Warning signage for suspected cases of measles is seen outside the main entrance of Woodstock General Hospital in Woodstock, Ont., in May.Nicole Osborne/The Canadian Press
Amid one of the worst measles outbreaks in decades, the head of the Canadian Medical Association wants federal and provincial examinations of how the health system handles the highly contagious virus.
CMA president Margot Burnell said she believes that the Pan American Health Organization’s November decision to strip Canada of its measles-free status should serve as a wake-up call for health authorities to begin working together to find ways to better contain future outbreaks.
That includes examining the weaknesses that have emerged during the current outbreak, which began in late 2024 and has seen dozens of new cases recorded in the past few weeks.
“I think there’s an obligation to take all of those lessons learned and say how can we do better,” Dr. Burnell said in a recent interview.
“We need to take that information and start having a really good discussion with all the stakeholders.”
How the measles made its way back to Canada
Canada was declared measles free in 1998 after widespread vaccination campaigns halted circulation of the virus inside the country. Since then, most cases have been imported by travellers.
But the current outbreak, which began when a visitor from Thailand attended a wedding in New Brunswick, has seen high levels of local transmission. After taking hold in communities with low vaccination rates, it spread across the country finding immunity gaps in the broader population. As of late December, there have been 5,377 cases recorded, including the deaths of two babies who contracted the virus in utero.
In addition to deaths, measles can cause problems including deafness and blindness, and has been known to attack the immune systems of its victims.
Dr. Burnell’s comments follow a Globe and Mail investigation last month that revealed weaknesses in how Canada monitors immunity and tracks vaccination against measles.
Former top officials inside the Public Health Agency of Canada said in the investigation that as far back as 2009, they began to fear that the country was significantly overstating how protected it was from measles, as a result of poor data gathering, and that Canada’s immunity from measles was likely lower than experts believed.
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Michael Garner, the agency’s senior epidemiologist in charge of measles surveillance at the time, said public-health officials were concerned that Canada was setting itself up for a major outbreak in the future.
David Butler-Jones, the chief public health officer from 2004 to 2013, said it was a continuing question inside the federal agency whether telephone surveys used to gauge immunity in the population were reliable enough to give an accurate depiction of national immunity. Several top experts said the agency needed better tools to gauge such critical numbers, but were instead forced to rely on estimations.
Though provinces track immunity differently, technical complications and jurisdictional wrangling have often stood in the way of creating a true national picture. In calling for an examination of measles processes in Canada, Dr. Burnell echoed Mr. Garner and Dr. Butler-Jones in their pleas for Canada to create a national registry of vaccine coverage at the federal level.
“We’re missing some key data points,” Dr. Burnell said.
“You need to know what your target rate for immunization is, and you need to know what your vaccinated rate is.”
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The most recent federal vaccine coverage survey for measles, from 2021, estimates that 91.6 per cent of two-year-olds have received one dose of the vaccine, and that only 79.2 per cent of seven-year-olds have received the recommended second dose for full immunity to measles. Both figures are well below the 95 per cent of the population considered necessary to keep the virus at bay.
The surveys don’t give officials a detailed picture of where in the country vaccination rates are slipping most, and which local areas or demographics need to be encouraged to get the shot most.
The Globe investigation found that PHAC produced a confidential report in 2012 showing that federal officials worried about their ability to keep up with misinformation and falsehoods online, which they feared were behind an increase in vaccine resistance.
Though the document did not reference measles directly, it warned that public health was losing the battle against online chatter and conspiracy theories.
Data collected last year by the CMA indicate that 78 per cent of respondents in a survey were either highly or moderately susceptible to believing false health information, while 37 per cent look for advice online because they lack access to a doctor. More than a third of respondents acknowledged avoiding effective health treatments because of false information. The CMA linked these trends to Canada losing its measles-elimination status in November.
A spokesman for Health Minister Marjorie Michel told The Globe in an e-mail that the federal government is giving PHAC more funds to help combat misinformation around the measles vaccines.
The Decibel: How measles made its way back to Canada
A measles-awareness campaign launched in September will have its funding increased to $2-million from $500,000 in the coming weeks. The expanded program, “informing Canadians about the rise in measles cases and the importance of being vaccinated,” hasn’t been announced publicly, said Guillaume Bertrand, spokesman for Ms. Michel.
Mr. Bertrand said the government could not say what type of formal review might be done once the measles outbreak subsides, but he indicated that such processes are possible given the extent of the outbreak.
Canada struck a federal commission to examine the SARS outbreak in 2003, and there were multiple reviews conducted after the 2009 H1N1 swine-flu outbreak, as well as federal committee hearings held during the height of the COVID-19 pandemic.
The Globe investigation detailed multiple past attempts to create a federal database to track measles vaccination rates, which failed because of a lack of co-operation among provinces, insufficient funding, and an inability to merge provincial data systems.
A new attempt, known as the Standardized Reporting on Immunization, or STARVAX, currently has only about half of the provinces and territories taking part, and provides only an estimate on national immunity to measles.
“While these tools are valuable, some challenges remain,” Mr. Bertrand said.