CPHA Canvax

Project Title: Examining and overcoming barriers to vaccine hesitancy in Yukon
Funding Recipient: Government of Yukon, Department of Health and Social Services
Project Contact: Su Omura, Community Health Nurse, RN, BScN, Health and Social Services (Su.Omura@gov.yk.ca)
Project Period: June 14, 2018 – March 31st, 2021


About the project

This project seeks to understand the scope of incomplete/non-vaccination among Yukoners and contributing factors from healthcare provider and parent/client perspectives, as well as from an immunization system lens. This will help identify barriers and opportunities and to better inform and target strategies aimed at improving vaccination service delivery and uptake in Yukon.

Goal

The goal of this project is to understand the contributing factors to vaccine acceptance and uptake as well as those associated with incomplete/non-vaccination in order to inform evidence-based strategies directed at improving immunization service delivery and uptake in Yukon.

Objectives

  1. Characterize the factors contributing to the incomplete/non-vaccination coverage among children under 5 years of age and school age cohorts in Yukon.

  2. Evaluate the status of a variety of factors related to the delivery of vaccination services in remote and rural areas of Yukon to inform the development of a framework that will improve the design, delivery and structure of vaccination services. The evaluation will focus on program operations; vaccine logistics (supply/transport); availability of front line support tools; identification of system related gaps, challenges, opportunities and increase accountability, transparency and collaboration in the delivery of services.

  3. Evaluate current reminder/recall practices in Yukon, identify potential gaps and help inform future reminder/recall resources/tools that can better support immunization reminder/recall processes in the territory.

  4. Explore vaccination providers’, attitudes, beliefs, behaviours related to vaccine hesitancy and their satisfaction with the availability and quality of vaccination-related training, tools, and resources.

  5. Develop a comprehensive education/communication plan for immunization providers in Yukon and improve health promotion outreach activities in schools, and with prenatal/postnatal facilities.

Outcomes

  • Short Term:
    • Enhanced understanding of existing systems (e.g. reminder/recall, service delivery) as well as reasons for incomplete immunizations/non-vaccination
    • Healthcare providers have access to immunization coverage status reports, resources and education as well as tools to support reminder/recall activities
  • Medium Term:
    • Improved ability of healthcare providers to communicate with clients and address vaccine hesitancy
    • Healthcare providers use resources and guidelines to deliver outreach health promotion activities with schools and with prenatal/postnatal and to participate in reminder/recall activities
    • Territorial immunization strategies are evidenced-based and reflective of Yukon needs and build on recommendations aimed to improve programs and services
  • Long Term:
    • Improved two-year, seven-year, school (K, 6,9) coverage rates, and pregnant women and influenza coverage
    • Reduced burden of vaccine preventable diseases
    • Improved effectiveness of publicly funded immunization programs and services

The challenge that the project addresses

Factors contributing to current coverage of immunization are not well understood in Yukon. The Department of Health and Social Services recently assessed vaccination coverage at age two, age seven and by school grade.  This assessment indicated that vaccine coverage rates have been improving over the past three to five years; however, there are still Yukoners who are not-up-to date for recommended vaccines at age two or seven.

A variety of factors may be contributing to suboptimal coverage rates, especially for vaccines within a series. Lack of schedule awareness, sub-optimal chart review processes, missed opportunities, staffing shortages, interrupted access to certified vaccinators, and interrupted access to vaccines among community health nurses were identified as potential barriers.

The Government of Yukon, Department of Health and Social Services (HSS) recognizes that a better understanding of the experiences and perspectives of front line staff and of the factors influencing the delivery and acceptance of vaccination services will inform the development of interventions supporting policies to increase vaccination coverage rates in the territory.

Recognizing that health care providers are identified as the most trusted source of information and advice on immunization, the territory will assess the knowledge, attitudes and beliefs regarding vaccination among healthcare providers in the territory as well as their access to appropriate data, reports, tools and resources.   

Lessons Learned

Preliminary data suggest that there is high interest in understanding vaccine hesitancy and immunization uptake in Yukon from health care provider and parent/client perspectives.  There is heightened awareness of the importance of vaccine hesitancy nationally and internationally.  As evidence based resources and on-line tools become more available, we all benefit from sharing knowledge with other jurisdictions.


About the Government of Yukon, Department of Health Social Services

Yukon Government, Health and Social Services Vision is “Healthy Communities –wellness for all”.

Its mission is to promote, protect, and enhance the well-being of Yukon people through a continuum of quality, accessible, and appropriate health and social services.

Yukon Government, Department of Health Social Services (HSS) provides health-care, disease prevention and treatment services to eligible Yukoners. Its’ goal is to help communities, families and individuals achieve and maintain the best possible health.

HSS operates health facilities throughout Yukon, with hospitals in Dawson City, Watson Lake, and Whitehorse, which are managed by the Yukon Hospital Corporation.

HSS operates 14 Community Health Centres which provide a wide range of health and medical services, delivered chiefly by primary health care nurses, working in an expanded role.