Why Canada’s Vaccine Schedule Isn’t Changing—Despite U.S. Updates

The U.S. Centers for Disease Control and Prevention has updated its childhood vaccine schedule, reducing the number of diseases it routinely protects against from 17 to 11—and putting many parents into a tailspin. Is 11 enough? Or still too many? Vaccinations have been a hot topic since before the pandemic, but COVID-19 really put disease control in the spotlight. And while President Trump says that the decision behind the change was "rooted in the gold standard of science," the Canadian vaccine schedule isn't changing.

Kids in Canada receive vaccinations against 15 diseases, including Hepatitis A and B, Meningococcal disease and RSV, which were removed from the schedule in the States and will be offered there for select high-risk groups. Vaccines for the flu, COVID-19 and Rotavirus were also removed from the official U.S. schedule, but families can discuss these with their doctor and decide if the vaccine is a good idea for their child.

Dr. Marina Salvadori, Senior Medical Advisor at the Public Health Agency of Canada, says that if a major country or trusted partner, like the U.K., Germany, Australia, Ireland, New Zealand—and historically, the U.S.—make changes to their vaccinations, Canada watches closely to find out why and possibly reassess our own policies. "If France or Germany is doing something different than us, we want to ask why. And if we can't tell, we call them up, we have a meeting with them, we ask them what made them change."

In the case of the recent changes in the U.S., Dr. Salvadori says, "I think that the vast majority of Canadians are looking south of the border, not just in the vaccine space but in all decisions and thinking, and realizing that maybe some of the checks and balances and usual procedures, and thoughtful way of doing things, is maybe not happening in the way that we're accustomed to."

So, how are vaccine decisions made in Canada?

"We have an independent and very robust system to make vaccine recommendations for children in this country. And it's actually one of the longest-standing national advisory committees for immunization," says Dr. Salvadori. The National Advisory Committee on Immunization (NACI) has been around for more than 60 years, and adds Dr. Salvadori,  "it's regarded as one of the best immunization decision-making bodies in the world."

What is the NACI review process?

• Health Canada Approval: First, Health Canada reviews clinical trials to verify the vaccine prevents disease as intended and checks for any potential safety signals before approving.
• NACI Review: Once approved, the Public Health Agency of Canada convenes the National Advisory Committee on Immunization (NACI) to gather scientific evidence using a structured framework.
• Evaluation Factors: NACI assesses the vaccine based on burden of illness, safety and efficacy, cost-effectiveness, equity, and ethical considerations before making a recommendation.
• Provincial Implementation: Provinces review the federal recommendations independently, often using their own committees as checks and balances, to decide how best to roll out the vaccine based on local needs and contexts.

How are vaccine schedule changes made?

While Health Canada closely monitors vaccine changes in other countries, they’re just one part of how Canada reviews and updates its own schedule. "No country in the world has the same level of different kinds of diseases," says Dr. Salvadori. "We have a winter climate, and we also have a publicly funded healthcare system, which makes a really big difference." Plus, the government of each province can tailor the recommendations for its specific population.

Health Canada and NACI also assess how a new vaccine is working and its impact on people. "We also look at evidence after the vaccine's been put out there from Canada and from other countries. So we're constantly scanning the evidence for any potential safety signals. And we will, of course, correct or change, should that be required," says Dr. Salvadori.

What parents need to know

Dr. Salvadori emphasizes that Canada's vaccine review process is among the best in the world. "We make all our decisions following a very strong and robust scientific method in a very structured way. And our decisions take into account the Canadian context," she says. "I think that we should be proud of our Canadian system right now."