Should vaccines be mandatory for school-aged children?

Infectious-disease experts say it’s time for all provinces to introduce vaccine requirements as a prerequisite for school attendance, as diseases such as measles make a comeback and put public health at risk.

The issue is in the spotlight this week as New Brunswick’s government holds hearings into a proposed change that would end non-medical exemptions for student vaccinations. While the province already requires most students to be vaccinated in order to attend school, officials say the law hasn’t always been enforced.

After a measles outbreak in the province earlier this year, the government decided to toughen the law by proposing an amendment that would put an end to religious or philosophical vaccine exemptions for students. If the law passes, it would give New Brunswick the strictest vaccination law in Canada.

During three days of hearings this week, a government committee heard from a variety of public-health experts, as well as anti-vaccination advocates, who argued both for and against the new law. Dominic Cardy, the province’s Education Minister, told the committee that there are no two sides to this issue and that anti-vaccination advocates put the public’s health at risk.

The committee will now write a report based on the hearings, after which point the legislature will vote on the matter. The exact timetable for the vote is unclear, but if it passes, it would take effect in 2021.

B.C. is also introducing vaccination requirements for schools this September, after a major measles outbreak in the province early in the year. The program will allow non-medical exemptions.

Ontario is the only other province that requires students to have certain vaccinations in order to attend school, although the province does allow for religious or philosophical exemptions.

“It’s time. Canada has to step up,” said Natasha Crowcroft, director of the Centre for Vaccine Preventable Diseases at the University of Toronto.

A surge in measles cases worldwide is prompting public-health officials around the world to look at new ways to stop transmission. So far in Canada this year, there have been 88 cases of measles reported, compared with just 20 cases at the same time last year. The World Health Organization reported Thursday that Britain, the Czech Republic, Greece and Albania can no longer be considered “measles free,” which means the disease may be actively circulating in those countries again, after having been eliminated.

Lower vaccination rates, fuelled by anti-vaccination sentiments that are often spread on social media, are behind much of the surge.

Joanne Langley, professor of pediatrics at Dalhousie University and head of the infectious-diseases division at the IWK Health Centre in Halifax, said New Brunswick’s move to end non-medical exemptions is a good example of public-health leadership that will likely push other provinces to act.

Several provinces contacted, including Alberta, Ontario, Nova Scotia and Manitoba, said they are not currently looking at introducing or changing vaccination requirements for students.

Dr. Crowcroft said legislation that requires immunization in order for students to attend school makes a lot of sense, particularly in light of the jump in measles cases. But, like some other public-health experts, she has reservations about going as far as New Brunswick and doing away with non-medical exemptions. The concern is that mandatory vaccinations could cause parents with anti-vaccination beliefs to grow even more distrustful of health officials and the government.

“I have some concerns about going that far,” Dr. Crowcroft said, referring to New Brunswick’s proposal. “I’m going to watch with interest.”

But there are other ways to help improve vaccination rates. For instance, the WHO has called on social-media companies to step up efforts to stop the spread of false information about vaccines. Some have responded. Earlier this week, Pinterest announced it would block all anti-vaccination search results and instead show users information from reliable public-health sources.

Tim Caulfield, Canada Research Chair in health law and policy at the University of Alberta, said despite some inroads, there is much more social-media companies can do to stamp out false information about vaccines.