Measles Vaccine Eligibility Has Been Expanded

With measles cases rising in our region and nearby areas, vaccine eligibility has been expanded:

  • Infants 6 months to 1 year – can now get their first dose early (they’ll still need two more after their first birthday).
  • Children 1–4 years – can get their second dose early, as long as it's been at least 28 days since the first.
  • Adults born after 1970 – can now get a second dose if they haven’t already.

To book your measles vaccine or learn more about symptoms, risks, and the MMR vaccine, visit: regionofwaterloo.ca/measles

Measles FAQs for Caregivers and Patients

What is measles?

  • Measles infection is caused by a highly contagious virus.
  • Measles begins with cold like symptoms such as a fever, cough, runny nose, and red watery eyes that are sensitive to light.
  • 3 to 7 days later, a red blotchy rash that is usually not itchy, appears on the face and spreads to the rest of the body.
  • A small number of people develop serious complications such as an ear infection, bronchopneumonia, or encephalitis (an infection of the brain).
  • Children less than five years of age, adults older than 20 years of age, pregnant women and people who are immunocompromised are at higher risk of complications from measles.

How does It spread?

  • Through the air when a person who is infected breathes, coughs, sneezes, talks or sings. It may also spread through direct contact with secretions of the virus when coughing or sneezing and germs on hands or other nearby items such as utensils, tables, chairs, etc.

The measles virus can persist in the air for up to two hours after a person with measles has left the space.

What are the symptoms of measles?

See the self assessment tool found here: Measles - Region of Waterloo

  • Fever that lasts for a few days.
  • Cough, runny nose, and red and watery eyes (pink eye/conjunctivitis).
  • Small red spots with bluish-white centers inside mouth appear two or three days later.
  • Rash that is usually not itchy and starts on face and hairline, upper neck and spreads down the body before spreading to arms, hands, legs and feet, three to five days later.

The rash lasts 4 to 7 days and the cough may persist for one to two weeks.

How soon do symptoms appear?

Symptoms usually start between 6 to 21 days after exposure.

What can I do to prevent getting measles?

Getting vaccinated is the best way to protect yourself against measles.

Routine vaccination recommendations for children

Current Ontario recommendations are that children receive two doses of a measles vaccine:

  • First dose on/after their first birthday.
  • Second dose at 4 to 6 years old.
  • For some infants 6 to 12 months of age, one dose of the measles vaccine can provide protection if there is a risk of exposure.

Routine vaccination recommendations for adults

Born in 1970 or later:

  • Should have at least one dose of the measles vaccine.
  • A second dose is recommended for international travellers and post-secondary students.

Born before 1970:

  • Adults born before 1970 are considered to be immune to measles based on probable exposure earlier in life.
  • One dose of the measles vaccine is recommended for international travellers and post-secondary students.

Health care workers or military personnel:

  • Two doses of the measles vaccine are recommended regardless of year of birth (or laboratory evidence of measles immunity).

Due to the ongoing spread of measles in our region and many other surrounding regions there is expanded vaccine eligibility for:

  • Infants 6 months of age to 1 year – may receive their first dose anytime after 6 months of age (will still require 2 doses after the first birthday).
  • 1-4 years of age – children 1-4 year of age may receive their second dose early (as long as 28 days have past since first dose).
  • Adult born after 1970 – are eligible for a second dose of vaccine.

How would I know my family members vaccination status or my own vaccination status?

You and your family members vaccination status can be found on their yellow immunization card or documentation from a healthcare provider.

  • Call your healthcare provider- they may have a copy on file.
  • Check with Public Health.

Everyone over age six should have two doses of the measles, mumps and rubella (MMR) vaccine.

Everyone who is aged one to 4 should have had one dose of MMR vaccination.

Keep your immunization card/document in your wallet or a photo of it on your phone for easy access.

Ensure that your children are up to date with their vaccines.

Waterloo Region is currently part of the larger area of western Ontario that is being aected by measles virus. Public Health Ontario's measles outbreak-related immunization schedule includes a map of all aected areas in the province and a comparison of routine and additional vaccine recommendations.

How do I know if I have been exposed to Measles?

A list of places in Waterloo Region that people may have been exposed to the measles virus is available on the Potential Public Exposures page.

Note: A list of potential public exposures on Regional public transit are listed in a separate table found in a separate table on the Potential Public Exposures page.

If you think you have been exposed to measles:

  • Stay home if you are ill to avoid passing germs to others.
  • Seek medical attention when exposure is suspected and before any symptoms appear.
  • Those who notice possible symptoms are asked to stay home and call ahead before visiting a clinic/healthcare facility.

If you have been exposed to a person with measles and are not fully protected against measles, you are at risk of developing the disease.

See Measles Exposures in Ontario for information about measles exposure locations in Ontario.

If you think you have been exposed to measles, click the button to access the Measles Self-Assessment Tool to guide your next steps.

For further information call Public Health at 519-575-4480 (Monday to Friday 8:30 a.m. to 4:30 p.m.).

