A resurgence in vaccine-preventable diseases is gaining momentum in Canada

Jessica Cohn

Respiratory Syncytial Virus (RSV) Advocate

_“When my son Eitan was two weeks old, his older brother Ari got really sick. Double ear infection, wicked cough. Ari had just started daycare so, you know, it wasn’t really that surprising. Every kid gets sick when they start daycare. I was concerned about Eitan catching it, but the doctors said not to worry too much. I was breastfeeding and breast milk is like liquid gold when it comes to immunity.

But sure enough, a couple of weeks later, Ari was back at daycare and Eitan was having trouble breathing. One night he couldn’t sleep, and then the next night it was even worse. I wasn’t panicking, but I took him to the hospital to be safe. Pretty much right away, they said it looked like RSV.

Two days later, Eitan was on oxygen saturation. One day after that he was in the intensive care unit on a ventilator. He still wasn’t improving and he’d developed pneumonia. He was hooked up to about ten different machines, all these wires. I was scared to even hold him. They told me they might have to intubate him. I’m not a religious person by any stretch, but I just started praying. 

We were lucky. We were so lucky. Our stay in hospital was two weeks long, and we were very close to losing him, but Eitan made a full recovery. The name Eitan actually means determination and perseverance, and that’s 100% who he is. Eitan’s 10 years old now and you’d never know any of this happened to him. But the trauma doesn’t go away.

Going through something like this changes you. When my third child was born during RSV season and I learned that immunization was available but she wasn’t eligible for it, I was a wreck. I felt like I couldn’t be a normal mom. I couldn’t enjoy anything. I was just so paranoid the same thing was going to happen to her. Even the healthiest baby can be a victim. 

Now that RSV immunization is an option for pregnant people as well as newborns, I certainly hope everyone will consider getting immunized. I don’t think there’s a more dangerous respiratory illness for a newborn baby than RSV. I don’t think people are as scared of it as they should be. If there’s anything a parent can do to prevent their child from going through what Eitan went through, it would break my heart for them not to take that precaution.”

Tristan Lachance

Human Papillomavirus (HPV) Advocate

_“My father was fifty years old when he died from HPV-induced squamous cell carcinoma. I remember how difficult it was for him to tell me and my sister when he got the news that the cancer had metastasized to his liver, that it had become terminal. My dad was never afraid to be emotional. He was the kind of guy who would cry openly at a sad movie. But he was also a prideful person. He was a phys ed teacher and he’d worked so hard his whole life. He was used to being the strong one.

Near the end, my grandfather came to visit us. My dad had lost so much weight and he had gotten so frail that seeing the two of them sitting together completely destroyed me. I had to watch my grandfather coming to terms with the fact that he was going to outlive his own son. After my grandfather left, I found my father alone in his bedroom crying, and I did my best to console him, but there was nothing I could say.

It wasn’t until after my dad passed that I understood his cancer was vaccine-preventable. I’m in my second year of medical school and, although I knew a vaccine was available​ and have been vaccinated myself, I​'ve just started to learn how the vaccine has improved over time and how much more effective it has become at preventing these cancers. I’ve also joined a task force to help shine a light on this virus here in Northern Ontario, where I can say from experience there is a huge need for more education and awareness.

This is the most common sexually transmitted infection out there. Over 70% of Canadians will be exposed to the virus in their lifetime, and people don’t understand how serious the outcomes can be.  Most people, if they think about HPV at all, seem to think it’s not a big deal because it’s so often asymptomatic. They figure, if everyone has it, then it can’t be that bad. But it only seems that way because HPV can lay dormant for a very long time. You could be asymptomatic for decades even and then, suddenly, cancer appears.

For men especially, acknowledging the connection between HPV and cancer can be uncomfortable. We don’t talk about the HPV-related cancers that affect men nearly as much as we talk about those that affect women. For a prideful man like my father, there’s still a lot of stigma around having your diagnosis linked to HPV. It can be difficult to come out and talk about it, but it’s so important that we do.

It’s just one vaccine, but it can prevent so many terrible outcomes.”

Dr. Cora Constantinescu

Pediatrician and Infectious Disease Expert

_“We know for sure that vaccine confidence is waning among Canadians. It’s not a rumour anymore. We have research. It’s a crisis for children’s health. And it’s especially bad among those aged 30 to 50, who are the parents of today’s children.

When you ask parents what their specific concerns are around vaccines, it usually comes down to safety and trust. They’re not confident the vaccines are safe, and they don’t necessarily trust that the healthcare system and the government agencies that review  vaccines have their best interests at heart. But I’ve also seen anecdotally that you can address these safety and trust concerns directly and at length and it doesn’t make much of a difference in terms of actually changing vaccination behaviour. Because the real problem is that people don’t truly believe their kids are at risk from vaccine-preventable disease. Until parents understand the threat of these diseases in a personal way, they aren’t likely to change their behaviour.

Misinformation and disinformation and the politicization of vaccines only become such serious problems when they rest on this foundation of complacency. I see it when I talk to parents about polio. The chance of catching polio is basically non-existent in Canada right now, but the polio vaccine doesn’t face the same hesitancy. Parents find the polio vaccine more palatable because they remember a grandparent or other family member who had it. They’ve seen how serious the lasting effects are. Other vaccine-preventable illnesses don’t seem as threatening, because people don’t have personal context for how bad they can be.

As a pediatric physician though, I can see the train coming down the tracks and it keeps me awake at night. Fewer people are getting vaccinated, which means fewer children are protected, which means we’re going to see a lot more vaccine-preventable disease. We’re going to see more HPV-related cancers. We’re going to see more measles outbreaks. We’re going to see more babies in the ICU with illnesses like RSV, and we’re going to see more families traumatized by that experience. In the near future, we may even see polio becoming once again a real concern in Canada. The vaccination decisions parents make today will inevitably determine what future their children inherit.

Unfortunately, I don’t see the situation getting better in the next 5 or 10 years unless we actually come up with an effective national strategy for communicating the seriousness of the risk to parents. I know that parents want to do what’s best for their child. That’s why these ideas of safety and trust resonate. But we need to reframe the conversation so parents understand that the risk from vaccine-preventable disease is on a whole different scale. And that, if we truly want to protect our children and give them a better life, immunization is one of the few things under our control that can actually help achieve that.”