Question Period Note: Measles Outbreaks in Canada

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KEY MESSAGES
• The current and ongoing multijurisdictional measles outbreak started with an internationally imported case and exposure at a wedding in New Brunswick in October 2024. The outbreak has resulted in cases being reported in Alberta, British Columbia, Manitoba, New Brunswick, Northwest Territories, Nova Scotia, Ontario, PEI, Quebec, and Saskatchewan.
• Cases of measles in Canada have been steadily declining following a peak at the end of April 2025. Activity is ongoing in Manitoba, Saskatchewan, Alberta and British Columbia.
• The majority of cases linked to this outbreak are from under-vaccinated communities. Limited chains of transmission have been reported outside of these communities and no sustained transmission has been observed.
• The measles virus lineage associated with this outbreak is now circulating in the Americas. Many of the affected communities have strong international ties and travel frequently to other communities with low vaccination coverage.
• Canada attended the fifth annual meeting of the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission in November (4-7) to provide an update on the measles outbreak in Canada and their progress towards PAHO’s recommendations. Following this meeting, PAHO notified the Public Health Agency of Canada that Canada no longer holds measles elimination status given evidence of sustained transmission of the same measles virus strain in Canada for a period of more than one year.
• Canada can re-establish its measles elimination status once transmission of the measles strain associated with the current outbreak is interrupted for at least 12 months. Canada is engaged with WHO/PAHO and public health partners across the country to discuss elimination status and the process of re-verification.
• The Public Health Agency of Canada is actively monitoring recent increases in measles detected worldwide, as well as supporting provinces and territories 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.
• 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.
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 for children living in or travelling to locations experiencing outbreaks (including within Canada).
Q3: If pressed on federal role – role of PHAC
A3:
• PHAC works with provinces and territories in the management of outbreaks of vaccine preventable diseases by providing technical guidance and advice, laboratory confirmation and characterization, coordinating multijurisdictional outbreak response, including international collaboration, and responding to requests for assistance from provinces and territories.
• PHAC updated its Guidance for the public health management of measles cases, contacts, and outbreaks in Canada in May 2025. The document has been shared with provinces and territories to support ongoing outbreaks within their jurisdictions and is available on Canada.ca.
• 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.
• The federal government has a role in regulatory approval of vaccines, national surveillance for both measles cases and for adverse events following vaccination, bulk purchasing of vaccines, coordination of multijurisdictional outbreak responses, national leadership, and coordination in knowledge development, innovation, and sharing of best practices.
Q4: If pressed on elimination status
A4:
• Measles was first eliminated in Canada in 1998, and this status is evaluated by PAHO’s Regional Verification Commission (RVC) annually.
• Measles elimination status is lost if domestic chains of transmission continue within a country for a year or more.
• PAHO's RVC assessed Canada’s elimination status during its annual meeting of member countries on November 4-7, 2025. The RVC reviewed recent epidemiological and laboratory data, confirming sustained transmission of the same measles virus strain in Canada for a period of more than one year.
• Following the meeting, an official letter was sent by PAHO to notify the Public Health Agency of Canada that Canada no longer holds measles elimination status.
• The size of the current multijurisdictional outbreak, and the loss of elimination status, indicates a need to improve immunization coverage in Canada, and to continue to work with vaccine-hesitant communities, Provinces and Territories, and international partners.
• In order to regain elimination status, Canada will be required to submit an updated country report to PAHO after 12 months without continuous domestic circulation of the outbreak strain or of another strain.
• Losing elimination status does not mean measles is widespread across Canada. It is a classification used to guide surveillance and response efforts. Canada continues to have strong immunization programs and public health infrastructure.
Q5: If pressed on Recommendations from the Pan American Health Organization (PAHO)
A5:
• In July 2025, the Pan American Health Organization and Regional Verification Commission (RVC) visited Canada to develop recommendations to help Canada maintain its measles elimination status by addressing immunity gaps, improving information sharing, leveraging strong partnerships, and providing evidence-based guidance and advice.
• Following PAHO’s RVC assessment of Canada’s elimination status during its annual meeting of member countries on November 4-7, 2025, the RVC re-issued similar recommendations to help Canada close the ongoing multijurisdictional outbreak and regain measles elimination status.
• The recommendations are aimed at multiple levels of government and are both short and long-term in nature. PHAC is collaborating with federal, provincial, and territorial partners to address the recommendations.

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KEY STATS
• As of November 21, 2025, a total of 5,159 measles cases have been reported to PHAC linked to a multijurisdictional outbreak that started in October 2024 and is still ongoing.
• Most outbreak cases have been in unvaccinated children and youth under the age of 18 years (94% of cases were unimmunized or had unknown vaccination histories and 71% of cases were under 18 years of age).
• There have been two deaths reported in Canada (one from Alberta and one from Ontario), both of which occurred in congenital cases of measles who were born pre-term.
• 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, recent data from five provinces and territories suggest a decline in routine childhood vaccination coverage, including vaccination for measles, between 2019 and 2023. Additionally, Canada has pockets of under-vaccinated communities at higher risk for measles outbreaks.