Background:An understanding of real-world nirmatrelvir/ritonavir (NMV-r; Paxlovid™) use in Canada is needed to inform strategies for therapy access and use. Objective:To describe the characteristics of adults who received NMV-r in Alberta, Canada. Methods:Population-level administrative data was used to describe adults (18 years and older) who received an outpatient dispensation of NMV-r between January 2022 and March 2023 in Alberta. Omicron variants predominated during this period. Results:Mean age of the cohort (n=11,793) was 65 years (standard deviation=18), 60.4% were female and 83.9% had one or more health condition associated with a risk for the development of severe COVID-19 outcomes. In comparison to the general Alberta population, a larger proportion of those that received NMV-r resided in urban areas (Alberta: 82.3%; NMV-r: 89.8%) and were more socioeconomically well-off (Material Deprivation Index quintile 1-Alberta: 20.0%; NMV-r: 25.8%). A total of 81.6% received three or more COVID-19 vaccine doses and 7.0% received one or no dose. The majority of dispensed NMV-r prescriptions were from physicians (83.6%), with 13.5% from pharmacists and 2.9% from other healthcare providers. Conclusion:In Alberta, adults who received outpatient NMV-r displayed characteristics associated with risk for progression to severe COVID-19 outcomes (related to age and health conditions) and healthcare-seeking behaviour (older age, female sex, presence of health conditions, higher socioeconomic status and highly vaccinated). Provision by urban/rural and socioeconomic status were noted. Findings can be used to inform strategies for overcoming barriers and ensuring equitable access to COVID-19 therapy for all who are most likely to benefit.
Background:Seasonal influenza vaccination programs aim to provide protection before the virus circulation begins. However, vaccine effectiveness (VE) may decline within a single influenza season due to waning immunity, antigenic drift, and season-specific factors, raising questions about optimal vaccination timing. The purpose of this review was to synthesize evidence on intraseasonal waning of seasonal influenza VE and examine the implications and key considerations for optimizing the timing of seasonal vaccination in Canada. Methods:A scoping review was conducted, with searches of MEDLINE, Embase, Scopus, Cochrane Library, and ProQuest Public Health Database that identified studies published from 2010 to June 2024, with an update in July 2025. Eligible studies included clinical trials, observational studies, systematic reviews, and modelling studies reporting at least two VE estimates by time since vaccination within a season or assessing vaccination timing and its impact on influenza outcomes. Results:Forty-nine studies met inclusion criteria, including 37 assessing intraseasonal waning and 12 examining vaccination timing. Overall, VE was generally highest within one to three months post-vaccination and declined over the season (e.g., three to six months post-vaccination). Waning was more consistently observed for influenza A, particularly A(H3N2), and among adults aged 60 years and older. Modelling studies suggested that delaying vaccination could reduce influenza burden under select late-peaking or fast-waning scenarios; however, estimated benefits were generally small and highly sensitive to assumptions. Conclusion:Intraseasonal waning of influenza VE is consistently observed, particularly for influenza A and in older adults, but represents a gradual decline that does not typically undermine season-long effectiveness. Evidence does not support substantial or consistent population-level benefits from delaying vaccination.
Background:Public health intelligence activities, including assessment of emerging public health threats, are core operations for many public health agencies. Threat assessment is intended to guide public health actions proportional to the assessed threat level within the context of an evolving situation. A risk-based threat assessment framework helps clarify the overall population-level health impacts of threats, guiding appropriate public health action. Objective:This work aimed to develop a standardized, risk-based tool for assessing public health threats that could be used across the Public Health Agency of Canada (PHAC), integrating diverse perspectives from various PHAC stakeholders to ensure the tool is applicable across the full entire spectrum of potential public health threats. Methods:A threat assessment framework was developed to assign an overall threat level based on the assessment of three distinct threat attributes: the severity of harm to human health, the degree to which a threat is likely to impact Canada, and Canada's capacity to prevent or mitigate the threat. A Delphi-based approach was used to develop a set of qualitative criteria enabling end-users to assign a rating of high, moderate, or low for each threat attribute and the overall assessment. Results:Three iterative surveys and two meetings led to consensus on definitions for the three threat attributes and the overall assessment, enabling a flexible framework capable of characterizing a wide range of public health threats. Conclusion:Standardized, broadly accepted definitions for threat assessment reliably characterize and communicate public health events of importance and provide support for public health action.
