Dr. Kieran Moore, Ontario Chief Medical Officer of Health, speaks at a press conference at the legislature in Toronto on April 11, 2022.Nathan Denette/The Canadian Press
Ontario’s top doctor says the government should not change a law that allows parents to exempt their children from routine vaccinations for philosophical or religious reasons, even as the province grapples with the largest outbreak of measles in nearly 30 years.
Kieran Moore, Ontario’s Chief Medical Officer of Health, said in an interview Monday that he supports letting unvaccinated children attend school so long as their parents have completed the necessary paperwork to release them from the otherwise mandatory requirements of the province’s Immunization of School Pupils Act.
“We have to respect their opinion and have to work with the community to ensure that they’re aware of the benefits of the vaccine,” Dr. Moore said of parents who choose not to immunize their children against measles and other vaccine-preventable illnesses such as mumps, rubella, polio, diphtheria and tetanus.
“We need to communicate effectively, address hesitancy, answer their questions and remain partners in this outbreak management in the community.”
Several regions in Ontario have seen requests for non-medical exemptions rise since the COVID-19 pandemic struck, according to a Globe and Mail survey of local public health units.
However, the available data is spotty. Most units couldn’t provide detailed figures about vaccination exemptions in a short time frame, including the Grand Erie and Southwestern public health units, which together form the epicentre of a major multi-jurisdictional measles outbreak that began in October.
A total of 572 cases of measles in 13 public health units have been linked to the outbreak, which Dr. Moore said in a March 7 memo had been traced to a gathering with Mennonite guests in New Brunswick. About two-thirds of the known Ontario cases are in Grand Erie and Southwestern, which cover neighbouring regions on the north shore of Lake Erie, south and east of London.
Dr. Moore said he and local public health leaders in the hotbed of Ontario’s measles outbreak believe they’ll be more successful with the carrot of positive communication than the stick of mandatory vaccination, particularly among vaccine-hesitant Mennonites who speak Low German, the predominant dialect in southwestern Ontario.
The Chief Medical Officer of Health said he has spoken with Mennonite leaders nationally and “they’ve told us, ‘Use radio, use print, use local leaders in the community and translate your information into Low German.’ And we’ve, thankfully, at the local level, they’ve done that and are trying to address the communication.”
Toronto Public Health reported a new measles case Monday in someone who works in the city and who may have exposed others to the virus at a pizza restaurant and on a Via Rail train to and from London. Toronto has so far reported two measles cases this year, both connected to international travel.
York Region, north of Toronto, is one place that has noted a significant increase in philosophical exemptions this school year, with 3,147 on file for non-medical reasons, which works out to just less than 2 per cent of students. That is up from 305 philosophical exemptions, representing 1.22 per cent of students, in the 2018-2019 school year, the last before COVID-19 struck.
Other public health units that supplied data to The Globe said their rates of religious and philosophical exemptions had either held steady or risen less dramatically than was the case in York Region.
For example, the North Bay Parry Sound District Health Unit indicated it had processed 168 non-medical exemptions so far this school year, up from 66 in 2018-2019, while Wellington-Dufferin-Guelph Public Health has processed 445 this year, up from 127 in 2018-2019.
Ontario and New Brunswick require students to present proof of vaccination to attend school, but both jurisdictions allow families to opt out.
In Ontario, parents seeking philosophical and religious exemptions must watch an online video about the safety and effectiveness of vaccines, then fill out and sign a form, witnessed by a commissioner for taking affidavits. Students who don’t have proof of vaccination or an exemption on file can be suspended.
Kumanan Wilson, chief scientific officer at the Bruyère Research Institute in Ottawa and a researcher in immunization and public health policy, said there could be risks to scrapping the exemption policy, including spurring vaccine skeptics to homeschool their children.
“Then you’re actually clustering the unvaccinated together, and that’s actually the worst-case scenario, because you’re really setting the kindling for an outbreak,” Dr. Wilson said.
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