Workshop to train N.W.T. health-care workers about vaccine-hesitant parents

In the midst of a whooping cough outbreak in the Northwest Territories, the territory's chief public health officer is addressing one factor in the spread of the disease: families who hesitate to vaccinate their children. 

On Wednesday, chief public health officer Kami Kandola said there were 20 lab-confirmed cases of whooping cough, also called pertussis, in Yellowknife, Behchoko and Whati. Four other people are believed to have the infection based on a mix of symptoms and epidemiological links. Eleven of the 24 people who got whooping cough were unvaccinated, according to the territorial health department.

In a press conference on Thursday, Kandola said this was partially because of "vaccine-hesitant parents, absolutely."

Canada sets targets for ideal vaccine uptake, Kandola told CBC News on Monday. For the vaccine that responds to pertussis, Canada has a target of 95 per cent uptake. But in the Northwest Territories, as of 2017, only 80 per cent of two year olds had received the vaccine.

"We are below the target, and I'm hoping that with ... spreading the word we can get more and more parents to make sure that the children are up-to-date on their vaccines," said Kandola.

Kandola was speaking outside a workshop that was organized months before the pertussis outbreak. The Canadian Pediatric Society was training front-line health workers on how to deal with parental hesitancy to vaccines. According to the the Northwest Territories' health department, 52 people in the N.W.T. and Yukon took part in the workshop. 

Dr. Sam Wong, the president-elect of the Canadian Pediatric Society, chaired the event. He has a message for front-line workers who deal with vaccine hesitancy: keep the lines of communication open and stay patient. Wong, who also works as a consulting pediatrician in the Northwest Territories, says it's important for health care providers to listen to parents' questions and concerns so they can offer evidence-based answers. 

"We always hear about the 'anti-vaccine people,'" Wong said to CBC News, adding it's much more common for parents to be unsure about vaccines than opposed outright. "If their concerns are addressed then they may actually be interested in actually having their child vaccinated. 

"Sometimes it takes a little bit of communication to find out what the concerns are."

Wong says there have been times where he had three or four conversations and doctor's visits before a parent became interested in immunizing their child against diseases like pertussis or measles, mumps and rubella. 

The Canadian Pediatric Society suggests providers ask patients and their parents about what the fears are so they can be addressed, and focus on the issues on the parents' minds. For example, if pain is the concern, Wong would let a parent know babies under three months — who haven't yet experienced the world of solid food — can be distracted from it with a few drops of sugar water.

"Babies are not exposed to a lot of flavours ... it's kind of mind blowing for their taste buds. They're like, 'Whoa, what is this that's in my mouth?' They don't actually feel the pain."

Hesitancy to vaccines is not the only reason people fall behind on their shots. Sometimes other commitments result in families postponing immunization appointments. 

Kandola also wants people to stay on top of any booster shots they may need. In the case of this pertussis outbreak, five of the people who contracted whooping cough had been vaccinated in the past, but didn't have their shots up to date. Some vaccines require multiple doses to remain robust, and no vaccine is 100 per cent effective. 

She says even families who are vaccinated should call their public health office if they have pertussis-like symptoms.