If measles keeps spreading, Canada may lose 30-year elimination status: PHAC – National

Canada has held measles elimination status for nearly 30 years — but that could be gone by the fall.

If the current outbreaks keep growing the way they have been, Canada could lose that status by October 2025, according to a recent risk update from the Public Health Agency of Canada (PHAC).

“It is a very substantial public health issue right now. Canada achieved measles elimination in 1998. We’ve not had outbreaks of this size in more than 30 years,” said Dr. Sarah Wilson, a public health physician from Public Health Ontario.

“I can only use the word startling to describe what it has been like as a public physician. And measles transmission will end once the measles virus stops finding people to infect.”

That means measles vaccination rates have to go up, she said.

And cases are not just exploding in Canada, but across the globe, in Europe and the United States, which is also at risk of losing its measles elimination status.

Measles is one of the most contagious infectious diseases — more contagious than diseases like COVID-19, influenza and chickenpox. This high level of contagiousness is one reason why measles outbreaks can spread rapidly, particularly in areas with low vaccination rates.

As of April 19, Canada has reported 1,177 measles cases this year across seven provinces, with Ontario seeing the highest numbers.

At the same time last year, there were just 65 reported cases.

This surge, driven largely by pockets of unvaccinated people, marks the largest measles outbreak since the virus was declared eliminated in 1998, PHAC’s latest risk assessment said.

“If the current chain of transmission continues beyond October 2025, Canada could lose its elimination status,” PHAC stated. “Prolonged transmission reflects gaps in population immunity, often due to limited access to or uptake of vaccines, and can lead to preventable illness, long-term complications, and death, especially in vulnerable groups.”

The report also said the likelihood of prolonged transmission in the next six months is moderate to high, “driven by an outbreak involving communities with low immunity to measles.”

Elimination status doesn’t mean measles is completely gone (that would be eradication), but it does mean the disease is no longer spreading continuously within the country.

Canada achieved measles elimination in 1998, after years of strong vaccination efforts. That meant measles was no longer really spreading via community transmission, and most cases were linked to travel.

And Canada was able to reach elimination status as a “direct result” of successful vaccination programs, PHAC said.

But, in recent years, measles has resurfaced due to a decline in vaccination rates.

Because the measles virus can spread before symptoms appear and remain contagious for an extended period, outbreaks are difficult to contain once they begin.

“Unfortunately, we know that measles has been introduced into parts of the province where we have pockets of unvaccinated and under-vaccinated individuals,” Wilson said.

To effectively prevent measles outbreaks and maintain herd immunity, at least 95 per cent of the population must be vaccinated.

A study published in October 2024 in the Canadian Journal of Public Health found that vaccination rates for the measles, mumps and rubella (MMR) vaccine declined in 2023 compared with 2019, before the pandemic. Specifically, coverage for one dose of MMR dropped from 89.5 per cent to 82.5 per cent.

“If people are fully vaccinated, they are not at risk of this outbreak,” Wilson said. “And for individuals who are not, I would really encourage people to speak to a trusted health care provider in terms of ensuring that their questions are answered .”

This is because complications from measles can be serious, including pneumonia, brain swelling, permanent hearing loss and even death, especially in young children or those with weakened immune systems.

The measles vaccine is available in Canada as measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV) vaccine.

The first dose of a measles-containing vaccine is usually given to children at 12 months of age. The second dose is usually given at 18 months of age or between four and six years of age.

Since its approval in Canada in 1963, the vaccine has led to a decrease of more than 99 per cent in measles cases, according to the federal government.

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