Minnesota is experiencing its worst measles outbreak in decades thanks to anti-vaccine activists who have spread their propaganda among the Somali immigrants that have moved into the state in recent years:
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-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 a 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 advocates repeatedly invited Andrew Wakefield, the founder of the modern anti-vaccine 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 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 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.”
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 advocates 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 now happening within the community: “I don’t feel responsible at all.”
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 92-94 percent threshold 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 anti-vaccine advocates. Wakefield’s prominence stems from a 1998 study he authored, which 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 Thursday, there were 41 cases, all but two occurring in people who were not vaccinated, and all but one in children 10 and 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.
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The roots of the outbreak there date to 2008, when parents raised concerns that their children were disproportionately affected by autism spectrum disorder. A limited survey by the state health department the following year found an unexpectedly high number of Somali children in a preschool autism program. But a University of Minnesota study found that Somali children were about as likely as white children to be identified with autism, although they were more likely to have intellectual disabilities.
Around that time, health-care providers began receiving reports of parents refusing the MMR vaccine.
As parents sought to learn more about the disorder, they came across websites of anti-vaccine groups. And activists from those groups started showing up at community health meetings and distributing pamphlets, recalled Lynn Bahta, a longtime state health department nurse who has worked with Somali nurses to counter MMR vaccine resistance within the community.
At one 2011 gathering featuring Wakefield, Bahta recalled, an armed guard barred her, other public health officials and reporters from attending.
Fear of autism runs so deep in the Somali community that parents whose children have recently come down with measles insist that measles preferable to risking autism. One father, who did not want his family identified to protect their privacy, sat helplessly by his daughter’s bed at Children’s Minnesota hospital last week as she struggled to breathe during coughing fits.
Anti-vaccination activists in general and Andrew Wakefield in particular have been a nuisance for some time now. Even though Wakefield’s now infamous study has been proven to be fraudulent and discredited, these people continue to push their well-debunked propaganda nationwide. The result has been increased cases of disease such as Measles, Mumps, and Whopping Cough in various parts of the country even after long periods in which all three childhood diseases, and others, had been completely or virtually eradicated in the United States and elsewhere thanks to successful vaccination and public health campaigns. In this case, though, Wakefield’s conduct in particular isn’t just a nuisance, it is odious, dangerous, and fairly close to something that probably ought to be considered criminal behavior. Notwithstanding the fact that his work has been thoroughly discredited, Wakefield and his supporters actively reached out to the Somali community and used the combined factors of the fears of a vulnerable immigrant community in a country that they are still struggling to get used to, the fears of parents for the safety of their children, and the relative isolation of the Somali community due to language and cultural barriers to spread his discredited propaganda and create unwarranted fear among Somali parents that their children would become autistic if they were vaccinated from childhood illnesses. At the very least, it strikes me that this ought to lead to some kind of civil liability on the part of the activists and people such as Wakefield who ought to know what they are doing is more likely to harm the children of these immigrants than to help them. Based on their actions, however, it would seem apparent that they don’t care what happens to the children at all.
At the very least, reports such as this indicate that public health officials in the state need to do a better job at reaching out to this community and others regarding the truth about vaccines and the lack of any scientific basis for the idea that there is any link at all between autism and vaccinations. For now, though, the damage is done and it’s going to be difficult to root out the impact that Wakefield and his propaganda efforts has had in the state in general and in the Somali community in particular. While that process is underway, though, I would hope that someone is looking into the possibility of some kind of legal sanctions against Wakefield and his supporters for this. As I said, at the very least they have operated in what can only be described as a callous and manipulative manner toward a vulnerable population that in many ways lacked the means to double check what they were being told by people they thought they could rely upon. It’s true that the parents bear some responsibility too, of course, but when you consider the fact that the parents were largely motivated by fear and their concern for their children, that responsibility is arguably mitigated by the more egregious conduct of the anti-vaccination crowd. These people already have enough blood on their hands, they obviously don’t care about more of it.
