Fault lines

The quiet streets of Taber, a small town in Southern Alberta, still hold reminders of the COVID-19 pandemic.
Taped to the windows of the Taber town office and a local bank are posters that encourage physical distancing. Pinned to the fence of a home near the only major highway that runs through the town is an anti-Trudeau tarp expressing support for protestors during the 2022 Coutts border blockade who opposed vaccine mandates.
Now, persistent anti-vaccine sentiment in this area is playing a role in the spread of a different virus.
Measles, long considered eliminated in Canada with the advent of the measles-mumps-rubella vaccine in the 1970s, has had a revival domestically and globally owing to lower childhood vaccination rates.
Canada's outbreak began last October in New Brunswick and has spread to multiple provinces.
One premature baby infected with measles in utero died recently in Ontario, the first fatality linked to the outbreak.
Alberta and Ontario have recorded the highest numbers of people infected, with more than 3,000 cases between them, mostly among unimmunized children. Alberta, however, has the highest number of cases per capita at 20.1 per 100,000 people, followed by 12.9 in Ontario.
Ontario's Chief Medical Officer of Health, Kieran Moore, wrote in a March memo to local medical officers of health that the provincial outbreak had been traced back to 'an exposure at a large gathering with guests from Mennonite communities in New Brunswick last fall.' Officials have not identified the source of Alberta's cases.
The outbreak in Alberta is concentrated in the South Zone, the area south of Calgary that includes Lethbridge and Medicine Hat, as well as many smaller towns and rural communities. Roughly 68 per cent of the provincial caseload of 984 is in this region.
Taber sits at the epicentre of the outbreak.
On a recent spring afternoon, Cam Hazell, a pharmacist at Johnson's Drugs in Taber's town centre, said it's no shock the area is seeing an uptick in measles cases. He's seen children with visible rashes around town.
Mr. Hazell said vaccine uptake in general has declined significantly since COVID, and that the pandemic drove people into one of two camps: pro- or anti-vaccine.
'Everything is so polarized,' he said, adding it's a difficult, even borderline impossible, task to change people's outlook on vaccines.
'People seem to be pretty entrenched in their views.'
The Municipal District of Taber, which encompasses the town, has the lowest vaccination rate for young children in the South Zone, making it easy prey for the highly contagious virus. Only 28.7 per cent of children born in 2022 had the recommended two doses of the MMR vaccine by their second birthday in 2024, the latest provincial data show.
While coverage was 83.2 per cent in 2024 for children who turned 17 that year, that was still nine percentage points lower than in 2019. Measles is easily transmissible, which means at least 95 per cent of the population must be immunized for herd immunity.
Taber, a former coal-mining town nestled in Alberta's vast prairies, is best known for being the 'Corn Capital of Canada,' a nickname it earned for its famous, sweet crop. The landscape outside of the town is dotted with grain elevators and fields full of hay bales.
This is the religious heartland of Alberta, a place deeply rooted in social conservatism. Taber and the surrounding municipal district have a population of roughly 18,000 people.
A significant number of Low German-speaking Mennonites call the area home, and many of them have roots in Mexico. There are also a handful of Hutterite colonies outside of town and a notable Mormon population. The town was settled by Mormons in the early 20th century.
The only obvious signs that the community is in the midst of Alberta's worst measles outbreak in nearly half a century are posters taped to the windows of the local hospital and clinics, which warn of the virus.
The situation has grown so dire in Southern Alberta that the provincial health authority, Alberta Health Services (AHS), abandoned the use of public alerts to warn people of site-specific measles exposures. There is now a standing advisory in place, meaning anyone living in or visiting the area is at significant risk of being exposed.
Prior to the change, alerts – which detail locations where someone with measles visited while infectious – were issued for a number of grocery stores in Taber, the local Aquafun Centre, a locally owned Mexican grocer, a Dollarama and a Shopper's Drug Mart.
Standing outside of the No Frills grocery store, one of the previous exposure locations, Lisa Fehr, a mother of three, said it was December when she first heard of measles making its rounds. Family members of hers were sick with the virus. She also learned in her weekly moms group of other children falling ill.
Her children, all aged 2 or younger, have been vaccinated. She isn't willing to take any risks, preferring to be in the company of those who are also protected against measles. Vaccination, she says, is a topic of contention in the community.
'It was a big, big thing, like, 'How dare you get the vaccine?' But it's like, why wouldn't I?' Ms. Fehr said. 'I'm not going to take any risks, especially when it comes to my kids. It was the same thing with the COVID vaccine.'
People in Taber who spoke to The Globe and Mail had varied reactions to the measles outbreak. Some did not know it was occurring or said it was nothing to worry about. Others blamed people with certain religious or political views, a handful pointing directly at the Mennonite community.
A mother of two, who was approached by The Globe and declined to provide her name, citing privacy reasons, was raised Mennonite. She said some church leaders preach that 'it's against their religion to get the vaccine and they're bound to hell if they do take it.'
She said this is a more common stance among traditional Mennonites, stressing that there are varied perspectives and practices among the broader religious community.
Tamara Miyanaga, reeve of the Municipal District of Taber, said she doesn't agree with people in the community who are identifying one culture as the root of the problem. 'There are other people, besides Low German Mennonites, who've chosen not to get vaccinated,' she said.
