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Resources for Clients

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The Canadian Association of Midwives and the National Aboriginal Council of Midwives have not reviewed the evidence on which these resources are based. Inclusion here does not reflect endorsement.

General Benefits

A History of Vaccineshttps://www.historyofvaccines.org/content/about

An educational website reviewing the international history of vaccines starting from the year 1000 in China.

History of Public Health (in Canada), https://www.cpha.ca/history-public-health

An interactive e-book, a virtual expo and 12 great achievements in public health in Canada.

Benefits of immunization: Canadian Immunization Guidehttps://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-3-benefits-immunization.html

Vaccination greatly reduces disease, disability, death and inequity worldwidehttps://www.who.int/bulletin/volumes/86/2/07-040089/en/

Reviews the benefits of disease control, protection of the unvaccinated population, prevention of related diseases and cancer, societal and other benefits in an international context.


International Governmental Agencies

Centre for Disease Control and Prevention (CDC)https://www.cdc.gov/vaccines/

The U.S. national organization for public health security, including infectious diseases.

The World Health Organization (WHO)https://www.who.int/immunization/en/

WHO website regarding Immunization, Vaccines and Biologicals.

Table 1: Summary of WHO Position Papers – Recommendations for Routine Immunizationhttps://www.who.int/immunization/policy/Immunization_routine_table1.pdf?ua=1

All WHO recommended vaccinations from birth to adulthood, including specific recommendations for pregnancy.

The Vaccine Safety Nethttps://www.vaccinesafetynet.org/

A global network of 89 member websites from 40 countries in 35 diffrent languages with information on vaccine safety; VSN websites are evaluated and certified by the WHO.


National Governmental Agencies

National Advisory Committee on Immunization (NACI)https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci.html

The Canadian informational hub for medical, scientific and public health advice on immunization. The NACI makes recommendations for the use of vaccines in Canada.

Canadian Immunization Guidehttps://www.canada.ca/en/public-health/services/canadian-immunization-guide.html

Immunize Canadahttps://immunize.ca/

Supported by the Public Health Agency of Canada, this site provides further information on National Advisory Commitee on Immunization (NACI) recommendations.

British Columbia Centre for Disease Control (BC CDC)http://www.bccdc.ca/health-info/prevention-public-health/immunization-vaccines

A very comprehensive website, it includes some BC-specific information but is applicable to people outside of BC.

National Collaborating Centre for Indigenous Healthhttps://www.nccih.ca/en/

INDIGENOUS – Offers many wonderful videos, posters, podcasts and reports on Indigenous health & wellness.


Provincial & Territorial Governmental Agencies

Provincial and territorial immunization information,  https://www.canada.ca/en/public-health/services/provincial-territorial-immunization-information.html

INDIGENOUS – The BC FNHA is responsible for programs and services formerly delivered by Health Canada and partners with over 200 First Nations communities across BC.​ Much of its information is applicable to people outside of BC.

Cree Board of Health and Social Services of James Bay (CBHSSJB) Vaccination and Prevention of Infectious Diseaseshttps://www.creehealth.org/public-health/vaccination-and-prevention-infectious-diseases

INDIGENOUS – Immunization program information for the Cree territory of Quebec (Eeyou Itschee).


Infectious Diseases and Vaccines

This podcast will Kill you: Season 2, Episode 26 Vaccines Part 1: Let’s Hear It For Mauricehttp://thispodcastwillkillyou.com/2019/05/16/episode-26-vaccines-part-1-lets-hear-it-for-maurice/

Two disease ecologists have fun explaining and discussing epidemiological topics in an entertaining way. This episode focuses on immunization (Part I)

This podcast will Kill you: Season 2, Episode 27 Vaccines Part 2: Have You Thanked Your Immune System Lately?https://thispodcastwillkillyou.com/2019/05/21/ep-27-vaccines-part-2-have-you-thanked-your-immune-system-lately/

Two disease ecologists have fun explaining and discussing epidemiological topics in an entertaining way. This episode focuses on immunization (Part II)

(Infectious) Diseases that affect First Nations and Inuit Communities, https://www.sac-isc.gc.ca/eng/1569867927914/1569867958318

INDIGENOUS – Understand some of the infectious diseases First Nations and Inuit are at risk for and get facts on programs to help prevent and manage illness.

