Ask the Pharmacist

Q: Why is measles a problem once again? I thought we got rid of that disease in Canada long ago.

A: Canada was effective at eliminating the measles virus as of 1998 with the United States claiming the same in 2000. There was still the odd case appearing but they were isolated cases that were related to travelling to a country where measles was present.

Here, in Canada, back in the 1970s, ‘80s, and ‘90s, most people did opt to be vaccinated against the usual childhood diseases. Sure, there were a few who did not get vaccinated but overall, it was easy to achieve a 95-per-cent vaccination rate.

There have been only a few deaths, globally, of late and the most recent death was in an immuno-compromised individual. Compare that to the 2.6-million people who died each year among the 30-million cases of measles before the vaccine was developed!

Thanks to the vaccine, this death rate dropped steadily until 2019 where the number of cases was below 90,000. With the resurgence of measles occurring now, the number of cases of measles has increased to nine-million and the number of deaths has increased to 136,000 each year.

As mentioned previously, up until now, the number of cases of measles has all been associated with travelling to areas of the world that may not have access to vaccines. However, there appears to be an uptick in the number of unvaccinated people in various communities and, thus, there are higher numbers of people infected with the measles virus.

The end result is, you do not have to travel far to be exposed to measles. There is a high number of cases of measles in Florida and we are seeing increasing numbers in Quebec as well. This increases the risk of getting infected among the many people who travelled to those areas during the recent spring breaks. A more concerning note we are seeing now, is there are cases of measles that are not associated with travel, either abroad or to Florida or Quebec.

Regarding measles in Canada, in 2023, we had 12 cases of the disease. Already, in 2024, we are aware of at least 26 cases. The concern is we are now seeing community transmission and not solely linked to travel.

It is believed that we can get rid of measles since it does not have an animal host and, therefore, we do not have to contend with mutations for the measles virus like we are so familiar with for the COVID-19 virus. We eliminated measles many years ago with the exception of those few flare-ups due to travel. To achieve this, we need to ensure we are vaccinated.

As mentioned earlier, we are seeing more people choosing to be unvaccinated. In a high school in Toronto, there is a concerning number of measles cases arising where the vaccination rate was known to be 95 per cent. That five per cent was enough to wreak havoc in that community with the spread of the measles virus. In Montreal, some schools have a vaccination rate as low as 30 per cent which might explain the serious increase in cases we are seeing in Quebec.

Many are asking why we have so many unvaccinated groups of people now. We can partially blame the COVID-19 pandemic since many children missed their vaccinations with the closure of in-person health-care appointments. It is important now to get these children vaccinated with the two doses.

We can also partially blame our health-care system with so many families that do not have a family physician. Without a health-care practitioner, many preventative diseases and disorders are at risk of causing harm.

Another reason for being unvaccinated may be due to religious beliefs, such as in some Jewish and Amish communities, among others. People avoiding vaccinations due to religious reasons, is on the rise. This is very interesting as it appears that the religion itself is not against vaccinations but rather the individual parents’ and/or the religious leaders’ controversial interpretation of their religious practices, that are opposed to vaccinations.

Also, there have always been groups of people that will not vaccinate as they believe the vaccine is poison. In North America and Europe, more people are shunning vaccinations for reasons due to misinformation. They are led to believe that their immune system is “magic” and they will not suffer any consequences of diseases.

Many years ago, Andrew Wakefield published a paper falsely linking autism to the MMR (measles, mumps and rubella) vaccine. It turns out that he was not against vaccines as was thought to be the case. Rather, he was pro-vaccinations and he had actually developed his own vaccine that he was bringing to market and hoped that this paper would send concerned parents to his vaccine.

Unfortunately for him, that is not how it turned out. This link to autism was proven false but that did not stop concerned parents from opting out of vaccinating their children. Many of these children are now adults and, thus, leading into a second generation of vaccine hesitancy.

There is also an increase in vaccine hesitancy due to the vaccine doing what it was supposed to do. To clarify, we did not see many, if any, cases of measles for decades. This is all due to the vaccine working so well that it was nearly non-existent for over a generation. Many parents were left to ponder if it was necessary any longer and were not so concerned about it being a poison.

It can be confusing when we are asked to give our children a vaccine for diseases that we have not seen in decades. Some of this vaccine hesitancy goes back to well before the COVID-19 pandemic. Add that hesitancy to the issues of getting children vaccinated during the pandemic and we now have a much lower vaccination rate among our children.

The measles vaccine available in Canada, is combined with mumps and rubella and called the MMR vaccine. It is an inactivated vaccine which allows your body to build up anti-bodies to the measles for the rest of your life. It prepares you for when you might get exposed to measles.

Though you can gain life-long protection by getting the measles virus, you can also run the risk of getting gravely ill, having a high fever, and risking blindness and/or deafness. You may also have to miss five to 10 days of school/work regardless of how sick you or your child become. The MMR vaccine is equally effective at providing immunity to measles and is not associated with those additional risks compared to the natural infection.

If you have been negligent in getting yourself or your children vaccinated, now is a good time to connect with your health-care provider and get vaccinated. To achieve herd immunity, 95 per cent of the population needs to be vaccinated. To get rid of the disease completely, we need 100 per cent of the population to be vaccinated. Is this even possible?

Remember that Canada did eliminate it once before so we can at least aim to eliminate it from Canada once again first and then talk of eradicating it altogether. To date, we have been able to get rid of only one disease in our lifetime, and that’s smallpox. We are close with polio but we continue to see some cases around occasionally.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/