CANCDTGEN 018/24

Canadian Cadet General Order (CANCDTGEN)

Increase in Measles cases in Canada: Health Protection Recommendations for the Canadian Cadet Organizations

References:

1. Statement from the Chief Public Health Officer of Canada on Global Increase in Measles and Risk to Canada, 23 February 2024
2. Measles vaccines: Canadian immunization guide
3. CF Health Services Group Instruction 4030-57, Consent to Medical Treatment (Link accessible only on the DWAN)
4. Provincial and territorial routine and catch-up vaccination schedule for infants and children in Canada
5. CF Health Services Group Standard 6635-18, Immunization Schedules (Link accessible only on the DWAN)

1. The Cadets and Junior Canadian Rangers Group (CJCR Gp) is monitoring the relative increase in measles outbreaks in Canada in recent months due in part to a decline in measles vaccine coverage in school-aged children, as reported by the Chief Public Health Officer of Canada at reference A.
2. Measles is an extremely transmissible disease that can cause serious health complications in susceptible individuals. Those who are not immunized and/or have a weakened immune system are at risk of acquiring measles if exposed. Cases of measles require strict infection control measures, including periods of isolation for those suspected or confirmed to have measles. For example, the exposure of a non-immune individual to a case of measles would result in an extensive period of isolation of up to 21 days post contact.
3. The Commander CJCR Gp, in consultation with the Canadian Armed Forces (CAF) Directorate of Force Health Protection (DFHP) Communicable Disease Control Programme, strongly recommends, but does not require that adult staff, cadets, and JCRs, without medical contraindications, be up to date with the complete measles-containing vaccine or series in accordance with reference B. This would include two doses for children and adolescents under 18 years of age, and one or two doses for adults, depending on their age and additional risk factors. Though there is very strong evidence supporting the use of vaccines to reduce harm and prevent disease burden, CJCR Gp affirms that a person’s consent to receive a medical treatment is voluntary. This principle is stated clearly within CAF medical policy at reference C.
4. The measles vaccine is already recommended to be given in early childhood in every province and territory in Canada as part of routine immunization schedules. For the wider health and safety of all persons, CJCR Gp recommends being immunized against all routine vaccine-preventable illnesses in accordance with provincial/territorial schedules, which can be found at reference D, in addition to being up to date with influenza and COVID-19 vaccines. Measles vaccination status can be confirmed by verifying provincial/territorial Immunization records for the measles or the measles-mumps-rubella (MMR) vaccine through local public health unit or community health care records.
5. For military members, the CAF Directorate of Force Health Protection recommends two doses of a measles vaccine regardless of age as a minimum in accordance with reference E, as does the Canadian Immunization guide at reference B. CAF members who are entitled to the spectrum of care and who require a measles vaccine may obtain vaccines from a supporting CAF Health Services Center.
6. For extended overnight activities which are supported by CAF Health Services, such as Cadet Training Centers (CTCs) or Junior Canadian Rangers Enhanced Training Sessions (JCR ETS), cadets, JCRs, and adult staff attending these activities and who are NOT immunized against measles should advise medical teams at the first opportunity upon arrival at the training site in order to facilitate contingency protective health measures should a measles outbreak occur.
7. General questions regarding vaccinations may be directed to the attention of the Regional Cadet Support Unit Medical Liaison Officers.