Immunization (Vaccine preventable diseases)https://www.fnha.ca/what-we-do/communicable-disease-control/immunization-vaccine-preventable-diseases

Explains infectious diseases & public health concepts for Indigenous people.


Influenza (Flu)

Flu (influenza): FluWatch surveillancehttps://www.canada.ca/en/public-health/services/diseases/flu-influenza/influenza-surveillance.html

FluWatch is Canada’s national surveillance system that monitors the spread of flu and flu-like illnesses. Reports with information on flu activity in Canada are posted every Friday.

Influenza Q & A for Pregnant Women and their familieshttps://eportal.mountsinai.ca/Microbiology/faq/infobro/Influenza-Pregnancy.pdf

A flu in pregnancy Q&A.

Influenza Informationhttps://www.fnha.ca/what-we-do/communicable-disease-control/influenza-information

INDIGENOUS – Flu information for Indigenous consumers.

Seasonal Influenza, Avian Influenza and Pandemic Influenzahttps://ipac-canada.org/influenza-resources.php

Comprehensive information about different flu strains.

Populations at risk for severe or complicated influenza illness: systematic review and meta-analysishttps://www.bmj.com/content/347/bmj.f5061

Systematic review of over 240 articles representing over 600,000 participants at risk factor-outcomes combinations for participants with influenza. Conclusion: The level of evidence to support risk factors for influenza related complications is low and some well accepted risk factors, including pregnancy and ethnicity, could not be confirmed as risks. Rigorous and adequately powered studies are needed.


Pertussis

Pertussis (whooping cough)https://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/pertussis-whooping-cough.html

Important Information on Pertussis (Whooping Cough)https://www.fnha.ca/what-we-do/communicable-disease-control/whooping-cough-pertussis

INDIGENOUS – An information and resource page on pertussis for Indigenous peoples.

Pertussis (Whooping cough) for Health Professionalshttps://www.canada.ca/en/public-health/services/immunization/vaccine-preventable-diseases/pertussis-whooping-cough/health-professionals.html

While created for health care providers, this comprehensive webpage provides information everyone can understand.

Pertussis in Canada: 2012https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2014-40/ccdr-volume-40-3-february-7-2014/ccdr-volume-40-3-february-7-2014-3.html

Regarding the pertussis outbreak in Canada in 2012. This outbreak was a factor that led to the first recommendation for Pertussis (Tdap) vaccination in pregnancy in 2013.

Asymptomatic transmission and the resurgence of Bordetella pertussishttps://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0382-8

About Diphtheria, Tetanus, and Pertussis Vaccineshttps://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/about-vaccine.html

Discusses possible reasons for increasing frequency of pertusiis outbreaks.

Whooping cough resurgence due to vaccinated people not knowing they’re infectious?, https://www.sciencedaily.com/releases/2015/06/150624071018.htm

Readable article summarizing a 2015 study that, while looking at over 30 studies to investigate reasons for the increase in pertusiis cases in the U.S. in 2012, found evidence of asymptomatic transmission from individuals vaccinated with the currently used acellular B. pertussis vaccines.


Tuberculosis

The time is now – eliminating tuberculosis in Canadahttps://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/eliminating-tuberculosis.html

INDIGENOUS – An excellent overview of biology, epidimiology, risk factors and the landscape of TB in Canada today.


Vaccines

Find a vaccinating clinichttps://vaccines411.ca/en

An online search engine and website.

CANimmunizehttps://www.canimmunize.ca/en/home

A free app that securely stores vaccination records.

Understanding How Vaccines Workhttps://www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-color-office.pdf

Explains the immune system, how vaccines are made and vaccination schedules.

Vaccination during pregnancyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093587/

Discusses live vaccines – like Measles, Mumps, Rubella (MMR) and Varicella – and inactive vaccines – like Hepatitis B and Tetanus in pregnancy.


Influenza Vaccine – Effectiveness, Benefits, Risks

Flu clinics across Canadahttps://www.canada.ca/en/public-health/services/diseases/flu-influenza/flu-clinics-across-canada.html

A list of flu vaccine clinics in Canada, by province.

