Canada lost its measles elimination status on November 10, 2025, after more than 12 months of sustained transmission of the highly contagious and deadly viral disease. The decision by the Pan American Health Organization (PAHO) – which is the regional office for the Americas of the World Health Organization (WHO) – comes as Canada faces a large, multi-jurisdictional outbreak of measles with over 5,200 cases year to date, leading to two deaths.
“Given the sustained downward trend observed in recent weeks, it is likely that the number of susceptible individuals is approaching its lowest point,” says Nicolas Parkinson, a spokesperson with PAHO.
The viral illness is preventable through a highly effective and affordable vaccine that has led to an 88% global drop in measles deaths between 2000 and 2024. Despite this, an estimated 95,000 people die due to measles annually, with most being children under 5 years of age, and remains one of the leading causes of death from vaccine-preventable diseases worldwide.
Public health guidance often cites about 95% vaccination coverage as a threshold to help prevent sustained measles transmission.
Measles elimination is defined as the absence of endemic measles virus transmission (meaning sustained local circulation) in a region or other defined geographical area for more than 12 months. If the virus returns and transmission is sustained continuously for more than a year, the country is no longer considered measles-free.
Measles was eliminated in Canada in 1998, but periodic cases and outbreaks have occurred due to travel-related imports from regions where the virus is circulating. In recent years, measles has resurged in many countries which once eliminated it, as vaccination rates have dropped.
“The outbreak is mainly due to very low vaccine coverage in certain communities spread across the country,” Anna Maddison, a spokesperson for Health Canada and the Public Health Agency of Canada (PHAC) told Global Citizen.
Mennonite communities in both Ontario and Alberta — provinces which have the most measles cases in Canada — have been at the centre of the government’s efforts to curb outbreaks due to how rapidly the virus spread in these communities. Due to cultural reasons, some traditional Mennonites may opt out of vaccinations. According to PHAC, the majority of people infected by measles are not vaccinated.
Rising Measles Outbreaks
According to the WHO, 59 countries reported large or disruptive measles outbreaks in 2024, which is nearly triple the number of outbreaks reported in 2021. This represents the highest number of outbreaks since the COVID-19 pandemic.
Over the last 5-year period, measles cases increased by 86% in the WHO Eastern Mediterranean Region, 47% in the European Region, and 42% in the South-East Asia Region compared with 2019.
Notably, Africa experienced a 40% decline in measles cases — but this progress could be affected.Countries in the Global South face increased importation risk, alongside potential strains on global immunization programs and diversion of resources as governments will need to allocate much-needed resources to outbreak measures.
Ascountries in the Global South observe the trend of rising measles outbreaks in developed countries, Parkinson says it’s important to maintain a 95% vaccination coverage rate and invest in surveillance and rapid response, in order to detect and contain outbreaks early.“
COVID-19 Impact on Routine Immunization
“Canada’s outbreak isn’t isolated. It’s part of a three-country outbreak, and Canada happened to detect and report cases a month earlier than the other countries, but it’s not an isolated situation,” says Kathryn H. Jacobsen, a global health epidemiologist and professor at the University of Richmond in Virginia.
If transmission continues in the U.S. and Mexico until February 1, 2026, both countries will lose their measles elimination status, marking over 12 months of sustained outbreaks. In an interview with Global Citizen, PAHO stated both countries are at “high risk” of losing their status. Currently, there are over 1,900 measles cases in the U.S. and over 3,700 cases in Mexico.
In some ways, the current measles outbreaks are related to the COVID-19 pandemic, she explains. During the pandemic, with health systems experiencing additional strain, many children did not receive their routine vaccinations on time. Jacobsen says some children still aren’t up to date on their vaccinations, which “creates an environment where measles can spread even among parents who want to vaccinate their kids on time.”
In addition, Jacobsen says that the way vaccines were rolled out during the pandemic – notably the accelerated timeframe to develop the vaccines – led to widespread hesitancy regarding vaccine safety. These doubts have persisted despite the health community’s efforts to educate the public on how existing mRNA technology led to developing COVID-19 vaccines at record speed.
Declining Confidence in Vaccines
“The resurgence of vaccine-preventable diseases in high-income countries signals a worrying decline in vaccine confidence,” says Parkinson. PAHO is urging developed countries to maintain high vaccine coverage – but this is a challenging task, given a landscape of eroding trust and misinformation.
“Trust of government, trust of science, and trust of medicine [is] really hard to build up — especially in the social media era where the messages that people receive can be so insular and can [reflect an] echo chamber,” Jacobsen says.
The Canadian government recognizes that [a lack of] confidence in vaccines and exposure to misinformation or disinformation has contributed to vaccination rates. Maddison reflects on government data which shows an increase in parents and guardians believing that “alternative practices such as homeopathy or naturopathy, healthy nutrition and hygiene can replace the need for vaccination.”
She says PHAC is focused on improving vaccination coverage, sharing knowledge, and countering misinformation and disinformation. The country must demonstrate that transmission of this particular strain is stopped for at least 12 consecutive months before its status can be reinstated. While the outbreak has slowed in recent weeks and some Canadian provinces have declared the end of their measles outbreak, the Public Health Agency of Canada did not share projections on when they aim to have their measles elimination status reinstated.
Historically, countries in the Americas which have lost their measles-elimination status have taken more than 24 months after the outbreak interruption to regain their status, states PAHO.
The soonest Canada can reclaim its status is November 2027, since PAHO meets annually in November, but even that may not be within reach, according to Jacobsen. Since the U.S. is experiencing measles outbreaks, the virus could be reintroduced to Canada “fairly easily” due to cross-border travel, she tells Global Citizen.