ÉDITORIAL

Politics and Health Policy

Of the critical health advances of the last century, among the greatest victories were vaccination efforts, leading to the global eradication of smallpox and the elimination of polio transmission in all but a few countries.   Yet since polio is still endemic in a number of developing countries, we have to be on our guard to keep the virus at bay and finally eliminate it globally.

Polio killed up to 500 people a year in Canada as recently as the 1950s, mostly children.  Yet a well planned and implemented vaccination program meant that there have been no cases of so-called wild polio transmission since 1977.  In the U.S., the last such infection dated to 1979.  However, news recently broke that New York State has registered polio virus in wastewater in June and July this year, meaning that the virus is circulating among residents of two affected counties.  Since polio vaccines are highly effective, this is happening among the unvaccinated.  In those counties, over a third of children aged two are not adequately vaccinated against the disease.  So far one person has been paralyzed, and the fear is that many more severe cases could follow in the months to come. 

The success of vaccination campaigns in the 20th century are in no small part attributable to how health policy was removed from political discourse.  It was never made a partisan issue.  People from all sides of the political spectrum vaccinated their children and trusted national health advisories, which tended to be harmonized across provinces and with other developed countries.

Over the Covid pandemic, however, this separation from politics has broken down, along with consistent global messaging.  Guidelines vary across provinces and between countries, which doesn’t help to build wide-spread confidence.  Who should get a fourth dose of the Covid vaccine is a good example.  Although there is a consensus that anyone who is immunocompromised should get a second booster, federal guidelines are currently that those over 70 should also get a 4th shot.  Provincial guidelines in Quebec lower this age to 60.  In the U.S., the Centre for Disease Control recommends a second booster for anyone over 50.  The pharmaceutical companies that produce the vaccines recommend a 4th dose for every adult.  When people are told to follow the science, situations like this can leave them understandably confused.  Political parties around the world have also joined the fray, looking to gain favour with targeted groups by peddling a specific take on Covid health policy.  Canada is certainly not exempt.

A significant danger here is that substantial segments of the population stop trusting public health guidelines generally, as well as messages portrayed in the media.  Lower vaccination rates for 3rd doses, as well as for younger children, already show less trust in such guidelines compared to the initial Covid vaccination roll-out of last year.  If this lost trust leads to large pockets of the population that become susceptible to diseases like polio, we’ll know that as a society we’ve truly dropped the ball.
Ian Barrett