Background:The early detection, assessment, and communication of potential public health threats are key activities in mitigating public health impacts by ensuring the timely deployment of an appropriate response. The Public Health Agency of Canada (PHAC) uses a standardized methodology to consolidate scientific and technical subject matter expertise on a weekly basis to systematically characterize and assess emerging public health signals and communicate assessments to decision-makers. Methods:Public Health Agency of Canada's coordinated threat assessment process, and the standardized methodology used to characterize and assess threats, are described. Results:The coordinated threat assessment methodology uses a standardized method that includes engagement with subject matter experts across PHAC to assess, document, and communicate the characterization of each threat. Three key attributes are used to assess each threat based on the concern for human health, the potential to affect Canada, and the concern that Canada has insufficient control measures to manage a specific threat. Qualitative criteria for each threat attribute are used to assess a threat based on 'high', 'moderate', or 'low' levels. An overall assessment is based on the three threat attributes and is accompanied by a narrative rationale to support the assigned threat level. Conclusion:The standardized threat assessment methodology provides a coordinated and systematic process to characterize and assess public health threats in a consistent and timely manner. The framework reflects important elements to consider in terms of public health significance, allows for flexibility in the indicators used to characterize a public health threat, and is applicable to any threat of public health concern.
Background:Healthcare-associated infections (HAIs) are a significant healthcare burden in Canada. National surveillance of HAIs at sentinel acute care hospitals is conducted by the Canadian Nosocomial Infection Surveillance Program. Objective:To describe device and surgical procedure-related HAI epidemiology in Canada from 2020 to 2024. Methods:Data were collected from up to 67 Canadian sentinel acute care hospitals between January 1, 2020 and December 31, 2024 for intensive care unit central line-associated bloodstream infections (ICU-CLABSIs), hip and knee surgical site infections (SSIs), cerebrospinal fluid (CSF) shunt SSIs and paediatric cardiac SSIs. Case counts, rates, patient and hospital characteristics, pathogen distributions and antimicrobial resistance data are presented. Results:Between 2020 and 2024, 1,846 device-related infections and 1,014 surgical procedure-related infections were reported. Rates of ICU-CLABSIs, hip and knee SSIs, CSF shunt SSIs and paediatric cardiac SSIs fluctuated throughout the study period, with no significant trends observed. The most commonly identified pathogens were coagulase-negative staphylococci (37%) in ICU-CLABSIs and Staphylococcus aureus (41%) in SSIs. Conclusion:Epidemiological and microbiological trends among selected device and surgical procedure-related HAIs are essential for benchmarking infection rates nationally and internationally, identifying any changes in infection rates or antimicrobial resistance patterns and helping inform hospital infection prevention and control and antimicrobial stewardship policies and programs.
Background:Pertussis, a vaccine preventable respiratory illness caused by the bacterium Bordetella pertussis (B. pertussis), has been a nationally reportable disease in Canada for over 100 years; however, cases resurged in Canada and globally in 2023-2024. Objective:To examine the breadth and depth of pertussis strain surveillance currently being carried out across Canada. Methods:A survey was sent to all ten provincial public health laboratories inquiring how pertussis was diagnosed or identified in the laboratory, including the polymerase chain reaction (PCR) diagnostic methods, bacteriological culture, identification and strain characterization such as molecular typing and antibiotic susceptibility testing. Results:Nine of the ten provincial laboratories provided responses. Five provincial laboratories reported performing bacteriological culture, and some only from specimens that tested positive by PCR. Long-term storage of submitted and historical specimens took place in six laboratories. Identification of B. pertussis was commonly done through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis, though immunochemical and PCR-based methods were also used. One laboratory conducted antibiotic susceptibility testing in specific circumstances. No laboratory performed fimbriae serotyping or examined expression of other pertussis vaccine antigens. One laboratory used whole-genome sequencing for outbreak investigation. The PCR diagnostics were performed in eight of the responding laboratories and always include IS481 and pIS1001 gene targets. Some laboratories also reported using other gene targets to identify and distinguish between B. pertussis, B. parapertussis, B. holmesii and B. bronchiseptica. Conclusion:Given the global increase in pertussis, with the emergence of macrolide-resistant and pertactin-deficient strains, strain characterization should be added to the Canadian national pertussis surveillance program.
