Measles blamed on anti-vaccine activists
Minnesota’s worst outbreak in decades hits Somali residents
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 3-yearold 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 hospitalized 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 3.
Salah no longer believes that the MMR vaccine triggers autism, a discredited theory that spread rapidly through the local Somali community, fanned by meetings organized by anti-vaccine groups. The activists repeatedly invited Andrew Wakefield, the founder of the modern antivaccine movement, to talk to worried parents.
Immunization 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 antivaccine 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 marginalized 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.”
Defending their role
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 U.S.-born children of Somali descent used to be higher than among other children in Minnesota. But the rates plummeted from 92 percent in 2004 to 42 percent in 2014, state health department data shows, well below the threshold of 92 to 94 percent needed to protect a community against measles.
Wakefield, a British activist who 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 anti-vaccine 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.
More cases expected
The current outbreak was identified in early April. As of last week, 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 hospitalized. 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.
Federal guidelines typically recommend that children get the first vaccine dose at 12 to 15 months of age and the second when they are 4 to 6 years old. The combination is 97 percent 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 6 months if there is concern for ongoing measles exposure.
Conclusive studies
While scores of studies from around the world have shown conclusively that vaccines do not cause autism, that is often not a satisfactory answer for some parents who say that if science can explain that vaccines do not cause autism, science should be able to say what does.
But researchers don’t really know. A growing body of evidence suggests that brain differences associated with autism may be found early in infancy — well before children receive most vaccines. Other studies have found that alterations in brain-cell development related to autism may occur before birth.
Meanwhile, the spread of the anti-vaccine message is making it harder to control the burgeoning number of measles cases.
When their two sick children are well, Suaado Salah and her husband, Tahlil Wehlie, plan to talk to friends and acquaintances to spread the word that the anti-vaccine groups are wrong and that all kids should get immunized.
“Because when the kids get sick, it’s going to affect everybody. It’s not going to affect only the family who have the sick kid,” she said. “They make sick for everybody. That’s when you wake up and say, ‘Okay, what happened?’ ”