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

Bobbi-Jean MacKinnon

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 im‐ munization programs, ac‐ cording to reports posted on Health Canada's Drug Short‐ ages website by Canada's two suppliers.

Merck Canada and GSK "have advised Health Canada that they are able to fully meet demand for these [rou‐ tine childhood immunization] programs, which are man‐ aged by each province and territory," an email sent by a spokesperson for Health Canada read.

But people who aren't eli‐ gible 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 esti‐ mated end date of April 19, for its private market short‐ age of MMR II vaccine. Mean‐ while GSK does not supply the private market with its PRIORIX vaccine, but posted a shortage report to "proac‐ tively indicate that they can‐ not 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 pre‐ sumed to have acquired im‐ munity 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 conta‐ gious disease that can cause serious illness and severe complications, including deafness, brain damage and even death.

The virus is transmitted through the air when an in‐ fected person breathes, coughs, sneezes or talks, or by direct contact with in‐ fected nasal or throat secre‐ tions.

There is a surge of measles in Europe and a rise in cases across North Amer‐ ica, related in part to a de‐ cline in routine vaccinations during the COVID-19 pan‐ demic.

At least 31 cases of measles have been reported so far this year across Cana‐ da, as of March 15, according to a CBC News tally of provin‐ cial and regional figures re‐ leased 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 in‐ fected, if the disease strikes communities with low vacci‐ nation 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 internation‐ al travellers who may be visit‐ ing countries where measles is circulating."

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 inter‐ esting that Public Health was‐ n'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.

The Department of Health "has recently been made aware" of the shortage of vaccines currently available through the private vaccine supply, spokesperson Hatchard said in an email Thursday.

The department plays no role in the private market, which supplies mostly phar‐ macies, he said.

New Brunswick's supply for the publicly funded provincial vaccine programs, where the department deter‐ mines the eligibility criteria and participates in a federally co-ordinated procurement process along with all provinces and territories, is not currently affected, Hatchard said.

"Public Health currently has a sufficient supply of the measles vaccines for eligible New Brunswickers."

"Although we understand that it may currently be chal‐ lenging for people [born be‐ fore 1970] to access the vac‐ cine, we expect this shortage will be short-lived.":

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 is‐ n't as worried after a conver‐ sation with her 94-year-old mother, who lives in Victoria.

"She still has the baby books for me and my broth‐ ers 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 ba‐ by book looks like you had measles at the same time.' And I would have been about five. So … I am less con‐ cerned."

'Quite a few requests' Andrew Drover, pharma‐ cist owner of Harrisville Phar‐ macy in Moncton, said phar‐ macists haven't received a lot of information about the prevalence of measles in oth‐ er countries or the likelihood someone would contract measles while travelling, but he wouldn't discourage peo‐ ple like McKeil from travelling at this point.

"There is, to my knowl‐ edge, 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 re‐ turn that they see their doc‐ tor right away," he said.

Measles typically starts with cold-like symptoms, such as fever, cough, red, wa‐ tery 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.

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, al‐ ready 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 ap‐ pointment 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 com‐ bined 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 eli‐ gibility criteria, Dr. Arifur Rah‐ man, acting deputy chief medical officer of health, ad‐ vised 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 (rou‐ tine 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 re‐ ceived 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 child‐ hood.

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 shortage

"If patients and/or care‐ givers 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 Cana‐ da is working closely with manufacturers, the Public address

Health Agency of Canada, provinces and territories and stakeholders across the health-care system to "moni‐ tor 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."

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

"We are working diligently with all relevant stakehold‐ ers, including provincial and federal health authorities, to provide a consistent supply of MMR®II vaccines in a timely manner," an unidenti‐ fied 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 spokesper‐ son Rita Moutinho said this temporary shortage is a re‐ sult of an increase in measles cases affecting different parts of the world, leading to added interest in MMR vac‐ cines.

"We continue to meet the public market demand of PRIORIX and our current sup‐ ply of PRIORIX is allocated to fulfilling our existing contrac‐ tual commitments in Canada for 2024," she said in an email.