Not Vaccinating Kids; Ignorance and Arrogance

We all knew this would happen with the amount of talk against vaccinations; here's real outbreak in Minnesota that was caused by aggressive anti-vaxxers on a community they knew would more susceptible to their influence.

Here's what happened via two stories in the Washington Post (red mine):
An outbreak of measles in Minnesota has sickened more than 30 children in recent weeks, primarily in the state’s large Somali-American community, where many parents avoid the measles-mumps-rubella vaccine because of unfounded fears that it causes autism.

Nearly everyone infected is unvaccinated, and all but a few are of Somali descent. So far, 11 children have been hospitalized.

The source of the outbreak is unknown, said Kris Ehresmann, infectious disease director with the state Department of Health. But since measles was declared eliminated in the United States in 2000, outbreaks in the U.S. are typically caused when international travelers are infected overseas and bring the virus home.

Nine other states have seen measles cases so far this year, but none has reported an outbreak of Minnesota’s magnitude, according to the Centers for Disease Control.
Minnesota law requires that a child be vaccinated before enrolling in child care, early education or school. But it also allows exemptions for medical reasons or “conscientiously held beliefs.”

The viral disease, can cause pneumonia, brain swelling, deafness and, in rare instances, death.
So how did the Somali community get hit so hard (besides the outbreak possibly coming in from out of the country)?

From the Washington Post:
The young mother started getting advice early on from friends in the close-knit Somali immigrant community here. Don’t let your children get the vaccine for measles, mumps and rubella — it causes autism, they said.

Suaado Salah listened. And this spring, her 3-year-old boy and 18-month-old girl contracted measles in Minnesota’s largest outbreak of the highly infectious and potentially deadly disease in nearly three decades. Her daughter, who had a rash, high fever and cough, was hospitalized for four nights and needed intravenous fluids and oxygen.

“I thought: ‘I’m in America. I thought I’m in a safe place and my kids will never get sick in that disease,’ ” said Salah, 26, who has lived in Minnesota for more than a decade. Growing up in Somalia, she’d had measles as a child. A sister died of the disease at age 3.
So why is this happening?
Salah no longer believes that the MMR vaccine triggers autism, a discredited theory that spread rapidly through the local Somali community, fanned by meetings organized by anti-vaccine groups. The advocates repeatedly invited Andrew Wakefield, the founder of the modern anti-vaccine movement, to talk to worried parents.

Wakefield, a British activist who now lives in Texas, visited Minneapolis at least three times in 2010 and 2011 to meet privately with Somali parents of autistic children, according to local anti-vaccine advocates. Wakefield’s prominence stems from a 1998 study he authored that claimed to show a link between the vaccine and autism. The study was later identified as fraudulent and was retracted by the medical journal that published it, and his medical license was revoked.

“It’s remarkable to come in and talk to a population that’s vulnerable and marginalized and who doesn’t necessarily have the capacity for advocacy for themselves, and to take advantage of that,” said Siman Nuurali, a Somali American clinician who coordinates the care of medically complex patients at Children’s Hospitals and Clinics of Minnesota. “It’s abhorrent.”

And activists from those groups started showing up at community health meetings and distributing pamphlets, recalled Lynn Bahta, a longtime state health department nurse who has worked with Somali nurses to counter MMR vaccine resistance within the community.
At one 2011 gathering featuring Wakefield, Bahta recalled, an armed guard barred her, other public health officials and reporters from attending.

Fear of autism runs so deep in the Somali community that parents whose children have recently come down with measles insist that measles is preferable to risking autism. One father, who did not want his family identified, to protect its privacy, sat helplessly by his daughter’s bed at Children’s Minnesota hospital last week as she struggled to breathe during coughing fits.

MMR vaccination rates among U.S.-born children of Somali descent used to be higher than among other children in Minnesota. But the rates plummeted from 92 percent in 2004 to 42 percent in 2014, state health department data shows, well below the threshold of 92 to 94 percent needed to protect a community against measles.

A University of Minnesota study that examined 7- to 9-year-olds in Minneapolis in 2010 found no statistical difference between the rate of autism among Somali children and white children, Ehresmann said.
While scores of studies from around the world have shown conclusively that vaccines do not cause autism, that is often not a satisfactory answer for Somali American parents. They say that if science can explain that vaccines do not cause autism, science should be able to say what does. 
And boy is that a problem.  Does medical science know the answer to everything?  Of course not.
But researchers don’t really know. A growing body of evidence suggests that brain differences associated with autism may be found early in infancy — well before children receive most vaccines. Other studies have found that alterations in brain-cell development related to autism may occur before birth. There are some genetic risk factors for autism, and advanced parental age has been associated with the condition.
California passed a vaccination law just a year ago.  From the LA Times:
The California vaccine law passed in 2015 was one of the most far-reaching inoculation laws in the nation. It bars parents from using religious or personal beliefs as a reason to excuse their children from enrolling in kindergarten without receiving all state-required immunizations. California joined just two other states — Mississippi and West Virginia — in making such a requirement as a condition for school enrollment.

The vaccination rate for California’s kindergartners soared this fall from the previous year, fueled by a state law that made it significantly tougher for parents to exempt schoolchildren from shots.

An astonishing 97.3% of California’s kindergartners reported receiving both measles shots, up from 94.5% a year ago and 92.6% reported in the fall of 2014, just before the Disneyland measles outbreak struck.

Vaccination rates for whooping cough, also known as pertussis, posted similar numbers.

The law requires that kids entering kindergarten and 7th grade have all their vaccinations, so elementary school children already older than kindergarten age will be required to be immunized eventually.

The UC system has said it will require vaccines for all new enrollees, but most young adults won’t encounter another vaccination checkpoint once they leave high school.


Tim said…
There was another interesting story on a maternal grandmother's smoking during pregnancy possibly affecting autism rates two generations later.

In other news, my kindergartener had all his shots at UW medicine, but SPS would not accept the doctor's office's standardized shot record printout. Instead, they made me laboriously fill out a tiny, detailed form by hand. And they wanted me to use a different date format and different names for the shots than the doctor's standardized printout. It took 1/2 hour of concerted effort to fill out this handwritten form. Even though my child had all his shots. And then they wouldn't let me submit it as a PDF. It had to be faxed to a fax number. Haven't had to do that for years. Took me ages to find one of those free online services that would allow me to send a scanned PDF as a fax. It's a pretty high bar. Considering my child had all his shots. And it took me hours to prove it to SPS in the only way they would allow. Seems like they could consider accepting UW Medicine's standardized form.
Anonymous said…
Agreed Tim,
Documenting vaccination for schools is a trip to the middle ages. I've had to fill those forms in countless times. Another medieval issue is the handling of sunscreen (schools require a doctors note to use it) - As the parent of a blazing ginger (Melissa, that is name calling but we use it affectionately!) I hope the legislature fixes that one. If the welter of bureaucratic barriers is oppressive to me I can't imagine what it must be like for parents who don't speak english or have other daily obstacles.

Anonymous said…
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Anonymous said…
I believe the sunscreen one has been corrected by the legislature.

Tim, that seems very lame, indeed.

Healthcare Barriers, my husband had red-hair; ginger is okay to use.
Anonymous said…
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Anonymous said…
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Anonymous said…
As someone whose family medical history is riddled with cancer diagnoses, including melanoma, I was especially grateful that the bill to allow sunscreen in schools passed both houses unanimously and was signed into law by Governor Inslee a few days ago.

Book Doctor said…
This article includes pictures of the children's sunburns that prompted one mom to go on a mission to change Washington state's sunscreen legislation:

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