Background:Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) continue to contribute to excess morbidity and mortality among Canadians. Objective:To describe epidemiologic and laboratory characteristics and trends of HAIs and AMR, 2020-2024, using surveillance and laboratory data submitted by hospitals to the Canadian Nosocomial Infection Surveillance Program (CNISP) and by provincial and territorial laboratories to the National Microbiology Laboratory. Methods:Data was collected from 109 Canadian sentinel acute care hospitals between January 1, 2020 and December 31, 2024 for Clostridioides difficile infections (CDI), methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs), vancomycin-resistant Enterococcus (VRE) BSIs (specifically Enterococcus faecalis and Enterococcus faecium), carbapenemase-producing Enterobacterales (CPE) and carbapenemase-producing Acinetobacter baumannii (CPA) infections and colonizations and Candidozyma auris (C. auris; formerly Candida auris) infections. Trend analysis for case counts, incidence rates (rates), outcomes, molecular characterization and AMR profiles are presented. Results:From 2020 to 2024, rates remained relatively stable for CDI (range: 5.01-5.38 infections per 10,000 patient days) and MRSA BSI (range: 0.99-1.16 infections per 10,000 patient days) and increased significantly for VRE BSIs (from 0.30 to 0.42 infections per 10,000 patient days; p=0.01). During this time, infection rates for CPE remained low compared to other HAIs but increased significantly (rates: 0.05-0.20; p=0.03), CPA counts continue to remain very low (n=22 infections) and C. auris counts remained low compared to other HAIs (n=43 isolates). Conclusion:The incidence of MRSA BSIs and CDI remained stable and VRE BSIs and CPE infections increased in the Canadian acute care hospitals participating in CNISP. An increased number of C. auris isolates were identified. Reporting standardized surveillance data to inform the application of infection prevention and control practices in acute care hospitals is critical to help decrease the burden of HAIs and AMR in Canada.
Background:Effective online communication is important for disseminating information during multi-jurisdictional enteric illness outbreaks in Canada. The Public Health Agency of Canada (PHAC) uses web-based Public Health Notices (PHNs) to communicate outbreak information and prevention measures. Despite this communication's importance, no study has examined online engagement with PHAC's PHNs. Objective:To assess access to and engagement with online information on multi-jurisdictional enteric illness outbreaks by analyzing website traffic and engagement metrics for PHAC's PHNs. Methods:Data on page and screen metrics, geographic location, device and browser types, and traffic source metrics for PHAC's PHN webpages (2020-2022) were obtained. Descriptive statistics were calculated for page and screen metrics data. Proportional frequencies were calculated for geographic location, device type, and traffic source metrics. Data were tabulated and visualized using R Studio. Results:Public Health Notice webpages had an average of 2,729±16,685 page views and 2,490±15,201 visits; decreasing (but not significantly) over the study period. Average session duration was 165±124 seconds; increasing (but not significantly) over time. Most visits originated in Canada (89.0%±4.2%) and were from mobile devices (74.6%±3.3%). Traffic sources were primarily search (49.1%±13.0%), followed by direct (23.9%±6.7%), social media (21.2%±8.4%), and referral (5.7%±2.5%). The geographic location, device type, and traffic source changed significantly year by year. Conclusion:Engagement with PHAC's PHN webpages declined over the three years of the study, while mobile and search-driven access dominated and levels remained consistent over time. Social media generated comparatively little traffic. These findings suggest opportunities to enhance search optimization and social media amplification to improve outbreak communication.
