As diseases such as measles and mumps remain threats to public health, Alberta continues to fall short of hitting targets for childhood immunization coverage that have been in place since the last century.
According to government data for 2016, the actual numbers for immunization of two-year-olds who had received the full diptheria, tetanus, pertussis, polio and Hib immunization was 77% while 87.9% had received their measles, mumps and rubella shots.
However, the targets for coverage, based on national standards, are 97% and 98% respectively.
That level of immunization has been the goal since at least 1999, but actual vaccination rates have held steady near the most recent numbers over that time period.
With National Immunization Awareness Week now underway, Dr. Karen Grimsrud, chief medical officer of health for Alberta, said that the ongoing gap is a cause for concern.
"For measles, mumps and rubella ... we know at that level of immunization we're going to get outbreaks once in a while," said Grimsrud in a recent interview.
"You have to have a high enough immunization rate for something like measles in order to provide enough protection that even those who aren't protected won't necessarily get measles. If we had 98% coverage we wouldn't get any sort of spread of measles. We might have a case coming into the country but it wouldn't spread. But if you have 88% coverage, you will get some secondary cases."
Earlier this year, Alberta Health Services declared mumps outbreaks in the south and Edmonton zone.
Just two weeks ago, AHS warned that shoppers in a northwest Calgary drugstore had potentially been exposed to measles, which can be deadly.
Grimsrud declined to criticize past efforts to address the immunization issue, but expressed confidence that a new initiative will pay off for the province.
Last fall, the NDP government passed legislation that allows school records to be matched against Alberta Health's vaccination data to allow school officials to access the files quickly in the case of a serious outbreak.
The law, which came into force in December, also means that parents whose children have not been immunized will be contacted by health officials who will provide information on the benefits of immunization.
The government stopped short of following the lead of New Brunswick and Ontario, which require students to be vaccinated in order to attend school. The Edmonton Catholic school board last week called on the government to mandate vaccinations for students.
But Grimsrud thinks the new Alberta law — which encourages "informed decision-making" — will have a greater impact than a heavy-handed mandatory system that still allows for exceptions.
"It's something we haven't tried before," she said.
"My thinking is we will see a substantial increase in our childhood or school age immunization rates as a result of that because it's a pretty big step forward."
In 2016, the number of children age 7 who had received their second dose of the measles, mumps and rubella immunization stood at 80%.
Liberal Leader David Swann, who in 2015 proposed mandatory immunization for students, said Friday that the government's initiative should be given a chance over the next few years to see whether it affects rates before considering mandatory vaccinations.
Swann, a physician, said there are a couple of factors depressing immunization numbers.
The anti-vaccination movement, often propelled by celebrities, that makes unsubstantiated claims about dangers of vaccines, is a serious concern, he said.
"The good news is (the rate) hasn't gone down," said Swann.
"But ... it's disappointing we can't get it up to where it should be."
Swann said access is also an issue that affects immunization levels.
For some people, especially those struggling with economic worries, issues such as clinic times and distance can loom large, said the Calgary-Mountain View MLA, who called for the government to focus on broadening the provision of service for immunization.
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The government's database shows the highest level of immunization among AHS's five zones for diptheria, tetanus, pertussis, polio and Hib immunization was 81.9% in the Calgary zone, while the south zone was the lowest at 68.2%. The two zones were also the highest and lowest for measles, mumps and rubella coverage, at 89.9% in Calgary and 82.1% in the south.
Among individual communities listed, High Level and the counties of Lethbridge and Two Hills all had fewer than half of their two-year-olds fully immunized with the diptheria shot. High Level also had the lowest rate of measles, mumps and rubella immunization at 48.2%, followed by Two Hills county and the communities of Wabasca and Fairview.
Grimsrud said the regional discrepancies in coverage could be explained by different service levels, as well as concentrations of parents who oppose vaccination on a religious or philosophical basis.
She said that in Canada, Alberta is believed to be in the middle of the pack for immunization rates, though information is sketchy for comparing jurisdictions.
Ian Culbert, executive director of the Canadian Public Health Association, said meeting immunization targets is a problem across Canada.
Beyond issues over access and opposition to vaccinations, immunization rates have slipped due to the sheer success of immunization in reducing disease, leading parents to believe shots aren't necessary for themselves or their children, he said.
Culbert said governments need to better track immunizations, with a centralized repository of information being ideal.
"There needs to be increased investments in public education programs ... and improved data-gathering tools for government," he said.