I stood at the entrance of Hastings Community Centre in East Vancouver, watching a young mother with a toddler on her hip hesitate at the door of the pop-up immunization clinic. Her uncertainty was visible—the subtle furrow of her brow, the way she shifted her weight from one foot to another. Eventually, she turned away.
“I just need more time to think about it,” she told me when I approached her, identifying myself as a journalist. Her concerns weren’t rooted in conspiracy theories but in a fog of conflicting information she’d encountered online. “I vaccinated my older kids without question. Now, I don’t know what to believe anymore.”
This scene has become increasingly common across Canada, where measles—a disease once declared eliminated in 1998—is experiencing a troubling resurgence. Canada now leads North America in measles cases, with infections rising exponentially since January 2024, according to the Pan American Health Organization (PAHO).
The numbers tell a concerning story. Canada has reported 60 measles cases between January and April 2024, compared to 38 in the United States—despite having just a tenth of the population. This represents a dramatic increase from 2023, when Canada recorded only 12 cases for the entire year.
Dr. Theresa Tam, Canada’s Chief Public Health Officer, has called the situation “deeply concerning” and emphasized that measles remains one of the most contagious diseases known to humanity. “One infected person can transmit the virus to 12 to 18 unvaccinated individuals,” she explained during a recent press briefing in Ottawa.
What makes this outbreak particularly worrisome is the concentration of cases. While affecting multiple provinces, British Columbia and Ontario are seeing the highest numbers, with clusters emerging in communities where vaccination rates have fallen below the 95% threshold needed for herd immunity.
In Chilliwack, BC, a community that has historically had lower vaccination rates, public health nurses have been working overtime to contain a localized outbreak that began when an unvaccinated traveler returned from Southeast Asia.
“We’re seeing the consequences of vaccine hesitancy that has been building for years, but was accelerated during the pandemic,” explains Dr. Bonnie Henry, BC’s Provincial Health Officer. “Trust in public health messaging has eroded in some communities, and we’re working hard to rebuild those relationships.”
The pandemic’s impact on routine childhood vaccinations has been substantial. Data from the Public Health Agency of Canada shows MMR (measles, mumps, rubella) vaccination rates among Canadian children dropped from around 92% pre-pandemic to approximately 85% by 2023—well below the threshold required to prevent community spread.
For many health professionals on the frontlines, the return of measles represents a frustrating step backward. Nurse practitioner Sonia Martinez, who has worked in Vancouver’s Downtown Eastside for fifteen years, told me about treating a previously healthy four-year-old hospitalized with measles complications.
“Her mother was devastated,” Martinez said. “She had delayed vaccination because of things she’d read online during the pandemic. Now she was watching her daughter struggle to breathe and wondering if permanent damage would result.”
The child recovered, but the experience transformed her mother into an unexpected vaccine advocate in her community.
Beyond the immediate illness, measles can cause serious long-term health impacts. The virus can suppress the immune system for months after infection, leaving children vulnerable to other serious illnesses. In rare cases, measles can lead to encephalitis (brain inflammation) or a fatal degenerative disease called subacute sclerosing panencephalitis (SSPE) that can develop years after infection.
Dr. Caroline Quach-Thanh, a pediatric infectious disease specialist at CHU Sainte-Justine in Montreal, emphasizes these risks. “People forget how serious measles can be because we haven’t seen much of it for decades. But this is precisely why vaccination is so crucial—it protects against severe outcomes that we simply shouldn’t be seeing in 2024.”
The geographic distribution of cases reveals patterns that correlate with socioeconomic factors and information access. Urban centers with diverse populations and areas with historical vaccine hesitancy are seeing higher case counts. Indigenous communities, which have worked diligently to achieve high vaccination rates through community-led health initiatives, have largely avoided outbreaks.
In Bella Bella on British Columbia’s central coast, the Heiltsuk Nation has maintained vaccination rates above 97% through a combination of traditional knowledge sharing and clinical care. “Our community remembers the devastating impacts of introduced diseases,” explains Sarah Brown, a community health representative. “Our elders speak about protecting our people, and we see vaccination as part of that responsibility.”
The federal government has responded to the rising case counts with a national awareness campaign and additional funding for targeted outreach in communities with low vaccination rates. Health Canada has also launched a digital literacy initiative to help parents navigate vaccine information online.
However, public health experts warn that these measures may not be enough to reverse trends quickly. “We’re fighting against years of declining trust in institutions and the algorithmic spread of misinformation,” notes Dr. Timothy Caulfield, Canada Research Chair in Health Law and Policy at the University of Alberta. “Rebuilding trust requires sustained engagement at the community level.”
Back at the Hastings Community Centre, I spoke with public health nurse Mei Lin, who has been conducting immunization clinics for over twenty years. “We’re not just offering vaccines—we’re offering conversations,” she told me. “Many parents just want to be heard. When we take time to listen to their concerns without judgment, they’re more likely to make decisions based on evidence rather than fear.”
As Canada’s measles cases continue to climb, health officials are emphasizing that this isn’t just about numbers—it’s about protecting vulnerable community members, particularly infants too young to be vaccinated, immunocompromised individuals, and those with medical contraindications to vaccines.
When I checked back with the hesitant mother I met earlier, she had returned to the clinic with her toddler. “I called my mother,” she explained. “She reminded me about my cousin who had measles complications in the 80s. Sometimes we need those personal connections to cut through all the noise.”
As the afternoon clinic wound down, Lin recorded the day’s immunizations in her records. “Thirty-two today,” she said with cautious optimism. “That’s thirty-two more protected kids. We’ll keep showing up as long as it takes.”
