As a registered nurse and a consultant to the Minnesota Department of Health, Asli Ashkir has spent nearly a decade talking with Somali parents about autism, vaccines and the importance of getting their children immunized.
Last week she redoubled her efforts. A measles outbreak in Hennepin County has sickened 12 children — all of them unvaccinated and all of them from Somali families, according to the department — throwing a spotlight on low immunization rates among Somali children.
Now state and county public health workers are doing their best to contact Somali parents and underscore the value of immunization. “I know when parents have facts, they do the best they can to make the right decision,” Ashkir said.
Ironically, just a few years ago Somali children in Minnesota had extremely high vaccination rates. Then, in 2008, an apparent cluster of autism cases among Somali children in Minneapolis prompted a scare based on a discredited theory involving the measles vaccine that was popularized 20 years earlier by British researcher Andrew Wakefield.
Vaccination rates among Somali children plummeted. For Somali 2-year-olds, they were as high as 92 percent in 2004, but today stand at just 42 percent.
“The community is not afraid of immunization [in general],” Ashkir said — just fearful that there is something suspect about the measles shot.
That link has been debunked by many scientific studies in several countries, stretching back several decades. In addition, expert reviews conducted by medical professional societies and other advisory bodies, including the National Academy of Medicine, have said there is no evidence to prove that the vaccine causes autism.
Anab Gulaid, a former member of the Health Department’s public health advisory group, stresses that sort of research when she counsels Somali parents.
But she also said health officials have to understand why Somali parents are anxious. She recalled a Somali mother who spoke at a public health meeting at the Brian Coyle Community Center some years ago. She had given birth to several healthy children in Africa, but her first child in the United States showed autism symptoms at an early age.
“We need compassion and resources,” Gulaid said. “We don’t want people pointing fingers at us.”
Home from day care
Fahmo Sayid is an example of their challenge. The St. Louis Park resident has three young children, all of them unvaccinated. Last week, she was told she would have to keep them home from day care for three weeks because of a suspected measles case at the center. (The Health Department said it could not confirm a measles cases at a Hopkins facility.)
“The day care told us we can come back if the kids don’t get sick in three weeks,” she said.
Sayid said she doesn’t oppose vaccines in general — she plans to get her oldest vaccinated at 7 and the younger two at age 4 — but she’s heard that early vaccination can damage an infant’s language skills.
“The internet and people in the community told me MMR causes autism,” Sayid said. “Everybody is afraid.”
To overcome this lingering skepticism, outreach workers like Fatuma Irshat, a member of the Somali public health advisory group, said she stresses science and community responsibility as she makes the rounds in her St. Louis Park neighborhood, talking to other Somali parents.
She points out that some infants are too young to have completed their MMR vaccination cycle, and she tells parents with older children they have an obligation to protect other families’ children.
“As a mother, I want to protect kids who are not vaccinated,” Irshat said. “Mothers who refuse to vaccinate their kids are putting younger kids at risk.”
In a related effort, several Twin Cities health care providers are tapping Muslim chaplains who may have special influence among devout families.
Sharif Abdirahman Mohamed is an imam at the Dar al Hijrah mosque in Minneapolis and a chaplain for Fairview Health Services. When he visits Somali families he cites the hadith, the sayings and actions of the prophet Mohammed, and verses from the Qur’an to allay fears.
Islam says “you should ask the people who have expertise and knowledge, if you don’t know the subject,” Mohamed said. Islam, he said, also instructs Muslims to protect others in their community.
“Spreading measles is harming the community, not just your kid,” he added.