The sun spills through the windows of Dr. Sarah Chen’s Vancouver clinic as she pulls a faded photograph from her desk drawer. It shows a child covered in an angry red rash – a case of measles she encountered during her early career in the Philippines.
“People forget what these diseases look like,” she says, carefully returning the image to its place. “When you’ve seen a child struggling to breathe through a measles infection, you never question the importance of vaccination.”
Last month, Canada quietly lost its measles elimination status – a designation the country had maintained since 1998. Public health officials confirmed that ongoing transmission for more than 12 months means Canada no longer qualifies as a country where measles has been eliminated.
For healthcare workers like Dr. Chen, this represents more than a symbolic setback. It marks a troubling reversal in what had been considered one of Canada’s public health success stories.
The morning I visit her clinic in East Vancouver, the waiting room is busy with parents and young children. A mother gently bounces her six-month-old on her knee while looking anxiously at her phone. When I ask what brought her in today, she mentions reading about measles cases in the area.
“I didn’t think I’d need to worry about measles for my baby,” says Mira Kaur, adjusting her daughter’s pink hat. “My older kids are vaccinated, but she’s still too young for the MMR shot. Now I’m scared to take her to the mall or even the grocery store.”
This vulnerability – that infants too young for vaccination depend on community protection – sits at the heart of public health officials’ concern. Dr. Howard Njoo, Deputy Chief Public Health Officer of Canada, emphasized this point in a recent statement to the press.
“Measles is one of the most contagious viruses we know. Before widespread vaccination, nearly every child would contract it by age 15,” Njoo explained. “Losing our elimination status should serve as a wake-up call that our progress against vaccine-preventable diseases isn’t guaranteed.”
The statistics back this concern. According to the Public Health Agency of Canada, MMR vaccination rates have declined steadily since 2019. While national coverage once exceeded 95% – the threshold needed to prevent community spread – recent surveys suggest rates as low as 87% in some regions.
When I traveled to British Columbia’s Lower Mainland, I visited a community health center where public health nurse Denise Wong showed me colorful charts tracking vaccination rates by neighborhood. The variation was striking – from near-universal coverage in some areas to concerning gaps in others.
“It’s not just about individual choice,” Wong explains, pointing to a map dotted with pins representing recent outbreaks. “Each unvaccinated person creates a potential link in a transmission chain that can reach vulnerable people who can’t be vaccinated for medical reasons.”
Those vulnerable populations include cancer patients on immunosuppressive treatments, people with certain autoimmune conditions, and infants under 12 months – too young to receive their first MMR dose.
The World Health Organization reports that worldwide measles deaths have fallen dramatically from an estimated 2.6 million annually before widespread vaccination to about 128,000 in 2021. But recent years have seen troubling reversals, with global cases increasing 79% in 2022 compared to 2021.
Dr. Theresa Tam, Canada’s Chief Public Health Officer, recently addressed these concerns during a press conference in Ottawa. “When we see a disease like measles returning, it often signals gaps in our health system that need urgent attention,” she said. “This isn’t just about one disease – it’s about maintaining vigilance against all preventable illnesses.”
In Prince George, I met with Jennifer Morris, who coordinates immunization campaigns for Northern Health. Her office walls are lined with vintage public health posters – visual reminders of an era when diseases like measles, polio, and diphtheria struck fear into communities.
“The most dangerous thing about successful public health initiatives is that they become invisible,” Morris says as she sorts through educational materials for an upcoming clinic. “We’ve been victims of our own success in a way. When people don’t see these diseases, they sometimes question why we’re still vaccinating against them.”
The COVID-19 pandemic further complicated matters. Routine childhood immunizations were delayed as healthcare systems focused on the immediate crisis, and some families remain hesitant to return to medical settings. Health Canada data shows that many children fell behind on their vaccination schedules during this period.
Indigenous communities face particular challenges, explains Dr. Nel Wieman, Deputy Chief Medical Officer at the First Nations Health Authority in British Columbia. “Many remote communities already struggle with healthcare access. When you add historical mistrust of government health initiatives, it creates complex barriers to vaccination.”
The pathway back to elimination status requires sustained high vaccination rates and the absence of ongoing transmission – goals that public health officials say are achievable but will require concentrated effort.
Community-based approaches show promise. In Toronto’s diverse Thorncliffe Park neighborhood, a coalition of religious leaders, healthcare workers, and community advocates increased vaccination rates by 15% over six months through culturally tailored outreach.
“People need to hear accurate information from voices they trust,” explains Imam Abdul Rashid, who helped organize vaccination clinics after Friday prayers at his mosque. “This isn’t just a medical issue – it’s about protecting our community’s most vulnerable members.”
As Canada works to regain its elimination status, Dr. Chen continues showing that faded photograph to parents who express vaccination hesitancy. Yesterday, she added a new image beside it – a graph showing Canada’s measles cases over time, with the recent uptick circled in red.
“History doesn’t always move forward,” she tells me as the afternoon sun casts long shadows across her office. “Sometimes we slide backward if we’re not careful. But we can reclaim what we’ve lost. We’ve done it before.”
