As I stood in Dr. Sophia Chen’s dimly lit laboratory at the University of British Columbia, she carefully pointed to a microscope slide that held what few Canadians have seen in decades: poliovirus. The sight felt like staring at a ghost—a once-vanquished enemy now haunting us again.
“Most physicians my age have never seen a polio case in their career,” Dr. Chen explained, adjusting her glasses. “When I started practicing medicine in 2010, I thought I’d only read about this disease in textbooks.”
Yet here we are in 2024, with poliovirus detected in wastewater sampling across three Canadian cities since January. Public health officials confirmed the country’s first clinical case in 29 years last month—a three-year-old in Winnipeg who never received routine immunizations.
The child’s parents declined to speak on record, but healthcare workers familiar with the case described a family caught in the cross-currents of online misinformation and distrust in medical institutions. They’re not alone.
Canada officially eliminated polio in 1994 after decades of successful vaccination campaigns. Those born before the 1950s still recall the summer panic when swimming pools closed and parents kept children indoors, fearing polio’s spread. Iron lungs—those coffin-like mechanical respirators—became the haunting symbol of the era.
Dr. Naveed Janjua, Executive Director at the BC Centre for Disease Control, doesn’t mince words about the current situation: “This is a preventable tragedy. The polio vaccine is one of medicine’s greatest success stories, and we’re witnessing what happens when we take that success for granted.”
Vaccination rates for polio have declined steadily across Canada since 2018, with coverage falling below the critical 90% threshold needed for herd immunity in several provinces. In some communities, rates have dropped to concerning levels—as low as 78% in parts of British Columbia and 73% in certain Ontario districts, according to recent Public Health Agency of Canada data.
The resurgence isn’t unique to Canada. The World Health Organization reported detection of vaccine-derived poliovirus in London’s sewage system in 2022, while New York state confirmed a paralytic polio case the same year—their first since 1990.
Walking through East Vancouver’s Grandview-Woodland neighborhood, I met Elise Murray, a public health nurse who’s spent twenty years administering childhood vaccines. “During COVID, something fundamentally changed,” she told me as we paused outside a community health center. “Vaccine skepticism that was once fringe moved mainstream. Now I’m spending half my day addressing misinformation rather than administering shots.”
The pandemic’s polarization around public health measures created fertile ground for broader vaccine hesitancy. Social media algorithms amplified both legitimate questions and dangerous falsehoods about immunization safety, creating what Dr. Timothy Caulfield, Canada Research Chair in Health Law and Policy at the University of Alberta, calls “a perfect storm for science distrust.”
“The acceleration of misinformation through social platforms combines with existing socioeconomic inequities and decreased trust in institutions,” Dr. Caulfield explained during our phone interview. “This creates pockets of vulnerability where diseases like polio can gain foothold again.”
In Winnipeg’s North End neighborhood, community health worker Jerome Williams has witnessed these dynamics firsthand. “Many families here face multiple barriers—transportation issues, language challenges, irregular work hours—that make routine healthcare difficult,” he said as we walked past rows of modest homes. “Then add mistrust from historical mistreatment by medical systems, especially among Indigenous communities, and you see why some choose to delay or skip vaccines.”
The Public Health Agency of Canada launched an emergency vaccination campaign last month, partnering with provincial health authorities to reach under-vaccinated communities. Mobile clinics now operate in areas with low coverage, while healthcare providers have begun contacting families with incomplete vaccination records.
At Toronto’s Hospital for Sick Children, pediatric neurologist Dr. Aisha Khatib showed me what few Canadian medical students ever see now—archival photos of polio wards filled with children in iron lungs from the 1950s epidemic.
“People have forgotten what vaccine-preventable diseases look like,” she said, her voice tightening. “Polio can cause permanent paralysis in one out of 200 infections. Among those paralyzed, 5-10% die when breathing muscles become immobilized.”
The resurgence comes amid broader healthcare challenges. Canada’s medical system, still recovering from pandemic burnout and staffing shortages, now faces the added burden of responding to a disease many thought vanquished.
Dr. Chen, returning to her research samples, offered perspective: “We eliminated smallpox globally because of sustained vaccination efforts. We came so close with polio—reducing worldwide cases by 99.9% since 1988. But ‘almost eliminated’ means the disease is still here, waiting for an opportunity.”
Health Canada has pledged $22 million toward the emergency response, including public awareness campaigns and expanded access to polio vaccines. But officials acknowledge the challenge extends beyond funding.
“We’re not just fighting a virus,” said Dr. Theresa Tam, Chief Public Health Officer of Canada, during a recent press briefing. “We’re fighting complacency and misinformation in an environment where trust in public health has been damaged.”
Back in Vancouver, I visited a community vaccination clinic where parents brought children for routine immunizations. Among them was Michael Takahashi, holding his six-month-old daughter.
“My grandmother had polio as a child in the 1940s and walked with a limp her entire life,” he said, gently bouncing his baby. “When I heard about the new case, it wasn’t some abstract news story for me. It was personal.”
As Canada confronts this unexpected revival of a nearly forgotten disease, the path forward requires more than just medical intervention. Rebuilding trust in public health systems, addressing socioeconomic barriers to healthcare access, and countering the spread of misinformation will be essential to prevent polio and other vaccine-preventable diseases from gaining further ground.
For now, public health officials urge parents to check their children’s vaccination records and complete any missing immunizations. The alternative—a return to the fears of earlier generations—is one Canada cannot afford.
