Physicians legally obliged to discuss vaccines, insurer says

Tuesday, December 3, 2002 - Page A8

VICTORIA -- Physicians who fail to counsel parents to have their children
vaccinated are leaving themselves open to legal action, the group that
insures most Canadian doctors is warning.
In its December newsletter, the Canadian Medical Protective Association
tells physicians the standard of care in Canada is to vaccinate against a
dozen childhood illnesses.
That means doctors have an obligation to talk to parents about the benefits
and risks of these vaccines, including three costly new vaccines that are
not offered free of charge in most of the country.
"This is creating a real ethical dilemma for pediatricians who want to do
what's best for the kids, but know that many parents cannot afford the
vaccines," said Marie-Adèle Davis, executive director of the Canadian
Pediatric Society.
She said the fact that some provinces offer vaccines against chickenpox,
meningococcal disease and pneumococcal disease, while others do not
undermines the principles of medicare, and discriminates against poorer
The CPS wants governments to make all childhood immunizations free of charge
from coast to coast.
"There should be no economic barriers to health care for children," Ms.
Davis said.
The growing inequities in the availability of vaccines in Canada is
dominating discussion at the Canadian National Immunization Conference in
Victoria, and fuelling calls for a national strategy.
Across the country, children are vaccinated against nine common infectious
agents: diphtheria, tetanus, pertussis, measles, mumps, rubella, polio,
Haemophilus influenza b (Hib), and hepatitis B.
All those vaccines are free of charge, and with almost universal coverage,
these once-deadly diseases have virtually disappeared from Canada. While it
is not yet on the schedules, most provinces will also cover the cost of
vaccinating children against influenza.
However, most provinces and territories have been slow to embrace new
These include a vaccine for varicella (commonly known as chickenpox), one
that protects against seven strains of pneumococcal bacteria (which are the
leading cause of earaches, meningitis and childhood pneumonia) and another
that protects against meningococcal group C bacteria (which can cause deadly
meningitis). There is also a growing debate about adding a booster shot
against pertussis (whooping cough) in adolescence.
Monika Naus, associate director of epidemiology at the B.C. Centre for
Disease Control in Vancouver, presented a series of maps that highlighted
the inequities between provinces and territories. According to her findings:
The chickenpox vaccine, called Varivax, is offered free of charge to
children in Prince Edward Island, Alberta, Nunavut and the Northwest
Territories. In other provinces and territories, it can be purchased, but
parents must pay $75 or more.
The meningococcal vaccine, called Menjugate, is part of the basic
immunization schedule in Quebec and Alberta. In other provinces, parents can
purchase it, but the cost can be as high as $200.
The pneumococcal vaccine, called Prevnar, is free of charge for children in
Alberta and Nunavut. Elsewhere in the country, it can cost up to $150.
The adolescent pertussis vaccine, called Adacel, is paid for by governments
in Newfoundland, Nunavut and the Northwest Territories. Other provinces are
hesitating, even though it costs only about $10