Background:In Ontario, over 600 cases of tuberculosis (TB) have been reported annually since 2015. Despite publicly funded health care, the direct and indirect costs to individuals have not been well studied and may be substantial. Objective:To assess the economic and social impacts of TB among individuals undergoing treatment at specialized TB care centers in Toronto, Canada. Methods:Patient-reported costs, work disruptions, social consequences and changes in household financial status were evaluated. A cross-sectional web-based survey was conducted among adults (18 years and older) receiving TB treatment at West Park Healthcare Centre and the Toronto Western Hospital TB clinic between April 2023 and April 2025. Respondents completed a modified version of the World Health Organization's Tuberculosis patient cost survey, which collected data on out-of-pocket costs, work loss and social outcomes. Descriptive statistics were used to summarize key findings and reported costs in 2025 Canadian dollars. Results:A total of 42 people with TB disease completed the survey (mean age=36.7 years; 38% female). The mean cost of a TB-related appointment was $42.82 (standard deviation [SD]=$47.89), with variation by treatment center, hospitalization status and transportation method to appointments. More than half (61.9%) of respondents reported missing work due to treatment, with a mean loss of 130 hours (SD=141). Following diagnosis with TB, 28.6% of respondents experienced job loss, and 45.3% of respondents experienced a worsening of their household financial situation, with 16.7% reporting that it had become much worse. Conclusion:Despite publicly funded health care, people with TB face economic and social challenges. These findings will contribute to a deeper understanding of the financial challenges faced by people with TB and may be useful in informing public health policy.
Background:Respiratory syncytial virus (RSV) is a leading cause of hospitalization among Canadian infants. In March 2026, the National Advisory Committee on Immunization (NACI) released updated guidance reflecting new evidence on the monoclonal antibodies (mAbs) nirsevimab (Beyfortus®) and clesrovimab (Enflosia) and the RSVpreF pregnancy vaccine (Abrysvo). This article summarizes NACI's updated guidance on protecting infants and children from severe RSV disease. Methods:To develop the statement, NACI used its standard evidence-based process, reviewing clinical trial data, real world effectiveness studies, RSV epidemiology, and Canadian cost utility modelling, as well as ethics, equity, feasibility and acceptability considerations, to inform program recommendations. Results:Both mAbs and the RSVpreF vaccine demonstrated strong protection against RSV related hospitalization, intensive care unit (ICU) admission, and medically attended illness in infants. All products showed favourable safety profiles. The RSVpreF vaccine was effective when administered ≥14 days prior to delivery. Economic modelling indicated that a combined program of RSVpreF vaccination during pregnancy and targeted infant mAb administration offers the best value for money at current product prices. NACI strongly recommends universal seasonal RSV immunization for infants. Jurisdictions may choose either 1) a universal infant mAb program or 2) a combined pregnancy RSVpreF vaccination plus targeted infant mAb administration program. Infants at increased risk of severe RSV disease should receive mAbs regardless of gestational RSVpreF vaccination status. Conclusion:Universal seasonal RSV immunization will substantially reduce RSV associated morbidity in infants and could likely be achieved through both program approaches. At current product list prices, the combined pregnancy-infant program offers better value than a universal mAb program. Jurisdictions should consider local epidemiology, feasibility, cost-effectiveness considerations and equity when selecting a program model.
Background:Respiratory syncytial virus (RSV) is a common respiratory virus that can have serious complications for older adults and adults with certain medical conditions. Since July 2024, the National Advisory Committee on Immunization (NACI) has provided immunization guidance for the protection of older adults against RSV. In April 2026, NACI updated its guidance to reflect emerging epidemiological data identifying younger adults at high risk of severe RSV and evidence on the benefits of RSV vaccines in older adults and adults at high risk. Methods:NACI reviewed available evidence on the benefits and risks of RSV vaccination in older adults and individuals at higher risk, as well as additional factors, including ethics, equity, feasibility, acceptability and cost-effectiveness. Results:The RSV disease burden in younger adults with certain underlying conditions is comparable to that in older adults. Among older adults, RSV infection may increase the risk of cardiovascular events and Guillain-Barré syndrome (GBS). The RSV vaccines demonstrate strong protection against RSV-associated lower respiratory tract disease and severe outcomes, with favourable safety profiles. Monitoring for rare adverse events following immunization, total duration of protection, and need for boosters is ongoing. Conclusion:NACI expanded the use of RSV vaccines to some adults at high risk for whom the balance of clinical benefits, safety and feasibility is favourable. NACI strongly recommends RSV immunization programs for all adults aged 75 years and older; adults aged 65-74 who are at increased risk of severe RSV disease; and adults aged 18 years and older who reside in chronic care facilities, have received a lung or hematopoietic stem cell transplant, are receiving home or chronic oxygen therapy, or are receiving dialysis. For other adults, vaccination may be considered on an individual basis.
