The Current - Measles is surging. Do you need a booster?

Episode Date: March 3, 2025

Measles is making a comeback in Canada and the U.S., despite the disease being declared eradicated in both countries more than 20 years ago. We discuss what’s behind this resurgence, and ask who might need a booster.

You're an entrepreneur. Growth is essential for your business. At BDC, we get that, and we're here to help you stay two steps ahead. With our flexible financing and advisory services, we help you adapt, growing your business in the face of today's challenges and tomorrow's opportunities. Stepping up for entrepreneurs. We're on it. BDC.

Financing. Advising. know-how. This is a CBC podcast. Hello, it's Matt here. Thanks for listening to The Current, wherever you're getting this podcast. Before we get to today's show, wonder if I might ask a favor of you

if you could hit the follow button on whatever app you're using There is a lot of news that's out there these days We're trying to help you make sense of it all and give you a bit of a break from some of that news, too So if you already follow the program, thank you And if you have done that maybe you could leave us a rating or review as well The whole point of this is to let more listeners find our show and perhaps find some of that information that's so important in these really tricky times. So thanks for all of that.

Appreciate it. And on to today's show. In 1998, public health officials declared measles eradicated from Canada. Two years later, the United States also celebrated the elimination of that disease there. Now, the highly contagious virus is making a comeback in both countries. We'll head to the US in a moment where one child died last month of measles but we begin in Canada. There are cases reported this year in British Columbia, Manitoba, Ontario and Quebec and Ontario in particular is dealing with its largest outbreak in nearly three decades. Of the 140 or so cases this year in that

province 18 children have been hospitalized. None of the children were immunized. Dawn Bowdich is a professor in the Department of Medicine at McMaster University in Hamilton, Ontario. Dawn, good morning. Good morning, Matt. As I mentioned, measles was eliminated with great celebration from this country in 1998. Why is it back now? Well, there's two reasons. One, we never eliminated it globally. So measles is one of those rare viruses

that has the potential to disappear forever if we could get everyone vaccinated because it only infects humans. So the fact that we weren't able to sort of eliminate it globally means that there's these pockets that will exist as far as we can see. The second reason of course is vaccination rates have decreased in both Canada and the U.S. globally means that there's these pockets that will exist as far as we can see. The second reason, of course, is vaccination rates have decreased in both Canada and the

US. And because it's so highly contagious, over 95% of the population has to be vaccinated in order for us to maintain that status of not having measles in Denmark and Canada. Do we have a sense as to, of these 140 cases this year in the province of Ontario alone, do we have any sense as to how the cases, those cases emerged and then started to spread? Well, we don't know definitively. Historically, measles cases came to Canada

by people who were traveling to places in the world where measles was endemic. And historically, outbreaks were easier to shut down because more people were vaccinated. So the testing and tracing was easier to do. In the current state of affairs, there's more measles circulating worldwide because more countries are losing that vaccination status. And so although we don't have, or I'm not privy to the exact thought of how it came to Canada this time, what we're seeing, especially in the province of Ontario, is that there's pockets of people who are very,

have very, very low immunization rates. And that means it can spread like wildfire in those communities. And that in part is because of just how wildly contagious measles is, right? Exactly, so the more contagious a virus is, the harder it is to stop it. It's also got this interesting property

of having a really long asymptomatic period. Six to 19 days, some people say five to 21 days. And what that means is a person can be walking around, breathing out the virus, and somebody could pick it up before they even know they're sick. So this means that people who have to isolate have to isolate for a really long time. And it also means that it's harder

to do that testing and tracing. It also means that it's, it's harder to do that testing and tracing. It also just, I mean, I'd read something about it, the way that it hangs around. You could be in a room where measles was present, leave, and then an hour later, the virus would still be present in that room. Absolutely.

One of my favorite examples of this was a big international airport where a child with measles got off the plane and someone four gates down who was unimmunized caught it even though it was predicted that they only sort of passed by each other or were in that actual airport for minutes. It stays in the air for a really long time. It's so highly contagious and and so like you said you can walk into a room where someone was breathing a couple hours ago and get measles. Typically, how serious is it?

I mean, I mentioned that there are children who are hospitalized. Last year, a child in your city, in Hamilton, died of measles. What do we know about how serious this can be typically? Measles is incredibly serious. Of all the vaccines we have, the one that has saved the most lives is measles.

