In the spring of 2019, 11 people connected to Kennebecasis Valley High School, located near Saint John, caught the measles, part of an outbreak that saw a 12th local person infected before it was declared over in July. Students with compromised immune systems – such as Marissa Gootjes, who was being treated for brain cancer at that time – had to stay home for the last month of school and avoid public places related to the outbreak.
It was big news in the area, and it made Paul McLellan wonder what a measles outbreak would look like at the nearby private co-educational boarding school he leads. His conclusion: it wouldn’t be good.
McLellan is head of Rothesay Netherwood School in Rothesay, N.B., just 10 minutes by car from Quispamsis, N.B., where the outbreak was centred. He says the measles cases – and the subsequent push by the province to change the laws around non-medical vaccine exemptions – prompted the school to take stock of its students’ vaccinations.
“We got to do some good inventory,” he says, noting the school currently has about four people in its student body of 285 who have not been fully vaccinated. This brings the total to much more than 95 per cent, the threshold for herd immunity – the point at which a large enough proportion of a group is immune to a disease that the unvaccinated are protected from it. Of that group, only one is a non-medical exemption.
“We have a boarding community, so we can’t have a big outbreak here,” McLellan says. “We vet those boarding kids really well, so we know they’re okay. We need to do the same for the community, and the same for any exchange student.”
The threat of outbreaks affects private schools across the country – especially religious or progressive schools, which often have lower vaccination rates than public schools, according to a 2016 analysis by The Hamilton Spectator. And while changes in provincial guidelines look promising for stopping the spread of disease, some schools, such as Rothesay Netherwood, are taking extra care to ensure their students are vaccinated.
The first case in the New Brunswick outbreak was diagnosed on April 26, in someone who had recently returned from a trip to Europe. In June, the province’s Education Minister, Dominic Cardy, introduced Bill 39, which would require all students attending public schools and licensed child-care facilities to be vaccinated for several diseases, unless they have a medical exemption. Starting in September, 2021, the bill would force unimmunized students to be home-schooled or attend a private school.
If passed, the changes would give New Brunswick the most stringent immunization policies of any province. Currently, New Brunswick and Ontario are the only provinces that track student immunizations, requiring parents to officially opt out from vaccinating their children for personal or medical reasons. A similar system will come into play this September in British Columbia, which saw a measles outbreak in early 2019, with 31 confirmed cases in the province so far this year. Health Minister Adrian Dix says both public and private schools in B.C. will require proof of immunization against measles and other diseases by this fall.
Several American states, including California, Maine, Mississippi, New York and West Virginia have also banned non-medical exemptions.
While New Brunswick has relatively few private schools, McLellan says it’s unlikely Rothesay Netherwood will see an increase in unvaccinated students leaving the public system.
“It wouldn’t be a group of kids we’re looking for,” he says. Rather, McLellan says the school aims to avoid “headstrong parents who don’t want vaccinations.”
“We need to be pragmatic. Look at how much money goes into [public] health,” McLellan says. “We need to do our best to follow along.”
McLellan says Rothesay Netherwood will continue to allow students with non-medical reasons for being unvaccinated to attend the school, but would not let them stay on the premises if an outbreak of a vaccine-preventable illness occurred.
Mike Dickinson, a Miramachi, N.B., pediatrician and former president of the Canadian Paediatric Society, says there are other proven ways to prevent the spread of illness, such as isolating someone who has a fever or is sick, handwashing frequently and wearing a surgical mask. But, he says, their effectiveness is limited when it comes to “really contagious” pathogens, such as the measles.
“You need just a drop of measles, and you can have a massive outbreak. It’s tough to avoid the virus,” he says, noting that since the outbreak in Saint John, he’s seen a wave of people in his office to get caught up on vaccines. “Seeing what can happen if you aren’t vaccinated has definitely motivated a lot of people.”