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.”
Skinstitut Holiday Gift Kits take the stress out of gifting
Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.
In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.
“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.
There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.
Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.
Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.
In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.
Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?
It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.
Here’s how you can prepare your digital life for your survivors:
Apple
The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.
For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.
You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.
Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.
Google
Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.
When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.
You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.
There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.
Facebook and Instagram
Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.
When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.
The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.
You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.
TikTok
The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.
Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.
X
It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.
Passwords
Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?
Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.
But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.
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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