The seasonal flu and the flu shot: protect yourself, protect your communityhttps://www.sac-isc.gc.ca/eng/1570037443226/1570037485313

INDIGENOUS – Information about the flu vaccine for Indigenous people.

Influenza Vaccinations for All Pregnant Women? Better Evidence Is Neededhttps://www.mdpi.com/1660-4601/15/9/2034/htm

Detailed discussion of the quality and types of evidence used to determine the effectiveness and safety of flu vaccines. Conclusion: Consistent with the Cochrane reviewers’ conclusions, further trials for influenza vaccines with appropriate study designs and comparison groups are required before promoting universal seasonal influenza vaccinations of pregnant women. Meanwhile, vaccination in second to third trimester should be offered while communicating the uncertainties that still exist, promoting informed choices.

Vaccines for preventing influenza in healthy adultshttps://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001269.pub6/full?highlightAbstract=influenza%7Cvaccin%7Cpregnancy%7Cinfluenz%7Cwithdrawn%7Cpregnanc%7CvaccinationThis systematic review concludes that inactivated vaccines can reduce the proportion of healthy adults (including pregnant people) who have the flu and flu-like illness (ILI) but that their impact is modest.


Tdap Vaccine – Effectiveness, Benefits, Risks

Q & A on Tdap Vaccination Against Pertussishttps://www.pregnancyinfo.ca/wp-content/uploads/2019/02/MCC_11776_Pertussis_WhoopingCough_QAInfographic_PRESS.pdf

Handout on Tdap vaccine in pregnancy; includes easy to understand infographics.

Immunological and Clinical Benefits of Maternal Immunization Against Pertussis: A Systematic Reviewhttps://link.springer.com/article/10.1007/s40121-019-00264-7

A systematic review of multiple studies conducted in diverse settings between 1995 and 2018 has confirmed the effectiveness of pertussis vaccination during pregnancy in preventing pertussis in infants prior to receipt of their first vaccine and beyond.

Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic reviewhttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-4824-3

A systematic review to assess the safety and effectiveness of pertussis vaccination in pregnancy after it was implemented in several countries. Overall conclusion: the Tdap vaccine in pregnancy provides effective protection against complications in unvaccinated infants and the benefits generally outweigh the risks. It also detected an associated increase in the risk for fever and chorioamnionitis but with no associated sequelae.

A Randomized Controlled Trial of the Safety and Immunogenicity of Tetanus, Diphtheria, and Acellular Pertussis Vaccine Immunization During Pregnancy and Subsequent Infant Immune Responsehttps://academic.oup.com/cid/article/67/7/1063/5053576

This study was not large enough to detect rare adverse events or adverse pregnancy outcomes. Conclusion: on-going surveillance of pertussis in early childhood is needed when pregnant women are being immunized.


Infant & Child Vaccines

Your child’s vaccination schedulehttps://www.healthycanadians.gc.ca/apps/vaccination-schedule/index-eng.php

An online tool to find a child’s recommended immunization schedule per province and age.

Immunization and Vaccineshttps://www.cps.ca/en/education/immunization-and-vaccines

The Canadian Pediatric Scoiety’s immunization information for parents and caregivers.

CPS Caring for Kids: Information for parents from Canada’s pediatricianshttps://www.caringforkids.cps.ca/handouts/immunizations-index

CPS printable Fact Sheets on infant, child and teen vaccines.

Vaccines for children: Vaccine safety, concerns and side effectshttps://www.canada.ca/en/public-health/services/vaccination-children/safety-concerns-side-effects.html

Don’t wait, vaccinate: a guide to immunization for First Nations and Inuit parents and caregivershttps://www.sac-isc.gc.ca/eng/1582148260779/1582148285602#s4 


Vaccine Ingredients (Components)

Canadian Immunization Guide Part 4-Active Vaccineshttps://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines.html

Provides a broad range of information about Health Canada authorized vaccine product monographs.