So there's two reasons for this. One is the initial infection is quite serious. Estimates range between one and three to one and five kids will need hospitalization or serious medical care. But unlike other respiratory viruses like RSV or influenza that infect your lungs or the cells that line your airways, measles also infects your immune cells and it kills them. And so what this means is you lose what we call immune memory. Some people call it amnesia. And so not only do you have to get through the initial measles infection, your immune cells have died and so you become vulnerable to things that you previously had immunity

for or even had vaccines for. And so there's this period post-mesals where kids end up having to go to the doctor more often and they need antibiotics, they need more medical care. And so it's not just the acute phase of measles that's dangerous, but it's this post-mesals period where there's more health concerns. And the one thing I'd like to point out is, you know, we emphasize so much on one death, but measles can have there's more health concerns. And the one thing I'd like to point out is, we emphasize so much on one death,

but measles can have long-term health impacts on children. One common feature of it is brain inflammation, which can affect the developing brain. So just because those children don't die doesn't mean they won't be carrying the scars of this infection for a really long time or forever. You said that the vaccine has saved more lives than any other vaccine in history, is that correct?

That's exactly right. And it's because it stops both measles, but it also stops this period post-measles where you become vulnerable to other common infections. It's like seeing them all again for the first time. We use this phrase, vaccine hesitancy, a lot, particularly having, it's five years since we've gone through the COVID pandemic,

and this has become one of those things that the trips off the tongue, but perhaps people don't entirely understand what it means. To you, what does vaccine hesitancy in this moment mean? Well, I think there's different spectrums of vaccine hesitancy, and I think it's, I'm glad you asked this question, because it really affects how we deal with these outbreaks.

So yes, there are people whose whole identity is based on not vaccinating, it's I'm glad you asked this question because it really affects how we deal with these outbreaks. So yes there are people whose whole identity is based on not vaccinating and we see some prominent politicians adopting that but in Canada actually vaccine hesitancy is not quite the same. So even if people have concerns about COVID vaccines or influenza vaccines or whatever they Canadians generally do trust childhood vaccines and they do place a lot of value on that. And we actually have a survey in Canada called the Childhood Immunization Coverage Survey,

which actually says that the reason parents aren't getting vaccinated, in some cases, yes, is vaccination, vaccine hesitancy, but in other cases, it's availability. It's the family doctor crisis. It's the not being able to get vaccines at a time that works with their work schedule. It's having to try to coordinate with public health units that are over stressed. So the Canadian situation is one in which

outright refusal is actually comparatively rare. It's access and availability and convenience that tend to be the drivers of this fall in vaccination rates. That's really interesting, because I think the assumption from a lot of people is that what we went through in the pandemic led some people, because of changing science and we're dealing with something that, I mean, it was unfolding in real time in many ways,

led some people to question the efficacy of not just a COVID vaccine, but all vaccines, and rethink those vaccine schedules. some people to question the efficacy of not just a COVID vaccine, but all vaccines and rethink those vaccine schedules. And you're suggesting that isn't broadly the case. Well, the Canadian situation is different. So that is more of a US fact, but that survey I just told you about, unfortunately, the last one we have is from 2021, but it actually said that due to the COVID pandemic, parents were increasingly seeing the value. They didn't have a decreased value in childhood vaccines.

They saw an increase in the value of that. And I think it's important to clarify that a lot of people have just questions that they need a healthcare provider to provide them a straight answer for. And that's not necessarily hesitancy. It's just them asking questions about, can they postpone this vaccine if their kid's sick today?

And if they don't have a family doctor, they can't do any of that. They can't do any of that. And trying to get people to coordinate. I mean, I had one woman reach out to me because she didn't realize you needed two measles vaccines. So she had gone to great lengths to try to get a vaccination going through urgent care clinics and her public health.

And was really dismayed to find she had to do it all again to get that second dose. So, so availability in the family health, uh, primary care crisis in Canada is actually one of our bigger drivers of these falling rates. Can I ask you about the boosters? I mean, there are, uh, a lot of people, I mean, I'm of a generation where it was vaccinated for,

for measles, but you wonder whether, did I get two vaccines? Do I need a booster? Should I get a booster? What should people be thinking about, especially now that measles is once again circulating? Well, it's interesting. So if you were born before 1970, we assume you had measles and that really does seem to provide lasting protection because if it wasn't, we'd be seeing outbreaks in nursing homes and long-term care facilities and things like that, and that has not happened.

