That's a very good question.
As a matter of fact, before the National Immunization Strategy was established, Canada looked pretty bad, quite frankly. If you look at the situation in terms of the geographic regions of Canada it was a patchwork.
The rich provinces had immunization programs. Alberta generally launched a program very soon after the introduction of a new vaccine. And in the rest of Canada, if there was a crisis or an epidemic, if the Journal de Québec was reporting the eight death, then a meningitis program might be implemented.