Anti-vaccination advocates double down as measles kills 50 Samoan children

Doug Hendrie

2/12/2019 3:18:33 PM

Non-medical alternatives continue to be pushed as a solution to the Samoan measles epidemic, which has now killed dozens more young children.

Measles and vaccination in Samoa
The measles death toll in Samoa now stands at 53, with all but three deaths occurring among children under the age of four.

Samoan, Australian and American anti-vaccination advocates are continuing to spread misinformation, even as measles rages unchecked among a population with one of the world’s lowest rates of protection.
The World Health Organization (WHO) has directly linked anti-vaccination messaging to the spread of the highly contagious virus.
Director of the WHO immunisation department Kate O’Brien told The Guardian that misinformation on vaccine safety has ‘had a very remarkable impact on the immunisation program’ in Samoa.
‘This is now being measured in the lives of children who have died in the course of this outbreak,’ she said.
However, public health experts have cautioned that the problem is wider than just anti-vaccination advocacy, with a sluggish government response a key reason for the spread.
The death toll in Samoa now stands at 53, with all but three deaths occurring among children under the age of four. One family has lost three children to the virus.
Yet, despite recent drastic measures such as making immunisation mandatory and banning public gatherings, the number of new cases has doubled in a week to more than 3700, prompting a two-day government shutdown to allow public servants to help conduct a mass vaccination program.
Dr Mark Little, mission leader for the Australian Medical Assistance Teams (AUSMAT), told SBS the crisis is like nothing he has seen in seven overseas deployments.
‘I had heard how bad it was, but it is much worse than I had expected,’ he said.
‘I’ve never seen a health system that has been so overwhelmed.’ 
New Zealand vaccinologist Dr Helen Petousis-Harris told newsGP that, judging by social media activity, Samoa has a ‘thriving anti-vaccine community’.
She said international anti-vaccination advocates have become more active after the 2018 deaths of the two infants due to a nurse error while administering the MMR vaccine.
‘Certainly, the international anti-vaccine community have moved in since last year,’ she said.
‘Some of these activists are selling woo claiming to cure or prevent measles. Their pursuit of self-interest at the expense of the Samoan community is deplorable.
‘Some of the misinformation is quite shocking.’
Samoan anti-vaccination advocates like coconut farmer Edwin Tamasese are calling for Samoans to use vitamin A instead of the vaccine, while alternative healer Fritz Alai’asa has had his alkaline water ‘cure’ shut down.  
Samoan-Australian online influencer Taylor Winterstein has likened the new mandatory vaccination regime to Nazi Germany, claiming it is fascism, following similar claims by Samoan rugby player Eliota Fuimaono-Sapolu.
Ms Winterstein claims children are making a full recovery after using ‘simple and effective protocols … the media are still trying to rubbish and “debunk”.’
In an email to newsGP, Ms Winterstein said her ‘Making Informed Choices’ tour – which was originally planned to visit Samoa before a government backlash – was not about encouraging non-vaccination, but rather ‘informed consent, freedom of choice and vaccine injury awareness’.
The dangerous calls have prompted the Samoan Government to order that anti-vaccination advocates immediately stop discouraging people from seeking vaccination, while Prime Minister Tuilaepa Dr Sailele Malielegaoi suggested jailing anti-vaccination advocates.
The 2018 infant deaths – in which the children were given the measles vaccine mixed with a muscle relaxant anaesthetic instead of water – led to the suspension of the nation’s entire vaccination schedule. Two nurses were jailed for five years for the medical error.
Only 31% of Samoan infants received the measles vaccine last year, falling from as high as 90% in 2013, according to WHO figures.
One of the largest players in global anti-vaccination advocacy is Robert F. Kennedy Jr’s Children’s Health Defense, which a study recently found pays for a significant proportion of all such advertisements on Facebook.
Mr Kennedy is the nephew of former US President John F. Kennedy. His family members have distanced themselves from his views.
In the wake of the infant deaths, Mr Kennedy’s organisation ran social media posts questioning the safety of vaccines and did not update them when the true cause came to light.
Mr Kennedy visited Samoa in June this year, where he coincidentally met Ms Winterstein, who captured the moment.  

