Joy SpearChief-Morris, 31, contracted measles in August even though she had been vaccinated for the disease as a child.Fred Lum/the Globe and Mail
It started with a small red patch above one eye.
I awoke one Saturday morning in August feeling incredibly hot. By Sunday, a painful, itchy rash covered every inch of me, from my face down to my toes; even my palms were affected. My skin hurt so much I had to lie naked on a bedsheet for some relief. I also had a fever, chills, a cough and a headache.
By Monday, it was time to seek medical help.
After waiting 12 hours in an Ottawa emergency room, hoping to learn the cause of what I believed to be a severe allergic reaction, a doctor asked me the routine questions: Are you on any medication? Have you travelled recently?
Ms. SpearChief-Morris says she experienced a painful, itchy rash from her face to her toes.Joy SpearChief-Morris/Supplied
I had spent a few weeks in Alberta with my family in July, I answered. The doctor stopped in her tracks. Had I come into contact with measles?
No, I told her. Besides, I couldn’t have measles. I’m fully vaccinated.
Yet within 24 hours, a nasopharyngeal swab and urine test confirmed I was Ottawa’s fifth confirmed case of the disease this year.
As an otherwise healthy 31-year-old, the news came as a shock. What I didn’t know then was that a prescription medication I was taking for eczema had possibly caused my immune system to become vulnerable to measles.
Breakthrough infections such as mine are exceptionally rare, but the possibility of them occurring is increasing as vaccine rates decline. Herd immunity – which requires about 95 per cent of the population to be vaccinated – is the best protection against measles circulating in a community. When fewer people get the vaccine, it puts immunocompromised individuals at risk, whether they realize they’re vulnerable or not.
Nearly 5,000 measles cases have been reported in Canada so far in 2025; in 2023, only 11 were recorded. All of us need to think more about how we view our own immunity not only for ourselves, but for our communities.
Once my diagnosis was confirmed, I was quickly contacted by Ottawa Public Health, which proceeded to trace my time in Alberta – where there had been an active measles outbreak – to try and locate the source of my infection. They also tracked where I had been and who I had seen during my transmission window.
Measles is highly contagious. It can incubate in people for up to 21 days but can only be spread four days before and after the rash appears. Transmission of the virus, which can live on surfaces for up to two hours, can happen when a carrier coughs or sneezes. People contract the disease by inhaling the virus or touching an infected surface and then their eyes, nose or mouth.
It can cause severe complications, including pneumonia, encephalitis (a swelling of the brain that can cause deafness and intellectual disabilities in children) and even death.
How the measles made its way back to Canada
Ms. SpearChief-Morris’s arm with the measles rash in August.Joy SpearChief-Morris/Supplied
After a public-health notice alerting people of potential contact with Ottawa’s fifth confirmed case was published citywide, Redditers speculated about how I had contracted the disease – and whether I was vaccinated. Although my identity remained anonymous, I wanted to defend myself to these strangers.
Only 7 per cent of this year’s Canadian cases have been in vaccinated individuals. This is because the measles, mumps and rubella (MMR) vaccine routinely given in early childhood provides nearly 100-per-cent protection after two doses, according to Health Canada. It remains the most effective way to protect against the disease.
“But nothing is 100 per cent, and rarely this does happen,” said Shelly Bolotin, an associate professor at the Dalla Lana School of Public Health and the director of the Centre for Vaccine Preventable Diseases at the University of Toronto.
I’ve received two doses of the MMR vaccine, first around age 1, then again at 4. The answer to how I became sick may lie in what’s called secondary vaccine failure, which happens when a vaccinated person’s immunity decreases over time until they are no longer protected. This can take place when an immune system doesn’t receive the “boost” it needs from encountering the virus.
“There is evidence to suggest that in the absence of these boosts, the immune response that is induced by the vaccine isn’t lasting as long,” said Janna Shapiro, a postdoctoral fellow at the Centre for Vaccine Preventable Diseases in Toronto. That means even those who were fully vaccinated as kids can lose their immunity.
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Individuals who are immunocompromised or people who are on immunosuppressive medications, can also experience vaccine failure.
A year ago, I started a biologic medication for a severe form of atopic dermatitis, commonly known as eczema. Biologics work by targeting specific parts of the immune system to stop the autoimmune or autoinflammatory response caused by a particular disease. But Ms. Shapiro has been studying how some medications, including biologics, can interfere with the immunity response given by vaccines, which is known as vaccine memory.
While my medication is not supposed to broadly suppress my immune system, it’s possible it made me more susceptible to measles – something my dermatologist could not have predicted.
More than a month since having measles, I am considered fully recovered, although my skin is still healing from the severity of the rash. (For a time, I was too embarrassed to be seen in public with my face showing the lingering marks of the illness.) According to my doctors, I am not expected to have any long-term side effects.
Knowing what I know now, I take my medications more seriously and am more anxious to get my flu and COVID-19 vaccines this season. Despite experiencing vaccine failure, being vaccinated did help protect me against the harsher effects of measles.
I also realized that protecting myself and those around me isn’t a job I can do alone.
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In the age of COVID-19, more of us have become familiar with vaccine boosters. But there is no booster for MMR and MMRV (a newer formula that includes protection against varicella or chickenpox) vaccines, given the effectiveness of the original two doses.
And for those who do have compromised immune systems, or those taking autoimmune or autoinflammatory medications, the vaccine is not recommended because of its status as a “live vaccine” that contains a fragment of the actual virus.
Broad population vaccine coverage is therefore necessary to avoid outbreaks and protect those who can’t be immunized, Prof. Bolotin said.
If my experience with measles has taught me anything, it’s that being vaccinated is as much about protecting those we love who are vulnerable as it is about protecting ourselves – and that, in many ways, we seem to have forgotten that.
