Law as a Barrier and an Enabler

Trust, Acceptance and Sufficiency: Law as a Barrier to, and Enabler of, Routine and Responsive Immunization, including COVID-19

Primary disease prevention through immunization is a global public health priority with clear economic and health and well-being benefits, a fact emphatically demonstrated by the COVID-19 pandemic. Nonetheless, immunization is a fragmented healthcare practice in Canada, vaccination rates are not optimal, and vaccine acceptance is variable, with resistance becoming more vocal in the pandemic setting. If Canada is to develop effective strategies to increase immunization, including during disruptive outbreaks of diseases for which there are no vaccines, then we need to know much more about immunization as a ‘regulated space’, for the reality is that are significant gaps in our understanding what public factors such as regulation exist across Canada, and how they exert influence over immunization practice and public behaviour. 

The ‘Law as Enabler/Barrier Project’ is aimed at better understanding immunization as a regulated space in Canada, focusing on how law compromises or facilitates immunization objectives. It will generate insights into the content and scope of immunization governance frameworks that exist, and assist in identifying what might be done for Canada to perform better in this setting. Though meant as a scoping exercise, its objectives are to: 

  • survey 7-13 Canadian provincial and territorial jurisdictions and create a map of governance frameworks (e.g., key actors, policies, laws); 
  • assess those frameworks using the designed schema to facilitate insights into how comprehensive governance frameworks are and how they compare to each other; 
  • more closely examine approaches to the critical issues of mandatory immunization and compensation for serious adverse events following immunization; 
  • develop options for reform of the legal regulation of immunization in Canada. 

These objectives are critical to better understanding both routine and responsive or emergency immunization, and improving immunization practice and governance in Canada. They will be achieved through an environmental scan of governance/policy documents, a literature review, an online survey and interviews with actors in the immunization setting, the data from which will be triangulated to develop new insights and recommendations.