Are children in the Toronto area more at risk of catching measles than the rest of Ontario?
It’s a question that could be answered, at least in part, by a report released by Public Health Ontario (PHO) that shows mostly declining vaccination rates against the highly-contagious disease among kids, especially in the Greater Toronto Area.
The report is from July, but helps to add context to Ontario’s current measles situation. As of March 13, eight cases have been confirmed in 2024 so far, one more than the seven reported throughout all of 2023, and four of those cases were in unvaccinated children. Half of those cases were reported in the GTA and Hamilton and all but two involved recent travel.
Since March 13, at least one additional case has been confirmed in Toronto, with the city’s public health agency warning of potential exposure at a mom and babies program downtown.
Immunization data for all 34 of the province’s public health units is included in the report and shows coverage rates for seven and 17-year-olds between the school years of 2019 and 2022.
While the older cohort has consistent immunization rates above or near 90 per cent across the board and over the years, vaccine coverage has slipped for the younger group since 2019, specifically in public health units located in the GTA.
For example, in Toronto, the percentage of seven-year-olds fully vaccinated for measles dropped from 80.2 per cent in the 2019-2020 school year to 38.9 per cent in the 2021-2022 school year. The situation appears to be worse in Peel Region, where rates have fallen from 77.7 to 37.2 per cent in the same time period.
In fact, every city in the GTA has seen a dramatic drop off in measles vaccination rates since 2019, led by York Region at 31.9 per cent.
“We need to have at least 70 to 80 per cent of kids vaccinated for this illness to keep the numbers at bay. As soon as percentages of vaccine rates dip below that, we're at risk of seeing these illnesses come back again, which had all but eradicated in Canada in the last number of decades,” Dr. Dina Kulik, a pediatrician and founder of Kidcrew Medical, told CTV News Toronto in an interview.
WHY THE DROP OFF IN VACCINE COVERAGE, PARTICULARLY IN THE GTA?
COVID-19 is at least partially to blame for the reduced immunization coverage, according to the PHO, which says it caused “significant disruptions” to the delivery of routine vaccines.
The report notes that because primary care offices were limited to virtual visits at the height of the pandemic, the “deferral of nonessential” medical treatments, like immunizations, followed.
Beyond that, Kulik said some patients in Ontario have had trouble accessing their family doctor in recent years, due in part to a province wide staffing shortage –more than half a million peoplein Toronto don’t have a family doctor, according to recent numbers released by the Ontario Medical Association.
As well, vaccine hesitancy in the wake of the global COVID-19 vaccine rollout continues to be a factor.“By and large, measles is a pretty benign illness for most people. However, if you have enough people that get it, just like COVID, just like flu, just like other illnesses, there are risks and some kids do get very, very sick, and some kids can die from measles,” she said.
Why the drop off in vaccine coverage, particularly in the GTA?
COVID-19 is at least partially to blame for the reduced immunization coverage, according to the PHO, which says it caused “significant disruptions” to the delivery of routine vaccines.
The report notes that because primary care offices were limited to virtual visits at the height of the pandemic, the “deferral of nonessential” medical treatments, like immunizations, followed.
Beyond that, Kulik said some patients in Ontario have had trouble accessing their family doctor in recent years, due in part to a province wide staffing shortage –more than half a million peoplein Toronto don’t have a family doctor, according to recent numbers released by the Ontario Medical Association.
As well, vaccine hesitancy in the wake of the global COVID-19 vaccine rollout continues to be a factor.
“I think when a new vaccine comes out, like the COVID vaccine, it brings up a lot of questions around how vaccines are made, and how are they tested and short-term and long-term side effects,” Kulik said.
“I think these are important conversations to have, I welcome these conversations with my patients, because I want them to be informed about why they're getting vaccines and what are the potential risks, but also the benefits.”
PHO has acknowledged that there is an “increase in measles activity globally” and last week Health Minister Sylvia Jones said the province hasboosted its stockpile of vaccines.
Late last year, the World Health Organization called the increase in global measles outbreaks and deaths “staggering” but also “not unexpected” due to declining vaccination rates over the years.
So what should you do?
Health officials have been urging members of the public tocheck their immunization recordsto make sure they are up to date on their measles vaccines, especially before travelling.
If you’re unsure, Kulik recommends booking an appointment with your doctor to review what vaccines you, or your children, may be missing.
“I think it's definitely a priority to make sure that kids are seeing their primary-care provider or family doctor, or pediatrician to review what vaccines may be required, what vaccines their kids are missing, and catch them up, because we know we need a couple of weeks after a vaccine to really reach good immunity.”
If you contract measles, Toronto Public Health has provided the following guidance, which includes:
- Seek medical care if symptoms arise particularly after travel or exposure to a measles-infected person
- Call ahead to clinics for precautionary measures and testing
- Do not attend work or school
- Remain watchful for symptoms even if vaccinated against measles
- Follow medical advice promptly for proper care and containment
