MAY 11, 2017

Measles Strikes Hard in Unvaccinated Communities in Minnesota

WRITTEN BY: Xuan Pham

The state of Minnesota is working overtime to treat and contain a measles outbreak that health experts are attributing to inadequate vaccination.

The outbreak includes 48 confirmed measles cases in Hennepin, Ramsey, and Crow Wing counties. "Usually, states will see one or two cases in a year, and what's concerning is, as of today, we'll be at 48 cases of measles," said Kristen Ehresmann, director of the Infectious Disease Epidemiology, Prevention and Control Division at the Minnesota Department of Health.

Of the 48 cases, a large majority (41) are Somali-American. But the link with measles has nothing to do with being Somali, and everything to do with vaccination.

"I want to be very clear that this outbreak has nothing to do with being Somali. It's just the sheer fact of being unvaccinated," Ehresmann said. In fact, in 45 out of the 48 cases, the patients were not vaccinated with the measles, mumps, and rubella (MMR) vaccine.

Minnesota is home to the largest Somali community in the United States. And up until 2008, these communities were quite diligent in following vaccination recommendations. "Between 2000 and roughly 2008, the Somali community in Minnesota actually had some of the highest vaccination rates for 2-year-olds of any population in the state," said Michael Osterholm, a former state epidemiologist for Minnesota.

But the vaccination rate began plummeting with the onset of the anti-vaccine movement. Parents bought into the now discredited work of Andrew Wakefield, which falsely claimed a link between vaccines and autism. After all, Wakefield and the anti-vaccine movement provided an explanation for what some parents saw as a disproportionate number autistic Somali children in their community.

"So, by about 2008, we started to see the vaccine rates drop as the word got through the Somali community that autism was linked to measles vaccination," said Osterholm. "In the years since then, Andrew Wakefield has actually been brought in several times to the Somali community here in Minnesota to actually give presentations supporting this information. ... His work has been retracted.”

But it’s hard to erase such a pervasive community-wide belief. Even when confronted with data showing that Somali and white children had the same risk level of getting autism, vaccination rates did not climb. Data from the Minnesota Department of Health showed the rate of MMR vaccination in 2014 was a paltry 42 percent for children of Somali descent, compared to 89 percent for children of non-Somali descent.

As health experts treat outbreak patients, they urge the importance of getting vaccinated. "The most worrisome thing is, it's a completely unnecessary outbreak," said Ehresmann. "We have a vaccine that can prevent measles, and yet we're seeing this widespread transmission."

"Measles is a serious disease. You can have pneumonia and dehydration ... and people do die from measles, so we take it very seriously," Ehresmann said. "Our goal for measles control is to protect all the individuals in the state, but for some people, they can't be vaccinated because of health conditions," she said. "There is some level of concern about those individuals, and if this outbreak keeps spreading, that just increases the likelihood that there may be individuals who are in high risk or have high-risk conditions that will be affected."

Additional source: CNN