So people who were born before 1970 do seem to be protected. Now, people who were born after 1970, there is a little bit of fading of the immune response, but it doesn't seem to be as problematic as never having been vaccinated. But there is one group of people who need to have a very serious think and a talk with their parents. In the late 1990s, there was a scandal about measles causing autism, completely debunked. But because of that scandal, in that sort of late 90s, early 2000s, there was actually a dip in vaccination. And why that's particularly concerning is if you do the math there,

those are the people who are going to be thinking about having babies now are starting having their babies. And measles is incredibly dangerous during pregnancy. It can lead to birth defects, it can lead to stillbirths, it can lead to premature labor, it can debilitate a child, and it can be very, very serious for the mom as well. And so those people, those young people who were born in that late 90s, early 2000s, need to really have a conversation with their healthcare provider, ideally before they're thinking

about getting pregnant and making sure they're covered so they don't have any of those grim side effects. I have to let you go, but just finally, how concerned are you that this spread is going to get even bigger? We're almost at March break. You mentioned the airport and there are a lot of people who will be traveling through airports.

There was a notice put out about a possible exposure at an airport in Toronto recently. So how worried are you that this, that this will continue to spread? I'm very worried. And again, I'm worried about pregnant people. I'm worried about young children to have a life of disability ahead of them if they have some of these severe complications.

And I'm worried about our public health units not being funded to do the testing and tracing that they need to do to stop this. Dawn, good to speak with you. Thank you very much. Thank you so much. Dawn Bowdich is a professor in the Department of Medicine at McMaster University in Hamilton, Ontario. You're an entrepreneur. Growth is essential for your business. At BDC, we get that. And we're here to help you stay two steps ahead. With our flexible financing and advisory services, we help you adapt, growing your business in the face of today's challenges and tomorrow's opportunities. Stepping up for entrepreneurs, we're on it.

BDC, financing, advising, know how. There's no playbook for this type of fraud. Many couples dream of adopting a child, but what if that dream became a nightmare? She kept telling us, forget about Sabrina's baby. Now, Tara has a problem, because there's no baby. And we all became investigators. From Sony Music Entertainment and Perfect Cadence,

this is Baby Broker. Available now on The Binge. Search for Baby Broker wherever you get your podcasts to start listening today. In the United States, since the start of this year, there have been at least 164 measles cases in nine different states. The biggest outbreak is in rural West Texas, where as of Friday, there were at least 146 cases. One child died in that state last week, the first measles death in the country in a decade. The child was not vaccinated. In fact, according to the Centers

for Disease Control, 95% of the cases were in unvaccinated people or people whose vaccine status was unknown. Emily Brunson is a professor of anthropology with a specialty in epidemiology at Brigham Young University in Provo, Utah. Emily, good morning to you. Good morning, Matt.

How alarmed are you by the spread of measles in the United States? I think it's concerning, especially going back to the point that Don was making that this was considered eliminated. In Canada and the US it was 2,000, so we don't have any native cases, but it's an ongoing issue and it seems like this year it's a big issue. And so let me ask you about the context that this is unfolding in. Robert F. Kennedy Jr., the US Health Secretary,

initially said the spread of measles was, in his words, not unusual. Then two days later, he called it a top priority. He published an op-ed piece in Fox News on the weekend talking about this being an issue of urgent concern, but also not explicitly asking people to get vaccinated. He talked about treatments using vitamin A, for example. What do you make of his response to the spread?

Interesting. It definitely is not a usual situation in the US. And like Don was saying, vaccines and vaccination is the primary way to stop the spread and to prevent measles outbreaks in the first place. Vitamin A has shown some efficacy with sick children, but it's definitely not a cure and it's not going to prevent anything.

What message do you think he's conveying to Americans about vaccinations? I think he has been opposed to vaccination for a long time. I'm not sure that's the way he's couching it at the moment, but I think it's sending a little bit of a mixed message, which goes along, and Don was talking about this too, some of the politicalization around vaccination that occurred during COVID that very well in some communities might increase levels of vaccine hesitancy. What does that landscape look like in your country right now

when it comes to the issue of vaccine hesitancy, particularly, as I said, five years on from the arrival of COVID-19? So I would say that, similar to what Don was saying in Canada, that the US, you know, we've always had pockets of people who didn't vaccinate, that it was typically going back 10 years looking at wealthier, white, suburban, better educated parents in more democratic leaning areas.

