Why all Albertans should care about the measles

By Lethbridge Herald on April 25, 2025.

Dr. Mark Joffee
For The Herald

With the federal election, tax deadlines, NHL playoffs and the arrival of spring, people have lots on their minds.  Unfortunately, measles should be, too.  Measles is a highly infectious and very serious disease.  It is entirely preventable.   Alberta’s current outbreak of easles, impacting mostly children, should concern us all.

Before vaccine became available, measles was an inevitable childhood illness.  But, it wasn’t a mild disease.  About 10 days after exposure to measles, fever begins, often high fever, together with some or all of:  red burning eyes, nasal congestion and cough.  A few days later, a rash begins on the face and spreads downwards.  These symptoms occur because of widespread invasion by the virus and the body’s response to it. 

The period from onset of fever to the end of the rash, comprises seven to 10 miserable days.  Complications occur in three out of 10 people, including ear infections, pneumonia and diarrhea with dehydration.  Of infected people, 10-20 per cent require hospital admission, burdening our already over-taxed health system.  A small number (one or two per 1,000) develop brain infection often leading to chronic disability or death.  

A similar number develop persistent brain inflammation (sub-acute sclerosing panencephalitis) five-15 years following infection resulting in behaviour and cognitive change and inevitable death.  

Measles is a horrid illness.  It is much more severe than most childhood infections.  Most people recover.  Some don’t.  Prior to the availability of vaccines, two to six million people (mostly children) died every year from measles globally; today, there are still 100-200,000 deaths per year.  

In Alberta in the pre-vaccine 1950’s, around 10 people (almost always children) died each year from measles.  With our current population, and without immunization, measles would cause 45-50 deaths each year in Alberta, mainly in young children.

Measles virus is uniquely diabolical.  It can destroy our immune system’s cells causing “immune amnesia”.  This makes individuals susceptible to a variety of infections, including diseases for which they previously had immunity, because of either immunization or illness.  This increased risk of death from non-measles infections endures for two to three years after recovery from measles. 

It is all entirely preventable with immunization for measles.  

Measles vaccine is a live but very much weakened strain of the virus.  Vaccine primes the immune system, protecting us from infection with the natural virus, and all its complications.  Alberta introduced this vaccine in 1970.  A single vaccine dose provided up to 93% protection but a large outbreak in Canada in 1995-96 taught us this was insufficient to prevent outbreaks with this extremely contagious virus.  A second dose of vaccine was added in 1997, providing nearly 100% protection.  In 1998, measles was eliminated in Canada, meaning that the virus stopped circulating in our population.

Alberta’s approved vaccine schedule includes two doses of measles-containing vaccine, at 12 mos of age and again at 18 mos, to protect children under five – the group most likely to have severe measles.  Measles virus seeks out and infects those who have not been immunized – babies, and immunocompromised children and adults who cannot receive this vaccine.  They rely on high rates of other people being immunized (community immunity) to protect them. 

The measles vaccine has been licensed for over 55 years and hundreds of millions of people have benefitted.  This vaccine has a well-established safety record.  No vaccine (or drug) is 100% free of side-effects.  The side-effect profile of measles vaccine is well known.  The risks of adverse effects from vaccine are substantially less than complications from measles infection. 

 In 1998, Andrew Wakefield falsely and fraudulently linked vaccine to autism.  Many subsequent high-quality studies show no link between measles vaccine and autism.  Autism is a complex spectrum of developmental disorders requiring ongoing research to better understand its cause(s) and treatments.  We can be confident that it is not caused by the measles vaccine. 

 The World Health Organization has recently reviewed its 50-year old Expanded Programme on Immunization.  An estimated 154 million deaths have been averted through immunization, including nearly 94 million (almost two-thirds of the total) from measles prevention.  In addition, an estimated nine billion years of life were saved by providing vaccines, including nearly six billion (63 per cent of the total) by preventing Measles.  The measles vaccine’s ability to prevent disease is truly one of the great medical and public health success stories.

  There is a global resurgence of Measles.  Canada should be contributing to international elimination efforts.  

Alberta could prevent the spread of measles within our borders.  The only way to do this is to maintain very high levels of immunization.  We require access to publicly funded vaccines and both cultural and language-appropriate promotion efforts.  

When times are tough, Albertans look out for their families, their neighbours, their communities and the vulnerable amongst us.  This is a critical pillar of the Alberta advantage.

Mark Joffe is Professor of Medicine (Infectious Diseases) at the University of Alberta and previously served as the Chief Medical Officer of Health for Alberta.