What do I do if I or my unvaccinated child or family member has been exposed to someone with measles?

Stay at home and self isolate.

If you think an unvaccinated child or family member has been exposed to measles, call Region of Waterloo Public Health Services at 519-575-4480 (Monday to Friday 8:30 a.m. to 4:30 p.m.) as soon as possible to speak with a public health nurse who can assess your risk of developing measles and recommend potential actions such as an MMR vaccination or immunoglobulin.

What do I do if a vaccinated child, family member or I have been exposed to measles?

Watch for signs and symptoms of measles until 21 days after exposure. You and your family member can continue to aend work, school or daycare.

How do I know if my family member, child or I have been exposed to measles?

If you or your family member are identified as a contact, Region of Waterloo Public Health will do one, or all, of the following:

  • Call to inform you that you or your family member are a contact
  • Send a leer to your home if you are unreachable.
  • Alert the community by issuing a media release if the exposure may have happened in a public space, such as a shopping mall, hospital, or a restaurant.
  • Update the exposure list on the Region of Waterloo Public Health website found here: Measles: Potential Public Exposures in Waterloo Region - Region of Waterloo.

What should I do if I or my family member have measles?

  • Get lots of rest, drink plenty of fluids and take medicine to help with fever.
  • Stay home. Do not go to school, daycare or work for at least four days after your rash started. You can leave the house on day five after the onset of rash unless notified otherwise by Region of Waterloo Public Health.
  • If you need to go to the hospital for an appointment or require care at the hospital, please call ahead and let them know you have measles.
  • For specific questions about symptom management or medical care, speak with your doctor or nurse practitioner.

What do I do if I, my child or family member has been tested for measles and are waiting for the results at home?

  • Anyone with a pending measles test is asked to quarantine at home until Region of Waterloo Public Health or Physician who ordered the tests calls with the results.
  • If you are waiting for measles test results, Public Health or the physician who ordered the tests will contact you as soon as possible to give you the positive OR negative results.
  • If you need to go to the hospital for an appointment or require care at the hospital, please call ahead and let them know you have measles.
  • If you, your child or family member are in hospital, you will be placed in a private room with a HEPA filter or an Isolation room in Airborne/Droplet/Contact precautions.
  • The door must remain closed.
  • The staff will be wearing a mask, eye protection, gown and gloves.
  • Your family members should not visit as they may be considered “exposed”.

What should I do if I or my family member need to see a doctor?

Call the doctors oice or clinic before you attend the appointment.

If you or your family member need to go to the Emergency Department, call ahead before you arrive, do not take public transit, wear a mask, inform the screener at the door, the nurse, and the registration staff immediately if you have:

  • Had exposure to measles
  • Tested positive for measles
  • Have symptoms of measles (fever, cough, shortness of breath, pink eye, rash)

Where can I get more information about the MMR vaccine?

More information about measles and the MMR vaccine can be found here: www.regionofwaterloo.ca/measles.

Measles FAQs for Caregivers and Patients with Appointments or Visits at WRHN

What should I verify before coming to my or my family members ambulatory visit at the hospital?

Everyone is asked to review if they are measles immune:

  • Born before 1970 in Canada - everyone born before 1970 is considered to have natural immunity unless it is determined by a physician there is an immunocompromising condition and/or therapy/treatment.
  • Everyone older than the age of one year should have had at least one dose of measles vaccine (takes 2 weeks to become immune after vaccination).

If you or your family member are not immune, we ask that prior to any upcoming appointments consider:

  • Measles exposure in the past 28 days
  • Symptoms of potential measles (fever, cough, rash, pink eye) in the past 21 days

A screening assessment tool from ROWPH can be found here: Measles Self-Assessment Tool.

And if the answer is yes, call your clinical team to discuss what would be most appropriate for your care. If you arrive at the hospital and meet these criteria, before entering the hospital call your clinical team for guidance on aending the appointment. If you are in the clinic and meet the criteria then your clinical team will decide if rescheduling your appointment is most appropriate or if care is required.

What does immunity mean?

People who are immune to measles means that their body can fight the virus eectively and they will not become sick if exposed to measles.

There are only two ways to become immune: either after vaccination or after infection.

What do I do if I have screened positive for measles?

Stay home and call your healthcare provider to guide your next steps. If you do not have a healthcare provider you can call 811.

Why was I told that I was exposed to measles and put in isolation when I was registered for my appointment?

If you were exposed at WRHN or we were notified by Public Health that you were exposed, we placed a flag in your electronic health record that you were exposed.

What does testing for measles include?

Testing for measles includes a urine test and a throat or nasopharyngeal swab.

Wearing a mask makes us smile!

There has been a detectable increase in COVID-19 activity to varying degrees across the province especially in recent weeks. Locally, WRHN & SMGH have begun to see the rise in cases.

WRHN and SMGH, along with our regional hospital partners in Ontario Health West, have continued to monitor this data closely in order to inform measures to keep people safe within our hospitals. In response to increased COVID-19 activity, WRHN and SMGH will implement the following changes, effective Wednesday, September 27, in alignment with our system partners until further notice.

