Measles Update
Manitoba is enduring its worst measles outbreak in decades. We are closely monitoring provincial updates to ensure you have the information you and your patients need to navigate the outbreak.
A Quick Reference Guide provided by Manitoba Public Health aims to support clinicians in recognizing and responding to measles cases and contacts.
Manitoba Public Health continues to monitor for measles cases and exposures.
View the exposure locations in Manitoba.
Active screening for measles-related symptoms are in effect for visitors to HSC Women’s Hospital, Neonatal Intensive Care Unit (NICU), Children’s Hospital, and Ambulatory Care Clinics. Entry may be restricted if there is a risk of measles. Screening may be expanded to other areas of the hospital as needed. You can read more about this change here.
Track cases across Canada on the federal government’s measles and rubella weekly monitoring report.
Vaccine Eligibility
As the number of cases increases, so too have provincial requirements for vaccine eligibility.
As of May 14th, children aged 6 to under 12 months who meet the following criteria are now able to receive one dose of MMR in addition to the routine schedule offered at 12 months and 4 — 6 years IF:
They reside in Southern Health-Santé Sud (SH-SS) or Interlake Eastern (IERHA), OR
They travel regularly to AND have close contact with residents of SH-SS or IERHA
The province has also expanded vaccine eligibility to include children aged six months to under 12 months who have been evacuated due to the fires.
Previously, eligibility was limited to 12 months or older with few exceptions.
Here is a list of resources to keep in mind as the measles outbreak continues:
Measles (rubeola) communicable disease protocol.
Manitoba Public Health updates its tally on Wednesdays. Information can be found here.
Information about what to do if you suspect a patient has measles can be found here.
Tips for Talking to Patients
Health care providers are asked to continue recommending measles vaccinations to patients. We know this can be increasingly challenging at a time when health misinformation is rapidly on the rise.
How you can help: Keep the conversations going.
- Patient views on vaccines are not black and white — it’s not simply for or against. Sometimes called the“moveable middle,” patients will often seek more information from trusted sources – including physicians – to feel more confident about their view.
- The Communicator Matters. Physicians are the most trusted profession or institution when it comes to vaccines. Your advice will often help patients make a final decision about getting immunized.
- The Message Matters. Patients favour a clear and strong recommendation from a physician. This can be accompanied by ensuring patients are aware of the risks of immunization, as well as the risks of the disease which are nearly always greater than the limited risks posed by the vaccine.
- The Approach Matters. No one likes to hear they are wrong, even if they have misinformation they found online. When information is but a‘mouse click’ away, it is very easy to find confusing and conflicting information. Consider using a motivational interviewing approach with patients who may be hesitant or undecided about the vaccines. This includes:
- Inquire: What have you heard?
- Affirm: Let the patient know they have been heard
- Correct, briefly, but avoid“that’s not true” statements
- Redirect the discussion to the benefits.
- Consider each patient individually in how you respond to hesitancy about the vaccine.
- Use an empathetic and affirming approach. Many patients will already have a“vaccine story” formed from what they’ve heard, and sometimes this includes misinformation. Show you understand their concern, and pivot to offering new information responsive to their concern in a supportive manner that is consistent with your clinical judgement.“That’s a valid concern” (if you agree) or“I understand why you’re worried about that.”
- Ensure balanced and informed consent. Like any medical treatment, a vaccine requires informed consent from the patient. This should include a discussion not only about the risks from the vaccine, but the risks of contracting measles.
- Provide a clear recommendation to get the vaccine, if medically appropriate.“For what it’s worth, I would recommend the vaccine for you.” You can reassure patients that you have received the vaccine yourself.
- Continue the Conversation. A“no” today may not be a no in the future. Continue the discussion during your next encounter with the patient, continuing to offer supportive information and a clear recommendation.
Adapted from Doctors Manitoba’s 2021 Guide to Responding to Vaccine Hesitancy