The grim numbers from Samoa ought to end ill-informed notions circulated by anti-vaccine activists that measles is a harmless, passing rash.
The small South Pacific country is in the midst of an alarming measles outbreak, with its government reporting 4,357 cases and 63 deaths as of Friday. Most of the victims are young children. Fifty-five kids under the age of 9 have died. Life on the island has ground to a halt as the government and health experts from around the world work desperately to stop the spread of this virus with treatment and a rapid vaccination campaign.
Crunching some Minnesota-equivalent numbers puts into perspective how devastating this health crisis is for Samoa. It has a population of 195,000. If a comparable outbreak occurred in Minnesota (population 5.6 million), around 125,000 people would become ill, and close to 1,800 would die, most of them children.
Thanks to vaccines, which have made measles relatively rare in the U.S., current generations of parents and grandparents have had the luxury of forgetting how severe a disease measles can be. The reality made painfully clear in Samoa is that the virus is far from vanquished. It still can spread rapidly and make those infected gravely ill. Letting vaccination rates lapse for measles and other serious childhood diseases is dangerous — a message public health officials in Minnesota and elsewhere must amplify to prevent more tragedies like the one in the South Pacific.
Vaccine conspiracy theorists take frequent aim at the measles, mumps and rubella (MMR) vaccine. A small, flawed and long-discredited paper drew a link in the 1990s between the measles shot and autism risk. Numerous larger studies and comprehensive research reviews since then have repeatedly failed to document such a connection. But vaccine opponents have continued to spread this falsehood while downplaying measles’ severity. Parents led astray have forgone immunizations.
In Samoa, fears about the vaccine were fueled further by a tragic accident. In 2018, two infants died after two nurses mistakenly mixed a muscle relaxant into the shots used at a clinic. Vaccination rates dipped to a precipitous level — 31%. The virus took full advantage of the almost defenseless population when it arrived, likely via a traveler.
There are still some who may downplay the risks even as Samoa illustrates the danger. Pushing back against this is Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine. He has written a book refuting common anti-vaccine arguments, drawing upon not only his medical expertise but his own family’s experience. His daughter, Rachel, has autism. In an interview last week, Hotez said that some falsely believe that measles is only a severe illness in extremely poor countries with high rates of malnutrition or without good medical care.
“This of course is false. For example in the New York City measles epidemic of 2019, of the roughly 600 cases, approximately 50 required hospitalization, including more than a dozen in the ICU. I believe the actual number was around 18. This is because measles can cause pneumonia in around 20% of the cases, and pneumonia is usually the leading complication leading to deaths in measles,” Hotez said. “Moreover, even in those who survive measles, they can frequently have long-term complications, including permanent hearing loss, and immune suppression lasting for years.”
Vaccines are a victim of their own success, allowing complacency in generations too young to recall the pain and panic childhood diseases once wreaked. The World Health Organization, UNICEF and other agencies must use their global reach and resources to counter vaccine disinformation and respond proactively in areas where immunization rates have dropped.
But parents also need to do their part. It’s healthy to have questions about vaccine safety. But answers should be informed by medical expertise. Not every information source is worthy of trust.