As Minnesota confronts its second measles outbreak in seven years, public health officials are battling to contain the disease while also trying to educate parents in the face of an organized opposition.
As happened in 2011, anti-vaccine activists are reaching out to Minnesota’s Somali community, where both outbreaks have been centered, with messages that reinforce the discredited belief that vaccines cause autism.
On Sunday afternoon, a coalition of anti-vaccine organizations plans a meeting at the Brian Coyle Community Center on Minneapolis’ West Bank in an effort to bring their message to Somali families, saying “The epidemic is autism, not measles.”
Fears of the MMR vaccine have taken hold within the Somali community, particularly after 2008, when many parents became concerned about what seemed to be a cluster of autism cases among Somali students in the Minneapolis schools. Measles vaccination rates among young Somali children have fallen sharply since, providing fertile ground for an outbreak to develop.
On Friday, health officials reported three new measles cases, bringing the total to 32 and marking the outbreak’s spread from Hennepin and Stearns County to Ramsey County. Officials are still trying to identify the source, but believe it was imported by a traveler from a foreign country, since measles no longer occurs naturally in the United States.
In an effort to reverse the drop in Somali vaccination rates, public health officials have been trying to directly debunk the idea that the vaccine causes autism, noting that many studies and scientific review panels have found no evidence of a link.
But vaccination rates continued to fall.
Now, Minnesota Health Department officials are trying a new approach that relies more on community leaders, building trust and talking more about the complexities of autism.
“We know that this is a complicated issue that is going to take long-term efforts,” said Lynn Bahta, an immunization consultant with the department. “You really have to have conversations and that is really very arduous, it is very slow.”
Since the new approach began, vaccination rates have still declined, but at a slower pace. And since the most recent outbreak emerged, state records showed a noticeable uptick in measles shots, although it is too early to know who is getting them.
‘I saw what measles can do’
The measles outbreak, and the vaccine argument, have been agonizing for many Somali parents.
Khadijo Ibrahim, a Minneapolis mother of four, vowed she would never vaccinate her children after her 6-year-old showed signs of autism at an early age following his one-year shots.
When she had another child three years later, she skipped the one-year shot because of what she now recognizes as an unfounded fear of autism.
But now, she says, the outbreak is a wake-up call she cannot ignore.
“I got paranoid after my son became autistic,” Ibrahim said in an interview Friday. “We were immunized in Africa, but when I came to Minnesota, I heard the vaccines in America have a lot of toxins. My stomach hurts every time I think about MMR vaccine.”
Since the measles outbreak, Ibrahim said, she has tried to enroll her daughter in Head Start but was turned away, making her realize the seriousness of the disease.
“Now that there’s this outbreak, I’m worried for my daughter because she’s not protected,” Ibrahim said. “Even though I have experienced a lot of misery with vaccines, I still believe in my heart that vaccines are important. You worry when your kids aren’t immunized.”
Safiya Ali, a mother of eight, said she shares her refugee experience with Somali families to stress the importance of the MMR vaccine. While her family was staying in a refugee camp in Ethiopia, she said, her sister’s four children caught measles. Ali, however, had vaccinated her children and says they were never infected despite living with her sister’s children.
“I saw what measles can do to kids,” Ali said. “It’s deadly. My kids shared blankets with their ill cousins and they never got the disease. The MMR vaccine saved our lives.”
Author to speak
Anti-vaccine activists insist that the Health Department is withholding research critical of vaccines and failing to tell Somali families about their rights to refuse immunization.
At their forum Sunday afternoon, a coalition of anti-vaccine groups plans to feature an author of several anti-vaccine books.
“We are looking to educate Somalis on their rights regarding vaccine law,” said Patti Carroll of the Vaccine Safety Council of Minnesota. “And to help them make informed decisions about whether they want to vaccinate their kids.”
Members of anti-vaccine groups have also appeared at forums for Somalis organized by the Health Department, distributing handouts that said that Somali children are being “vaccine-damaged.”
To counter that message, public officials have tried to present the overwhelming evidence that there is no link between vaccines and autism.
But public health officials say they’re learning that parents are more interested in learning about the causes of autism — so they can rule out the vaccine as a possible factor. As a result, they are talking to the Somali community about some of the known risk factors for autism and how to recognize signs of the disorder at an early age.
“We know that science is answering many of those questions,” said Asli Ashkir, a registered nurse consultant with the Health Department who does many outreach sessions with Somali parents.