Ontario has changed its mind about mandating measles shots

The province of Ontario has reversed its refusal to make the measles vaccine mandatory, turning the program to providing seasonal flu shots to all children, while ramping up efforts to vaccinate more young children and people at risk for measles, like preschool-age children.

Children must already be immunized against measles by the time they turn 2. The new requirements mean that they’ll be required to be immunized up to the age of 5.

It’s already been a hot year for measles in Canada.

Already, Ontario has recorded three cases of measles this year, compared to just three in all of 2018. The problem there, and in the rest of the country, may be partially due to a decline in public education about the vaccine.

Canada is largely a place where the anti-vaccine movement has been muted by a highly effective vaccination campaign. In 2018, there were 54 measles cases reported, one of which was in Toronto. In 2016, there were more than 3,000 cases.

But there’s less education in Canada about getting the flu shot. And in the past, some might have avoided the shot just to keep their kids from getting immunized.

Shelley Papworth, a York University professor who specializes in public health, said that she thought that the decision made by the Ontario government in December was misguided, that it was wrong to avoid the vaccine, and that the move was bad policy.

The difficulty, Papworth said, is in trying to build confidence in the information about vaccines.

“People’s perception of the safety of vaccines changes quite often,” she said. In part, she said, it’s because the information gets altered, and in part, it’s because the messages get confused.

“No matter how safe the vaccine is, it can still hurt people,” she said. And the same message about not vaccinating might resonate even more, because parents don’t know the risks of getting the flu shot.

Canada had a lot of vaccine hesitancy and misbelief around the time of the 2012 Toronto outbreak, which was largely driven by misinformation circulating online about the benefits of the vaccine. It’s a sort of loose network of influencers in the online health world who suggest the dangers of vaccines, and it can be difficult to counter misinformation.

In Ontario, immunization rates are the highest in the country, according to an organization called Immunize Ontario. There are roughly three times as many who are protected by the measles vaccine as those who are not. And vaccination rates for the 2019 winter flu shot have also been high, according to the organization.

So far, there are eight confirmed cases of the flu in Ontario, all of which were people over the age of 65. But of the 16 pediatric deaths in Canada in 2018, five happened during the year of the influenza vaccine. As Papworth noted, the 2016 and 2017 outbreak has taken a toll on childhood immunization rates.

Papworth said the question for the Ontario government moving forward was whether the program would be considered “enough.”

“Getting them vaccinated against the flu … is a really worthwhile step,” she said.

It’s also a sign of a public health experiment.

The country appears to be in a generally good position, one that was welcomed by Papworth, who doesn’t think Canada is in danger of a more pervasive outbreak of measles, but acknowledged that the data speaks for itself. She said the population’s overall health is improving, partly due to the government’s recent, aggressive campaign.

“For every one of those people dying from measles, you’re always worried there could be ten times that number who didn’t get vaccinated,” she said.

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