FAQs: Product Monographs posted to the Health Canada websitehttps://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/applications-submissions/guidance-documents/product-monograph/frequently-asked-questions-product-monographs-posted-health-canada-website.html

Contents of immunizing agents available for use in Canadahttps://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-15-contents-immunizing-agents-available-use-canada.html

A comprehensive list of vaccine components available in Canada. Includes brand name, route, vaccine type, immunogen, adjuvant, and potential allergens.

Drug Product Databasehttps://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html

A way to search for vaccine monographs.

Product Monographshttps://vaccines411.ca/en/healthcare-professionals/product-monograph

Links to product monograph information for vaccines available to Canadians.

Top vaccine concerns and why we shouldn’t worry about themhttps://www.cbc.ca/marketplace/blog/top-vaccine-concerns-and-why-we-shouldnt-worry-about-them

Reviews the safety of vaccine components.

A systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide, and its soluble saltshttps://www.tandfonline.com/doi/full/10.3109/10408444.2014.934439

A systematic review which includes “justification for routine addition of Al to vaccines is required” in its conclusions.

Critical analysis of reference studies on the toxicokinetics of aluminum-based adjuvantshttps://www.sciencedirect.com/science/article/pii/S0162013417303380?via%3Dihub

Reviews 3 studies commonly referenced when discussing AI in vaccines.

Vaccines and Autism: A Tale of Shifting Hypotheseshttps://academic.oup.com/cid/article/48/4/456/284219

Twenty studies performed in several countries have shown that neither thimerosal nor the MMR vaccine causes autism. Studied populations are large enough to detect rare associations.

Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studieshttps://www.sciencedirect.com/science/article/pii/S0264410X14006367

This meta-analysis of 5 cohort studies (with over 1 million subjects) and 5 case-control studies (with over 9000 people) concludes vaccinations are not associated with the development of autism or ASD.


Safety & Adverse Events Following Immunization (AEFI)

Canada’s eight-component vaccine safety system: A primer for health care workershttps://www.cps.ca/en/documents/position/vaccine-safety-system

An excellent summary of the eight components of Canada’s vaccine safety system.

Immunization in Canada – Canadian National Report on Immunizationhttps://web.archive.org/web/20080414131846/http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/97vol23/23s4/23s4b_e.html

Outlines the Canadian process for licensing, adverse event reporting and Canada Health Act laws.

Vaccine safety and pharmacovigilance: Canadian Immunization Guidehttps://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-2-vaccine-safety/page-2-vaccine-safety.html

Learn how vaccine safety is assured and monitored from pre-licensure to post-immunization and who is responsible for what in Canada.

Historical Vaccine Safety Concernshttps://www.cdc.gov/vaccinesafety/concerns/concerns-history.html

Explains past vaccine safety concerns, how they have been resolved, and what we have learned.

Canadian Adverse Events Following Immunization Surveillance System (CAEFISS)https://www.canada.ca/en/public-health/services/immunization/canadian-adverse-events-following-immunization-surveillance-system-caefiss.html#f1

Explanation and breakdown of adverse events reporting system in Canada.

IMPACT, Canada’s Immunization Monitoring Program ACTivehttps://www.cps.ca/en/impact

IMPACT is a paediatric hospital-based national active surveillance network for AEFIs, vaccine failures and selected infectious diseases.

Reporting Adverse Events Following Immunization (AEFI) in Canada: User guide to completion and submission of the AEFI reportshttps://www.canada.ca/en/public-health/services/immunization/reporting-adverse-events-following-immunization/user-guide-completion-submission-aefi-reports.html

How to report an AEFI.

Adverse Event Following Immunization (AEFI) Report Formhttps://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/aefi-form-jan10-eng.pdf

This is the actual form required to report an AEFI. For some more detailed instruction go to: https://www.canada.ca/en/public-health/services/immunization/reporting-adverse-events-following-immunization.html

Canada Vigilance adverse reaction online database – Report a side effecthttps://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/adverse-reaction-reporting.html

The Canada Vigilance Adverse Reaction Online Database contains information about suspected adverse reactions (also known as side effects) to health products, including but not exclusive to vaccines.This is the form to report a side effect from a vaccine.

Contact information for Adverse Events Following Immunization (AEFI)https://www.canada.ca/en/public-health/services/immunization/federal-provincial-territorial-contact-information-aefi-related-questions.html

List of contact numbers by province/territory.

