Vaccinate All Immigrants And...
Many of Canada's current cases of measles can be linked to travellers—or their children—who have travelled overseas and brought the disease back to Canada. Only three cases (all in the same family) of measles in BC can be linked directly to anti-vaxxers. Out of the 20 or so cases in Canada, almost half are linked to unvaccinated travellers or their children. Currently, Canada does not require any new immigrants, tourists, or refugees entering the country to be vaccinated and Canadian media seldom reports on the nationalities or citizenship status of these “travellers”.
India's courts recently struck down mandatory vaccination, while the Philippines and Ukraine are currently facing a measles outbreak that has claimed hundreds of lives. In February, a man travelling from Manila brought the disease into Vancouver, as reported by the Vancouver Sun:
Chris Devauld, a spokesman with Vancouver International Airport, confirmed one of two new measles cases reported in Vancouver was a traveller arriving from the Philippines, where an outbreak had killed at least 136 people and infected more than 8,000 people in recent months.
Devauld said that the passenger arrived in Vancouver on Feb. 11 on Philippine Airlines flight PR 116 from Manila, and then departed Vancouver on Feb. 12 on Air Canada flight AC236 to Edmonton.
It is unknown where the second passenger was travelling when the individual contracted measles.
Originally, some of BC's cases could be linked to an anti-vaxxer family that travelled to Vietnam. As days turned into weeks, new cases emerged from international “travellers”. The media and provincial health officials never reveal the identities or nationalities of those infected, but news can travel through unofficial channels and, when the travel locations and destinations of “travellers” are made public, it can be easy to determine where the diseases may have come from.
The first confirmed case of measles in Cochrane, Alberta hints at a country outside of Canada as the possible source. As published by Alberta Health, the infected person spent time at the Bella Concert Hall at Mount Royal University on March 12 and has been confirmed as a traveller. Alberta's second case has also been directly linked to international travel.
Following the anti-vaxxer outbreak linking to French schools in Vancouver, four new cases emerged without the apparent link to the anti-vaxxer movement. When linking to anti-vaxxers, media shows no hesitation revealing names and causes, but when cases of measles have direct links to “travellers”, we are seldom made privy to names, nationalities or countries of travel. As seen with the recent case of measles in Toronto, which was again linked directly to international travel:
Dr. Vinita Dubey, the city’s associate medical officer of health, said Tuesday the case involves an unvaccinated infant under 12 months of age whose parents sought medical care for the child after the family recently returned home from a trip abroad.
For privacy reasons, TPH is not identifying the family, the infant’s exact age or sex, or what country was visited.
While the family did travel through Pearson International Airport, the infant was not showing any symptoms of measles and was deemed not to have been contagious at the time.
Why would the media and health officials refuse to disclose the country the family visited?
The anti-vax father who was at the centre of BC's earlier outbreak faced media attention and criticism from all corners of social media after his name spread through unofficial channels—leading to an eventual interview with the CBC. As attention now has shifted to unvaccinated “travellers”, media has neglected to do any further investigation into the travellers who have actively spread and carried the disease.
All questions about new cases of measles brought into Canada from overseas have fallen by the wayside. Any revelations about countries of origin are blacked out or redacted by media and health officials. We aren't allowed to know what countries new measles cases are coming from or who is bringing them into Canada—unless they can be directly linked to members of the anti-vaxxer movement.
In the United States, media is a bit different in their coverage, but they still refuse to acknowledge the nationalities or citizenship status of so-called “travellers”, while still acknowledging that international travel is a major source of measles cases in the United States, as pointed out by the New Your Times:
Measles isn’t only in the headlines these days; it may also be on your airplane.
An adult contagious with the disease flew from Asia to San Francisco in February, infecting two others — one adult and one child — during the flight, California health departments said this month.
It’s an inauspicious development in a year that has already seen 228 cases of the serious and potentially lethal disease in 12 states, including six outbreaks of at least three people. All the outbreaks in 2019 have been linked to travelers who carried measles from countries with lower vaccination rates, according to the Centers for Disease Control and Prevention, and sickened people in areas of the United States where residents were not vaccinated.
As pointed out, all of the cases in the United States this year have been linked to travellers who brought the disease into the country from countries with low vaccination rates. Earlier last month, another case was reported in Nevada, when another international traveller exposed Americans to measles at Treasure Island. Around the same time, a traveller from Israel was confirmed to have carried the disease into Michigan and yet another traveller from China brought measles into California during a layover at LAX.
In March as well, two people became infected with measles in San Francisco when a traveller on the same international flight was infected with the disease. In New Hampshire, a person who arrived on an international flight to Boston took a bus to Manchester, New Hampshire, potentially exposing hundreds of Americans to measles along the way. In San Antonio, a “foreign traveller” was confirmed to have the first case of measles in Bexar County in over ten years.
Although the US often requires those who apply for permanent residency to be vaccinated for measles, foreign born Americans and their children are under-vaccinated for for most preventable diseases, as reported by the US National Institute Of Health:
An estimated 13% foreign born persons are living in the United States. Foreign born persons are considered at higher risk of under-vaccination and exposure to several vaccine preventable diseases pre-migration or during return trips to their birth country. Information on vaccination coverage among foreign born populations is limited.
Last year, it was reported that the children of immigrants to the United States are less likely to be vaccinated:
A recent study from the Centers for Disease Control and Prevention (CDC) reports that vaccine coverage in children under 3 years of age may vary depending on the birth country of a child’s parents. Since children of immigrants are the fastest-growing population of children in the U.S., this requires consideration not only at the state and national levels, but also by all providers caring for immigrants and/or children of immigrants.
Whether measles is brought into Canada by immigrants, or by tourists in both Canada and the United States, media attention is almost always focused on the small, insignificant anti-vax movement and the risks its members pose to children. Based on this logic, in which unvaccinated adults pose risks to unvaccinated children, it is important to acknowledge the risks posed by unvaccinated tourists, immigrants and refugees in Canada—all of which are just as significant as those posed by the anti-vax movement.
Vaccinate Tourists, Travellers, Immigrants And Refugees
Vaccination rates in the United States among immigrants and their children are low, despite the US requiring new immigrants and permanent residents to be vaccinated for most preventable diseases. In some cases, immigrants receive blanket exceptions and are allowed to receive permanent residency without vaccinations, while millions of undocumented and unvaccinated immigrants continue to live in the United States. Tourists to the United States are not required to provide proof of vaccination before entering.
In Canada, immigrants, refugees, travellers and tourists are not required to be vaccinated.
With the measles outbreak in the United States and Canada, the debate about mandatory vaccination has boiled over. However, the discussion cannot be had when tourists, immigrants, refugees and homegrown travellers are being excluded from the argument. Anti-vaxxers pose a significant threat to unvaccinated children in Canada, as do unvaccinated trourists, immigrants and travellers—equally so.
In 2018, more than 21 million tourists entered BC. How many of them were vaccinated is anyone's guess. Included in the debate about mandatory vaccination must be the question of whether tourists to Canada—and Canadians travelling to high risk destinations—must provide proof of vaccination along with their passports.
When applying for a passport, should Canadians require up-to-date vaccinations? Before entering Canada, should tourists and new immigrants have to provide proof of vaccination before entering? If unvaccinated people pose a threat to our children, the answer is yes.