In the garden of a Vancouver Island family home, 5-year-old Noah carefully inspects a ladybug crawling across his palm. His mother, Jen Wheeler, watches with visible relief. Just three months ago, she couldn’t have imagined such a simple moment. Noah was among British Columbia’s first measles cases of 2024, spending nine frightening days in hospital with a raging fever and the telltale rash.
“The doctor said we were lucky,” Jen tells me as we sit on her porch. “Noah developed pneumonia as a complication. We didn’t know if he would pull through.” Her voice catches. “I never thought measles would touch our lives. It felt like something from history books.”
Noah’s story reflects a troubling national reality. In 2023, Canada lost its measles elimination status – a public health designation it had maintained since 1998. The World Health Organization (WHO) revokes this status when a country experiences sustained transmission of the virus for more than 12 months. For Canadian public health officials, it marked a sobering setback.
Dr. Theresa Tam, Canada’s Chief Public Health Officer, has emphasized the gravity of this development. “Losing our elimination status represents a significant public health challenge that requires immediate and coordinated action,” she stated in March during a national immunization strategy meeting.
The loss came after multiple outbreaks across provinces, with clusters in British Columbia, Ontario, and Quebec throughout 2022-2023. Data from the Public Health Agency of Canada shows 138 confirmed cases nationwide in 2023 – a stark increase from just 12 cases in 2019, the year before the pandemic began.
I visited Toronto’s SickKids Hospital immunization clinic on a Tuesday morning in April. The waiting room was fuller than usual, with parents clutching blue immunization booklets. Dr. Sarah Karmali, a pediatric infectious disease specialist, explained between patient consultations how the path to regaining elimination status runs through these everyday clinical moments.
“Elimination doesn’t mean zero cases,” Dr. Karmali clarifies. “It means we don’t have continuous transmission within our borders. Occasional cases from travel will happen, but our collective immunity prevents spread when vaccination rates stay above 95 percent.”
That threshold – 95 percent – is the magic number for measles. Public health experts call it “herd immunity,” the point where enough people are vaccinated to protect even those who cannot be immunized, like infants or people with specific medical conditions.
According to the most recent data from Statistics Canada, our national MMR (measles, mumps, rubella) vaccination coverage sits at approximately 92 percent for two-year-olds – below the critical threshold. Some communities have rates as low as 70 percent, creating vulnerable pockets where the virus can gain foothold.
Walking through Vancouver’s Commercial Drive neighborhood the following week, I meet Sahila Johnson, a public health nurse who runs a mobile vaccination clinic out of a converted van. She parks strategically at community centers, libraries, and farmer’s markets, trying to reach families who might have missed routine vaccinations.
“The pandemic disrupted everything,” Johnson explains as she organizes supplies. “Routine appointments were canceled, school vaccination programs were paused, and some families never caught up. Then there’s the spread of misinformation that makes some parents hesitant.”
The path to regaining elimination status isn’t simple, but public health authorities have outlined key strategies. Dr. Howard Njoo, Deputy Chief Public Health Officer, shared the four-part framework during a recent media briefing: strengthening immunization registries, targeting under-vaccinated communities with tailored outreach, ensuring healthcare provider education, and countering vaccine misinformation.
In Montreal, I visit the offices of Immunize Canada, where Director Lucie Marisa shows me their new digital campaign. “We’re focusing on answering parents’ questions honestly,” she explains. “Rather than dismissing concerns, we address them with transparency and evidence.”
Their approach seems to be working. Recent polling from the Angus Reid Institute indicates 83 percent of Canadians support stricter enforcement of school immunization requirements, up from 70 percent in 2019.
For Indigenous communities, culturally appropriate approaches are crucial. In northern Manitoba, community health representative Winona Sinclair leads vaccination initiatives that blend Western medicine with traditional knowledge and healing practices.
“Trust is everything,” Sinclair tells me over the phone. “Our community has experienced historical trauma from the medical system. When we center Indigenous knowledge and involve elders in our health messaging, families are more receptive.”
International cooperation also plays a vital role. The Public Health Agency of Canada is working with WHO and neighboring countries to strengthen border health screenings and share surveillance data. A case detected quickly means faster contact tracing and isolation measures, preventing wider spread.
Back in Victoria, I visit a science museum where a new exhibit about infectious diseases draws steady crowds. Children peer through microscopes while parents read information panels. Museum educator Marina Thompson points out a historical timeline of measles in Canada.
“Young parents today didn’t grow up seeing measles,” Thompson observes. “Before vaccination, nearly every child got infected. People forget it killed thousands annually in Canada before the 1960s.”
Health officials anticipate Canada could regain its elimination status within two years if vaccination rates improve and outbreaks are quickly contained. For families like Noah’s, this timeline feels urgent.
As I prepare to leave, Jen Wheeler shows me Noah’s vaccination appointment card. “He’s fully protected now,” she says quietly. “I wish I hadn’t waited. I thought we had time, that these diseases weren’t a threat anymore.”
With provinces like Ontario and British Columbia now strengthening immunization reporting requirements for schools and daycares, public health experts are cautiously optimistic. The path to regaining elimination status requires sustained effort from public health authorities, healthcare providers, and families alike.
Noah releases his ladybug into the garden. For now, his recovery represents both a warning and hope – a reminder that elimination isn’t permanent unless we actively maintain it, and that with coordinated action, Canada can reclaim its measles-free status once again.
