The current measles outbreak, largely occurring in the Somali-American population in Minneapolis, requires a brief history lesson if we are to understand what public health and health care workers are up against in preventing new cases and even possible deaths.
I was state epidemiologist at the Minnesota Department of Health in 1990, when 460 cases of measles occurred, largely in the Twin Cities Hmong community. Three children died in that outbreak; I can remember each one of them and their family’s grief as if it were yesterday.
Those tragic deaths didn’t have to happen. We had a highly effective and safe measles vaccine that could have saved those three lives had the children been vaccinated. But at that time officials didn’t have the means to identify children who lacked access to regular medical care. Painfully, these kids fell through the cracks of our statewide immunization efforts.
We learned some difficult lessons from that experience and worked hard to solve the vaccine access problem. For the past 27 years; we’ve not had another outbreak of measles because of a lack of vaccine access in Minnesota.
Instead, we’ve witnessed a new kind of measles outbreak — one in which parents decide not to vaccinate their children, largely out of an unfounded fear about vaccine safety. We have had measles outbreaks in 1991 (27 cases associated with the Special Olympics); 1995-96 (25 cases in a single religious community); 2011 (21 cases in the Somali-American community) and now again in 2017. In each of these outbreaks, cases occurred largely in unvaccinated individuals whose parents chose not to vaccinate them. Until we can effectively address the public’s misconception that there is a safety issue with measles vaccine, these kinds of outbreaks will only grow in number and size.
Measles vaccine safety questions were first raised by Andrew Wakefield, a British physician who published a paper in the medical journal “The Lancet” claiming there was a link between the measles, mumps and rubella vaccine and the occurrence of autism and bowel disease. This paper was subsequently retracted by the journal after a detailed investigation of the work documented multiple examples of scientific fraud and dishonesty, abuse of developmentally challenged children and financial fraud. The journal editors concluded that the paper was “utterly false” and that they had been deceived. Shortly thereafter, Wakefield’s medical license was revoked by the U.K. medical register for the deliberate falsification.
Tragically, Wakefield’s dangerous legacy lives on in the form of organizations and individuals who continue to spread his fraudulent conclusions, particularly about the measles vaccine causing autism. Every parent’s nightmare is receiving a diagnosis that their child has autism, regardless of severity. So it is only reasonable that all parents will avoid any action that might place their young children at an increased risk.
But they must know that, despite the fraudulent claims of a few, receipt of measles vaccine DOES NOT put a child at increased risk of developing autism. There are few areas of public health science that have been more studied than this issue; the answer is unequivocal.
The current measles outbreak will continue in Minnesota until we vaccinate those who are at high risk of exposure, or until most of the unvaccinated children eventually develop measles. If the outbreak ends because of this latter scenario, it will last for many more weeks, there will be many more cases and, inevitably, some children will die. If this outbreak continues to spread, vulnerable children across Minnesota, including those who are too young to be vaccinated or who are immunocompromised, potentially will be infected.
All of us must stand up against those who exploit vulnerable Somali-Americans and who spread fraudulent information about measles vaccine. For those few licensed health care professionals — like doctors, nurses, chiropractors and pharmacists — who publicly espouse this fraudulent and dangerous information, it’s time their colleagues file complaints with their respective licensing boards and formal action be taken. They are putting children’s lives at risk.
Michael Osterholm is regents professor and director of the Center for Infectious Disease Research and Policy, University of Minnesota.