Canada is on the verge of losing its status as a measles-free country due to a significant outbreak that began in New Brunswick and has now spread to other provinces. The country had successfully eliminated measles in 1998 and maintained that status for over 25 years, with new cases primarily being travel-related. However, as of October 27, 2024, more than 5,000 individuals in Canada have contracted the virus, including two infants in Ontario and Alberta who were infected in the womb and died shortly after birth.

Public health experts attribute the resurgence of measles to declining vaccination rates, which have been influenced by misinformation and vaccine hesitancy, as well as disruptions in routine immunizations during the COVID-19 pandemic. The Pan-American Health Organization (PAHO), the regional office of the World Health Organization for the Americas, is set to review Canada’s measles elimination status in November.

Other countries, including the United States, are also experiencing a rise in measles cases. PAHO noted that the U.S. outbreak began in January of this year, giving it more time before it risks losing its elimination status, which it achieved in 2000.

Dr. Natasha Crowcroft, vice-president of infectious diseases and vaccination programs at the Public Health Agency of Canada, expressed concern over the situation, stating, "We haven’t managed to get ahead of the virus." She emphasized the need for Canada to demonstrate that there is no ongoing transmission for at least 12 months and to ensure that public health systems are functioning effectively to sustain that status.

Key components of these systems include high-quality surveillance to quickly identify and contain suspected measles cases and maintaining a vaccination coverage rate of 95 percent, which is necessary for herd immunity against this highly contagious disease.

Venezuela and Brazil, two other PAHO member countries, lost their measles elimination status in 2018 and 2019, respectively, but were able to regain it after about five years of sustained public health efforts.

Crowcroft noted that the success of vaccination in eliminating measles has led to a generational gap in awareness of the disease's dangers. "They knew the kid who was deaf because they got measles or the kid who was behind at school who had a bad case of measles, or ... just how horrible it could be. That’s something we’ve forgotten," she said.

Nicole Basta, an associate professor of epidemiology at McGill University, called the current outbreak a "wake-up call for all of us." She highlighted the importance of increasing vaccination rates and rebuilding trust in vaccines, stating, "It’s another reminder as to how much work we have to do on a daily basis to try to increase vaccination."

Basta also stressed the need for community leaders to advocate for vaccination, saying, "It’s really those vaccine champions from communities that help improve vaccination, spread awareness about the need for vaccination, and create the positive change that we need."

Dr. Cora Constantinescu, a pediatric infectious disease specialist in Calgary, urged for renewed focus on vaccination in public discourse, especially after the fatigue surrounding vaccine discussions during the pandemic. She expressed concern that the measles outbreak could indicate declining vaccination rates for other diseases, such as polio and whooping cough. "I did not think that we were going to have such a massive measles outbreak in my lifetime," Constantinescu said. "Now I’m looking at all these vaccine-preventable diseases and thinking, ‘Oh my gosh, they’re probably coming, and we need to be prepared.'"