* Canada has more measles cases than the United States * Outbreak of virus has lasted a year in the country * Public health experts fear slipping vaccination rates will lead to other resurgent, preventable diseases By Anna Mehler Paperny TORONTO, Oct 28 (Reuters) – Canada is poised to lose its measles elimination status after nearly three decades, and public health experts fear outbreaks of other preventable diseases as vaccination rates fall. Canada has recorded more than 5,000 measles cases in nine provinces and one territory since the current outbreak started in Ontario and New Brunswick a year ago. More are likely going undetected, health experts told Reuters. Two premature babies have died this year after being infected with measles, one in Ontario and one in Alberta. The virus has been especially prevalent in some religious-minority communities, including Mennonites, which often have lower vaccination rates. Health experts say the spread of an opportunistic virus enabled by slipping vaccination rates in parts of the country is a harbinger of more vaccine-preventable illnesses resurgent in a population increasingly skeptical and mistrustful of vaccines since the pandemic, despite the success of COVID-19 shots. As of October 21, there have been 1,618 measles cases detected in the United States, which has a population about 8.5 times larger than Canada's. To be considered measles-free, a country where an outbreak takes place must get back to zero cases within 12 months. That deadline expires this week for Canada, while the U.S. has until January and Mexico until February. The Pan American Health Organization will meet with member nations about their measles elimination status in early November, Health Canada said in a statement, and is expected to make a decision in December. FALLING VACCINATION RATES Mark Joffe, who had been Alberta's chief medical officer until earlier this year, said more could have been done to boost immunization and prevent spread. About 72% of Albertan children had their second dose of the measles-mumps-rubella vaccine by age 7 as of 2024, down from about 82% in 2019, according to provincial data. Alberta has identified almost 2,000 measles cases since March, giving it the country’s highest case rate per capita. “If the vaccination rates were high, this would never have happened. There may have been (some spread), but nothing like this,” Joffe said. Ontario, whose population is more than triple Alberta’s, reported 2,375 cases as of early October. Ontario declared its outbreak over on October 6, after no new cases were reported in 46 days. Ontario moved more quickly with contact tracing and immunization catch-up clinics than Alberta, said Ontario-based epidemiologist Nitin Mohan, so the virus ran into transmission-stopping firebreaks of immunity and could not spread. A spokesperson for Alberta's Ministry of Primary and Preventative Health Services said Ontario's outbreak started and peaked earlier. "We’re now seeing the same steady decline in cases," the spokesperson said. "Alberta’s government has taken the measles situation seriously from the outset." Ontario has also seen vaccination rates slip, with measles inoculations down to 70.4% for children by age 7 in 2024 from 86.1% in 2020. Health experts say 95% of the population should be inoculated to achieve herd immunity that can protect those in the community unable to get the vaccine. Immunization rates have also been dropping in Alberta for other diseases. The share of provincial children who had four doses of a shot that includes diphtheria and polio by age 2 dropped from 76.8% in 2019 to 68.9% in 2024, according to provincial data. Ontario's polio immunization rate by age 7 dropped from 86.3% in 2019 to 70.2% in 2023, according to public health data. “Other vaccine-preventable diseases would be expected to follow in due course,” said Edmonton-based infectious disease doctor Lynora Saxinger. “I sometimes feel like we're heading back to the late 1800s.” POWER TO PERSUADE Fueled by a vaccination push during the outbreak, Alberta doubled the number of weekly measles shots given between mid-February and mid-March – evidence, experts say, that people are persuadable if given accurate, compelling information and easy access to the shot. “There are a lot of people out there who don't refuse the vaccine per se,” Joffe said. “I think the reality is that parents in this era of young children, they don't know what measles is. It didn't exist in their lifetime.” Some of Alberta’s cases have been concentrated in close-knit Mennonite communities that may not trust or feel connected to public health officials. Tina Meggison started her health advocacy early. As the oldest girl in a family of 12, translating for parents who did not speak fluent English often fell on her. Now, as a community health representative with the provincial government, she works with Low German-speaking Mennonite communities in southern Alberta. Much of the trust-building happens in the waiting room, she said, by accompanying people to one appointment and determining their health needs. During the measles outbreak, she has sought to inform. "COVID was definitely something that was a negative experience for many and as such I think a lot of anxiety can surround these sorts of decisions around vaccines," she said. "As parents, we all want to make the best decisions we can for our kids. And what we hope to do as community health reps is to equip these parents to make informed decisions." (Reporting by Anna Mehler Paperny in Toronto; Editing by Caroline Stauffer and Bill Berkrot)
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