Canada faces shortage of measles vaccines amid rise in cases, demand

March 21, 2024 Canuck

Canada is facing a shortage of measles vaccines amid a rise in cases across the country and around the world, and an increase in demand.

Remaining doses of the the measles, mumps and rubella, or MMR, vaccines are being reserved for public immunization programs, according to reports posted on Health Canada’s Drug Shortages website by Canada’s two suppliers.

Merck Canada and GSK “have advised Health Canada that they are able to fully meet demand for these [routine childhood immunization] programs, which are managed by each province and territory,” an email sent by a spokesperson for Health Canada read.

But people who aren’t eligible for a publicly funded vaccine and hoped to get one through a travel clinic or pharmacy are likely out of luck for at least the next month.

The private market for measles vaccines “makes up an extremely small portion of the overall demand,” the Health Canada email to CBC News read.

Merck is reporting an estimated end date of April 19, for its private market shortage of MMR II vaccine. Meanwhile GSK does not supply the private market with its PRIORIX vaccine, but posted a shortage report to “proactively indicate that they cannot fulfil private orders,” the spokesperson said.

Unable to follow N.B. Public Health’s advice

April 19 will be too late for Debra McKeil, of Burrts Corner, near Fredericton. She leaves that day for Morocco.

McKeil looked into getting a shot after New Brunswick Public Health recommended last week that people born before 1970 get a measles vaccine if they plan to travel outside the country.

Although most adults born before 1970 are presumed to have acquired immunity from past exposure to the measles virus, Public Health recommended they get at least one dose before any international travel, as a precaution.

Measles is a highly contagious disease that can cause serious illness and severe complications, including deafness, brain damage and even death.

The bare back of a young child, covered with a red rash. — It can take up to 21 days after exposure to the virus for symptoms to appear, according to the Public Health Agency of Canada, and people who are infected can spread the virus to others before they develop symptoms. (CBC)

The virus is transmitted through the air when an infected person breathes, coughs, sneezes or talks, or by direct contact with infected nasal or throat secretions.

There is a surge of measles in Europe and a rise in cases across North America, related in part to a decline in routine vaccinations during the COVID-19 pandemic.

At least 31 cases of measles have been reported so far this year across Canada, according to a CBC News tally of provincial and regional figures released by public health teams, and new projections suggest there’s a high chance of a “sizable outbreak” — with anywhere from dozens to thousands of people infected, if the disease strikes communities with low vaccination rates.

Most measles cases that have occurred in Canada have been acquired from travel outside the country, New Brunswick Department of Health spokesperson Sean Hatchard said. “Therefore, the largest risk of measles exposure is with international travellers who may be visiting countries where measles is circulating.”

A portrait of a smiling woman in the Amazon rainforest, wearing glasses, a hat and fuchsia top. — Debra McKeil, pictured here during a trip to Ecuador last year, is heading to Morocco next month and hopes to get the measles vaccine before she leaves. (Teri Young)

McKeil, who was born in 1958, wanted to follow Public Health’s advice, but when she called a Fredericton pharmacy that offers travel vaccines, she was told: “They couldn’t give me the vaccine because they said it was in short supply and they were only giving it to children.”

McKeil then called Public Health and says the woman she spoke to wasn’t aware of the shortage.

“I just thought it was interesting that Public Health wasn’t aware of that. If they’re advising people my age to get the shot, you know, and then it turns out there’s a shortage and I can’t get the shot,” she said.

Public Health has not responded to a request for comment.

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McKeil contacted some other local pharmacies, but couldn’t get the vaccine from them either.

She said she plans to keep trying before her trip, but isn’t as worried after a conversation with her 94-year-old mother, who lives in Victoria.

“She still has the baby books for me and my brothers and sister, and she looked at mine and it looks like my older brother Michael had … measles when he was nine. And she says, ‘Your baby book looks like you had measles at the same time.’ And I would have been about five. So … I am less concerned.”