Guillain-Barre syndrome (GBS)https://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/symptoms-causes/syc-20362793

A good overview of GBS.


Immunization & Informed Choice

Is vaccination mandatory? https://immunize.ca/immunization-mandatory-canada

Canadian legislation around immunization.

Informed Consent to Vaccination: Theoretical, legal and empirical insightshttps://papers.ssrn.com/sol3/papers.cfm?abstract_id=3319395

Drawing on the extensive theoretical and empirical literature on informed consent, the article sets out what an ideal informed process for vaccination consists of.

Informed Consent: Are Canadian Health Care Professionals Really Getting It? https://www.ttlhealthlaw.com/health-law-blog/details/health-law-blog/2014/12/02/informed-consent-are-canadian-health-care-professionals-really-getting-it-#:~:text=In%20order%20for%20health%20care,an%20opportunity%20to%20ask%20questions

An outline of the legal components of informed consent.

The Canadian Midwifery Model of Care Position Statementhttps://canadianmidwives.org/wp-content/uploads/2018/10/FINALMoCPS_O09102018.pdf

Outlines the model of midwifery in Canada, including the principle of Informed Choice.

The legacy of midwifery and the women’s health movement in contemporary discourses of patient choice and empowerment,https://www.cjmrp.com/files/v15n1-macdonald-choice-empowerment.pdf

This commentary traces the roots of patient empowerment and patient-centred care to the radical beginnings of the women’s health movement and feminist critiques of medicalized childbirth.

Physician Dismissal of Vaccine Refusers: A Legal and Ethical Analysishttps://mjlhmcgill.files.wordpress.com/2020/03/mjlh-13.1-faour-2020-03-17.pdf

A nuanced look into physicians who are responding to vaccine hesitancy/refusal by dismissing refusers and their families from their practice.

When is it permissible to dismiss a family who refuses vaccines? Legal, ethical and public health perspectives, https://academic.oup.com/pch/article/12/10/843/2647887

”If patients are being dismissed from care, it is fair to say that, given the current shortage of primary care physicians, referrals to other physicians may not be possible. If this is indeed the case, then dismissing a patient due to a clash in values has significant legal implications, raises ethical issues and negative population health implications.”


Vaccine Reporting Regulations

British Columbia Vaccination Status Reporting Regulationhttps://www.healthlinkbc.ca/vaccination-status-reporting

British Columbia’s requirements for immunization status reporting for school-aged children include home-schooled children. They do not apply to children attending schools on reservations.

British Columbia Vaccination Status Reporting Legislationhttps://www.bclaws.ca/civix/document/id/oic/oic_cur/0376_2019

Outlines immunization reporting obligations for guardians, health care providers and medical officers.

New Brunswick Proof of Immunization Policy, https://www2.gnb.ca/content/dam/gnb/Departments/ed/pdf/K12/policies-politiques/e/706A.pdf

Outlines New Brunswick’s policy and procedures regarding immunization status reporting for children attending primary or secondary school.

Ontario Immunization of School Pupil’s Act (ISPA)http://www.health.gov.on.ca/en/pro/programs/immunization/ispa.aspx

Details Ontario’s requirements for immunization status reporting for children attending primary or secondary school.


Vaccine Exemptions

Vaccine Choice Canada – Legal Exemptions Formshttps://vaccinechoicecanada.com/exemptions/legal-exemption-forms/

British Columbia Non-Vaccination – Medical Contraindication Formhttps://www2.gov.bc.ca/assets/gov/health/forms/2369fil.pdf

Guardians are required to submit statements if their child has a medical contraindication to vaccination or the family intends not to vaccinate.

Ontario Vaccine Medical Exemption Form (Students), http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?OpenForm&ACT=RDR&TAB=PROFILE&SRCH=&ENV=WWE&TIT=medical+exemption&NO=014-4895-64E

Form required for medical exemption from vaccination for school-aged children.

Ontario Vaccine Social Conscience or Religious Belief Exemption Form (students), http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?OpenForm&ACT=RDR&TAB=PROFILE&SRCH=&ENV=WWE&TIT=Statement+of+Conscience+or+Religious+Belief&NO=014-4897-64E

Form required for social conscience/religious exemption from vaccination for school–aged children. Completion of a public health information session is also required.

