Samoa has shut down its government in the wake of a deadly measles outbreak that has claimed the lives of 55 Samoans and infected around one in 70 people across the country since the disease began to spread six weeks ago.
Prime Minister Tuilaepa Sailele Malielegaoi announced a full shutdown of all public and government services so that “all public servants can assist with a mass measles vaccination campaign throughout the country.”
“Let us work together to encourage and convince those that do not believe that vaccinations are the only answer to the epidemic. Let us not be distracted by the promise of alternative cures,” he said.
The Ministry of Health reported today that there have been 3,881 confirmed cases across the country, with 153 confirmed in just the past 24 hours. Statistics show that children are the most affected with 50 of the 55 confirmed dead below the age of five.
Since the government ruled vaccines compulsory and declared a state of emergency on November 20, which banned public gatherings and closed schools and universities, a mass vaccination campaign has been under way, with more than 58,000 people already successfully vaccinated.
Tonga and Fiji, although not having reported any deaths, have also declared states of emergency to tackle their measles outbreaks.
Measles is one of the most contagious diseases known. The virus starts with minor symptoms like a runny nose and skin rash, but can quickly devolve into complications such as brain damage. It can also leave a person with “immune amnesia,” which effectively wipes out a person’s immune system, leaving them more susceptible to other diseases.
Measles deaths worldwide have fallen sharply since a vaccine was introduced in the 1960s. According to the World Health Organization, major measles epidemics used to occur approximately every two to three years and would cause an estimated 2.6 million deaths each year, but that has been brought down to around 110,000 deaths a year more recently.
Despite this, measles is still the second biggest vaccine-preventable killer in the world, according to the University of Washington’s Global Burden of Disease Study. The WHO reports that global vaccination coverage has slowed down in the last few years, estimating that around 19.5 million infants are still at risk of vaccine-preventable deaths because they simply miss out on basic vaccines.
One reason for the decline in the measles vaccine coverage is perhaps due to the vaccine requiring two separate doses to be most effective. WHO estimates that 86 percent of children worldwide receive their first dose, but that it drops to just 64 percent for the second dose.
In Samoa, only 31 percent of children had received the first dose of the measles vaccine, a drop from 65 percent in previous years. In contrast, the vaccination rate among other pacific nations such as Naura, Niue, and the Cook Islands is 99 percent.
Another reason for an uptick in measles cases worldwide is due to “vaccine hesitancy,” which is defined by the WHO as a “delay in acceptance or refusal of vaccines despite availability of vaccination services.” With vaccine hesitancy on the rise, measles has seen a 30 percent increase in cases globally in just the last few years, prompting the WHO to declare vaccine hesitancy one of the 10 biggest threats to global health.
To be more specific, the low rate of vaccination in Samoa is partially attributable to public concern following two vaccine-related deaths that occurred in Samoa in July 2018. The deaths, however, were later established to have been caused by the nurses mixing the vaccine with an expired muscle relaxant instead of water. The two nurses pleaded guilty to manslaughter and were sentenced to five years in prison.
Social media platforms have been enormously influential in the spread of vaccine hesitancy. Realizing this, the president of the American Academy of Pediatrics, Kyle Yasuda, wrote a letter to the chief executive officers of Google, Facebook, and Pinterest earlier this year requesting they take more action against the growing threat to children posed by online misinformation about vaccines. Facebook has since began removing groups and pages that share anti-vaccine misinformation from its recommended algorithm.
Despite this, the anti-vaxxer sentiment online still looms large. Just yesterday, Samoan police and the office of the attorney general confirmed that they had questioned two local residents who had allegedly “attempted to undermine the mass vaccination drive through social media posts, and by promoting alternative treatments.”
In June of this year, the anti-vaccine activist Robert F. Kennedy Jr., a nephew of President John F. Kennedy, visited Samoa “for a program that is not government-related,” an official in the prime minister’s department told the Samoan Observer. While there, however, Kennedy met with Australian-Samoan anti-vaccine activist Taylor Winterstein. “I am deeply honored to have been in the presence of a man I believe is, can and will change the course of history,” Winterstein wrote in the caption of a photograph of the two posted to her Instagram with the accompanying hashtag #investigatebeforeyouvaccinate.
Kennedy has often asserted that vaccines cause autism, a claim disproved by extensive research and debunked by the Centers for Disease Control and Prevention, the American Academy of Pediatrics, the World Health Organization, the National Academies of Sciences, Engineering and Medicine, and many other leading health and science organizations around the world.
Earlier this year, Kennedy’s siblings Kathleen Kennedy Townsend, who is the former chair of the Global Virus Network, and Joseph P. Kennedy II, a former member of Congress, as well as his niece, Maeve Kennedy Mckean, who is the executive director of Georgetown University’s Global Health Initiatives, published an article in Politico Magazine accusing Robert Kennedy of being “complicit” in a misinformation campaign.
“He has helped to spread dangerous misinformation over social media and is complicit in sowing distrust of the science behind vaccines,” they wrote.
“His and others’ work against vaccines is having heartbreaking consequence. The challenge for public health officials right now is that many people are more afraid of the vaccines than the diseases, because they’ve been lucky enough to have never seen the diseases and their devastating impact.”
The Washington Post reported that Kennedy had wrote a letter to the Samoan prime minister, in which Kennedy encouraged officials to examine the MMR (measles, mumps, and rubella) vaccine. “To safeguard public health during the current infection and in the future, it is critical that the Samoan Health Ministry determine, scientifically, if the outbreak was cause by inadequate vaccine coverage or alternatively, by a defective vaccine,” he wrote.
Prior to Facebook changing its policies around anti-vaccine advertising, the majority of Facebook advertisements spreading misinformation were funded by just two groups, including one led by Kennedy.
Amids the current outbreak in Samoa, two doctors based in Auckland, New Zealand, have designed and now operate a free, interactive and instant online messaging service on messenger where they address misinformation and encourage MMR vaccinations.
Canaan Aumua and Sanjeev Krishna claim that they have received well over 20,000 interactions since they launched the service several weeks ago. “We saw a real need to bridge the gap between technology and healthcare as a way to not only help the public find medically sound advice among misleading opinions, but also gain an understanding of how people interact with social media and technology relative to healthcare,” Krishna told Scoop Media.
Aumua said they have seen misinformation in the form of measles treatments such as “magic water, or there’s supposedly a magic purple rice out there, there’s people organizing workshops to supposedly inform people about vaccinations, but really, it’s all a complete lie and a lot of these people have an ulterior motive,” he told New Zealand Radio.
Taylor Winterstein, the woman who met with Kennedy in Samoa, planned to hold an anti-vaccine workshop in Samoa as part of an international tour, titled “Making Informed Choices.” She eventually cancelled the $200-ticketed event after backlash from the country’s health ministry which described the event as a “public health threat.”