By John Mariani, CNN • Updated 18th March 2020
TORONTO (CNN) — Toronto is stepping up efforts to vaccinate all residents against rubella, the German birth defect that can be fatal if left untreated.
Most parents have opted out of the flu shot or to have only one, two or three doses instead of the recommended three, the city’s child advocacy bureau said Friday.
Toronto, Canada’s largest city, has had a high rate of rubella (COv-1), which was found in just 7% of area children between the ages of 2 and 7 years in 2015, the last time data was available.
One in 80 children in Toronto gets rubella each year, the city’s child advocacy bureau said. The infection can cause severe birth defects in a small proportion of people and lead to medical complications.
“Vaccinating is the only way to protect a child,” Ben Chang, a first-grade teacher, said after he got his two children vaccinated Friday with the help of the Toronto group Let’s Encourage.
“One door is closed, and the other door is opening,” he said.
His 4-year-old daughter has short leg syndrome that prevents her from getting up straight, and his 2-year-old son has a mild case of epilepsy.
“Vaccination helps my daughter get up and move in the right direction. And now my son will also be protected,” Chang said.
The city’s child advocacy bureau is leading the City First campaign that has started Sunday, encouraging all residents to see a doctor and get a rubella vaccination from the City Health Department.
Toronto is seeking a screening threshold of community to see if they can vaccinate for rubella before the vaccine becomes mandatory. If it turns out they don’t meet the screening threshold, Toronto will ask the provinces of Ontario and Alberta to expand immunization for rubella to residents, and possibly to those who are young for the age of infection.
Rudy Persaud, an emergency room physician, said the target population should be the most vulnerable: pregnant women and children under 5 years of age. He explained rubella is commonly transmitted through kissing, hugging and casual contact and can be transmitted at any time.
Persaud, who was one of the doctors at Friday’s campaign event, pointed out that the Canadian measles cases were reported in women who hadn’t been vaccinated and that it is possible the virus is mixing up with the country’s large population of people who have been infected with measles in the past.
“They’re high risk now,” he said.
The Canadian province of Alberta announced in January that it would consider requiring a mandatory rubella vaccine for women and newborns. A spokesman for Ontario Premier Doug Ford told CNN Friday that the province hadn’t decided if it would make the vaccine mandatory.
The federal government previously announced in late 2016 that children can get a $14 vaccination for rubella, but the vaccine, COv-19, was available only at one hospital in Canada, according to the World Health Organization.
“There was an outbreak here in 2012,” said Isabelle Saget, director of the child advocacy bureau, who was a neurologist at the time of the outbreak. “We could not get a vaccine because only one was available.”
Rubella is a common cause of birth defects and measles, which caused the greatest number of childhood deaths in Canada between 1955 and 2010, according to the WHO. Children can contract rubella through non-sexually transmitted route, such as sharing cups or spoons. It does not spread easily and starts causing complications after four days, the WHO said.
Ottawa stopped offering the rubella vaccine as a requirement for school entrance in December 2016 after realizing that the majority of children who wanted it had already been vaccinated for measles, the city’s child advocacy bureau said.