There's a Huge Measles Outbreak in Minnesota Due to Vaccine Skepticism

Experts explain how this happened—and how to prevent it from happening again.

Photo: Getty.

Minnesota health officials are ramping up vaccination recommendations for children after the state reported 48 recent confirmed cases of measles in three counties, with “more cases likely.” The scary outbreak has mostly affected unvaccinated Somali-American children, according to data released by the state's department of health on Monday. This is the largest measles outbreak for the state in recent history—online data reveals that the state has had 56 reported cases of the infectious disease over the last 20 years, not including the latest outbreak. And experts say anti-vaccine sentiments are to blame.

"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," Kristen Ehresmann, director of the infectious disease epidemiology, prevention and control division at the Minnesota Department of Health, told CNN, adding that the outbreak is “completely unnecessary” given that there is a vaccine that can prevent measles.

According to CNN, vaccine skepticism started in the state’s Somali-American community in 2008 after parents noticed a disproportionate number of Somali children receiving special education services for autism. Autism and vaccines are not linked, according to the wealth of research on the subject, but there was understandably still concern about what could be contributing to Somali-American children's autism. "At that point, the anti-vaccine groups just really started targeting the community," Ehresmann said. In response, vaccination rates of the measles, mumps, and rubella (MMR) vaccine dropped. British researcher Andrew Wakefield, who published a paper linking vaccines to autism that was later found to be fraudulent and was retracted, also visited the community several times.

Despite absolutely no scientific evidence, the anti-vaccination community continues to insist that there's a link between vaccines and autism.

Many major health organizations, including the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, the National Academy of Medicine, and the World Health Organization, have repeatedly stated that there is no connection between vaccinations and autism or other neurological conditions. Many studies have also backed up those statements.

Skeptics are specifically wary of thimerosal, a mercury-containing preservative used in some vaccines. The Food and Drug Administration (FDA) has extensive information on thimerosal and vaccines on its Web site, repeatedly stating that the preservative poses no harm to humans—and offering scientific research to back up those statements.

Thimerosal was removed as an ingredient from many vaccines in the late ‘90s as a precaution but, after research found it wasn’t linked with health problems, it was added to some flu vaccines, the CDC says. Federico Laham, M.D., medical director for pediatric infectious diseases at Orlando Health Arnold Palmer Hospital, tells SELF that signs of autism tend to surface earlier in life, which is also around the time that children receive vaccines—and that may help explain the connection. “People look for culprits for kids’ autism, but we can say that vaccination is not responsible for it,” he says.

The CDC recommends that children receive two doses of the MMR vaccine—the first dose at age 12 to 15 months and the second when they’re four through six years old. But unfounded vaccination fears are causing some parents to space out vaccines or avoid the vaccine altogether—and experts say that’s worrying.

The MMR vaccine is an essential part of keeping children safe and healthy.

“[Foregoing the vaccine] is dangerous because this is a serious infection of children,” William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells SELF. “People have forgotten that before we had vaccines in the U.S., each year 400 to 500 children died of measles and its complications.”

When someone contracts measles, they typically develop a cough, runny nose, red eyes, and a rash of tiny red spots that starts at the head and spreads to the rest of the body, the CDC says. But Schaffner points out that children often get complications of measles, including pneumonia and meningitis, which can be deadly. Laham agrees, noting that he recently treated a child who went deaf from pneumococcal meningitis that could have been prevented from following the MMR vaccination schedule. “There are unintended consequences of not vaccinating children,” he says.

Measles is also easily spread among people who are unvaccinated, Amesh A. Adalja, M.D., a board-certified infectious disease physician and affiliated scholar at the Johns Hopkins Center for Health Security, tells SELF. “It can remain suspended in particles in the air—it’s literally spread through the air,” he says. “Someone with measles can leave a room but those particles remain and can be infectious.” Ensuring that everyone who can get vaccinated does so also helps protect vulnerable populations (like young children or those with compromised immune systems) from contracting a deadly disease. This is what's known as "herd immunity," a phenomenon that occurs when people in a community are protected against an illness because the majority of them are vaccinated against it.

Hence why Adalja calls the MMR vaccine a “crucial component” of controlling measles. “It’s so highly contagious—that’s why we want vaccination rates to be as close to 100 percent as possible,” he says. However, Adalja points out that there are pockets in the U.S. where vaccination rates have fallen to “dangerously low levels,” including the Somali-American population in Minnesota, which has vaccination rates of only about 42 percent, according to the Minnesota Department of Health.

The Pan American Health Organization announced in 2016 that endemic measles, i.e., cases caused by local strains instead of imported ones, has been banished from the U.S. and the rest of the Americas. However, people can still contract measles from an infected traveler if they’re unvaccinated—and then it can spark an outbreak. “If a measles case from abroad gets in, it can work its way through an unvaccinated community quickly because it’s so highly contagious,” says Schaffner.

If you have concerns about vaccinating your children, experts urge you to talk to your child’s pediatrician about your fears. It can also be helpful to read information from reputable sources, like the CDC, American Academy of Pediatrics, and FDA. “You have to be informed and make choices on behalf of your kids who are too young to make them,” Laham says.

Adalja calls outbreaks like the one in Minnesota “very ominous,” noting that it’s harkening back to a more “primitive” time in medicine. “The anti-vaccination movement is pulling people back to an era of civilization when infectious diseases were the norm and many kids didn’t make it out of childhood,” he says. “The choice is clear here.”

The thing is, convincing skeptical parents to vaccinate their children is often incredibly difficult.

It's not enough to have facts on your side, and it's not enough to argue about those facts until you think your point must have gotten across. All that will do is make the person on the other side even more committed to their beliefs—or committed to ignoring everything you're saying.

Instead, bringing more parents around to the safety and efficacy of vaccination mainly comes down to empathy and finding common ground. An October 2015 study from Stanford University, for example, found that conservatives and liberals who worked to appeal to the opposite group's moral values were more successful at swaying opinions. This is actually very easy to do with parenting, because every parent just wants to keep their children happy and healthy.

Telling wary and fearful parents they're wrong because vaccines are safe, effective, and not linked to autism doesn't make them inclined to change their minds, according to a February 2015 study in the journal Proceedings of the National Academy of Sciences of the United States of America. But when skeptical parents learned about how dangerous diseases like measles, mumps, and rubella can be and that a vaccine can prevent these diseases, saw photos of children suffering from these illnesses, and heard from a mom whose child almost died due to measles, they were more inclined to support vaccination.

So, when we talk about a health crisis like the one brewing in Minnesota, let's keep this in mind: Facts and anger aren't going to change minds. Empathy and understanding in an effort to reach the common goal of keeping children safe might.

This story originally appeared on Self.

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