'Vaccine-free' daycare sign of Canada's fraying immunization safety net

A private daycare touts it is a “vaccine-free environment,” but public health officials in Ottawa can’t do anything about it, another sign Canada’s immunization system seems to be fraying.

CBC News reported the daycare in the Ottawa suburb of Orléans run by Paapa and Melissa Abekah was set up for fellow vaccine skeptics who believe that live-virus vaccines are a threat to the unvaccinated.

"The live vaccine that’s administered to you, you carry that vaccine. It’s a virus," Paapa Abekah told CBC News. “You’re a walking, living, breathing virus for at least 30 days, and in some cases longer.”

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But Marie-Claude Turcotte, program manager at Ottawa Public Health, said there’s absolutely no truth to the claim live attenuated vaccines, essentially weak versions of a virus designed to provoke an immune response, can cause disease in others.

But there’s nothing her agency can do about the way the couple operates their daycare, which apparently is unlicensed, Turcotte told Yahoo Canada News. Officials have not contacted the Abekahs, she said Monday.

Ontario law requires operators of licensed daycares to ensure the children in their care are vaccinated, unless the parents submit a notice of exemption on the basis of religion or conscience or the advice of a medical professional.

Turcotte said her agency receives immunization information from licensed daycares but isn’t able to track unlicensed ones, so it’s difficult to know the true rate of vaccination among pre-schoolers.

The law covering vaccination for school-age children is a little stricter, though it, too, includes provision for exemptions on religious or other grounds. However, Turcotte said parents are warned if they choose not to vaccinate, their children could be excluded from school.

The agency’s statistics for the 2012-13 school year show a vaccination rate of 97 per cent for 17-year-old students, but the rate drops to 82 per cent for seven-year-olds.

The lower figure could reflect the apparent growth in anti-immunization supporters, but agency spokeswoman Donna Casey said it’s likely due to under-reporting by parents who neglect to inform the local health unit when a child has received its booster at age four. It can also take a while for school records to catch up.

Lower vaccination rates threaten ‘herd immunity’

The official exemption rate on religious, philosophical or medical grounds for that school year was 1.22 per cent.

Immunologists believe you need a vaccination rate of 95 per cent or more to achieve what’s know as “herd immunity,” which effectively keeps a virus from acquiring a foothold in the general population. That approach to vaccination has effectively eradicated once-common childhood illnesses such as mumps, measles, pertussis (whooping cough) and polio.

Statistics from the Public Health Agency of Canada (PHAC) covering the years 2002-2012 suggest immunization rates for the measles, mumps and rubella vaccine (MMR) remain above 90 per cent nationally.

But the pushback against vaccination seems to be growing over concerns about their safety, chief among them the now-debunked claim that vaccines can cause autism. It’s led to measles outbreaks in Toronto and the Niagara region, and another last spring involving more than 100 cases in B.C.’s Fraser Valley linked to a school run by a Christian denomination that doesn’t believe in vaccination.

A study published last year by the PHAC found almost 43 per cent of two-year-old children in southern Alberta communities were unvaccinated and the rate for fully immunized seven-year-olds often fell well below 90 per cent.

“We’d almost obliterated things like measles, and here we go because vaccination rates haven’t kept up,” health economist Douglas Angus told Yahoo Canada News. “We’re now having outbreaks of measles where we shouldn’t be having them, not at all.”

Angus, a professor at the University of Ottawa’s Telfer School of Management, was part of an advisory committee that last year produced a report for the Ontario government on its system of publicly-funded immunization. It concluded that the province falls short of national immunization targets needed to provide general population immunity.

The report recommended a push to promote immunization and build public confidence in vaccination programs, developing a provincial immunization registry so officials have a better picture of what’s going on and a better system of gathering and distributing evidence gathered from those programs.

The Ontario government has had an election and changed health ministers since the report was submitted last March, said Angus, so he’s not sure if the recommendations are being implemented.

“Of course since we’ve had flare-ups of measles in the Toronto and Niagara area, maybe this will put the impetus to acting on these recommendations a little bit sooner rather than later,” he said.

Vaccination issue not just regional

But Angus said the problem extends outside of Ontario to include neighbouring provinces and the United States, because the regions are so closely linked by travel.

“We should be having co-ordinated data right across the country to make sure that if there’s something that’s popping up in one part of the country, the whole country is really aware of that,” he said in an interview.

That’s part of the PHAC’s responsibility, Angus said.

“The Public Health Agency over the past number of years has really been kind of not given the kind of authority and resources that they probably should have had and it’s been a bit of a struggle for them to make sure we have a national strategy,” he said.

The problem became evident during the H1N1 influenza pandemic of 2009, said Angus.

“We were fortunate that it really wasn’t that severe,” he said. “The public health people right across the country were looking for explicit leadership coming from the Public Health Agency and it just never emerged.

“So provinces were kind of grappling with this on their own and we didn’t have a kind of consistent approach right across the country, which is what the Public Health Agency should have done.”