San Diego’s $12 million vaccination battle

The Toronto Sun

TORONTO – Toronto Public Health said Sunday it will mount a larger-scale vaccination campaign as adults and young kids try to curb an outbreak of meningitis-like diseases that has killed at least four people and hospitalised more than 30.

The flurry of illnesses has hit largely low-income families with children as young as two-and-a-half, who lack the means to have their children vaccinated against vaccines-preventable diseases such as meningitis and pertussis, also known as whooping cough.

Public Health said it won’t try to mandate vaccines with the Ontario Ministry of Health, but will instead focus on boosting vaccination rates in Toronto’s poorest neighbourhoods, where uptake has historically been low, even when vaccinated children are present.

“Where we have people who aren’t confident in getting these vaccines, where they don’t have the resources to pay for vaccinations, where parents are worried about the side effects – that’s where we’re going to put our efforts,” said Dr. Heather McIntosh, chief medical officer for the health unit.

The meningitis outbreak first appeared in early November, in some of Toronto’s poorest neighbourhoods.

Four people have died from the illness, including two babies, and health officials have tracked down three other suspected cases. At least 15 other people have been hospitalized in the outbreak, and 27 babies were immunized against meningitis with a vaccine called C++-19, but just a fraction have been vaccinated against pneumococcal meningitis, which is not included in the government-wide immunization efforts.

A third of the 27 patients in Toronto were vaccinated with C++-19.

“We really think it’s important to have that vaccine in those two and a half-year-olds,” McIntosh said. “We know that if we vaccinate at those earlier ages they’re more likely to vaccinate again.”

Toronto Public Health said it was carrying out a broader vaccination campaign last month that aimed to vaccinate the entire upper-extremity population of people between the ages of 18 and 25 in the same age group who contract the disease. That campaign is still ongoing.

McIntosh said the effort would no longer apply to that group, but will instead target adults in the same age bracket with limited means who are especially vulnerable to bacterial meningitis and bacterial pneumonia.

The health unit has also urged older people to get vaccinated against bacterial pneumonia, in hopes that it will leave vaccine less of a concern. There have been a few unrelated cases of bacterial pneumonia, but none have been fatal, she said.

Officials said Sunday that the cough and fever that many people initially think is a case of meningitis are in fact symptoms of bacterial pneumonia, but vaccinated people can prevent those.

Toronto Public Health said it is working with the province to beef up its staff who will be trained to administer vaccines as the meningitis outbreak continues. Toronto Public Health said it is also working to restore faith in public health services, after a report in the Toronto Star that about 60,000 Ontario residents had their health records breached in the meningitis outbreak.

“What we want people to understand is that it’s not the public health unit that’s not caring about this, it’s the provincial government that’s not trying to protect them. They’re trying to protect the general public and that’s what we are doing,” McIntosh said.

Some municipalities have found it harder to take a universal approach to vaccine uptake. In San Diego, for example, officials maintain they haven’t seen a spike in cases, but say they’re still taking aggressive actions to reach affected communities, like offering $50 vouchers for people who come in for free flu shots.

And San Diego has put up a record $12 million on a task force to fight the disease.

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