You know, we've had Andrew Wakefield, who was in charge of the measles episode that Don was talking about and blaming the measles vaccine on autism. He moved to the US, and then he moved to Texas recently, which is sort of contributing to what's going on there, I think. But with COVID, what ended up happening is the vaccine and the pandemic itself became politicized. And you ended up with pockets of people of a particular political persuasion,

becoming more and more hesitant about vaccines. The anti-vaccine movement became involved in the discussions about COVID vaccines. And so we have seen in the U. US, childhood vaccination rates drop since the pandemic. And that's really particularly concerning because this isn't, measles isn't COVID, the vaccine's been around a long time and it works. And in many ways, measles is a much more concerning disease than COVID.

I mean, in some ways, what the opponents of RFK Jr. were concerned about was something like this, or something much worse, but something like this, where there would be a stress on the health care of the nation. And as the leader, people would look to him for guidance. What are you thinking about in this moment? Yeah, this is an interesting situation. Interesting is doing a lot of work there. Yeah, this is an interesting situation. Interesting is doing a lot of work there.

Yeah, yeah. You know, it's just, yeah, it's an interesting situation because in some ways I'm surprised that he came out with the op-ed that he did yesterday. In other ways, you know, it's disheartening to think that this is our response at the moment. How difficult is it for families to get a vaccination for their child in the United States right now? There are some differences to Canada. We don't have the same type of medical system.

But like Don was saying, the majority of people in the US, well over 70% of children who don't have measles according to a 2017 study, don't have that because of access issues. And I think that one of the concerns that I have and looking at the Texas outbreak specifically is that access can include a lot of things, including do parents feel safe going to vaccine clinics? And in a situation where we have a high Hispanic population and this intense immigration crackdown, you could imagine that there are situations where parents may not feel comfortable taking

their child to a public space to get vaccinated. And so that I think is also playing into this, which is just going to make the situation worse. Because they're worried about the threat of deportation and that going to a public space like that, going to an official space like that could exacerbate or increase that risk. Yeah. And maybe it's that they are citizens or they're waiting for asylum so there's no issue with them being in the country, but just the harassment and the potential problems may be enough to deter them. Is there a sense in the United States, I mean, I talked about that idea of the elimination

of measles, that in 1998 it was declared eradicated from Canada, two years later in the United States, that people in the United States broadly don't see this as a threat. I think that it's more similar to what Don was saying for Canada is that, you know, people do, but most people have never experienced measles. They've never had this themselves. And so they've never known anyone to have it. And so to some extent, you're, you know, being told to be afraid of something that you don't know how bad it is. And so there is some questioning going on.

And so what should the United States do in order to slow the spread of this disease now, do you think? There are different things that could happen. One of them that's the most effective is for states. All of our vaccination laws are by state, not as the country, to eliminate personal exemptions, which is what's going on in Texas, is people are saying, I just philosophically disagree, and so they can exempt from vaccination.

Can a state do that? Can a state say, no, I'm sorry, you can't take that personal exemption, you need to take this for the broader public health? Yeah, California did that after the Disneyland outbreak in 2014. So it's totally possible for that to happen. I like the approach more of,

instead of making people do something of persuading them. And so I think it's, you know, better public health messaging and then really working on the access issue. I mean, some of this just finally is just around the state of public health in the United States and how people think of that idea of public health five years on from a pandemic.

What does public health mean to people broadly, do you think? Well, I think that's part of the issue is, like Canada, public health is typically overfunded, but we go through roller coaster moments like COVID, the funding went way, way up and so public health was able to do some things, but then that goes away. And so I think that some people don't know it exists and other people are irritated that it seems that, you know, things were working and you said you would do this and now all of a sudden

you're not. And it's not that they're not interested or there's not a need, it's there's not the funding anymore. So it would be better to have more of a steady state public health funding than we do. Emily will be watching. Thank you very much. Thank you. Emily Brunson is a professor of anthropology with a specialty in epidemiology at Brigham Young University. She was in Provo, Utah.