“Once implemented, research ramps up, not down,” Dr. Sadarangani says. Post-licensure effectiveness studies test how vaccines perform in the real world as safety surveillance expands to millions of recipients and program optimization studies refine schedules. The HPV vaccine illustrates the point. “We started with three doses because that was assumed necessary,” Dr. Sadarangani says. “Trials showed two doses performed just as well; newer evidence indicates one dose appears to be as effective. That shift improves access and affordability, without compromising protection.” Dr. Halperin’s centre in Halifax is designed to span the arc from lab bench to clinic to communities. “We bring an interdisciplinary lens,” he says, describing a network that includes basic scientists, clinicianscientists, epidemiologists, statisticians, nurses, sociologists, anthropologists, psychologists, health law experts, bioethicists, health economists and public health practitioners. “Our evaluation group does clinical trials and burden-of-disease research,” he says. “Our programs, policy and implementation group looks at how vaccines get into practice, public perceptions, hesitancy, and program evaluation.” At the policy end, Dr. Tunis and NACI serve as the bridge from evidence to implementation. “We’re the interface between the expert panel and the Public Health Agency of Canada,” he says. NACI’s recommendations, published in the Canadian Immunization Guide and public statements, inform provincial and territorial programs, which then adapt schedules to local needs and resources. The through-line in this process is integration. Laboratory insights inform clinical design, clinical outcomes feed policy, policy drives equitable delivery, real-world data loop back to improve the product and the program. “It takes a village,” Dr. Sadarangani says. “Great vaccines sitting on the shelf are not that great.” Health Care Professionals and Vaccines Health care workers face a different risk profile than the general public. They encounter people at their most vulnerable, often before a diagnosis is clear. “We can infect our patients, and our patients can infect us,” Dr. Halperin says. “Some infections are mild; some can be severe. Hepatitis B is a clear example, potentially leading to liver cancer down the road. We used to only target high-risk professions, but infections still occurred. Now we recommend that all health care providers should be protected.” The rationale is two-fold. Immunization helps shield the worker in the course of routine care, when people may be presymptomatic or still shedding virus. And it also protects patients. Dr. Halperin says that keeping vaccines up-to-date is healthy for both the individual and The vaccine pipeline is more diverse than ever, driven by advances in immunology, molecular biology and datarich surveillance. Some of the most tangible near-term gains are in respiratory disease. their community. Some people, he explained, simply can’t respond to vaccines because of genetic immune deficiencies, illnesses like cancer, or treatments that suppress the immune system. “Even if we vaccinate them, their response may be inadequate,” he says. “But we can create a protective environment around them if the rest of us are immunized.” Natural aging itself, he added, weakens immunity, so a growing (and aging) share of the Canadian population is vulnerable. For Dr. Halperin, vaccination is part of a social contract: protecting one another through collective immunity. “You might not need that protection today,” he said, “but someday you or your family might. Keeping up-to-date is an obligation to ourselves and to the people around us.” Dr. Tunis emphasizes that immunization is one layer in a broader infection-prevention strategy. “Vaccination is part of a set of building blocks, alongside PPE and other infectioncontrol measures, that, together, create an ideal environment for protecting workers and the populations they serve,” he says. The Canadian Immunization Guide outlines specific recommendations for health care personnel, reflecting both occupational exposure risk and the imperative to prevent onward transmission in clinical settings. “People have a trusted relationship with their dentist. We know that most people see the same dentist for decades,” Dr. Sadarangani says. “We’ve seen over and over that a recommendation from a health care provider is the most trusted piece of advice. Even if dentists aren’t administering vaccines themselves, knowing where to refer patients—and being willing to raise the topic—can make a real difference.” In some jurisdictions, dentists already play a more direct role. Alberta permits dentists to administer the HPV vaccine, given its link to oropharyngeal cancers. For clinicians who hesitate to initiate vaccine conversations, Dr. Sadarangani offers a practical nudge. “Go in well-armed with a bit of knowledge,” he says. “Even a redirect to a local provider can help. The point is to use that trusted encounter to a maximum benefit.” 23 Issue 2 | 2026 | Issues and People
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