Deputy Premier and Minister of Health Sylvia Jones is sworn in to cabinet during a ceremony in Toronto, on March 19.Nathan Denette/The Canadian Press
Ontario’s Health Minister is defending her government’s response to a growing measles outbreak as the province recorded the sharpest single-week increase in cases since the first infection was identified in October.
Public Health Ontario said in its weekly update on Thursday that 1,243 cases (1,065 confirmed, 178 probable) are now associated with the provincial outbreak, which is predominantly affecting unvaccinated children. This includes 223 cases that were identified over the last week.
The Progressive Conservative government and Ontario’s Chief Medical Officer of Health, Kieran Moore, have faced calls, including from the opposition parties, to be more pro-active to increase immunization.
But Health Minister Sylvia Jones defended the work of Dr. Moore on Thursday, telling reporters that he directed local public-health units a year-and-a-half ago to refocus efforts to ensure childhood vaccinations, which have been in decline, are up to date.
“I just want to acknowledge and thank him for his work,” said Ms. Jones at an unrelated announcement, adding that Ontario has made sure, through Dr. Moore‘s leadership, that there are sufficient numbers of vaccines for everyone who wants one.
The province also restarted a public-health campaign recommended by the Chief Medical Officer of Health to ensure parents and caregivers understand the “critical importance of getting that vaccine,” the Health Minister said.
Seventeen public-health units, an increase of two from last week, are now linked to the measles outbreak.
Ottawa Public Health confirmed on Thursday that it is investigating the capital’s first confirmed cases of measles since 2019. It said an adult and child who live in Ottawa are believed to have acquired measles while travelling internationally.
Ontario NDP Leader Marit Stiles said the government must do more to curb the spread of measles, including by boosting spending on public health and through public appearances by Dr. Moore.
“The government’s response has been that this is an ideological thing, like we’re making it political. Well, you know what? It is a political issue right now. We need people to understand the importance of immunization,” she told reporters at Queen’s Park. “My fear is we’ll see it grow every year.”
Ontario Liberal Leader Bonnie Crombie, also at Queen’s Park, blamed lower vaccination rates on cuts to public-health budgets by past governments and said Dr. Moore needs to “take this a little bit more seriously.”
In 1998, Canada declared measles eliminated owing to the measles, mumps and rubella (MMR) vaccine. The country’s multijurisdictional outbreak began last fall with a travel-related case in New Brunswick.
Picard: Measles is spreading quickly in Canada. Where is the public-health response?
Government officials in Alberta, which is facing its own outbreak, have also come under scrutiny for their response to growing measles cases. The province’s former chief medical officer of health, Mark Joffe, who left the role last month, said during a presentation last week that “there has been a complete failure of leadership at all levels,” in addition to public complacency.
In total, 170 cases have been identified in Alberta as of Wednesday. The majority are among unvaccinated children, as is the case in Ontario.
Roughly 70 per cent of Ontario children aged seven were reported to be fully immunized against measles in the 2023-24 school year, a significant decline compared to prepandemic levels. Alberta data shows roughly the same percentage among children for 2023.
Measles is a highly contagious, airborne disease and symptoms include fever, cough, runny nose, red and watery eyes and a rash. Severe complications can include pneumonia, brain swelling and even death.
While some anger has been aimed at public health and government officials for falling short in their response to surging cases, infectious diseases experts explained there are much deeper roots to the problem. The decline in measles vaccination coverage, they say, is also a symptom of fragmented primary care access, lacking immunization programs and medical misinformation.
Zahra Shajani, an associate dean at the University of Calgary’s nursing faculty, said vaccine accessibility and hesitancy are two major problems that need to be addressed. The latter, she said, could be improved by the use pop-up vaccination clinics, workplace immunization programs and the extension of community clinic hours.
Whereas combatting vaccine hesitancy, she said in an interview, requires empathy and time, with all communication rooted in facts, not opinion, on the safety and efficacy of the MMR vaccine.
“It starts with the basics: listening, showing up, being consistent, providing real-life, reliable information,” said Dr. Shajani, adding that building trust with people is key to making inroads.
Isaac Bogoch, an infectious diseases specialist at Toronto General Hospital, who also works in the University of Toronto’s Department of Medicine, said it is important for public-health information to be communicated appropriately to the highest risk communities.
Mennonite communities in both Ontario and Alberta, for example, have been affected by cases.
This work, Dr. Bogoch said in an interview, is traditionally done at the community level with local public-health units and medical leaders who work closely with the people in these areas, listening and addressing any concerns.
He said the re-emergence of vaccine-preventable illnesses, including measles, is not just a Canadian phenomenon but a global one.
Some people’s mistrust in public health stems from the COVID-19 pandemic, Dr. Bogoch said, and that it will take a “long time” and “a lot of work” to build that trust back.