This story is part of CBC Health’s Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven’t subscribed yet, you can do that by clicking here.
In Canada, measles was once a disease of the past. But it’s increasingly becoming a health threat of the present, after backsliding vaccination rates allowed the virus to creep back into circulation.
Canada officially eliminated measles nearly three decades ago, but for years, medical experts warned it was poised to make a comeback — and disruptions to routine childhood immunization efforts throughout the COVID-19 pandemic may have sped that up.
Now, after tens of thousands of cases in Europe, and close to 100 recent infections across Canada and the U.S., health officials are on high alert.
There are warnings about travel abroad, calls for people to ensure their families are up-to-date on the measles vaccine, and fresh reminders that the virus is highly contagious and capable of causing pneumonia, brain inflammation, and even death.
“A lot of people are worried,” said Dr. Alykhan Abdulla, a family physician in Ottawa. “Measles hasn’t really been around in our society for a long time.”
So how should Canadians navigate the latest guidance around measles vaccination, and who’s actually protected? And if you’ve already had at least one measles shot, are you now set for life?
Who should get the measles vaccine?
If you or your child has never had a combined measles, mumps and rubella (MMR) vaccine — and never had a prior measles infection — the official guidance is simple: Get vaccinated.
But after that, it gets a little more complicated.
For Canadian children, the typical schedule is now two doses, both administered before they enter school. The first MMR dose should be given when a child is 12 to 15 months of age and the second dose at 18 months, or any time after that, but no later than around school entry, notes the Canadian immunization guide.
As for adults, if you were born after the two-dose MMR vaccine became routine, you probably had both rounds as a child.
Some adults might’ve only had one dose, however. That includes people born before 1970, who were likely exposed to the virus, given how widely measles used to circulate — and federal guidance assumes those individuals have natural immunity.
However, the same guidance suggests anyone who’s at a higher risk of being exposed — like health-care workers, military personnel and international travellers — should get an MMR vaccine, regardless of their year of birth.
Confused yet?
What if you don’t have your immunization record, or can’t remember if you had a measles infection in childhood? Experts suggest simply getting an MMR dose, to be safe.
“If there’s any concern about whether you’ve been vaccinated, it’s actually cheaper and easier just to get vaccinated again,” said McMaster University associate professor and immunologist Dawn Bowdish.
What do I need to know if I’m travelling outside of Canada?
More than 50 countries are reporting “large and disruptive” measles outbreaks, World Health Organization officials warned this week.
So if you or a family member hasn’t been vaccinated against measles before travelling, there’s a higher risk of catching it, medical experts warn, making it even more important to be up-to-date on your shots.
That’s because measles is capable of lingering in the air for up to two hours (yes, hours) after someone infected enters a space.
Infants under the age of one are “particularly vulnerable” to a measles infection, according to the Public Health Agency of Canada (PHAC), since their routine shots typically start at 12 months of age.
In a statement, PHAC told CBC News the current advice for people travelling internationally is as follows:
Infants between six months and less than 12 months of age: One dose if they’re travelling to a high-risk area. (However, that shot will be considered “dose zero” on their record, as children who get an early dose will still require two more doses later.)
Children and adolescents: Two doses.
Adults born in 1970 or later: Two doses.
Adults born before 1970: At least one dose.
WATCH | How to protect yourself against measles:
How to protect yourself against measles
18 days ago
Duration 7:50
The potential community spread of measles in several cities and an alarming rise in cases abroad has health officials warning Canadians to make sure their vaccinations are up-to-date. The National asks the experts to break down how we got here and what you can do to protect yourself from one of the world’s most contagious viruses.
If people need a shot, how can they get one?
If you need an MMR shot, medical experts suggest speaking to your primary care provider such as a family doctor or nurse practitioner — if you have one — or reaching out to your local community health centre or public health team.
Travel clinics are also an option to quickly get a shot before a trip, though private businesses can charge $75 or more for a dose.
Still, it’s not always easy.
Despite the guidance around staying up-to-date on measles vaccinations, multiple Canadians told CBC News that some doctors and pharmacies are either short on supply, or simply discouraging patients from getting another round because they’re either deemed too young or too old to need one.
