Vaccines were once mandatory for Manitoba students. Does the measles outbreak warrant a return?

Linda Ross wonders if Manitoba’s measles outbreak would have spiralled to hundreds of cases if school divisions had pushed for mandatory vaccination against the illness for students almost a decade ago.

“I don’t foretell the future, but I do have to admit that thought has crossed my mind from time to time,” Ross, a Brandon School Division trustee, told CBC. 

In 2018, her division asked the Manitoba School Boards Association to formally lobby the province to make vaccination for several illnesses, including measles, a requirement for students.

The proposal was defeated, with school boards voting overwhelmingly against it. Parental rights were the main argument brought up, Ross said.

But as the province grapples with a number of measles infections not seen in years, she would like immunization to be a requirement to attend classes.

“If you don’t have your children vaccinated and there is no pressing medical reason for them not to be vaccinated, the question is then, is it fair to place those children in public schools where you now put other people at risk?” said Ross. 

The 2018 proposal to the school boards association recommended mandatory inoculation for nine illnesses, with an exemption for students who had an allergy or other medical condition.

School officials were concerned about dropping immunization rates as more cases of preventable illnesses were reported, said Ross, who was chair of the Brandon School Division at the time.

“Schools are a wonderful breeding ground for diseases to be transmitted,” she said. “You have so many people in close proximity to each other for the majority of the day.… It’s really problematic.” 

‘It’s just so unnecessary’

Ross is concerned about herd immunity dropping low enough that diseases would start to circulate again years after eradication.

“That’s what’s happening right now,” she said. “It’s just really frightening to see diseases that we have eradicated coming back.”

While other provinces have managed to tame their measles outbreaks in recent months, or declare them over, the number of cases is still growing in Manitoba.

With only half the data in, Manitoba has already recorded more measles cases in February than in any single month since the outbreak began over a year ago.

Since February 2025, there have been 27 hospitalizations for measles in Manitoba, including 18 children under the age of 10. Two people have been admitted to the ICU.

Of the 520 measles cases reported in Manitoba to date, 85 per cent involved people with no doses of the measles vaccine, the province says. Vaccination status was unknown for another five per cent.

“It does make me angry,” said Ross. “It’s just so unnecessary. We’ve made such progress and now we’re going backwards.”

The measles virus is “not just going to be contained to those who chose to not get vaccinated,” she said.  

“It’s going to certainly spread [to] very young children and people who are vulnerable for other medical reasons. It’s very concerning.”  

She thinks public health authorities have done as much as they can to prevent the spread of measles, and there are few alternatives left to create herd immunity. 

“Short of making vaccination mandatory with medical exceptions, I don’t know what else we can do.”

Tipping point

Dr. Gerald Evans, an infectious disease specialist physician at Queen’s University in Kingston, Ont., said a number of studies indicate mandatory vaccination for measles has helped reduce the number of cases. 

It’s particularly effective among children, because measles is highly contagious and kids in school tend to spend more time in close proximity with others than adults do, said Evans.

“Adults socialize, but not to the same degree that small children and adolescents do. That allows for this transmission to occur quite easily.”

First vaccine doses and boosters are considerably more effective for younger people, Evans said. 

The consequences of having measles are also far more serious in children.

And for children who can’t get vaccinated because of medical conditions, the only protection against measles is herd immunity — which underscores the importance of high immunization rates in school settings, said Evans.

While Evans said there would be pushback to making vaccines mandatory for students, he argues we have reached a tipping point. 

Doctors are worried about dropping immunization rates amid misinformation around vaccines on social media, which favours the return of other preventable diseases after years without cases, he said.

While Canada is now considered free of illnesses like polio, they continue to live in the environment.

Any return of such a disease would “result in a huge challenge for the health-care system … [and] significant mortality and morbidity amongst these people who are not vaccinated,” Evans said.

Manitoba has relied on health-care providers to encourage vaccination, but Evans is not sure that strategy is effective if those who are unvaccinated trust online content more than doctors. 

“The mandates at least will help to overcome and push back against this sort of tidal wave of disinformation,” he said. 

Manitoba not considering mandates

But making vaccines mandatory is not a decision that can be taken lightly, said Michelle Driedger, a University of Manitoba professor who specializes in community health.

She pointed to vaccine mandates during the COVID-19 pandemic, which drew mixed responses, even from people who are generally in favour of immunization.

“Is part of what we’re seeing with [the current] uptake of routine immunizations an artifact of that?” she said. “Nobody can fully know, but it may be having a bit of an influence.”

WATCH | Measles outbreak traced back to Ag Days event in Brandon:

Measles outbreak traced back to Ag Days in Brandon

Doctors and daycare operators are bracing for more cases of the measles in Brandon. Provincewide, the number of measles cases is the highest it’s been in decades, with more than 30 new cases related to Ag Days. And now, Manitoba’s top doctor has approved vaccines for infants.

Vaccine mandates can be recommended by public health, but imposing them is ultimately a decision of the government, Driedger said.

Dr. Brent Roussin, Manitoba’s chief public health officer, said at a news conference last week that Manitoba is not considering mandating measles vaccines at this point, but public health will continue relying on building trust between health-care workers and those living in high-risk areas.

Manitoba Health Minister Uzoma Asagwara said the province “follows the guidance of Manitoba’s public health officials, who … provide evidence-based recommendations to inform our response.”

Vaccination remains one of the most effective tools for preventing serious illness, Asagwara said, and the province is trying to increase vaccination rates by working directly with communities to make information and doses available.

The minister of education told CBC questions about immunization should be directed to Public Health.

Vaccines required in other provinces

New Brunswick and Ontario already require children to be immunized against measles — and a number of other illnesses — in order to attend school. Exemptions are given in both provinces for some reasons.

In New Brunswick, parents can opt not to have their children vaccinated, but the student might be excluded from a school or day care in the event of an illness outbreak.

In Ontario, parents who want an exemption on religious or conscientious grounds must first attend an education session to answer questions about vaccination.

Ontario declared its measles outbreak over in October.

A review released last month into the handling that outbreak found more than 40 per cent of Ontario’s public health units cited the enforcement of vaccine policies for students as one of the most effective tools to mitigate the outbreak.

Brandon Trask, a University of Manitoba associate law professor, said in theory, legislation to mandate vaccination in Manitoba “could actually move fairly quickly if there were the political will for it.”

But Trask, who said he’s in favour of vaccination, said the political implications and legal complexities surrounding such rules are “probably the reason why only a few provinces in Canada have similar legislation.” 

Manitoba once required students to be vaccinated under the Public Schools Act, but that was repealed through an amendment in 1999, Trask said. 

It is possible for the province to craft similar legislation again, but there could be some legal risks depending on how the rules are set out, Trask said.

Those could be reduced if the province were to allow exemptions for medical, religious and conscientious reasons, he said.

Without exemptions, there could be legal arguments about Charter of Rights and Freedoms infringements, but Section 1 of the Charter states that its provisions are subject to reasonable limits.

Trask said in order to use that section to defend a vaccine mandate against a legal challenge, the province would need to show there were no other lesser measures that could have achieved the same goal.

“That could get complicated,” he said. 

But whether it’s required or not, Ross, the Brandon School Division Trustee, says vaccination is about the responsibility a person living in a community has to protect others.

“[People] need to be concerned not only about their own well-being, but the well-being of others,” she said.