This week, Canada lost its measles elimination status.Nicole Osborne/The Canadian Press
It is easy to be angry that Canada has lost its hard-won status as a country where measles has been eliminated. The Pan American Health Organization (PAHO) declaration to that effect this week is an embarrassment. Failing to prevent a measles outbreak that killed two infants explodes the comfortable conceit about Canada being a modern developed country. It also resurfaces old antagonisms about anti-vaxxers and misinformation.
But anger is the wrong response. The correct response is to seize the moment to increase rates of vaccination for childhood diseases that had been stagnating or falling well before COVID-19. The outbreak over the past 12 months contains useful lessons about how even a small vulnerability in the armour that is supposed to protect children can result in real harm.
How the measles made its way back to Canada
First lesson: Measles is a ferociously contagious virus that can be transmitted through the air, and which can remain afloat for up to two hours. An infected person can sneeze in a library at noon and leave, and someone who walks in 90 minutes later can catch the bug. The virus is also crafty. It doesn’t make its presence known for days, disguising itself as a common cold until it has been able to spread further.
A Globe and Mail story in September showed how an unknowingly infected woman who travelled from Thailand to rural New Brunswick to attend her sister’s wedding in October, 2024, was the source of the outbreak that eventually sickened more than 5,100 people across the country, and hundreds more in Texas, according to PAHO.
Second lesson: Measles preys on the unvaccinated. According to PAHO, 89 per cent of the Canadian cases in the outbreak involved unvaccinated people, and 5 per cent involved people of unknown vaccination status. PAHO says the outbreak was especially prevalent in “vaccine-hesitant” populations, in this case Mennonite communities in both Canada and the U.S.
Third lesson: Measles is a deadly disease that too many have grown complacent about. The two outbreak-related deaths in Canada, and three more in the U.S., are a reminder of its lethality.
Before a vaccine was developed in the early 1960s, this country saw as many as 400,000 cases a year, with a mortality rate among children of about one in 1,000. Worldwide, mostly in less developed countries, 107,000 people died from the disease or its related complications in 2023, according to the World Health Organization. Most of them were children under the age of 5.
But those deaths are occurring too far from Canada, or too far in the past, to feel like a threat. In Canada and the U.S., where children have access to good nutrition and medical care, some vaccine-skeptical parents believe their children are better off unvaccinated because they are unlikely to suffer the worst consequences of an infection. It was this privileged delusion that led to “measles parties” in California in 2015, at which children were deliberately infected with measles in order to “naturally” immunize them. It may have also contributed to a drop in Canada’s vaccination rates for measles, mumps and rubella (the MMR vaccine), which have fallen below the 95-per-cent rate required for herd immunity.
Canada has lost its measles elimination status. Here’s what you need to know
Fourth lesson: Eliminating the disease is hard. After the introduction of a measles vaccine in the 1960s, it still took a generation of concerted work for Canada to earn its status as a country where the disease was eliminated. That happened in 1998, and now it has fallen apart in the space of 12 months. It could be years before Canada gets back its status.
These lessons add up to a clear message that politicians and the public need to hear: Stop playing games with vaccines. They are the safe and effective foundation on which a disease-free world for children is built. Without the MMR vaccination, millions of children worldwide would die every year from measles, including hundreds in Canada, where the population has more than doubled since the 1960s.
Public health officials across Canada need to reinforce the value of vaccines, and to remind Canadians of the risks they create with they become complacent or fall prey to misinformation. Governments need to gently yet persistently deliver this message. People who are skeptical about vaccines need information and compassion, not judgment or opprobrium.
The tragedy of the past year is the perfect opportunity to do that. It should not be wasted.
Editor’s note: An earlier version of the story referred to measles having been eradicated in Canada, but that term refers only to diseases that have been eliminated globally.