Ms. Miyanaga added that some locals may be resistant to vaccination because they are unaware of the serious risk of measles, a virus that has been relatively dormant for decades, or do not have access to health care guidance in their language.
Part of AHS's strategy to stifle measles in Southern Alberta is sharing information in Low German. This includes social-media infographics and a YouTube video that explain what measles is, its symptoms and how to stay safe, including by vaccination. There is also a helpline with Low German speakers.
Public-health officials have also been working directly with affected communities, collaborating with physicians, public-health nurses and faith leaders to communicate the risks of measles.
The focus in this part of Alberta has shifted from eliminating measles in the region to controlling its spread. Vivien Suttorp, AHS medical officer of health for the South Zone, said cases are significantly underreported and it's likely that tracked infections are just the 'tip of the iceberg.'
Her team was prepared for measles to touch down in Southern Alberta. They didn't need a crystal ball – data on declining childhood vaccination rates and cases popping up globally made it inevitable.
The last outbreak declared in the South Zone took place in October, 2013. Less than 50 cases were formally identified, the majority of which were among members of a religious community where immunization was not generally accepted, before it was confirmed over in January, 2014.
Declining immunization rates compared with 10 years ago, in addition to increased travel, are reasons this outbreak can't be so easily contained, Dr. Suttorp said. She noted that there is an increasing number of sporadic cases with no known connection to the larger outbreak.
There is no indication, she said, that the outbreak will be over soon.
Canada declared measles eliminated in 1998 owing to widespread MMR vaccine coverage. If public health is unable to get measles under control by the fall, the country risks losing its status.
In an effort to protect the vulnerable, visitor restrictions have been put in place at the Chinook Regional Hospital in Lethbridge, Medicine Hat Regional Hospital and acute care units at the Brooks Health Centre and Taber Health Centre.
All visitors under the age of 16 must provide proof of MMR vaccination to enter the neonatal intensive care, pediatric, maternal-child and labour delivery units. Critics of the province's response say these actions have come too late, with cases already surging in the region.
At the entrance of the Taber Health Centre is a sign that, in all caps, warns people who have been exposed to measles not to enter. There is a separate entrance to avoid possibly infecting other patients.
Yet there have still been multiple cases of individuals infected with measles, perhaps unknowingly, who have spent hours sitting in the emergency department – for nearly five hours on May 9, four hours on April 16 and three hours on March 11, according to public alerts. The measles virus can linger in the air for up to two hours after an infected person has left the room.
Dr. Suttorp at AHS said the outbreak is causing strain on health care workers, especially those working in rural communities where there is limited staff. She said there are plans in place to open a measles assessment and treatment centre if existing sites are unable to manage.
Vaccine outreach is focused on children, she said, because they are more at risk of serious complications from measles. Most children do recover, but some of the possible complications include immune amnesia, which essentially wipes out the body's immune memory, and subacute sclerosing panencephalitis (SSPE), a rare but deadly brain disorder.
Even if a child recovers from measles, SSPE can develop seven to 10 years later. 'All of a sudden, it impacts physically and mentally to a vegetative state, and then death. There is no treatment,' Dr. Suttorp explained during an interview at Chinook Hospital.
Infants in the South Zone who are six months of age or older are eligible for an early dose of vaccine because of the severity of the outbreak. Ontario put similar measures in place in the southwestern part of the province, the hotbed of the measles resurgence.
In May, the Alberta government broadened its measles awareness campaign to radio, print and digital platforms, in addition to adding more immunization appointments provincewide.
Paul Parks, an emergency physician and past president of the Alberta Medical Association, said the United Conservative government has done too little, too late. He said the province has 'completely abdicated' its responsibility to protect public health provincewide.
'There's been even some active support and bolstering of misinformation,' said Dr. Parks, referencing a government-commissioned report on the pandemic that recommended the use of COVID-19 vaccines be halted. 'They've courted some of the fringe beliefs out there, which has had a negative effect on public-health education and advocacy.'
In the parking lot of the Taber Health Centre, Rhien DeGagne said he thinks some people in the community are hesitant to get the MMR vaccine because they believe it will cause autism – a myth that has been repeatedly debunked by experts.
'I don't agree with that at all. I just think it's a combination of the junk we put in our system nowadays,' he said.
Mr. DeGagne said he doesn't support the COVID vaccine because of its novelty. But he agrees with more established vaccines, such as those that protect against measles, polio and smallpox, because they have eliminated, or eradicated, the presence of disease.
'Parents these days have to open their eyes a bit,' he said.
His daughter was initially opposed to getting her children vaccinated against measles before they had a tough conversation about it. 'I said, you know, at the end of the day, you have to live with the decision you made. If something bad happens to your child, that's on you.'
Since January, 75 people have been hospitalized for measles in Alberta, 12 of whom have required intensive care.
The conversation about measles often comes back to children.
Outside of Taber's Walmart, Harold Earhart said he isn't worried about measles. He's vaccinated. He points to a young girl holding her mother's hand in the parking lot. 'They are the ones who are going to be going through the pain and suffering.'
What must Canada do to stop the spread of measles? Columnist André Picard spoke with The Decibel about the science and the stakes for your health. Subscribe for more episodes.
With measles making a comeback, doctors race to fight a disease many have only seen in textbooks
Views on measles vaccine differ in Southwestern Ontario after baby's death
Ask a Doctor: Should I get a measles booster?

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