Measles, a highly infectious disease recorded in Canada by health officials since 1924, was declared eliminated in 1998. Then, in January 2024, 40 cases emerged across the country — three times more than the total number of cases reported in 2023, according to data by the Public Health Agency of Canada.
Between March 3 and 9 alone, nine measles cases were reported nationally. Making up this number, Quebec contributed to six of the nine cases reported and Ontario contributed to three. Of Quebec’s six cases, five people were not fully vaccinated. And among Ontario’s three cases, two people were completely unvaccinated.
How did an infectious disease that was almost eradicated, return to Canadian immune systems?
What’s going on?
Noting that rates in vaccine hesitancy (a delay or refusal to accept vaccines) should not be more than an average of 30 per cent of the population, a 2023 study by Health Promot Perspect analyzed the global willingness to get vaccinated against COVID-19 and found that 29.72 per cent of people are hesitant to vaccinate.
The study sees the COVID-19 vaccination refusals as more than an individual phenomenon. It understands them as “a complex, multifaceted behaviour” that usually stems from the spread of fake news online and a lack of trust in clinical trials.
The same 2023 study found that parents who are vaccine-hesitant claim to trust the advice they consume on social media platforms like Instagram, Facebook, X and YouTube almost as much as they trust their family doctors.
Consider this: At the height of COVID-19 restrictions, as we attempted to figure out our “new normals,” many individuals spent a considerable amount of time scrolling through social media as a means of entertainment to cope with an unprecedented level of boredom.
In addition, the bare highways, the abandoned shopping malls and those eerily still downtown hubs are a reminder to just how much the COVID-19 restrictions brought the hustle and bustle of daily life to a halt.
This new-found quietness provided an opportunity that shone a light on social issues brewing in the shadows of nine-to-five chaos. From Black Lives Matter to climate change advocacy, 2020 and 2021 became a period of increased polarization towards topics of concern.
Anti-vax growth
In particular, debates between those for and those against the COVID-19 vaccine — or “anti-vaxxers” as they came to be known — loomed to the forefront.
In 2019, the World Health Organization (WHO) listed vaccine hesitancy as one of the 10 most significant factors negatively impacting public health. Placing some of the responsibility on vaccination refusals, WHO saw a 30 per cent increase in global measles cases that same year.
Like those infectious diseases brought to countries by travellers or passed between members of religious groups who resist vaccination, measles is now being spread across Canada because of the lasting effects of COVID-19 vaccine concerns.
Vaccine hesitancy, however, is not new to WHO’s 2019 discussion — it’s always been around.
Before the widespread distribution of a vaccine for measles took place in Canada during the early 1970s, the disease claimed the lives of 892 people in 1926 and more than 83,000 cases were reported in 1935 — both incidences were the highest number ever documented nationwide for each category.
Between 1996 and 1997, a two-dose routine program and “catch up” campaign were introduced in Canada to boost the immunization status of everyone who got vaccinated between the ’70s and the early ’90s. When completed in 1998, measles cases had declined by 96 per cent — making Canada almost measles-free, according to a 2004 study by Oxford Journals.
Effective prevention
With social media as a breeding ground for misinformation that poses a risk to public health and safety, the Government of Canada advises parents to always get their vaccination information from healthcare professionals and share these guidelines on how to have that conversation.
When speaking with vaccine-hesitant parents, healthcare professionals should:
- Use presumptive statements
- Cultivate a “safe space” by creating an opportunity for the patient to express their questions and concerns about vaccination
- Open up about your own experiences getting and giving vaccines
- Activate the “right emotions” by encouraging positivity instead of feelings of shame or guilt
- Avoid judgment or negative labels related to not getting vaccinated
- Be transparent about the risks and benefits of vaccination
While staying six feet apart from others and using copious amounts of Lysol wipes worked to limit the spread of COVID-19, these efforts do not eradicate infectious diseases like measles—vaccines do.
In the way widespread vaccinations diminished the influenza pandemic (Spanish Flu) from a ravaging infectious disease in 1918 to what is now a common cold, vaccines for COVID-19 and the measles strive to do the same by reducing the severity of the viruses and hopefully eliminate them altogether.
In a statement released on March 27, 2024 the Public Health Agency of Canada expressed concern about the low number of school-aged children vaccinated against measles due to the 90 per cent contagiousness rate of the disease.
Providing a solution, the agency says that two doses of the “measles-containing vaccine is almost 100 per cent effective at preventing measles infection.”
“No one should have to experience serious illness from a vaccine-preventable disease like measles,” they wrote. “Help stop the spread of measles in Canada by ensuring you and your family receive recommended measles vaccines.”