Image copyright Getty Images Image caption The Burmese under-14s have suffered from a multi-organ failure rate that accounts for nearly a quarter of all sick children
Vaccinating all people in Canada against cholera and measles is a good idea, the World Health Organization says.
WHO in June called for the “no-show” vaccination to be “established nationally”.
The groups affected are the sickest – with a high rate of pneumocystis pneumonia linked to people lacking a full vaccination.
There is still a way to go before it can happen, but officials say this week’s announcement marks progress.
Pneumococcal disease (whooping cough) strikes 210,000 children each year, and over 70,000 people die every year from it.
The WHO’s plan had long been to provide vaccines for the bottom two tiers of the health system.
Some provinces, like Ontario, will be able to treat most cases of pneumonia, as well as seeing more people through its emergency capacity.
Health officials in California and Texas had been requesting additional vaccines, and these were found to be part of WHO’s plan.
“These other places had been lobbying for several years,” Dr Atul Khare, WHO’s assistant director-general, told the BBC.
“They actually had very good public health leadership, but did not have the resources to do a coherent, large-scale vaccination effort,” he said.
Doctors can offer extra vaccinations on the spot in emergencies, so long as they have the resources to get around the country.
“Providing vaccines in the field through health centres is critical,” said Scott Halpern, Director of the Non-Invasive Diseases Branch at the Global Center for Communicable Diseases at Tufts University.
“It’s an effective, quick, and inexpensive means of prevention that we now have access to,” he told the BBC.
“The most at-risk population is children and babies up to six months of age.”
This week’s announcement is another step on the road to getting every Canadian vaccinated.
Before the rise of the under-14 Burmese expat population, much of Canada’s ethnic community received their first cholera vaccinations at six weeks of age.
Fast forward to the past few years and this happens only in parts of a few large cities. Vaccinations cost tens of thousands of dollars and require a lot of coordination.
“The system doesn’t exist to deliver that, so there has to be a separate outreach and vaccinations that happen on the ground in the hinterland,” Dr Halpern told the BBC.
“The whole effort was considered by WHO a good step towards this.”
Vaccine campaigners say this has not been an easy road.
“Canada has actually started to lay out a roadmap for a national program, but has not produced a comprehensive program. We would be happy to see this happen,” said Richard Robinson, the UK-based director of the Children’s Rights Project of Canada.
Dr Khare said he does not see the obstacles to reach the 95% national coverage goal as insurmountable.
“There is a degree of public engagement that just isn’t there,” he said.
“Many communities tend to think of local hospitals as the healthcare provider, but our public health system is oriented around infection control, so we need to work very closely with this population.”
Health officials point out that medical facilities have an advantage, as they are often already working with young children who are immunised on demand.
At the moment they hope this will be enough to get the full 65% to receive the vaccines against pneumococcal disease.
“We would like to see everyone immunised. We are confident that we are making progress. Each year we are succeeding in getting it out to as many people as possible,” said Dr Halpern.
“In future years as we try to scale up efforts to get immunisation rates to a more 100% coverage level, of course there will be a need to add capacity and be more creative about where we go.”