Question Period Note: Measles

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KEY MESSAGES
· The current and ongoing measles outbreak started with an internationally imported cases and exposure at a wedding in New Brunswick in October 2024 is continuing to spread in Ontario, Alberta, Saskatchewan and Manitoba, with sporadic cases in PEI, Quebec and Northwest Territories, while it has been declared over in New Brunswick.
· The majority of cases linked to this outbreak are from under-vaccinated communities.
· The measles virus lineage associated with this outbreak is also circulating in the United States and Mexico. Some of the affected communities have strong international ties and travel frequently to other communities with low vaccination coverage.
· Measles vaccination is highly effective in limiting transmission and preventing severe outcomes. With measles cases rising worldwide and in Canada, staying up to date with routine vaccinations remains critical for individual protection and to help prevent outbreaks in our communities.
· The Public Health Agency of Canada is actively monitoring recent increases in measles detected worldwide, as well as supporting provinces as needed with new cases in Canada.
IF PRESSED …
Q1: If pressed on vaccination
A1:
· Measles is highly contagious and can cause serious health complications including deafness, brain injury, and death. Fortunately, the measles vaccine is very effective at preventing infection and severe outcomes.
· Over the past fifty years, successful measles vaccination programs in Canada have played a crucial role in eliminating measles circulation in Canada.
· The Government of Canada encourages people of all ages to ensure they are up to date on routine vaccinations, including measles.
Q2: If pressed on vaccination – NACI recommendations
A2:
· The National Advisory Committee on Immunization (NACI) recommends that routine immunization for children 12 months to less than 13 years include 2 doses of measles-containing vaccine, using either MMR or MMRV vaccine, which are highly effective at preventing infections.
· Measles vaccines can be given as early as 6 months of age for children travelling outside of Canada where the disease is of concern or travelling to locations experiencing outbreaks (including within Canada).
Q3: If pressed on federal role
A3:
• The federal government has a role in regulatory approval of vaccines, national surveillance for adverse events following vaccination, bulk purchasing of vaccines, national leadership, and coordination in knowledge development, innovation, and sharing of best practices.
Q4: If pressed on federal role – role of PHAC
A4:
• PHAC works with provinces and territories in the management of outbreaks of vaccine preventable diseases by providing technical guidance and advice, and assisting with laboratory testing when requested by a P/T and the coordination of multijurisdictional outbreak response, including international collaboration.
• PHAC has recently updated its Guidance for the public health management of Measles cases, contacts, and outbreaks in Canada, which has been shared with provinces and territories to support ongoing outbreaks within their jurisdictions. The document will be published on Canada.ca within the coming weeks.
• Each week, PHAC receives measles surveillance data from P/Ts and reports cases to the Pan American Health Organization. Weekly national measles surveillance reports are published on the Canada.ca website.
• PHAC conducts ongoing efforts to enhance the public's knowledge about vaccines and vaccine preventable diseases, including what to do if exposed to or infected with measles, build public confidence in vaccines, and address the rising challenge of mis and disinformation.
Q5: If pressed on elimination status
A5:
• Measles has been eliminated in Canada since 1998 and this status is evaluated annually.
• In November 2024, the National Certification Committee re-verified Canada’s elimination status for measles, rubella and Congenital Rubella Syndrome (CRS) for the 2023-2024 period.
• If domestic chains of transmission continue for a year or more, Canada will lose measles elimination status.
• Canada is engaged with WHO/PAHO to discuss elimination status and the process of re-verification, should it be necessary.

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• As of May 9, 2025, a total of 1,850 cases have been reported to PHAC linked to a multijurisdictional outbreak that began in October 2024. This exceeds all annual reported case counts since measles was eliminated in 1998.

• Overall, the risk remains highest among unvaccinated individuals (96% of cases were unimmunized or had unknown vaccination histories) and children (75% of outbreak cases were under 18 years of age).

• Based on the most recent childhood National Immunization Coverage Survey in 2021, one dose coverage of a measles-containing vaccine for two-year-olds was 91.6% and two dose coverage for seven-year-olds was 79.2%. However, Canada has pockets of under-vaccinated communities vulnerable to measles virus transmission.