Measles WAS and IS STILL a big deal

Prior to the introduction of vaccines, there were on average 45,000 measles cases each year in Canada (1-3). Contrary to some claims, measles-related deaths were pretty common in the early 1900s, killing hundreds each year. In 1926, Canada saw its highest death toll ever reported, with nearly 900 deaths (21 deaths per 1,000 cases) (3-6).

While death numbers had declined into the double digits by the late 1950s – largely due to improvements in medical care, nutrition, and living conditions – measles itself remained widespread. Case numbers did not significantly decrease, and annual deaths didn’t drop below 10 until after vaccination began (3,5,7-9).

Although most people survived the infection, measles was not benign and serious complications were still common. About 1 in 10 Canadians developed secondary infections like bronchopneumonia, and roughly 1 in 1,000 developed brain inflammation which can lead to coma, seizures, permanent neurologic damage, and death (5-7,10). 

The first measles-containing vaccine was approved in Canada in 1963 and introduced into routine immunization programs across the country early in the 1970s (6). In the decade before routine vaccination, Canada saw an average of 358 cases per 100,000 people. By the early 1990s, that rate had fallen to around 18 per 100,000 – a drop of 95% (3-5,10,11). But because local transmission continued despite one-dose coverage, a second dose was added to routine immunization programs by 1997 to strengthen people’s protection (3,4,6,10,12,13). By 1998, the virus no longer spread locally and cases only appeared when brought in from outside the country (14,15). But cases and deaths remained high worldwide (16). In 2019, only 113 cases were reported in Canada – an incidence rate of just 0.3 per 100,000 people (17).

So while measles wasn’t always fatal, it was far from harmless. It may not have been widely talked about back in the day because deaths had already declined, not because it wasn’t serious. Vaccination made a dramatic difference in both preventing illness and avoiding its serious consequences.