Ontario Vaccine Social Conscience or Religious Belief Exemption Form (parents of daycare children and employees, owners and family members of home-based daycares), http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?OpenForm&ACT=RDR&TAB=PROFILE&SRCH=1&ENV=WWE&TIT=exemption+immunization&NO=010-3042E

Form required for social conscience/religious exemption from vaccination for family of daycare-aged children.

Ontario Vaccine Medical Exemption Form (parents of daycare children and employees, owners and family members of home-based daycares), http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?OpenForm&ACT=RDR&TAB=PROFILE&SRCH=1&ENV=WWE&TIT=exemption+immunization&NO=010-3041E

Form required for medical exemption from vaccination for family of daycare-aged children.

Ontario – How to Find a Commissioner or Notary Publichttps://www.attorneygeneral.jus.gov.on.ca/english/courts/notary_public/faqs.php#FIND

A signature from a Commissioner or Public Notary is required for social conscience/religious exemption from vaccination.

New Brunswick Immunization Exemption Form for School Entryhttps://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/CDC/HealthProfessionals/412-SchoolExceptionForm.pdf

Form required for medical or religious/social conscience exemptions from vaccination.


Understanding Research & Identifying Misinformation on the Internet

What researchers mean by…. https://www.iwh.on.ca/what-researchers-mean-by

Explains the terminology used in research.

How to Read a Scientific Study (and why it’s pretty hard)http://v6.examinecdn.com/learn/2015-ERDStudyGuide.pdf

Understanding medico-scientific research.

Making Sense of Medical Researchhttps://cwhn.ca/node/40799

Understanding medical research.

A Parent’s Guide to Immunization Information on the Internethttps://www.caringforkids.cps.ca/handouts/immunization_information_on_the_internet

Some tips on how to assess the credibility of an online information source on immunization.

Bad Newshttps://www.getbadnews.com/#intro

Pretend to be a cunning fake news creator in this social impact game that teaches how to judge internet information. Available in many languages and in a Junior version.


Indigenous

Wellness for First Nations, https://www.fnha.ca/wellness/wellness-for-first-nations

Online wellness resources for Indigneous people.

Planning Your Journey to Wellness: A Road Maphttps://www.fnha.ca/WellnessSite/WellnessDocuments/FNHA_Wellness_Map.pdf

A wellness ‘roadmap” – workbook/diary.

Wellness Diaryhttps://www.fnha.ca/WellnessSite/WellnessDocuments/Wellness_Diary.pdf

A health & wellness daily organizer.

First Nations Traditional Food Facts Sheetshttps://www.fnha.ca/WellnessSite/WellnessDocuments/Traditional_Food_Facts_Sheets.pdf

Traditional foods information; focuses on BC First Nations foods.

Eating Well with Canada’s Food Guide – First Nations, Inuit and Metis, https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/eating-well-canada-food-guide-first-nations-inuit-metis.html

An Overview of Aboriginal Health in Canada, https://www.ccnsa-nccah.ca/docs/context/FS-OverviewAbororiginalHealth-EN.pdf

Colour-Coded Healthcare: the Impact of Race and Racism on Canadians’ Health, https://www.wellesleyinstitute.com/wp-content/uploads/2012/02/Colour-Coded-Health-Care-Sheryl-Nestel.pdf

TB and Aboriginal People, https://www.cpha.ca/tb-and-aboriginal-people

History of TB and Indigenous people in Canada.

Communicating Risk to Aboriginal Peoples: First Nations and Metis Responses to H1N1 Risk Messageshttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0071106

The focus of this paper is on First Nations and Metis people in Manitoba. While risk communication practice has improved, ‘one size’ messaging campaigns do not work effectively, particularly when communicating about who is most ‘at-risk’. Public health agencies need to pay more attention to the contexts of Indigenous peoples.

Involve Indigenous People in Vaccine Development, Disease Expert Sayshttps://www.cbc.ca/news/canada/thunder-bay/involve-indigenous-people-in-vaccine-development-disease-expert-says-1.5071275

Discusses using a different, grassroots strategy with Indigenous communities to develop vaccines.