Team Members & Volunteers

  • Masking is required for team members and volunteers during all direct inpatient and outpatient encounters on entering a room AND when two metres of distancing cannot be maintained.
  • Masks are not required in non-clinical spaces (e.g., nursing stations, hallways, offices, meeting rooms) but continue to be available for anyone who prefers to wear one.

Patients & Visitors:

  • To support our team and for the safety of our patients, we strongly encourage visitors to wear a mask in clinical areas, especially while at the bedside.
  • While masks are not mandatory, we continue to make these readily available for anyone coming to SMGH or WRHN
  • We continue to support our patients in asking their care team to mask up if they prefer.
  • Visitors who are experiencing respiratory and gastrointestinal symptoms are reminded to stay home and connect with Patient Experience who can assist in facilitating virtual visits.

We can all do our part to stop the spread of illness, and masking is just one tool in our toolkit. Please get your flu vaccine, COVID boosters and always remember to wash your hands often.

Looking for screening? Please scroll down!

Visiting a patient at Waterloo Regional Health Network

Visitors and care partners are an essential part of a patient's recovery! Visiting is encouraged while following our guidelines, below.

  • Visiting hours are 9 a.m. – 9 p.m. every day.
  • During outbreaks, visiting may be temporarily suspended. Outbreaks are posted to our website and will be communicated by the patient’s care team.
  • Visiting may also be restricted at times of increased circulation of respiratory viruses in the community, for example during winter flu season. We will update this page with the latest visiting guidelines.
  • Please do not visit if you have respiratory or gastrointestinal symptoms such as cough, fever, sore throat, runny nose, vomiting, diarrhea, or conjunctivitis (pink eye). Visitors and care partners with COVID-19 must wait ten days after their first symptoms before they will be allowed to visit. Please discuss with the patient’s care team in the event of exceptional circumstances.
  • During your visit:
    • Follow instructions from the care team when visiting. They may advise you on appropriate personal protective equipment, hand hygiene, or ask you to step out of the room during patient care tasks, etc.
    • Please do not eat or drink in the patient’s room.
    • As a reminder, smoking or vaping is not permitted on hospital property.

Visiting a patient staying in the hospital (inpatient visiting)

Accompanying a patient to a outpatient clinic visit:

  • One care partner (12+) can accompany a patient to an outpatient visit.
  • Please do not accompany a patient if you are feeling unwell: Take the Self-Assessment.
  • As a reminder, smoking is not permitted on hospital property.

Specific guidelines for some areas are included below:

Day surgery:
  • While the patient is in surgery, the care partner will be asked to wait outside of the hospital.

Exceptions:

We recognize that each patient’s circumstance is different and may allow for exemptions to our guidelines. Exemptions are reviewed on a case-by-case basis by the manager of the area where the patient is receiving care. For more information about this, please call 519-742-3611 and ask to speak to the manager of your loved one’s care area to discuss.

Virtual visiting

In situations where an in-person Care Partner visit is not possible, our staff can support patients and families to connect virtually and/or by phone.

WRHN offers free wireless internet (“GrandServe – Free patient Wifi”) inside the hospital to support virtual visiting.

Patients are encouraged to have their mobile phones with them. We have a limited number of bedside phones available which are reserved for patients who do not have access to a mobile phone.

Please speak to your loved one's care team for more information.


Screening

Please complete this screening before entering the hospital.

Do you have any of these symptoms of an infectious illness? (new, worsening, and not related to other known causes or conditions)

  • Fever and/or chills
  • Cough
  • Shortness of breath
  • Decrease or loss of taste or smell
  • Muscle aches / joint pain
  • Extreme tiredness
  • Sore throat
  • Runny or stuffy nose
  • Headache
  • Nausea, vomiting, and/or diarrhea
  • Abdominal pain
  • Pink eye
  • Rash

Within the last 10 days:

  • Have you tested positive for COVID-19?
  • Have you been in direct contact with someone who has tested positive for COVID-19 or has COVID-19 symptoms (as listed above)?

If your answer is YES:

  • Patients: Clean your hands, put on a mask and tell a member of our team that you answered “yes” to this screening. We will ensure appropriate safety measures are in place while caring for you.
  • Visitors: Please postpone your visit. If you have symptoms, you must wait until:
    • 10 days after you first started experiencing symptoms; AND
    • you do not have a fever; AND
    • your symptoms have been improving for at least 24 hours (48 if you had nausea, vomiting, and/or diarrhea).

General tips to avoid the spread of illness:

Practicing typical hygiene can help:

  • Wash your hands often
  • When coughing or sneezing, cover your mouth and nose with your arm to reduce the spread of germs. If you use a tissue, throw it away as soon as possible and wash your hands.
  • Avoid touching your eyes nose and mouth

Physical Distancing

  • We want everyone to stay safe so whether in hospital, at home or out in the community we remind you to keep a distance of two metres from others.
  • We encourage people to wear masks in our facilities.