Background:Management of Mycobacterium abscessus (M. abscessus) skin and soft tissue infections outbreaks require collaboration between clinicians, public health authorities and reference laboratories providing bacterial molecular identification and genotyping. Objective:This study reports on a M. abscessus skin and soft tissue outbreak linked to mesotherapy treatments in Montréal, Canada. We present an innovative approach combining Nanopore long read and Illumina short read whole-genome sequencing data with a novel open access bioinformatic molecular epidemiology pipeline to support public health investigations by identifying genomically related isolates. Methods:Public health investigations and physician questionnaires were used for outbreak identification and investigation. The complete genomes of six isolates from four individuals were sequenced. Nanopore and Illumina data were combined to assemble genomes de novo using a hybrid approach. Single nucleotide polymorphisms (SNPs) were identified within each genome by mapping the short reads to a reference genome. Single nucleotide polymorphisms distances among isolates, and between isolates and the reference genome were used alongside core SNP alignment analyses to evaluate genetic similarity between isolates and other contemporary M. abscessus genomes. Results:Identified individuals had received mesotherapy injections from the same esthetician within a one-month period. Outbreak isolates were genomically nearly identical, differing by only 0-2 SNPs when using the earliest collected isolate as a reference. A phylogenetic tree revealed genetic distinctness between outbreak isolates and other contemporary M. abscessus isolates from Montréal. Conclusion:Genomic sequencing and the presented bioinformatic approach can identify M. abscessus genomic relatedness suggestive of clinical outbreaks. This approach can support public health investigations, particularly when epidemiological links are uncertain.
Background:The National Advisory Committee on Immunization (NACI) has been working to develop inclusive language for vaccine guidance related to pregnancy and breastfeeding. Starting with early efforts in 2018, NACI sought to update the language approach in 2023 based on the latest available evidence. Methods:Gender-neutral and gender-additive language approaches were assessed using an equity lens focused on inclusion and representation. Evidence was gathered through a jurisdictional scan of National Immunization Technical Advisory Groups (NITAGs) and government organizations, a literature review, and iterative stakeholder engagement. Draft policy options were developed, translated into French, and reviewed by NACI. Results:The jurisdictional scan across Canada, the United States, Australia, the United Kingdom, and France showed wide variation, with many sources using gendered terms. The literature review identified little original research on language use in immunization settings. A Canadian research initiative examining inclusive language supported context-specific gender-additive terminology. Stakeholders emphasized the need for inclusive and adaptable language. NACI developed recommendations for a context-dependent gender-additive approach, including French language options. Conclusion:In February 2024, NACI endorsed an additive language approach, which has been implemented across NACI statements and relevant Canadian Immunization Guide chapters. NACI and the Public Health Agency of Canada will continue adapting to evolving language needs, recognizing that clinical communication should use terminology that best resonates with each individual. When implementing vaccine recommendations in clinical practice, it is important to use whatever language that will resonate best with the individual being immunized.
