Achi news desk-
This story is part of CBC Health’s Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven’t subscribed yet, you can do so by click here.
In Canada, measles was once a disease of the past. But it is increasingly becoming a current health threat, after sliding vaccination rates allowed the virus to slip back into circulation.
Canada officially eliminated measles nearly three decades ago, but for years, medical experts warned it was about to make a comeback — and disruptions to routine childhood immunization efforts throughout the COVID-19 pandemic may have increased that.
Now, after tens of thousands of cases in Europe, and close to 100 recent infections across Canada and the United States, health officials are on high alert.
There are warnings about traveling abroad, calls for people to make sure their families are up-to-date on the measles vaccine, and new reminders that the virus is highly contagious and can cause pneumonia, meningitis, and even death.
“A lot of people are worried,” said Dr. Alykhan Abdulla, a family doctor in Ottawa. “Measles hasn’t really been around in our society for a long time.”
So how should Canadians navigate the latest measles vaccination guidelines, and who is really protected? And if you’ve already had at least one measles shot, are you now set for life?
Who should get the measles vaccine?
If you or your child have never have had a combined measles, mumps and rubella (MMR) vaccine—and have never had a measles infection before—the official guidelines are simple: Get vaccinated.
But after that, it gets a little more complicated.
For Canadian children, the typical schedule is now two doses, both administered before they go to school. The first dose of MMR should be given when a child is between 12 and 15 months old and the second dose at 18 months old, or any time after that, but no later than when they start school. notes Canadian immunization guide.
As for adults, if you were born after the two-dose MMR vaccine became routine, you probably had both rounds as a child.
However, some adults may only receive one dose. That includes people born before 1970, who were likely exposed to the virus, given how widely measles used to circulate – and federal guidelines assume those individuals have natural immunity .
However, the same guidelines suggest that anyone at increased risk of exposure – such as healthcare workers, military personnel and international travelers – should get the MMR vaccine, regardless of their year of birth.
Confused again?
What if you don’t have your immunization record, or can’t remember if you had measles as a child? Experts suggest getting an MMR dose, just to be safe.
“If there’s any concern about whether you’ve been vaccinated, it’s actually cheaper and easier to get vaccinated again,” said Dawn Bowdish, associate professor and immunologist at McMaster University.
What do I need to know if I’m traveling outside of Canada?
More than 50 countries are reporting “large and disruptive” measles outbreaks, World Health Organization officials warned this week.
So if you or a member of your family have not been vaccinated against measles before travelling, there is a greater risk of catching it, medical experts warn, making it all the more important to be aware of d latest pictures.
That’s because measles can stay in the air for up to two hours (yes, Hours) after an infected person enters a space.
Babies under the age of one are “particularly vulnerable” to measles infection, according to the Public Health Agency of Canada (PHAC), as their routine shots usually start at 12 months of age.
In a statement, PHAC told CBC News that the current advice for people traveling internationally is as follows:
- Infants between six months and less than 12 months of age: One dose if they are traveling to a high risk area. (However, that shot will be considered a “zero dose” on their record, as children who receive an early dose will still need two more doses later.)
- Children and young people: Two doses.
- Adults born in 1970 or later: Two doses.
- Adults born before 1970: At least one dose.
The possible community spread of measles in several cities and an alarming increase in cases abroad have health officials warning Canadians to ensure their vaccinations are up to date. The National asks the experts to analyze how we got here and what you can do to protect yourself from one of the world’s most contagious viruses.
If people need a shot, how can they get one?
If you need an MMR shot, medical experts suggest talking to your primary care provider such as a family doctor or nurse practitioner – if you have one – or reaching out to your local community health center or public health team.
Travel clinics are also an option for a quick shot before a trip, although private businesses can charge $75 or more for a dose.
Still, it’s not always easy.
Despite the guidelines about staying up-to-date on measles vaccinations, several Canadians told CBC News that some doctors and pharmacies are either out of stock, or discouraging patients from getting another round because they are either considered too young or too old to need one.
“I think we’re all adjusting to this reality of the resurgence of measles from overseas,” said Shelly Bolotin, director of the Center for Vaccine-Preventable Diseases at the University of Toronto. “And maybe that’s why different people are in different places.”
Is there a sufficient supply of the MMR vaccine available in Canada?
If you need a dose, there are two MMR vaccines currently in use in Canada, from drug makers Merck and GSK.
Shortage notices have also been posted for both brands’ shots, but Health Canada said the companies have assured they will be able to “fully meet demand” for public immunization programs, including routine childhood vaccines.
GSK told CBC News that the “temporary” shortage for its Priorix vaccine is related to increased demand in the Canadian private market, adding that it continues to meet demand in the public sector. Merck Canada said it is working with provincial and federal health authorities to provide a consistent supply “in a timely manner.”
What is unclear to Canadian healthcare teams is whether continued increases in demand will further complicate vaccination efforts.
“We have to be wise, we have a limited resource,” said Abdulla, in Ottawa. “And we have to be thoughtful in the way we use it [the available supply].”
Family physician Dr. Allan Grill, in Markham, Ont., said his team is currently distributing measles vaccines as needed.
“You can imagine how overwhelmed family medicine would be if we suddenly decided to focus all our attention on everyone’s measles vaccine status.”
Meanwhile, Andrew Sisnett, president of Summit Health, a travel vaccine provider, said the company rarely gave out MMR shots before this year. Yet demand increased recently, and he is having problems ordering more.
“There are concerns, from a private sector perspective, that we are not going to be able to procure enough.”
Measles cases in greater Montreal and north of Toronto are of concern to health officials because two of them are not linked to international travel nor are they linked to any other known cases in Canada. They say this could mean the virus is spreading in the community, and they are urging people to get vaccinated.
How protective is a previous infection or vaccination against measles?
If you have had a measles infection before, there is a silver lining.
Peer reviewed research of a team including Bolotin emphasized that immunity from measles is believed to last a lifetime.
The study cited evidence from the remote Faroe Islands, off the coast of Denmark, which experienced measles outbreaks in 1781. The next outbreak in 1846 managed to spare everyone over the age of 65 — as in the case of all the people who would have been infected. 65 years exactly. before.
“This early observation remains some of the best evidence of lifelong immunity to measles,” the team wrote.
That’s because of how the measles virus works, Bowdish said.
“Unlike RSV, or flu or other respiratory infections… it actually infects our immune cells,” he said. “And then it hijacks those immune cells to travel to our lymph nodes, where there are millions and millions more immune cells to infect them.”
A serious infection like this requires a serious immune response, Bowdish said. It’s a bit like your body fighting a great war, giving it deep, lasting memories of how to protect that attacker if he ever attacks again.
So, does the same apply to getting a full set of MMR shots?
To some extent, yes.
The measles vaccine contains small amounts of live virus, making it one of the most protective shots available, Bolotin said, with two doses showing 97 percent effectiveness (how well it’ n done in an ideal and controlled environment) in studies, and 94 percent effectiveness (real world performance) in field estimates.
“It’s really a small infection in your body. And so it creates something very, very similar to what you would see if you’re infected. “
There may be cases when immunity after the shots decreases over time, and Bowdish and Bolotin agreed, and various global studies documented sporadic breakthrough infections. However, evidence suggests that the shots still protect against serious illness and help curb transmission.
“For most vaccines, what we’re doing is we’re modifying or reducing the severity of infections rather than preventing them 100 percent,” Bowdish said.
“But the measles vaccine is a different case, where it seems to prevent infections from starting in most people, most of the time.”
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