Mr Kennedy wrote to the Samoan Government after the measles outbreak began in November, calling on the health ministry to ‘determine, scientifically, if the outbreak was caused by inadequate vaccine coverage or alternatively, by a defective vaccine’, according to The Washington Post.
The huge outbreak has overwhelmed the small nation’s healthcare system, prompting medical teams from Australia, the US, the UK, French Polynesia and New Zealand to rush to help.
The first child died in mid-October, but the Government did not declare a state of emergency until 15 November.
Death rates from measles plummeted by 84% worldwide between 2000 and 2016, but the virus – dubbed the most infectious on the planet – is making a major resurgence in areas with poor primary care, access to immunisations, affected by conflict or where anti-vaccination advocates are gaining traction.
A New Zealand-based pro-immunisation advocate and editor of What’s the Harm? told newsGP anti-vaccination advocates are having an ongoing impact in Samoa.
‘When the two children died last year in Samoa due to the medical error, New Zealand and Australian anti-vaccine groups pounced on this, with several anti-vaccine activists going to Samoa to spread misinformation,’ he said.
‘There was already public distrust of the MMR vaccine as it took the Samoan Government so long to advise of the medical error, but anti-vaccine groups made the most of this.
‘Whenever there is a disease outbreak or vaccine incident, the organised Australian and USA anti-vaccine groups will weaponise local anti-vaccine posts in their misinformation campaign, giving them massive exposure via social media systems.’
The advocate, who did not want to be named, said he has been moved to get involved challenging anti-vaccination information after losing two friends to vaccine-preventable diseases.
Sydney University Professor Julie Leask, an expert in vaccine hesitancy, told newsGP the Samoan outbreak looks like a ‘perfect storm of tragedy.’
She said the Samoan Government’s decision to shut down the entire immunisation program for nine months after the deaths of the two infants, coupled with New Zealand’s significant outbreak and constant flows of people between that country and Pacific nations, set the scene for the current outbreak.
‘It’s such a stark example. A tragic [vaccine] administration error, very slow recommencement, no vaccines given to children for nine months and anti-vaccination activists leveraging public fear,’ she said.
‘What do you get? Vaccination rates go down, measles rates go up and people die.
‘If you miss vaccinating your country’s children for nine months and there’s a build-up of susceptible individuals because there’s been less than 95% coverage for a period of years, then you’ve got a population where measles will catch fire, very rapidly. And that’s what’s happened.’ 
Professor Leask said the Samoan outbreak is part of a global resurgence of the virus, linked to failures of primary care systems, war and conflict and vaccine refusal.
She said that to attribute blame only to anti-vaccination advocates, however, is an error.
‘We should be very wary of running to blame the anti-vaccination heuristic, when at the heart of this is a tragic administration error of vaccines,’ she said.
‘When the primary care systems are not up to scratch, you increase the chance of these tragic errors – and then [when] the government is very slow to recommence immunisations, you get measles.
‘Good immunisation programs need government support as much as they need public support. We need to examine what’s happened systemically. How can we improve the system? How can we reduce the chance of such a human error?’
But Professor Leask was clear that anti-vaccination ‘opportunists’ should also receive a degree of blame.
‘You do have opportunists who are culpable for going in and amplifying existing fear and concerns around vaccination, and using it to further whatever agenda they have,’ she said. ‘Those people should just be keeping right out of it, now that we’ve got so many dead.’
More than 58,000 Samoans have now been vaccinated, out of a population of almost 200,000. The vaccine takes up to 14 days to provide protection.
The modern anti-vaccination movement began with a fraudulent 1998 Lancet paper by Andrew Wakefield linking the measles vaccine with autism. Mr Wakefield was stripped of his medical licence and the paper was retracted completely in 2010.

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A.Prof Christopher David Hogan   7/12/2019 7:48:19 AM

What an absolute & utter tragedy that fear, ignorance & misinformation has caused so many deaths and compounded administrative calamities.
To blame administration errors alone & ignore the anti-vaccination sentiment is misplaced. This initial error would not have been compounded had it not been for anti-vaccination sentiment
Now is the time to highlight to our country & to the world the consequence of inaction. Now is the time to reinforce the message that the only way to prevent more suffering is to vaccinate.
It is not disrespectful to count the dead & the damaged- it is essential to save others.
We should not wait until the issue has settled & then act- as a student of history I can affirm that this delay & inaction never works.
Are people who arrive in Australia from Samoa being screened? What advice is being given t Australian doctors to deal with them