Background:The National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI) undertook a review to adopt, or adapt, the 2021 recommendation for chlamydia and gonorrhea screening issued by the Canadian Task Force on Preventive Health Care (CTFPHC). Methods:The NAC-STBBI adapted the guideline following the 2014 World Health Organization (WHO) handbook. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and GRADE-ADOLOPMENT methods were also applied to determine the certainty of evidence and strength of the recommendations. The guideline question was "should any screening vs no screening/usual care/any other screening be used for non-pregnant people?". Conflicts of interest were managed according to the Public Health Agency of Canada guidelines. Results:An environmental scan found 17 guidelines published between 2015 and 2023. Five systematic reviews and 32 original articles were identified and included, addressing screening types, patient values, preferences, feasibility, equity and cost and cost-effectiveness of chlamydia and gonorrhea screening. The search was conducted between October 1, 2019, to May 19, 2023. The certainty of evidence was very low. Conclusion:The NAC-STBBI suggests universal annual screening for Chlamydia trachomatis and Neisseria gonorrhoeae infections in all sexually active persons under the age of 30 years (conditional recommendation; very low-certainty evidence). The NAC-STBBI also suggests screening every three to six months for adults and adolescents with multiple sexual partners or a new partner since last tested and "opt-out" screening as frequently as every three months for high prevalence populations or communities (conditional recommendation; very low-certainty evidence).
Background:The World Health Organization recognizes antimicrobial resistance (AMR) as a top global health threat. Antimicrobial resistance-related deaths in Canada are projected to exceed 13,500 annually by 2050. In long-term care homes (LTCH), 40% to 75% of antimicrobial prescriptions are inappropriate or unnecessary. Nurses are well-positioned to lead in antimicrobial stewardship (AMS) initiatives; however, it is unclear what challenges LTCH nurses face in participating in AMS activities. This study aims to provide insights into barriers and facilitators influencing nurses' engagement in AMS within Canadian LTCHs. Methods:A survey was developed using literature and an AMS working group assessing AMS knowledge (10 questions), confidence, barriers and facilitators. The survey targeted nurses working in Canadian LTCHs and was administered through Qualtrics online from January 20, 2023 to April 10, 2023 by distribution partners to obtain a convenience sample. Open-coding thematic analysis was used to describe quantitative data and analyze qualitative responses. Results:A total of 346 complete responses were recorded. The mean knowledge score was 71% (standard deviation [SD]=15%). Most respondents perceived infection prevention and control measures, and monitoring changes in the health of residents to be part of the duties of nurses within AMS. However, making recommendations about antimicrobials was the least cited nursing responsibility. This suggests a lack of clarity around the role of nurses in AMS. Barriers to AMS activities included pressure to treat and lack of meaningful interprofessional communication, while AMS education and senior management support were drivers for AMS engagement. Conclusion:Education, senior-level support, and formal recognition of nurses in AMS programming represent key facilitators to effectively engage LTCH nurses in AMS best practices.
Background:Language concordant care can influence patient outcomes. The level of language concordant care and its impact on adherence to infection prevention protocols has not been well described. Objective:To assess whether patients' preferred language impacts their ability to follow infection prevention protocols. Methods:A multicentre survey was performed to assess understanding and self-reported adherence to two different sets of infection prevention instructions: preoperative chlorhexidine bathing before cardiac surgery and central line care during chemotherapy for hematologic malignancy. Standardized interviews were conducted following cardiac surgery or central vascular catheter insertion. Preferred language was defined by patient's stated preference, with professional hospital-based interpretation used for patients with non-English language preference. Results:Among 238 eligible patients, 222 (93%) completed the interview across both sites, including 179 (81%) with English preference and 43 (19%) with non-English preference. Comprehension of infection prevention instructions among English-preferred and non-English-preferred groups was no different (97.2% vs 93.0%; p=0.19), and similar for reported adherence (97.8% vs 97.7%; p=0.97). Among 26 (65%) non-English-preferred patients, instructions were reported to be interpreted by family rather than by hospital-based interpretation services. Qualitative themes included reliance on family for interpretation or other informal solutions, patient frustration with language barrier and expressed desire for improved language services. Conclusion:No significant difference was identified in comprehension or adherence to infection prevention protocols based on language preference; however, closing this gap relied on family members or other informal solutions. Given the risks and inequity of such workarounds, improved use of hospital-based interpretation services is needed.
