Ottawa family doctor Dr. Alykhan Abdulla believes the rise of social media has exacerbated the amount of false information people are exposed to about vaccination.Justin Tang/The Globe and Mail
At his office in Ottawa, family doctor Alykhan Abdulla sees a growing number of parents with concerns about routine childhood vaccinations. They have questions about the research behind them and whether the vaccines are safe.
Dr. Abdulla, a physician for 32 years, has watched childhood vaccination rates fall over the years and believes the rise in social media in the last decade or so has exacerbated the level of misleading and false information that people are exposed to.
It is important to help educate them and hear their concerns, he said.
“The first thing, of course, is to not say that the person is wrong,” Dr. Abdulla explained.
“The right way to start is say: ‘What are your concerns? Where did you get that information? How have you checked those resources? What more can I offer you, or some guidance that I can give you?”
What Dr. Abdulla is seeing at his practice underscores a wider issue: childhood vaccination coverage is sliding. A recent study published in the Canadian Journal of Public Health found a decline in measles vaccination coverage in children in 2023 compared with 2019.
Along with a sea of online medical misinformation, medical professionals point to other factors to explain the falling numbers, including children who were not immunized in school during pandemic lockdowns and others who do not have access to a primary care provider.
They now face the challenge of looking to make inroads with families and build trust, in hopes of getting more children vaccinated.
The stakes are increasingly high. Canada’s chief public health officer Dr. Theresa Tam recently warned measles cases are on the rise in parts of the country, mostly among unvaccinated children. Ahead of the spring break travel season, Ontario says the number of cases in the province has doubled since an outbreak started in the fall. New Brunswick, too, saw an outbreak.
Measles is also on the rise globally, particularly in Europe. There are also current outbreaks in New Mexico and rural parts of Texas. This week, an unvaccinated school-aged child died in West Texas from measles, the first death in the U.S. from the disease since 2015.
In a recent e-mail that was distributed in the health care community, Dr. Tam detailed her concerns about locally spread measles infections and about how vaccination rates among children are not high enough to stop the spread of infection. She also warned of the potential for cases to span multiple jurisdictions.
“I’m reaching out to ask for your help in raising awareness on measles prevention and control with those working on the front lines,” she wrote.
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Routine vaccinations are recommended by public-health officials to be administered in the first two years of life to protect children against serious illnesses such as measles, mumps, rubella and chicken pox.
Immunize Canada, a national coalition of organizations that promote the benefits of vaccination, says inoculations are not mandatory but, in Ontario and New Brunswick, proof of inoculations is required for children and adolescents to attend school.
Kimberly LeBlanc, the president of the Canadian Nurses Association and an affiliate professor at McGill University, said one of the ways health care providers can educate families is through data about vaccine-preventable diseases like measles and how severe they are. It is important to hear concerns and to acknowledge them in a non-judgmental fashion, she added.
“We need to be compassionate.”
A recent survey commissioned for the Canadian Medical Association found that more Canadians are encountering health misinformation and that this has consequences for health outcomes. And south of the border, Robert F. Kennedy Jr., who was recently confirmed by the U.S. Senate as President Donald Trump’s Health and Human Services Secretary, has offered a high-profile platform for anti-vaccination sentiments.
Mr. Kennedy has been critical of inoculations that public-health officials say are critical for disease prevention. He recently told Health and Human Services employees that childhood vaccination schedules, such as the ones for measles, would be scrutinized.
Vaccine skepticism is not new. But there is a “war on science” taking place right now, said Anna Banerji, an associate professor in pediatrics at the University of Toronto who specializes in infectious disease and public health. She said immunizations have saved millions of lives and that vaccine-preventable diseases like measles resurge when people are not immunized.
“Measles can kill people, as we’ve seen in the past year,” she said.
In 2024, an unimmunized child under the age of 5 died in Hamilton after contracting measles.
Michelle Barton-Forbes, the chair of the Canadian Paediatric Society’s infectious diseases and immunization committee, said she is concerned measles is circulating, in part, because people have decided not to immunize their children, and they do not recognize the social responsibility they have to children who do not have means to protect themselves because they are immunocompromised.
Dr. Barton-Forbes, the division chief of infectious diseases at the Children’s Hospital at London Health Sciences Centre, said measles is highly contagious and if it spreads within communities where there is a high rate of individuals who are not immunized, it is harder to control.
The World Health Organization has pointed to the high proportion of measles cases in Europe among children under 5 as evidence of the impact of the pandemic on routine immunizations. It says this resulted in a significant accumulation of susceptible children who missed routine shots against measles and other vaccine-preventable diseases. The WHO also says it is working to counter misinformation and disinformation around vaccines.
Shannon MacDonald, a professor in the University of Alberta’s faculty of nursing and an adjunct professor in the School of Public Health, said the uptake of routine childhood vaccines is lower than it was before the pandemic in Canada.
But it is not known if this is a carry-over effect of practical barriers people faced in getting children vaccinated instead of actual hesitancy about vaccines, she said.
“Only once we remove those barriers can we say with any certainty that attitudes, such lack of trust, are impacting uptake,” Prof. MacDonald said.
The Canada Research Chair in Applied Pediatric Immunization has been studying the consequences of the COVID-19 pandemic on routine childhood immunization coverage.
Results from the most recent Childhood Seasonal Immunization Coverage Survey conducted by the Public Health Agency of Canada, show fewer children have been getting influenza and COVID-19 shots.
Prof. MacDonald said she and other researchers are working to clarify evidence on whether trust in routine childhood vaccines has changed.
In the meantime, public-health units across the country are working to boost routine childhood immunizations and seasonal shots.
Dr. Vinita Dubey, an associate medical officer of health with Toronto Public Health, said it has seen lower immunization rates compared with before the pandemic. In the last school year, she said 72 per cent of students were up to date on vaccinations for MMR, which protects against measles, mumps and rubella. Rates were at 79 per cent prior to the pandemic, she said.
Historically, cases of measles in Toronto have been related to travel, Dr. Dubey said, adding that vaccination rates in places like Britain have slipped.
She warned if vaccination rates are not high or if uninoculated populations congregate, the disease will absolutely spread.
“People absolutely will get sick, and very sick, including dying,” she said. “That’s the tragic part about this.”
With reports from the Associated Press