First 2020 Spring Forum – Measles – The Disease, the Vaccine, and the Legislation

Measles – the Disease, the Vaccine, and the Legislation
Dr Vinita Dubey, Associate Medical Officer of Health for the City of Toronto
Dr. Persia Etemadi, Lawyer for the City of Toronto

I must confess… my interest in the first of the 2020 Forums was largely due to my curiosity about the whole “anti-vax” issue. My own childhood memories of measles consisted largely of being put in the same room as my younger brother – who already bore the red spots of a full-blown case - in the hopes that I would catch them at the same time. Similar ‘measles parties’ were taking place in the homes of my school friends throughout the neighbourhood. When it came time for my own sons to be vaccinated, to be honest, I didn’t think much about it; it was just another one of the many checkpoints in a child’s development. It simply never occurred to me to question it, nor to do more than trust and act on the advice of our family physician.

But my sons, now both of an age when they could well be fathers themselves, have no memory of measles – no memory of how serious this ‘childhood’ illness is and only a general awareness of how it is one of the world’s top 10 global health threats. When the time comes for them to make decisions about vaccinating their own children, what information will they see? What advice will they be given? Might they be taken in by another fraudster like Dr. Andrew Wakefield?

As soon as Dr Dubey and Dr Etemadi began speaking, it was evident that the issue is very complex, and that the abundance of readily available information (some credible, some completely misleading) is making it very difficult for communities like the City of Toronto to manage the best interests of all of its residents. It is an issue that involves more than practical science and logical proofs, it has an emotional component as well – and that only complicates matters.

From the session I learned:

- The term ‘vaccine hesitancy’ is more accurate than the more commonly used ‘ant-vaxxer’. There are many more individuals with vaccine hesitancy than there are ‘refusers’ on medical, religious, or conscientious grounds.
- 50% of caregivers get their information online, do not necessarily have the ability to discern the relative value / accuracy / credibility of what they read, and do not have the tools to reliably evaluate the sources.
- While the fear of autism is a key reason for vaccine hesitancy, it is not the only one. There is also the belief that “natural things are good and safe, while unnatural things are not”, and the concept that the pro-vaccine message is warped by ‘big pharma’.
- How do communities, and officials like our speakers, balance risks and rewards on this issue? How do they balance the protection and promotion of public health against real or perceived interference with civil liberties such as freedom of choice?

Should communities mandate vaccination and limit exceptions to those with a solid religious basis? Should unvaccinated individuals be barred from public spaces or schools? How can they protect particularly ‘at-risk’ individuals in the current situation? How can they ensure that people have the current, comprehensive and reliable information and advice that they need to make an informed decision? These are some of the critical, yet complex questions with which our speakers, their colleagues in Toronto, and their peers in communities across the country have to deal.

submitted by Cathy Spark