CPHA Canvax

Nova Scotia Health Authority

Project Title: Nova Scotia’s Enhanced Immunization Access Project
Funding Recipient: Nova Scotia Health Authority
Project Contact: Lori McCracken, Health Protection Managers/Project Lead, Public Health, (lori.mccracken@nshealth.ca)
Project Period: February 1, 2019 – March 31, 2021

About the Project

In Nova Scotia, vaccination coverage of children at two years of age are far below the national targets and there are concerns that, among some populations and geographic areas, coverage rates may be even lower.  Further, inconsistencies in reporting may be affecting the quality of vaccination data in the province.  To increase vaccination coverage rates and address gaps in reporting, this project will establish an accurate baseline of coverage rates at age seven. Data will be used to identify populations and geographic areas with low coverage rates and inform interventions designed to address barriers. This project will also partner with interested First Nations communities that have been identified as having vaccination coverages rates below national targets. Through working with these communities, Nova Scotia Health Authority will better understand barriers to immunization and enhance the opportunity for culturally appropriate vaccination services.


The overall goal of the project is to increase childhood vaccination coverage rates in Nova Scotia.


  1. Obtain accurate estimates of immunization coverage rates at 7 years among children in Nova Scotia using an immunization coverage survey methodology.
  2. Identify areas and/or specific populations with low childhood coverage rates and determine whether low coverage is due to lack of access to immunization services or other barriers.
  3. Identify gaps in data by comparing survey coverage rates with Panorama coverage rates.
  4. Increase immunization coverage rates (goal = 95% coverage) among children in NS through targeted public health interventions informed by the survey.  
  5. Work with identified and interested First Nations communities whose immunization coverage rates at age 7 are below the Provincial targeted coverage rate (95%).  


  • Short Term:
    • To have an accurate assessment of immunization coverage at 7 years among children in Nova Scotia.

    • To create a detailed understanding of low coverage rates in Nova Scotia and identify precisely where access or lack of awareness to vaccination may be the primary driver.

    • To identify schools with lower immunization coverage rates and explore opportunities to collaborate with local schools to promote immunization.

  • Medium Term:
    • To increase immunizer and partner awareness of low coverage rates in the school-aged population.

    • To create targeted interventions to overcome barriers to childhood immunizations and understand the resources required to support these interventions.

    • To increase the level of knowledge regarding the importance of immunization in the community, specifically parents of school-aged children.

  • Long Term:
    • To increase immunization coverage among children in Nova Scotia.

    • To have a sustainable plan for:
      -    Immunization coverage assessment
      -    Reduce barriers or gaps to immunization services

    • Influence policy making on immunization service delivery and the provincial immunization surveillance framework

The challenge that the project addresses

Using the Public Health immunization information system, an analysis of immunization coverage at two years of age was performed for birth cohorts from 2006 to 2013.  The analysis revealed: low vaccination coverage rates among the two year old population; variations in coverage by health zone; and challenges with missing data, particularly in one zone.  Although the 2015 Childhood National Immunization Survey reported a higher rate of complete vaccination coverage at age two, Nova Scotia is still well below the target of 95% coverage.

Nova Scotia is the only province in Canada that does not have a regular system for assessing childhood coverage rates on a regular basis. This is due to challenges with accurate reporting of information to public health. Nova Scotia is also experiencing an ever-increasing number of citizens who do not have access to a primary care physician (who normally provide routine childhood vaccinations), which places increasing pressure on public health to provide additional vaccination.

Finally, recent work with a First Nations community has highlighted the need for culturally sensitive practice to improve coverage rates in these communities.

About the Nova Scotia Health Authority

Nova Scotia Health Authority (NSHA) provides health services to Nova Scotians and select specialized services to Maritimers and Atlantic Canadians. It operates hospitals, health centres and community-based programs across the province and its team of health professionals includes employees, doctors, researchers, learners and volunteers who provide the health care or services Nova Scotians need.  NSHA works in partnership with universities, colleges, community groups, schools, governments, foundations and auxiliaries and community health boards.

Nova Scotia Health Authority (NSHA) provides sustainable, safe and high-quality health care that is accessible, people-centered, promotes health and wellness and optimizes the health of all Nova Scotians.  Their mission is to achieve excellence in health, healing, and learning.


Last Reviewed: October 8, 2019