First Nation Infants Subject to ‘Human Experimental Work’ for TB Vaccine in 1930s-40shttps://www.aptnnews.ca/national-news/first-nation-infants-subject-to-human-experimental-work-for-tb-vaccine-in-1930s-40s/

First Nation infants were used for Saskatchewan trials of a tuberculosis vaccine in the 1930s and 1940s.

Cultural Safety Mindfulness during a Pandemichttps://ubccpd.ca/sites/ubccpd.ca/files/Indigenous-Patient-Led-Cultural-Safety.pdf

Reviews some of Indigenous history with infectious diseases and public health. Outlines trauma-informed and culturally safe care for Indigenous people in relation to infectious diseases and pandemics.

Bacille Calmette-Guérin (BCG) Vaccine – Canadian Immunization Guidehttps://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-2-bacille-calmette-guerin-vaccine.html

Hepatitis A Vaccine – Canadian Immunization Guide, https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-6-hepatitis-a-vaccine.html


Midwifery Core Competencies, Professional Standards and Scope of Practice Regarding Immunization

Studies on Healthcare Provider Immunization Knowledge

Vaccination Against Influenza in Pregnancy: A Survey of Canadian Maternity Care Providershttps://www.jogc.com/article/S1701-2163(18)30703-5/fulltext

This study assesses Canadian maternity care providers’ (including midwives) knowledge, attitudes, and practices regarding influenza vaccination in pregnancy.

Survey of Healthcare Providers’ Views and Experiences with Vaccine Hesitancy Final Reporthttps://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/public_health_agency_canada/2018/118-16-e/report.pdf

This survey assesses health care providers’ experience with vaccine hesitancy and parental concerns, which resources they use, and their knowledge, attitudes and beliefs on vaccine effectiveness & safety. The study included 297 Registered Midwives in Canada.

Opinion et formation des sages-femmes québécoises sur la vaccinationhttps://www.inspq.qc.ca/pdf/publications/1833_Sage-Femme_Vaccination.pdf

This study looks at the knowledge, training, attitudes and practice of Quebec midwives and midwifery students regarding immunization. In French only.

By Province

Alberta

Enhanced Midwifery Regulations Proclaimed Under the Health Professions Acthttps://alberta-midwives.ca/newsroom/enhanced-midwifery-regulations-proclaimed-under-the-health-professions-act

New changes will have taken effect April 2019. Supplemental information about the HPA Transition for AB midwives mentions the ability to “prescribe or administer vaccines” but there are no specifics.

College of Alberta Midwives Standards and Policieshttps://www.albertamidwives.org/site/about/college_policies_guidelines?nav=sidebar

List of standards, policies and guidelines for AB midwives, including guidelines on prescribing drugs [as of Jul. 2020, drug list does not include vaccines, does include Hep B immunoglobin]

British Columbia

Health Professions Act – Midwives Regulationhttps://www.bclaws.ca/civix/document/id/complete/statreg/281_2008

Outlines midwifery scope of practice – lists “vaccines” as a general category and does not give specifics.

Standards, Limits and Conditions for Prescribing, Ordering and Administering Therapeuticshttps://www.cmbc.bc.ca/wp-content/uploads/2019/10/Standards-Limits-and-Conditions-for-Prescribing-Ordering-and-Administering-Therapeutics.pdf

Specific vaccines listed under “vaccine” header, updated to March 2018 – Influenza, Hepatitis B, MMR, Varicella and Tdap included.

Cree Territory of Quebec (Eeyou Itschee)

Act Respecting Health Services and Social Services for Cree Native Persons (Chapter S-5) (1991, c. 42, s.594; 1994, c.23, s.20)http://legisquebec.gouv.qc.ca/en/ShowDoc/cs/S-5

IMs Practicing Under Exemption

Indigenous Midwifery Knowledge and Skills: A Framework of Competencieshttps://indigenousmidwifery.ca/wp-content/uploads/2019/07/NACM_CompetencyFramework_2019.pdf

Manitoba

Core Competencieshttps://www.midwives.mb.ca/document/4604/core-competencies.pdf

The Midwifery Act (C.C.S.M. c. M125)https://web2.gov.mb.ca/laws/regs/current/_pdf-regs.php?reg=68/2000

Schedule B (Section 13) lists drugs and devices within midwifery scope – BCG, Hepatitis, MMR, Influenza vaccines are all listed.