Background:The National Advisory Committee on Immunization (NACI) previously released guidance in May of 2024 regarding the use of Imvamune® for the prevention of mpox in the context of a routine immunization program. Since the release of this guidance, the emergence of a novel subclade of mpox (clade Ib) has led to a shifting epidemiological landscape and several international jurisdictions have, therefore, revised their Imvamune guidance. Objective:To summarize the updated NACI guidance on the use of Imvamune for the prevention of mpox. Methods:NACI reviewed data on the current epidemiology of mpox, both in Canada and internationally, current evidence on Imvamune vaccination coverage in Canada, and published scientific literature regarding the effectiveness, immunogenicity and safety of Imvamune. NACI has also considered additional factors including ethics, equity, feasibility and acceptability. Guidance on the use of Imvamune in the context of international travel was developed in collaboration with the Canadian Committee to Advise on Tropical Medicine and Travel. Results:NACI concluded that available evidence supports the limited expansion of groups considered at high risk of mpox. Conclusion:NACI now recommends that in addition to previously identified groups at high risk of mpox, certain travellers to areas with ongoing community transmission of mpox virus clade I should receive Imvamune. Healthcare workers travelling internationally to support mpox outbreaks should also receive Imvamune, and domestic healthcare workers with a high risk of frequent exposure may consider vaccination with Imvamune on an individual basis.
Background:Vaccination rates of healthcare workers in Canada against influenza are below the national target of 80%. The objective of this study was to identify the preferred promotional formats and types of information that healthcare professionals would consider when deciding whether to get immunized against influenza. The goals of this survey were to 1) inform the design of a social marketing campaign to help healthcare professionals make informed decisions about influenza vaccination, and 2) inform future education and promotional work by vaccination stakeholders. Methods:A bilingual survey was implemented online using Facebook ads to recruit healthcare professionals across Canada. The survey consisted of 15 mixed multiple-choice and open-ended questions. Eligibility requirements included being a practising Canadian healthcare professional, such as a medical doctor, nurse, pharmacist, nurse practitioner, midwife, or dentist. Results:A total of 265 healthcare professionals completed the study, with a majority (51.3%) being nurses and practising in Ontario (32.1%). Infographics were viewed as the promotional format most likely to influence their decision-making (33.6%). Healthcare professionals relied on news from various media outlets and peer-reviewed journals (15.8%) to make their decisions. Finally, respondents indicated that influenza vaccine effectiveness was the most relevant information with respect to their decision-making (80.8%). Conclusion:Infographics may be an important method for promoting influenza vaccination among healthcare professionals. These visual representations should focus on up-to-date information about influenza vaccine effectiveness to respond to the information needs of healthcare professionals. The next steps will be to design a marketing campaign focused on vaccine effectiveness, using infographics as a promotional format.
Background:In 2015, Public Health Agency of Canada (PHAC) identified a set of priorities for research and development (R&D) of new and improved human and animal vaccines. Thirty human pathogens were grouped by vaccine development timeline (short: 0-6 years; medium: 7-12 years; long: 13 years or longer) and ranked by R&D priority (high, medium, low). Objective:To characterize the vaccine development pathway for these 30 pathogens to inform a 2025 update to PHAC's vaccine R&D priorities. Methods:For each pathogen, we conducted a targeted search for vaccines authorized in Canada since 2015 using the Health Canada Drug Product Database and Canadian Immunization Guide and for candidates in clinical trials, in the registry, ClinicalTrials.gov (primary completion date of May 1, 2015 or later). Search results were downloaded and filtered by study status, phase and type. For select pathogens, we conducted additional searches in published (PubMed) and grey literature (other trial registries, industry press releases, and Web searches). Results:Seven pathogens had at least one newly authorized vaccine since 2015: three of 13 high-priority (influenza, n=4; Streptococcus pneumoniae, n=2; respiratory syncytial virus, n=3); two of eight medium-priority (herpes zoster, n=1; meningococcal serogroup B, n=1); and, two of nine low-priority pathogens (dengue, n=2; human papillomavirus, n=1). Nineteen pathogens had no authorized vaccine in Canada or elsewhere, although five had candidates in phase 3 trials (Clostridioides difficile, Neisseria gonorrhoeae, Borrelia burgdorferi, norovirus and cytomegalovirus). Conclusion:Although some of the pathogens on the 2015 list now have authorized vaccines or candidates in late-stage clinical development, important gaps persist, which will inform PHAC's 2025 vaccine R&D update.
