Whooping cough! Mumps! The names seem archaic, the afflictions of suffering youngsters in some old-time children's book. Yet here we are, experiencing regular outbreaks of easily preventable diseases, so it should come as no surprise that Canada's vaccination rates are unacceptable.
A quick recap: The aim of mass vaccinations is "herd immunity," ensuring that a base level of the population is resistant to a disease in order to contain its spread.
Measles, for example, has a herd immunity threshold of about 95 per cent. The exact number depends on a variety of factors, but doctors begin to lose confidence in their ability to control the measles virus when 6 per cent of people dismiss or reject the needle.
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It should be an easy target to hit: There's been a vaccination against measles since the early 1960s and the combined measles, mumps, rubella (MMR) shot has been available for 46 years. But Statistics Canada released its new childhood immunization coverage report last week, and as of 2015, just 89 per cent of two-year-olds were up to date on their MMR shot.
Only 77 per cent of two year olds were up to date for pertussis, otherwise known as whooping cough, which has a threshold of about 92 per cent.
I'm not here to debate a routinely debunked, 20-year-old report that questioned the value of these medicines. There's no time: Whooping cough hit Manitoba in January, Toronto saw mumps in February and Nova Scotia dealt with measles in the spring.
I have a beloved cousin, 31, undergoing chemotherapy after a double mastectomy. Two of her children aren't yet four and so haven't completed their immunization schedules yet.
This isn't a joke: Certain people truly can't get vaccinated. So, with vaccinations down in rich countries, the issue has become what to do with those who refuse their responsibilities.
Which brings us to France, which has had enough of school children dying of measles. There's a measles outbreak across Europe, and between 2008 and 2016, the country saw 24,000 cases, including 10 childhood fatalities, as the MMR vaccination rate dropped to 75 per cent.
This past Tuesday, Prime Minister Éduoard Philippe announced that eight vaccines, including MMR, will become mandatory for public-school students as of 2018. That makes a total of 11, since protection against diphtheria, polio and tetanus were already required.
No vaccines are mandatory anywhere in Canada, though the issue comes up regularly. Last year, both the Edmonton Catholic school board and a Fort McMurray father of a toddler with brain cancer requested that the Alberta government consider the matter, which it rejected even as it acknowledged that vaccination rates are lower than acceptable.
Ontario and New Brunswick require proof of immunizations before school enrolment, but both provinces allow certain exceptions. In May, the Ontario government passed a bill that will require abstaining parents to undergo mandatory education on the science of immunization, though it's not yet determined when it will come into effect.
The bill was introduced by Ontario Minister of Health Eric Hoskins in spring of 2016, at a time when Whistler, B.C., was undergoing a mumps outbreak. In an interview in 2016, British Columbia's provincial health officer, Perry Kendall, expressed discomfort with the idea of mandatory education, let alone compulsory needles.
Opining that a "carrot was better than a stick," Dr. Kendall said that any sort of pressure might solidify the fears of people wary of vaccines. He also said that inoculations "are a victim of their own success": Because herd immunity was so reliable for so long, we've become lax about the need to get shots and the risks of these diseases.
I think that statement actually speaks to the benefit of giving people a little prod: My own diligence about the flu shot came after realizing that my laziness put others at risk. I'd like to believe that most people are just busy, not negligent, and some mild encouragement would go a long way.
As for the others, government-mandated needles would definitely be drastic, as would keeping students out of school because of their parents' stubbornness. In this age of redebating basic science, it's a less medieval choice than watching a child die of whooping cough.
Eds note: An earlier version of this column said the combined Measles, Mumps, Rubella vaccine has been available for 64 years. In fact, the solo measles vaccine has been available since the early 1960s, while the MMR vaccine has been available since 1975.