Practice Standardshttps://www.midwives.mb.ca/site/midwifery/midwifery_in_manitoba/standards?nav=sidebar

New Brunswick

Bill 75 – Midwifery Acthttps://www.gnb.ca/legis/bill/FILE/56/2/Bill-75-e.htm

Vaccines don’t seem to be listed.

Midwifery Act (O.C. 2010-416)https://www.gnb.ca/0062/acts/BBR-2010/2010-113.pdf

Northwest Territories

Standards of Practice for Registered Midwives in the Northwest Territories for Prescribing, Ordering, and Administering Drugs/Controlled Substances and Medical Supplies/Equipmenthttps://www.hss.gov.nt.ca/sites/hss/files/resources/nwt-midwifery-practice-prescribing-drugs-controlled.pdf

Vaccines don’t seem to be listed.

Nova Scotia

Midwifery Regulations (Drugs and Minor Surgical and Invasive Procedures, 50(1))https://novascotia.ca/just/regulations/regs/midwifery.htm

Lists “vaccines” but no specifics.

Regulations Respecting Midwiveshttp://mrcns.ca/images/uploads/MID-Midwifery_Regulations-SchA-APPROVED.pdf

Midwifery Scope of Practicehttp://mrcns.ca/images/uploads/Scope_of_Practice_amended_Sept_2014.pdf

Nunavik

The Practice in Nunavikhttp://www.osfq.org/admission/travailler-au-quebec/?lang=en

Nunavut

Nunavut Immunization Certification Policyhttps://www.gov.nu.ca/sites/default/files/nunavut_immunization_certification_-_section_6_-_nunavut_immunization_manual_final_july_2018_0.pdf

Outlines certification protocols and scope of practices.

Midwifery Profession Practice Regulations, Nu Reg 028-2009https://www.canlii.org/en/nu/laws/regu/nu-reg-028-2009/latest/nu-reg-028-2009.html

5(1): “The drugs and substances that a registered midwife may prescribe and administer are (a) any drug or substance that may lawfully be purchased or acquired without a prescription; and (b) the drugs and substances set out in Schedule E, Part 1” – vaccines are listed under part 1 “for women of reproductive age and infants” but gives no specifics.

Ontario

O. Reg. 884/93: Designated Drugs un Midwifery Act, 1991 S.O. 1991, c 31, https://www.ontario.ca/laws/regulation/930884

Lists specific vaccines that midwives can independently administer.

Professional Standards for Midwiveshttp://www.cmo.on.ca/wp-content/uploads/2018/06/Professional-Standards.pdf

Lists professional standards for midwives, including being competent in all aspects of practice.

Changes to the Prescribing and Administering Drug Standard (includes link to original document)https://www.cmo.on.ca/changes-to-the-prescribing-and-administering-drugs-standard/

Most recent updates to Drug Standard.

Quebec

Regulation respecting drugs that a midwife may prescribe or administer in the practice of midwifery (Chapter S-0.1, r.12)http://legisquebec.gouv.qc.ca/en/ShowDoc/cr/S-0.1,%20r.%2012/

Lists specific vaccines within scope – MMR (for pregnant parent); Hepatitis B vaccine (child)

Saskatchewan

Midwifery Regulations (M-14.1 Reg 1), http://www.saskmidwives.ca/legislation

Link to Saskatchewan midwives’ site with option to download Midwifery Regulations; mentions ability to prescribe drugs “as outlined in The Drug Schedules Regulations 1997” but no specific drugs.

Midwifery Practice (Codes, Competencies and Model of Practice)http://www.saskmidwives.ca/aboutmidwifery

A list of competencies and standards.

The Drug Schedules Regulation, 1997, https://scp.in1touch.org/document/4003/Drug%20Schedule%20Regulations%201997_2014.pdf


The Canadian Association of Midwives and the National Aboriginal Council of Midwives has not reviewed the evidence on which these resources are based. Inclusion here does not reflect endorsement.