The Public Health Agency of Canada (PHAC) says it shares the concerns raised by international health experts this week of the renewed risk of measles and other vaccine-preventable diseases among children.
In a statement to Global News Thursday, the agency noted intake of the measles vaccine in Canada has gone down over the past several years, but pointed to the COVID-19 pandemic and vaccine hesitancy among some parents as reasons for a current decline in vaccinations.
“Canada’s provinces and territories have indicated that the COVID-19 pandemic has resulted in disruptions, delays and gaps in routine vaccinations for children,” the statement read.
There are currently no active cases of measles in the country but three cases have been reported this year, according to the latest report by PHAC.
A joint report published Wednesday by the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) stated that measles is an “imminent” global threat because of declining vaccine coverage and weakened surveillance of the disease during the COVID-19 pandemic.
The report noted that in 2021, a record high of nearly 40 million children around the world had missed a dose of the measles vaccine as the pandemic disrupted and delayed routine immunization programs.
“It’s very concerning,” Shelly Bolotin, director of the Centre for Vaccine Preventable Diseases at the University of Toronto, told Global News on Thursday.
“When coverage is down globally, it’s a concern to all of us because we live in a globalized world, and measles importations do come in from other countries on occasion.”
In line with WHO guidelines, Canada has set a target of 95 per cent vaccination coverage for the first dose of measles by age two and a second one by age seven.
A survey done before the COVID-19 pandemic showed that 90 per cent of children aged two years had received at least one dose of the measles vaccine. It is a two-dose vaccine with the second shot given at 18 months or usually before the child starts school.
However, the pandemic has disrupted childhood vaccinations in the country.
In Ontario, thousands of students were behind on vaccines usually administered in schools, health officials warned in April.
Routine immunizations usually provided by doctors, such as the measles, mumps and rubella vaccine, had also been delayed in some areas because of the pandemic, they said.
Meanwhile, in Alberta, provincial data for the Calgary zone showed in September that immunization rates of measles, mumps and rubella (MMR) vaccines had dropped from 86 per cent of kids with two doses by age seven in 2019 down to just shy of 78 per cent in 2021.
In a previous interview with Global News, infectious disease specialist Dr. Craig Jenne said that number is well below the 95-per cent coverage needed to prevent a measles outbreak.
A combination of factors like lingering social distancing measures and cyclical nature of measles may explain why there has not yet been an explosion of cases globally despite the widening immunity gaps, but that could change quickly, according to WHO’s measles lead, Patrick O’Connor.
“We are at a crossroads,” O’Connor told Reuters on Tuesday. “It is going to be a very challenging 12-24 months trying to mitigate this.”
According to PHAC, measles was eliminated in Canada in 1998 thanks to vaccination efforts but occasional outbreaks occur from international travel. However, the elimination was “re-verified” in July of this year.
PHAC urges Canadians travelling outside of the country to consult the travel health notices for information on measles and rubella outbreaks occurring in other countries.
“Measles anywhere is a threat everywhere, as the virus can quickly spread to multiple communities and across international borders,” the WHO says.
Bolotin said public health reminders to parents of the importance of vaccination were “absolutely” important given the new report’s findings, particularly if their children’s appointments were missed during the height of the pandemic.
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She also stressed that the measles vaccine is “incredibly safe,” despite some concerns among hesitant groups, and has been used effectively for decades.
“I am hoping, despite the conversations that have been had about COVID-19 (vaccines), that people do trust in this (measles) vaccine and trust in the way their health care providers are communicating with them,” she said.
Measles is a highly contagious and serious respiratory disease that can spread from direct contact or through the air when an infected person breathes, coughs or sneezes. The virus can also transmit by touching contaminated surfaces.
Initial symptoms include high fever, runny rose, cough, watery eyes and small white spots inside the mouth. Several days after the onset of first symptoms, a red rash erupts on the face and body, lasting about a week.
Bolotin called measles vaccine coverage “the canary in the coal mine” for child health, due to how infectious the disease is. The period of infection can begin up to four days before symptoms appear, she said, and can last up to four days after the rash fades away.
“When there is something that has gone awry with child health, child vaccination, one of the first things that jumps out at us to let us know are measles outbreaks,” she said.
Despite the availability of a safe and effective vaccine, thousands of young children worldwide die from measles each year.
Last year, an estimated nine million measles cases and 128,000 deaths were reported, according to the WHO. Health Canada says over 140,000 deaths occur on average every year, mostly involving children under five years old.
— with files from Reuters and The Canadian Press