Report on the Administration of Vaccination Programs and the Control
of Communicable Diseases in Canada, October 1989.
summary of a study conducted by Info-Lynk Consulting in October
1989 provides an account of how the Canada's federal / provincial
system of government manages infectious diseases - while so much
has changes, so much remains the same.
report has been prepared to explain, to a largely no-Canadian audience,
how the people of Canada are protected against communicable diseases.
It is based on structured interviews conducted between May and August
1989 with health care professionals who are involved in the administration
of vaccination programs at the federal, provincial and municipal
levels of government across Canada as well as a review of the pertinent
Canada the vaccination programs are an integral part of provincial
health programs. As a confederation of ten provinces and two
territories where the responsibility for health is constitutionally
recognized as residing with the provincial and territorial governments,
Canada does not have a “national” health care system.
Each provincial government organizes the delivery of its health
services in accordance with its historical, cultural and political
Health Protection Branch of Health and Welfare Canada which oversees
the regulation of drug approval, including the approval of vaccines
for use in Canada, is also responsible for monitoring the incidence
of infectious diseases. These two functions of government:
the regulatory, licensing function and the disease surveillance
function report to the Assistant Deputy Minister, Health Protection.
However, their respective missions and operations are quite separate.
The regulatory function is a jurisdictional responsibility of the
government of Canada. The surveillance function is a voluntary
agreement among the provinces and the government of Canada to participate
in such an activity.
Laboratory Centre performs the surveillance of communicable diseases
at the national level for Disease Control (LCDC). LCDC is
serving a major function in providing a forum for the development
of national guidelines on the administration of vaccination programs
at the provincial level. Two advisory committees accomplish
this work: the National Advisory Committee on Immunization (NACI)
and the Advisory Committee on Epidemiology (ACE).
periodically publishes, under the authority of the Minister of National
Health and Welfare, a set of guidelines entitled “Canadian
Immunization Guide”. The third edition of these guidelines
was published in 1989. The voluntary Boards of Directors of
the Canadian Medical Association, Canadian Paediatric Society, and
the College of Family Physicians of Canada endorsed the 1989 edition
of the guidelines.
December 1988, the Advisory Committee on Epidemiology (ACE), through
its sub-committee on Communicable Diseases, published a report that
outlines an infrastructure for the development of a national approach
to the operation and surveillance of communicable diseases in Canada.
The same report also published the draft criteria for formulating
a point system that would serve to assist in prioritizing notifiable
diseases. Case definitions have been developed for each of
the diseases identified by the above criteria. Objectives
for surveillance, and an optimum surveillance system have also been
developed. This protocol, when adopted by the provinces, holds
great potential for establishing a basic national common database
and the accurate monitoring of communicable diseases in Canada.
discussions held with provincial officials about their management
of hepatitis B viral infection and their general administration
of the vaccination programs, the political milieu of the jurisdiction
was presented as justification for why the prevailing situation
existed. During these discussions, consistently, the same
issues emerged that centered on the management of hepatitis B infection
surveillance in Canada; the need for more well directed public educations
programs; the political will to recognize and cater to the needs
of high risk groups; the organizational relationships between provincial
governments and their regional health units; the relative roles
of the private, fee for service, physician and the public health
nurse; the use of suitable software for support in communicable
disease management; the need for a permanent vaccination record;
the need to monitor adverse drug reactions resulting from the administration
study serves to provide an overview of the diversity that exists
in the way Canadians are protected against communicable diseases.
The reference to hepatitis B has provided a focus for assessing
how the mosaic, that constitutes the health care delivery system
in Canada, serves to protect its citizens in demonstrating the need
for systems that monitor and provide surveillance of a disease that
exhibits a variety of forms: acute, chronic and carrier state and
which can be difficult to diagnose.
Info-Lynk Consulting Services
The full report of this Executive Summary was prepared for Snith
Kline and French Canada Ltd., as a basis to a marketing intelligence
survey for its sister company Smith Kline Biologics, Belgium, regarding
the sale of their recombinant DNA hepatitis B vaccine in Canada.
Smith Kline French has undergone several corporate mutations since
1989 and is currently part of Glaxo Smith Kline (GSK), which has
its Canadian headquarters in Mississauga Ontario. For a more updates
version of the situation on Canada go to the Health Canada link
Center for Emergency Preparedness and Response.