Ontario is still trying to catch up on routine vaccinations that many children missed during the pandemic, and public health officials warn it could be years before the problem is resolved.
“What we see around the world is that when vaccination rates drop, there is a resurgence of vaccine-preventable diseases,” Dr. Anna Banerji, a Toronto-based pediatric infectious disease specialist, told CTV News Toronto.
“If someone had measles and was with a group of unvaccinated children, for every person who had measles, they would typically infect about nine or ten other children. And that’s why it’s extremely, extremely contagious.”
About 60 percent of seven-year-olds are fully vaccinated against measles, as well as other diseases such as mumps and chickenpox, according to a report published by Public Health Ontario at the end of March.
This is a significant drop from coverage in 2019-2020, when those numbers were between 82 percent and 86 percent.
Ontario has seen a slight resurgence of measles this year, with 13 cases identified in 2024 so far.
Of the seven infected children, five were unvaccinated and the vaccination status of two others was unknown.
Three of the adults received two doses of the vaccine, while one was unvaccinated and the status of the other two is unknown. All but one of the cases have been travel-related.
In 2023, seven laboratory-confirmed cases of measles were reported in Ontario.
For the 2022-2023 school year, just under 60 percent of seven-year-olds were vaccinated against diphtheria, tetanus, polio and whooping cough. Immunization coverage rates were similar for 17-year-olds, with the exception of the polio vaccine, which has a strong 90 percent coverage rate.
Hepatitis B coverage among 12-year-old students is about 58.4 percent for that school year, while HPV vaccine coverage is 47.8 percent.
A Public Health Ontario spokesperson said factors such as a lack of in-person health care and delays in non-essential appointments during the COVID-19 pandemic negatively affected childhood vaccinations.
School vaccination programs were also put on hold due to the lockdown. The report noted that while in-person classes resumed for most students in 2021-2022, most public health units did not resume vaccination programs until the following year.
“This was very disruptive to vaccine administration during routine well-child visits and to adolescents who needed their tetanus, diphtheria, and pertussis booster between ages 14 and 16,” officials said in a statement. release.
“This has likely led to underreporting of vaccinations to public health, but it is unclear to what extent this underreporting has affected our coverage estimates.”
Some communities may also have general difficulties accessing health care, Banerji said, adding that factors such as lack of communication with new immigrants or misinformation can also play a role.
“The reason we live so long and the reason children don’t die at a young age are three things: access to clean water, sanitation and vaccination,” he added.
“I think people forget.”
Peel could take 7 years to catch up
At a meeting last week, Dr. Katherine Bingham, Peel’s chief medical officer of health, said about 50 per cent of the region’s students were missing at least one mandatory vaccine dose.
A report presented to the Reel Region council He noted that “multi-year strategies” are needed to address delays and disruptions in routine childhood vaccines.
“Without significant dedicated resources, we estimate it will take seven years to complete the review, catch up and reach pre-pandemic coverage rates,” Bingham said at the meeting.
In Toronto, it is unclear when vaccination coverage rates will return to pre-pandemic levels.
“This is a really important question,” Dr. Vinita Dubey, associate medical director of health, told CTV News Toronto.
According to city dataThere is 57.1 per cent vaccination coverage for Toronto students between grades 10 and 12 against hepatitis B.
HPV vaccine coverage is 50 percent and quadrivalent meningococcal vaccine is 77.5 percent.
“Why are we 10 percent lower when we do the same program we did before the pandemic? I think that’s something we really need to pay close attention to. Is it vaccine fatigue, vaccine hesitancy, or simply complacency?
Dubey says vaccination rates in Toronto speak to the importance of school vaccination programs, especially for vaccines that require multiple doses over time.
“These vaccines can prevent cancer and are the type of vaccine that is ideally administered before exposure to these infections. And then it will provide that protection to your life.”
“We need resources”
The COVID-19 pandemic showed that if resources are channeled into immunization programs, they can be successful, Dubey said.
“We need to pay attention to that. In fact, we may have to work harder to get back to where we were. “It’s not just about restarting what we had,” she added. “We need to have the necessary resources.”
In November, the Toronto Board of Health requested $3.8 million from the Ministry of Health to support catch-up immunizations through vaccination clinics, as well as the promotion of routine vaccination.
A spokesperson for the Minister of Health said in a statement that they have increased investments in public health units by an average of 16 percent since 2018.
They also said they restored a 75-25 funding model for public health units in 2023. However, the same government also reduced 2019 funding to a formula in which the province funded 70 per cent of the funding and the 30 percent was contributed by the municipalities.
“We are also working with PHUs to clarify their roles and responsibilities. All changes respond directly to the requests of Public Health Units and Municipalities throughout the province,” the statement says.
“Our government knows that it is never too late to catch up and resume vaccination schedules. That’s why we’re working with our partners, including public health units, to get children up to date on their routine immunizations. This includes memos from the Chief Medical Officer of Health communicating this approach to PHUs in recent years. “We have seen efforts remain strong among providers, including increases in school programs over the past two school years, and we will continue to build on this progress.”
There is also concern that some children have received their vaccines but parents have not informed them.
The data depends on parents and guardians sending their children’s vaccination record to public health units. Both Peel Region and Toronto officials have said it would be beneficial if doctors and clinics could enter data directly into a provincial system.
As it stands, if a child is missing a dose of a required vaccine, public health units have to send notifications to parents, threaten students with suspensions, and then suspend students if their vaccines are not up to date. day. Dubey said the process is successful and that both data from Toronto and figures provided by Public Health Ontario show immunizations are slowly beginning to increase.
In the Peel region, Officials have said that they are currently “mailing suspension orders to students in kindergarten through first grade who have not provided updated immunization records”
The ministry did not say whether they would consider a provincial vaccination registry when asked by CTV News Toronto.
With files from CTV News’ Jesse Tahirali