The mother of a 12-year-old Winnipeg boy with a heart transplant is urging people to vaccinate their kids to protect them and the lives of vulnerable children like her son.

Doctors warn that Manitoba's immunization rates, which are among the lowest in the country, could lead to a measles outbreak like the ones happening in BC and south of the border.

Ever since his heart transplant at the age of four months, Quinn Kriewald has been in and out of hospital for infections, check-ups and complications.

"You've been fighting so many things that you don't have control over that have made your child so sick, and then there's something that people do have control over, and they're not taking care of it, they're not immunizing their kids. It's frustrating. It's frustrating and it's terrifying because I don't think they know the consequences of that," said his mother, Kim Crane.

According to the province's most recent data from 2014, only 75 per cent of children had received both doses of the measles vaccine by age seven. An estimated sixty-six per cent of children were up to date for all recommended vaccines by age two and a mere 62 per cent of children were up to date by age seven.

"It's very, very scary," said Crane.

Quinn is among a small percentage of children in Canada with severely weakened immune systems who cannot get live virus vaccines, like the ones for measles, mumps and rubella. They rely on herd immunity to stay well, which is when there's a high enough number of immune people in the population that when a disease is introduced, it doesn't spread.

Kim Crane and her military family have spent a lot of time in hospitals after 12-year-old Quinn's heart transplant when he was a baby. (Submitted by Kim Crane)

Quinn was born with a condition called hypoplastic left heart syndrome, where the left side of his heart was underdeveloped and the right side had complications. The only treatment for him was a transplant. Now, he has a weakened immune system because of the medications he needs to prevent his body from rejecting the heart.

"On the extreme side, the consequence of my son getting measles is that he may die from it. The other side is we end up in the hospital again and he ends up going through treatments which is traumatizing for him. He's been in and out so many times. It's a lot to put on a family," said Crane.



Cold and flu season are worrying enough, she said, because it often means another hospital admission.

"I just want people to be aware that there are people that are relying on others to protect my kid and it's not getting done and that's scary."

And yet, schools take measures to protect children with severe food allergies, she said.

"For good reason. If my kid was to bring that product to school it could very well cause the death of another child. But yet, if a non-immunized child comes to the school and brings something to the school that's deadly to my kid, it's not considered in the same way."

She's urging parents to do the research on vaccines and make sure their children are up to date, and supports the idea of mandatory immunization for school enrolment. She says she respects that parents have rights, but when their decisions cause harm, feels measures are necessary.

"It's terrifying. You never know. Like what I'm sending him into, and you don't want him to live in a bubble."

Kim Crane and her 4 children, including 12-year-old Quinn who has a heart transplant, is unable to get vaccinated and is at risk to catch preventable diseases. (Submitted by Kim Crane)

'Herd immunity in Manitoba is not a thing'

With the exception of Newfoundland, which boasts high immunization rates, Canada has a ways to go before it sees herd immunity, according to doctors.

"The numbers are disappointingly low, so really, there's no logical reason why they should be lower than 95 percent if we were doing a good enough job of convincing the general public that vaccines are going to prevent severe disease in small children," said Dr. Joan Robinson, a pediatric infectious disease doctor at the University of Alberta and spokesperson for the Canadian Pediatric Society who authored the report on strategies to improve pediatric immunization rates across the country.

Measles cause the most worry, she said, because about ten per cent of children who get it end up in hospital and a 'tiny percentage' could die.



"There is no question that with our measles immunization rate being below 90 per cent, we will continue to see measles outbreaks off and on until we can get that rate up to 90 per cent."

She said the answer isn't necessarily mandatory vaccines for school entry — as exists in Ontario, New Brunswick, the U.S. and Australia — because it raises human rights concerns that 'might backfire' and available data shows immunization rates in those provinces are only marginally better.

Instead, she believes the history of vaccines and vaccine preventable diseases should be taught as part of the science curriculum so children learn the evidence — such as how the polio vaccine nearly eradicated that disease — and can advocate for themselves or become parents who see the importance.

She said although anti-immunization folks appear more vocal today because of social media, the vast majority of parents still immunize their children, or at least are not opposed. It's difficult to say definitively whether immunization rates are lower now than they were 10 or 20 years ago, she said, because each province compiles its immunization data in different ways, based on what's available and submitted.

According to a provincial spokesperson, Manitoba has updated its immunization registry and a new report on data will be released publicly. The province is leading a federally funded initiative to map immunization rates to identify gaps and work with health authorities, doctors and families to devise programs to boost rates.

A national data registry would be the ideal, added Robinson, so all immunizations could be tracked and analyzed.

Measles is still relatively rare in Manitoba — with about one or two cases per year which then spark a couple more each — and there have been no cases yet in 2019, according to the province's medical officer of health for vaccines, Dr. Tim Hilderman.

The mother of a 12-year-old Winnipeg boy with a heart transplant is urging people to vaccinate their kids to protect them and the lives of vulnerable children like her son. 3:28

"Because we have a highly effective vaccine for measles, we have high rates of coverage. And so we don't see, at a population level, outbreaks of measles occurring," he said, adding importation of measles could still occur in communities or areas with poor immunization rates.

He said the "complete for age" rates of an estimated 62 per cent (age two) and 66 per cent (age seven) reflect the number of children who have had all recommended vaccines including boosters; the rates per vaccine are higher.

"As long as people choose to delay or decline immunizations, we will likely not hit vaccination rates high enough to have very effective herd immunity — especially for highly contagious infections like measles," said Dr. Raj Bhardwaj, CBC radio columnist and Calgary family physician.

"Herd immunity in Manitoba is not a thing. If you're hoping that herd immunity will save you and you live in Manitoba, you are wrong."

And that's especially a problem for children like Quinn, who have no other option.

Not only is he at a higher risk for infection, he has a much harder time fighting it off. But his nickname remains 'Mighty Quinn' for all he's been through and survived.

"We need to do what's right as a society to protect each other, to protect each other's children. Go and get your children vaccinated," urged his mother.

"You making this choice for your kid doesn't just put your own child at risk. It's putting other people's children at risk as well."