“I think we’re all adjusting to this reality of measles resurgence from abroad,” said Shelly Bolotin, director of the Centre for Vaccine Preventable Diseases at the University of Toronto. “And perhaps that is why different people are in different places.”
Is there enough supply of the MMR vaccine available in Canada?
If you do need a dose, there are two MMR vaccines being used in Canada right now, from drug makers Merck and GSK.
Shortage notices have also been posted for both brands’ shots, but Health Canada said the companies have assured they’ll be able to “fully meet demand” for public immunization programs, including routine childhood vaccines.
GSK told CBC News the “temporary” shortage for its Priorix vaccine is linked to an increase in demand in the Canadian private market, adding it continues to meet the demand in the public sector. Merck Canada said it is working with provincial and federal health authorities to provide a consistent supply “in a timely manner.”
What’s unclear to Canadian health-care teams is whether an ongoing spike in demand will further complicate vaccination efforts.
“We have to be judicious, we have a resource that is limited,” said Abdulla, in Ottawa. “And we have to be thoughtful in the way that we use [the available supply].”
Family physician Dr. Allan Grill, in Markham, Ont., said his team is currently distributing measles vaccines on an as-needed basis.
“You can imagine how overwhelmed family medicine would get if we decided all of a sudden to just focus all of our attention on everybody’s measles vaccine status.”
Meanwhile, Andrew Sisnett, president of Summit Health, a travel vaccine provider, said the company rarely doled out MMR shots before this year. Yet demand recently shot up, and he’s having issues ordering more.
“There are concerns that, from a private-sector perspective, that we’re not going to be able to procure enough.”
WATCH | Measles is spreading in some Canadian communities:
Measles may be spreading in some communities, health officials warn
21 days ago
Duration 3:25
Measles cases in greater Montreal and north of Toronto are concerning health officials because two of them are not connected to international travel and are also not tied to any other known cases in Canada. They say this might mean the virus is spreading in the community, and they urge people to get vaccinated.
How protective is prior infection or vaccination against measles?
If you’ve had a prior measles infection, there’s a silver lining.
Peer-reviewed research from a team including Bolotin stressed that immunity from measles is thought to be life-long.
The study cited evidence from the remote Faroe Islands, off the coast of Denmark, which experienced a measles outbreak in 1781. The next outbreak in 1846 spared all those older than 65 — as in, all the people who would have been infected exactly 65 years earlier.
“This early observation remains some of the best evidence of life-long immunity to measles,” the team wrote.
That’s because of how the measles virus operates, Bowdish said.
“Unlike RSV, or influenza or other respiratory infections … it actually infects our immune cells,” she said. “And then it hijacks those immune cells to travel to our lymph nodes, where there’s millions and millions more immune cells to infect.”
A serious infection like that requires a serious immune response, Bowdish said. It’s a bit like your body fighting a major war, giving it deep, lasting memories of how to fend off that attacker if it ever invades again.
So, is the same thing true for getting a full set of MMR shots?
To some extent, yes.
The measles vaccine contains small amounts of live virus, making it one of the most protective shots available, Bolotin said, with two doses showing 97 per cent efficacy (how well it does in an ideal and controlled environment) in studies, and 94 per cent effectiveness (real-world performance) in field estimates.
“It’s actually a mini infection in your body. And so it creates something very, very similar to what you would see if you’re infected.”
There can be instances where immunity after the shots does wane over time, both Bowdish and Bolotin agreed, and various global studies have documented occasional breakthrough infections. Even so, evidence suggests the shots still protect against serious illness and help curb transmission.
“For most vaccines, what we do is we modify or minimize the severity of infections as opposed to preventing them 100 per cent,” said Bowdish.
“But the measles vaccine is a different case, where it really does seem to prevent infections from getting started in most people, most of the time.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
All orders are protected by SSL encryption – the highest industry standard for online security from trusted vendors.
Bizarre Sunlight Loophole Melts Belly Fat Fast! is backed with a 60 Day No Questions Asked Money Back Guarantee. If within the first 60 days of receipt you are not satisfied with Wake Up Lean™, you can request a refund by sending an email to the address given inside the product and we will immediately refund your entire purchase price, with no questions asked.
