SERIES: WHAT DO HEALTH CARE PROFESSIONALS HAVE TO SAY? *CAROLYN, THE PUBLIC HEALTH NURSE IN CANADA*

Vaccine schedules differ from country to country based on various reasons, but so do many aspects of health care. Carolyn, BSN, gave me the inside scoop on vaccine administration, hesitancy, and her experiences as a registered nurse in public health in Saskatchewan, Canada.

Public health nurses are highly knowledgeable and extensively trained when it comes to immunizations.

Most of Carolyn’s vaccine knowledge and experience comes from on-the-job training, as she didn’t study it extensively in school. Nurses outside of the public health department may not have to be as well versed in vaccination. Public health nurses are required to know the science behind vaccinating, as well have to be able to answer immunization-related questions.

The majority of vaccines in Saskatchewan are given out by public health nurses.

Nurses like Carolyn are responsible for making sure new mothers, as well as new fathers, in the maternity ward, are up-to-date on their vaccinations. 

Public health nurses educate on the importance of the pertussis vaccine, for example, to protect the newborn from whooping cough. 

They are also responsible for giving vaccinations to children, teens, and adults, as well as providing education about vaccines. 

Public health nurses in Saskatchewan, Canada make reminder calls to parents with children who have fallen behind.

Carolyn is required to operate the clinics and keep track of children who have not made it in to get their recommended vaccines. 

Unlike the US, the age-dependent recommended vaccine schedule parents are to follow is dependent upon the providence in which they live. Schedules may be different in some providences due to funding and disease rates. 

Even with clinic reminders, many children are behind on their recommended vaccinations, especially in areas with transient populations.

Carolyn lives in a place they call “The Gateway to the North.” were a large part of the population moves in and out of the city from northern or surrounding communities. This can make it difficult to keep children up to date on scheduled vaccinations because records aren’t always efficiently found, or shared, between communities.

Why are children falling behind?

Carolyn explains that parents, who are not vaccinating their children, can be excuse-makers. Forgetting or not being able to find the time are common excuses. 

Beyond making excuses, some parents like to pick and choose vaccines like they’re ordering off a menu, leaving their child to either fall behind or be unprotected.

And, just like in the US, Canada sees both vaccine-hesitant parents, as well as parents entirely unwilling to vaccinate.

The good news? Parents whose child hasn’t been fully vaccinated, for whatever reason, are sometimes open to discussion.

People are just looking for answers… It’s establishing the relationship with people so they’re trusting that the info you’re giving them is true.

Carolyn

Carolyn understands that parents just want their children to be healthy. She wants that, as well.

All parents are sent home with educational materials, whether they choose to vaccinate or not.

If you don’t tell people everything, they get suspicious. Prior to vaccinating, we have to get informed consent. We have to tell people exactly what the diseases are, and what the side effects are. If they ask for a monograph, we give it to them. It’s surprising that people ask ‘you can give me (the monograph)?’

 I think people are told to expect us withholding information. Sometimes you can scare people with all the new information, but it is better for people to be informed and ask questions.

 Often minds are changed in the process, but it can take a really long time. People do want to do the best for their kids and are trying. Just that there are people out there who want to take advantage of vulnerable people, it can be frustrating–all the misinformation.

Carolyn

Carolyn explains that misinformation makes the front-page news, and even when retracted, it never has the same effect.

Some parents are entirely unwilling to vaccinate.

There are many parents unwilling to vaccinate and unwilling to listen to health experts. Carolyn explains that people who come into the office and are reluctant to immunize their child will keep getting reminders at landmark checkups when their child is due for immunizations.

Carolyn says it’s interesting being in an office where she vaccinates against and treats the same vaccine-preventable diseases.

I see lots of things being on the communicable disease end. I’m often the one who has to make the phone calls to people who are sick or to family members who have loved ones who have died due to a vaccine-preventable illness.

Carolyn

Carolyn, for example, may be contacting a parent of a child who had whooping cough and died, and on that same day, a parent will refuse the vaccine to prevent this terrible disease. 

 I want to ask people to have an open mind and to try to find the best sources they can and to think hard about what they’re doing and why. It still is a risk not to vaccinate. Your risk the full force of the disease versus the minimal side effects by not vaccinating.

 Whether it is about wearing a helmet to prevent injury from biking, washing hands to prevent other illnesses…We have the medical technology (vaccines) to prevent specific diseases…We don’t see certain diseases anymore because these vaccines have been so effective. Maybe that’s why people don’t know what their risks really are.

Carolyn

Carolyn’s approach has changed over the years from “this is how it is,” to realizing that parents have good intentions.

I want people to continue to be patient and spread the message of factual information. And just do their best. If people want to be left alone, then that’s what you do. You do have a choice, but choices come with different consequences.

Carolyn

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