‘Quite a few requests’

Andrew Drover, pharmacist owner of Harrisville Pharmacy in Moncton, said pharmacists haven’t received a lot of information about the prevalence of measles in other countries or the likelihood someone would contract measles while travelling, but he wouldn’t discourage people like McKeil from travelling at this point.

“There is, to my knowledge, no [measles] pandemic at the moment, so I would … just kind of, you know, make sure they’re aware of the symptoms of measles … So that if they end up having those symptoms and they return that they see their doctor right away,” he said.

Measles typically starts with cold-like symptoms, such as fever, cough, red, watery eyes, and runny nose.

About three to seven days after symptoms begin, a rash that looks like small red spots appears. It usually starts on the head/neck and spreads down the body, arms and legs.

A portrait of a man wearing a white lab coat in a pharmacy. — Andrew Drover, pharmacist owner of Harrisville Pharmacy in Moncton, who was born in 1978, said he recently travelled internationally and did not get a measles vaccine before he left, but he believes he received a second dose while he was a pharmacy student. (Alexandre Silberman/CBC)

Drover has had “quite a few requests” for the measles vaccine in recent weeks.

He had doses in stock, having ordered some before the shortage, but has since run out and can’t get any more right now.

“If they’re not eligible for a public vaccine, we encourage them to try other pharmacies or even like a travel clinic. There’s a few travel clinics around, they might be able to try one of those, who may have had stock, you know, already that they could use,” he said.

“If they are eligible for publicly funded one, we refer them just straight to Public Health to schedule an appointment to go get one there.”

Infants now eligible for vaccine in N.B.

As part of the routine schedule in New Brunswick, children can receive a combined measles, mumps, rubella and varicella (MMRV) vaccine in a series of two doses at 12 and 18 months.

Children ages six to 11 months who are travelling outside of Canada can also now receive one dose of MMR vaccine, under new eligibility criteria, Dr. Arifur Rahman, acting deputy chief medical officer of health, advised all health-care providers in a March 15 memo, obtained by CBC News.

“If MMR is given before 12 months of age, the child will require two doses of MMRV after 12 months of age (routine schedule at 12 and 18 months),” it says.

As part of the routine schedule in New Brunswick, adults born in 1970 or later who have not previously received two doses of MMR are eligible to receive two doses of MMR or MMRV vaccine (one month apart) or receive one dose if they have had one previous dose in childhood.

The dose for adults born before 1970 is not currently publicly funded. It costs about $140.

Being fully vaccinated provides almost 100 per cent protection, according to health officials.

Working to address shortage

“If patients and/or caregivers are concerned about access to, or the supply of, a specific vaccine, they should speak with their primary health-care provider about treatment options,” the Health Canada spokesperson said.

Meanwhile, Health Canada is working closely with manufacturers, the Public Health Agency of Canada, provinces and territories and stakeholders across the health-care system to “monitor the supply situation,” they said in an email.

“The department does everything it can to prevent shortages when possible and to mitigate their impacts and help resolve them when they do occur.”

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Quebec has launched measles vaccination clinics as officials fear a major outbreak would put thousands of children at risk of getting very sick or even dying. The number of confirmed cases in Canada in 2024 has already exceeded the total for 2023, and modelling shows it could quickly get out of hand if vaccination rates don’t increase.

Merck Canada said the increase in measles cases across the country and abroad has resulted in an increase in demand for MMR vaccines and, as a result, its recently declared shortage.

“We are working diligently with all relevant stakeholders, including provincial and federal health authorities, to provide a consistent supply of MMR®II vaccines in a timely manner,” an unidentified spokesperson said in an emailed statement.

“Our priority remains firmly focused on ensuring the availability of this vaccine to those who need it the most.”

Similarly, GSK spokesperson Rita Moutinho said this temporary shortage is a result of an increase in measles cases affecting different parts of the world, leading to added interest in MMR vaccines.

“We continue to meet the public market demand of PRIORIX and our current supply of PRIORIX is allocated to fulfilling our existing contractual commitments in Canada for 2024,” she said in an email.

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