box and stop doing the same thing we did before because, obviously, it’s not working.”
There have been ongoing concerns about declining childhood vaccination rates in Alberta.
Publicly available provincial data shows coverage rates for immunizations, including measles whooping cough, polio and other diseases, are below target rates.
For example, 68 per cent of Alberta children who turned two in 2024 were up-to-date with two doses of the measles vaccine. Coverage rates were lowest in the north zone (54.5 per cent), the south zone (55.8 per cent) and the central zone (56.1 per cent).
The target is 95 per cent.
Immunization rates for whooping cough (also known as pertussis) and polio are also dropping.
The provincial data shows 68.9 per cent of Alberta children had four doses of the vaccine that protects against pertussis, diphtheria, polio and other diseases by the age of two.
In 2016, coverage sat at 76.8 per cent.
According to the province, the target for that vaccine is also 95 per cent.
Hospitals under too much pressure: government
The Alberta government said while it continues to increase access to immunization in community settings, it is not considering pediatric hospitals as an additional access point, noting they’re already under strain.
“We are continuing to expand access through public health clinics, including walk-in and extended-hour options, and strongly encourage families to keep immunizations up to date,” a statement from the Ministry of Primary and Preventative Health Services said in part.
“Routine immunization is not offered in pediatric hospitals because these facilities care for highly vulnerable children and are already under significant pressure. Bringing in higher patient volumes for services that are safely and effectively delivered in community settings would increase staff workloads and could put vulnerable children at risk.”
The statement went on to say that if a child is hospitalized and needs an immunization due to an exposure or extended stay, public health outreach teams work to make that happen.
The ministry also said some vaccines require specific storage conditions and administration techniques, which are not available in hospitals.
‘Ridiculous’ delay
“It’s an opportunity that’s missed” said Dr. Sidd Thakore, a pediatrician at Alberta Children’s Hospital in Calgary, where the vaccines are also given out once a week.
Each time a patient is admitted, according to Thakore, parents are asked if the child is up-to-date on their immunizations. Often, they’re not, he said.
“It still comes back to individual choice,” he said. “But individual choice means you have the opportunity to access it.”
Thakore said just last week he had to postpone starting treatment for a sick child who needed to be vaccinated ahead of time. Some medications can suppress the immune system, and doctors like to ensure vaccines are up-to-date before those treatments begin. The treatment was delayed by nearly a week.
“Imagine how frustrating that is, not just for a family having to wait for further treatment,” said Thakore, “but also just taking up time in a hospital, taking up resources, for a delay that, to me, I think is ridiculous.”
Wong said he recently saw a patient who had been exposed to measles and needed to be given the vaccine (a preventative measure taken when there is a known exposure), and there was no system in place to get one to the child in the hospital that day.
The hospital was eventually able to arrange to have public health provide the vaccination.
But Wong said it took an unnecessary amount of time and was difficult to arrange.
“It shouldn’t be that hard,” he said.
The Ministry of Primary and Preventative Health Services said there were no active measles cases as of Friday, and no one was hospitalized due to the illness at that time.
“We continue to promote vaccination, and we’re hopeful that numbers will continue to fall and remain low, allowing us to declare the measles outbreak officially over, though there is always a risk of new introductions,” the ministry’s statement said.
