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In the Canadian town of Aylmer, where Mennonites in traditional dress walk down the main street alongside secular locals, bitter divisions over vaccine skepticism that arose during Covid have intensified with the reemergence of measles.

Canada, which officially eradicated measles in 1998, has registered over 3,500 cases this year and the United States is confronting its worst measles epidemic in 30 years, with the UN warning of the global risk as misinformation and lack of funding impact vaccination rates.

Different communities in Canada have been hit, but experts link the brunt of the outbreak to anti-vaccine Anabaptist groups in the provinces of Ontario and Alberta.

Growing up in Aylmer, a bucolic town surrounded by farmland in southwestern Ontario, Brett Hueston said he didn't give much thought to the differing world views among the town's religious and secular residents.

That changed during the Covid-19 pandemic.

"I grew up, perhaps naively, thinking that we were all sort of on the same page as a community," said Hueston, 40, whose family publishes the 145-year-old local paper, the Aylmer Express.

"Covid really exploited whatever differences there were," he told AFP.

Aylmer was a pandemic flashpoint. The town has 13 churches, a substantial number given its roughly 8,000 population.

A major congregation -- the Aylmer Church of God that sits on an expansive, well-manicured grounds -- enthusiastically defied some lockdown restrictions.

The church's pastor, Henry Hildebrandt, tried to challenge the rules in the supreme court, before agreeing in 2022 to pay a CAN$65,000 ($47,400) fine for gathering people to worship.

Hildebrandt said he admitted "to one count of obeying God rather than man," asserting that he had knowingly broken the law.

Hueston said "when measles came up, I thought, I know where this is going."

"Everybody thinks... Mennonites are (all) anti-vaxers. It certainly isn't the case, but there's certainly a conservative part of this end of the county that is strongly anti-vaxer, and I don't quite understand it," he told AFP.

'Difficult to watch' 

Michelle Barton heads the infectious diseases division at the Children's Hospital at the London Health Sciences Center, southwestern Ontario's main referral hospital.

She's seen some of the most serious pediatric measles cases this year and told AFP observing the recurrence of a once eradicated virus has been "difficult to watch."

She noted that not every case can be tied to unvaccinated Mennonites.

Infections have also occurred among new immigrants from the developing world who, for various reasons, did not keep up with immunizations after settling in Canada, including due to an acute family doctor shortage.

Barton said it was long clear "pockets of unvaccinated people" made the region vulnerable to measles.

She recounted a range of attitudes towards vaccines among Mennonite families.

Some mothers, when confronted with how sick their children had become, voiced openness to vaccinating their other children, only to back away, fearing consequences from their husband or pastor, Barton told AFP.

"They don't want to go against the grain of their culture, and they don't want to go against the (church) elders," she said.

She also voiced sympathy for a Mennonite community that faced "resentment" from some healthcare workers, who at times displayed frustration over having to respond to an entirely preventable outbreak.

Barton said she hoped the relationships forged between medical staff and vaccine-skeptical families could improve acceptance, and she encouraged public health officials to persist in trying to bring church leaders on board.

'Wall of lies'

For Alon Vaisman, an infectious diseases doctor at Ontario's University Health Network, officials must keep trying, regardless of opposition.

"From a public health perspective we ought not to accept anything to be insurmountable when it comes to vaccine campaigns."

Child vaccination rates remain below where they need to be, making another viral outbreak, including measles, possible, Vaisman said.

"There really needs to be more of an effort," he told AFP, conceding the difficulty of finding a successful path forward.

"You're fighting against the wall of disinformation and lies," he said.