Anti-vaccine activists spark a state’s worst measles outbreak
MINNEAPOLIS: The young mother started getting advice early on from friends in the close-knit Somali immigrant community here. Don’t let your children get the vaccine for measles, mumps and rubella - it causes autism, they said.
Suaado Salah listened. And this spring, her three-year- old boy and 18-month- old girl contracted measles in Minnesota’s largest outbreak of the highly infectious and potentially deadly disease in nearly three decades. Her daughter, who had a rash, high fever and cough, was hospitalised for four nights and needed intravenous fluids and oxygen.
“I thought: ‘ I’m in America. I thought I’m in a safe place and my kids will never get sick in that disease,’ “said Salah, 26, who has lived in Minnesota for more than a decade. Growing up in Somalia, she’d had measles as a child. A sister died of the disease at age three.
Salah no longer believes that the MMR vaccine triggers autism, a discredited theory that spread rapidly through the local Somali community, fanned by meetings organised by antivaccine groups. The activists repeatedly invited Andrew Wakefield, the founder of the modern anti-vaccine movement, to talk to worried parents.
Immunisation rates plummeted, and last month the first cases of measles appeared. Soon there was a full-blown outbreak, one of the starkest consequences of an intensifying anti-vaccine movement in the United States and around the world that has gained traction in part by targeting specific communities.
“It’s remarkable to come in and talk to a population that’s vulnerable and marginalised and who doesn’t necessarily have the capacity for advocacy for themselves, and to take advantage of that,” said Siman Nuurali, a Somali American clinician who coordinates the care of medically complex patients at Children’s Hospitals and Clinics of Minnesota. “It’s abhorrent.”
Although extensive research has disproved any relationship between vaccines and autism, the fear has become entrenched in the community. “I don’t know if we will be able to dig out on our own,” Nuurali said.
Anti-vaccine activists defend their position and their role, saying they merely provided information to parents.
“The Somalis had decided themselves that they were particularly concerned,” Wakefield said last week. “I was responding to that.”
He maintained that he bears no fault for what is happening within the community. “I don’t feel responsible at all,” he said.
MMR vaccination rates among US-born children of Somali descent used to be higher than among other children in Minnesota. But the rates plummeted from 92 per cent in 2004 to 42 per cent in 2014, state health department data shows, well below the threshold of 92 to 94 per cent needed to protect a community against measles.
Wakefield, a British activist who now lives in Texas, visited Minneapolis at least three times in 2010 and 2011 to meet privately with Somali parents of autistic children, according to local antivaccine activists. Wakefield’s prominence stems from a 1998 study he authored that claimed to show a link between the vaccine and autism. The study was later identified as fraudulent and was retracted by the medical journal that published it, and his medical license was revoked.
The current outbreak was identified in early April. As of Friday, there were 44 cases, all but two occurring in people who were not vaccinated and all but one in children 10 or younger. Nearly all have been from the Somali American community in Hennepin County. A fourth of the patients have been hospitalised. Because of the dangerously low vaccination rates and the disease’s extreme infectiousness, more cases are expected in the weeks ahead.
Measles, which remains endemic in many parts of the world, was eliminated in the United States at the start of this century. It reappeared several years ago as more people - many wealthier, more educated and white - began refusing to vaccinate their children or delaying those shots.
The ramifications already have been significant. A 2014 to 2015 measles outbreak infected 147 people in seven states and spread to Mexico and Canada. In California, high school students were sent home because of infected classmates. One patient who was unknowingly infectious visited a hospital and exposed dozens of pregnant women and babies, including those in the neonatal intensive care unit. Another adult patient was hospitalised and on a breathing machine for three weeks.
Federal guidelines typically recommend that children get the first vaccine dose at 12 to 15 months of age and the second when they are four to six years old. The combination is 97 per cent effective in preventing the viral disease, which can cause pneumonia, brain swelling, deafness and, in rare instances, death. State health officials are now recommending doses for babies as young as six months if there is concern for ongoing measles exposure.