No change in vaccination rates among Quebec children despite pandemic: INSPQ

As the school year begins this week for many children, data from the Institut national de santé public du Québec (INSPQ) show that vaccination coverage has remained stable. According to experts, Quebec is in a good position, but this has not come without effort.

Vaccination coverage for vaccines required for the start of the school year in 2023 was 78.3 per cent among 7-year-olds, compared to 78.4 per cent in 2021, according to the INSPQ’s survey on vaccination coverage among Quebec children aged 1, 2, and 7.

After observing a decline in vaccination rates among very young children during the pandemic, no further decline was noted in 2023. For the 1-year-old cohort, complete age-appropriate vaccination coverage was 89.6 per cent, a rate nearly identical to that of 2021 (89.3 per cent) and slightly lower than that of 2019 (92.3 per cent).

A similar pattern is observed for two-year-olds: full vaccination coverage was 85.6 per cent in 2023, compared to 84.2 per cent in 2021 and 88.3 per cent in 2019.

“In many other countries, following the pandemic, we saw a certain decline in vaccination coverage,” says Dr. Nicholas Brousseau, a medical advisor at the INSPQ and co-author of the report. “So seeing that, despite the pandemic, coverage in Quebec has remained relatively stable is good news. But this is the result of a great deal of effort made in the years following the pandemic.”

He notes that, year in and year out, about 90 per cent of children in Quebec “are still well vaccinated”—that is, they have received most of the childhood vaccines included in the immunization schedule. “That’s still a high percentage,” comments the immunization specialist.

Dr. Arnaud Gagneur, a pediatrician at the Université de Sherbrooke hospital centre (CHUS) and a professor in medicine and health sciences department at the Université de Sherbrooke, is the driving force behind the motivational interviewing program in maternity wards for childhood immunization (EMMIE).

Thanks to his research presented to the Ministry of Health, EMMIE was launched in 2018 as a pilot project. This program has trained vaccination counselors who, starting in the first days of a child’s life, meet with parents to discuss vaccination in a non-judgmental manner. EMMIE has now been expanded to all of Quebec.

“Since the program has been in place for eight years, the counselors have met with a large proportion of parents in Quebec. This likely contributes to reducing vaccine hesitancy in Quebec,” says Dr. Gagneur.

Dr. Brousseau also praises the positive effects of EMMIE. “I think that’s the key,” he says. “Every parent has a different profile and may have different fears. So, it’s about understanding what might cause parents to hesitate and providing the appropriate information.”

Lower vaccination rate among immigrant children

In general, vaccination coverage is significantly lower among children born outside Quebec or to a mother born outside Canada, according to the INSPQ report.

“A great deal of effort is being made to ensure timely vaccination. A lot is being done, for example, in the CLSCs for children. One of the key strategies is to be proactive in offering appointments directly to parents. If an appointment is missed, we follow up,” says Dr. Brousseau.

For children starting kindergarten, an additional dose of the combined vaccine against diphtheria, pertussis, tetanus, and polio is normally administered.

“To my knowledge, the back-to-school dose—which is often given just before or during kindergarten—has a lower rate of children being reached. “That said, throughout their school years, there are various catch-up initiatives,” emphasizes Dr. Brousseau. “For example, in 9th grade, there’s a review of the entire vaccination record. Often, the vast majority end up receiving the required doses, but there are indeed additional efforts that could be made to effectively reach children as soon as they reach school age to increase this proportion.”

Parents’ concerns

The main reasons parents hesitate to have their children vaccinated are fear of side effects and the belief that vaccines are unnecessary, reports Dr. Gagneur, who published a book in 2025 examining vaccine hesitancy in the population, *To Vaccinate or Not to Vaccinate?*, published by Éditions du Trécarré.

He explains that diseases like diphtheria and polio were a cause for concern at one time, but are much less so now. “For some vaccines, these are diseases that have completely disappeared, so parents aren’t familiar with them. It’s hard to get motivated about something you don’t know. You don’t perceive the threat,” explains Dr. Gagneur.

He adds that since the pandemic, much of the hesitancy has grown due to “the widespread questioning of society and the system,” and there has been “a loss of trust in political and health authorities.”

The INSPQ report states that “25 per cent of parents did not perceive any risk in delaying vaccination, nearly 40 per cent believed that multiple shots increased the risk of side effects, and 13 per cent felt that children were receiving too many vaccines.”

There are many reasons for vaccine hesitancy. “Parents often have a lot of questions and a lot of doubts, which is normal. But we find that, in the end, when they have access to information, they end up making the right decision and ensuring their child is properly vaccinated,” says Dr. Brousseau.

Vaccination is not mandatory in Quebec. The government relies on public awareness and information to maintain public trust.

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–This report by La Presse Canadienne was translated by CityNews