Public health takes low-key approach to measles

WINNIPEG — Public health officials in Manitoba are taking a soft-sell approach when it comes to their messaging about measles, a highly infectious disease that can be deadly in severe cases.

The provincial government issues a weekly news bulletin that lists sites where people diagnosed with measles have been — most recently, a school, medical clinic and a fast food restaurant. The bulletins are reported by local media.

In addition, the province’s social-media accounts occasionally feature information about measles, for which a vaccine is available.

A provincial spokesperson said messaging on measles outside of the bulletins is focused on “targeted communications.”

“There have been pop-up clinics, communication with schools and parents, and specific health authorities are working on targeted communications in their districts, ensuring people are met where they are at,” the spokesperson said.

The subdued approach is in sharp contrast to the government’s full-on campaign during the COVID-19 pandemic. For months and months, there were daily bulletins, billboard messaging, radio, television and social-media ads, all of which included calls from officials and politicians for people to stay home, mask up and get vaccinated.

Christopher Schneider, a sociology professor at Brandon University, said the gentle approach was likely made for a number of reasons.

COVID-19 presented a unique situation, while measles is the opposite: we’ve long known that a full vaccine complement is nearly 100 per cent effective, and a large number of the population, anyone born before 1970, is considered immune.

Schneider wonders whether years of push-back against COVID vaccines and restrictions — mostly in southern Manitoba, which is now over-represented in measles hospitalizations and exposure sites — prompted the public health office to temper its approach.

“We could surmise that the blowback from COVID has contributed to government considerations about not discussing or promoting public health in relation to measles outbreaks,” he said.

“That said, I think there is a duty of care and responsibility on the government to promote public health and spotlight measles outbreaks, because this is a highly communicable disease, and all Manitobans are susceptible to it.”

For years, chief provincial public health officer Dr. Brent Roussin was the face of COVID-19 information shared in Manitoba. He was also the voice for television ads in 2021 that were part of the province’s “Safe at Home” campaign, end with a soundbite from him, asking Manitobans to “Do a bit more of what keeps us all safe, for a little longer.”

Rousin said much work is being done behind the scenes when it comes to the response to the measles outbreak, which has seen 211 confirmed cases and 17 probable cases in Manitoba since February.

“It just might not be as visible as daily press conferences or things that we saw during COVID,” he said.

Manitoba had the gift of foresight when measles cases began ramping up in the spring. Case counts had skyrocketed in other provinces, including Ontario, where the number of infected hovered at 200. Roussin said officials here were able to gauge that there would be widespread transmission in pockets of the province that have low immunity, but transmission wouldn’t spread to the greater public.

“There is a duty of care and responsibility on the government to promote public health and spotlight measles outbreaks, because this is a highly communicable disease.”

That, in part, has informed their approach to getting the word out, he said.

“It’s not the same approach as we saw with a novel virus, that at many times did put our health-care system at risk, and where we saw pretty much universal susceptibility, at least at first,” he said.

Instead of billboards across the province, information has been given out to physicians to give to their patients. Letters describing the measles outbreak have been written in English, French and Low German.

Social-media posts are to the point: a recent tweet from the Manitoba government posted on X features a cartoon of a baby with a rash caused by measles and the hashtags #GetImmunized and #VaccinesWork.

“There is a duty of care and responsibility on the government to promote public health and spotlight measles outbreaks, because this is a highly communicable disease.”– Christopher Schneider

Health Minister Uzoma Asagwara said the messaging has been adapted.

“We know that the attention span of folks on social media is a tight window, and people scroll. We want to make sure that the way information is being distributed is evolving with the times, is really meeting people where they’re at.”

A focus on pop-up testing and vaccination clinics in areas where exposures occurred gives people a chance to ask questions and speak with medical professionals in their own health region.

While vaccination is the only way to prevent measles, staff are directed to advise on best practices if a person refuses the shot. That includes watching for symptoms and seeking medical attention early.

“We have to find ways to certainly broaden the recommendations if vaccine uptake is still going to be low, and we see this in other jurisdictions, who also have put in a tremendous amount of work doing outreach with vaccines,” Roussin said.

Roussin doesn’t think “pandemic fatigue” — which describes exhaustion, de-motivation and apathy throughout a prolonged health crisis — plays a role in measles messaging.

However, vaccine hesitancy, fuelled by misinformation and disinformation throughout the pandemic, has to be considered by public health officials.

As vaccination rates decline, preventable illnesses such as mumps, chickenpox and even polio could become more prevalent or return, Roussin said.

“We have to make sure we don’t get complacent. (Measles) is an example of what we see,” he said.

“Once we start seeing diminished immunity, we’ll start seeing the transmission of once almost forgotten illnesses.”

Many of the exposure locations recorded by the province are schools, medical centres and churches in southern Manitoba.

The region had the lowest vaccine uptake rates in the province during the pandemic and continues to struggle with immunization.

Briefings obtained by the Free Press via a freedom of information request in August found area households were sending non-immunized children who had been exposed to measles to school. The May 22 issue of the Winkler Morden Voice includes a column that criticizes rumoured “measles parties” in the region.

Two-thirds of Manitoba’s 15 measles-related hospitalizations occurred in the Southern Health catchment.

It’s a painful statistic, said Dr. Davinder Singh, a medical health officer in that region.

“These are severe outcomes. If you’re a parent (or a) family member, it’s terrible,” he said.

“It would be terrible to have your child admitted to the hospital or go to the ICU for something that is preventable with an effective and safe intervention, like an immunization.”

Singh said case counts are a fraction of the circulation rate in Manitoba. He said he’s not confident any approach could sway the vaccine naysayers.

“Unfortunately, I think this is going to take a long-term sort of effort to turn around,” he said.

“Because I think that the people who have wanted to get immunized, due to the change in circumstances, this being a large measles outbreak, have had various opportunities to do so. So, the people who have chosen not to get immunized at this point, may be, unfortunately, more set in their position to not choose to get immunized, or immunize their kids.”

Robert Dyck, a partner at building company Goodon Industries Ltd., says he appreciated the province’s ‘localized response’ when there was a measles exposure at their work site.

He also believes the work needed to improve vaccine uptake will be at the “individual, local level.”

“That’s something that we can support at the provincial level, but unfortunately, it’s not something that we can do for each community,” he said. “They need those local, trusted people.”

Dyck said a public health nurse reached out to the company, based in Boissevain, a community of 1,500 in the Prairie Mountain Health region near the North Dakota border, to let them know they were an exposure site and discuss the possibility of setting up an on-site vaccine clinic.

They were “more than happy” to host the clinic, he said. Some staff got vaccinated, others didn’t. There hasn’t been a recorded exposure at the business since then.

Today, he said, he appreciates what he describes as a “localized response” — getting contacted by a local nurse, who came to answer questions and offer immunizations in a low-pressure setting.

“I appreciated that, because I think a lot of people are still a little bit, I don’t know what you’d call it, numb, to the response that COVID did bring about,” he said.

“Perhaps (they are) asking themselves whether or not that could have been handled in a different way as well.”

» Winnipeg Free Press