Measles outbreaks spotlight need for national registry

Measles outbreaks across Canada could increase unless a national vaccination registry and other preventive steps are taken, a Canadian medical journal editorial argues.

Measles will not remain within provincial borders because it has such a high transmissibility or contagiousness, Dr. Gordon Giddings said in Monday's issue of the Canadian Medical Association Journal.

Measles "must be managed and monitored with a national solution," Giddings concluded in an editorial.

• Dr. Brian Goldman: Time for a national vaccine registry
• Measles: what you need to know
• B.C. measles outbreak reveals vulnerability of unvaccinated children

The "disfiguring and paralyzing ravages" of conditions like measles are not routinely seen in Canada today.

So far this year, British Columbia's Fraser Valley has experienced an outbreak and there have been cases in Alberta, Saskatchewan, Manitoba and Ontario.

Internationally, the Public Health Agency of Canada's travel notice earlier this month said measles continues to be imported in Brazil and the U.S. The Philippines has an ongoing outbreak and Vietnam is also experiencing one. Japan reports three times more cases than the same time period last year. Australia and the United Kingdom are also dealing with outbreaks from imported cases.

More than 90 per cent of unvaccinated people who are exposed to the measles virus will contract the disease, the U.S. Centers for Disease Control and Prevention notes in encouraging vaccination.

Canada's most recent national data, a decade old, suggests a trend of decreasing immunizations. The fall in uptake for the shots likely contributed to Canada placing 28th out of 29 of the richest countries for childhood vaccination rates, Giddings said, pointing to a UNICEF report published last year.

"The simple fact is that low vaccination rates are contributing to preventable disease outbreaks," Giddings said.

His national solution includes:

• Promptly and accurately identifying children and adults who are due or overdue for vaccinations to contain outbreaks.
• Harmonize vaccine schedules, which currently vary by province and territory, to help simplify public health messages and education.
• Introduce a national vaccination registry, which could help target education campaigns towards specific groups and geographic regions.
• Oversee a national committee's work on vaccine hesitancy. 

"Unless these measures are put in place, Canadians can expect to see more measles outbreaks," he concludes.