“T

hey are everywhere. Like, every event, every forum.”

This is how anti-vaccine activists were described by a community outreach worker in Minneapolis, where the Somali-American population was systematically and incessantly warned against vaccines. Activists including Andrew Wakefield — who published a fraudulent paper in the late ’90s pushing the vaccine-autism myth – made multiple visits to the Minneapolis area to engage a community that was trying to find its place in society.

The campaign led to an increase in mistrust of vaccines, particularly measles, mumps, and rubella vaccine, among Somali-American parents, as well as dangerously low vaccination rates — 41 percent among 24-to-35-month-olds, according to one estimate. You don’t have to be an epidemiologist like me to comprehend the consequences of such drastic drops in vaccination rates.

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Minnesota is now experiencing its worst outbreak in 30 years. It’s centered among Somali-Americans.

But the consequences of all this extend far beyond measles infections and far beyond Minnesota.

Measles is not a trivial disease. The virus that causes measles is one of the most infectious human pathogens. Before the introduction of routine measles vaccination, an estimated 3 million to 4 million cases of measles occurred every year in the United States.

The measles virus depresses immunity among those who get infected — thus impairing the body’s ability to respond against other infections. In a recent groundbreaking paper in Science, Michael Mina — then a student at Emory University — confirmed that measles vaccination played a major role in decreasing deaths from other infectious causes.

Recognizing the importance of measles, the Centers for Disease Control and Prevention, along with other key stakeholders, undertook efforts to eliminate indigenous transmission of measles from the country. This effort was successful in eliminating endemic spread of measles in the US by the year 2000. Since then, measles outbreaks have been mainly associated with importation due to travel.

But the major public health success of measles elimination is under threat. The concern that localized outbreaks such as the one in Minnesota can morph into large, national-level epidemics is not far-fetched. Many high-income countries — such as Germany and France — have seen large national outbreaks in recent years. In fact, multiple countries in Europe are in the middle of large measles outbreaks right now.

My colleagues and I assessed the risk of large measles outbreaks in the US. In a paper published in the American Journal of Epidemiology, we reported that approximately 12.5 percent of US children and adolescents are susceptible to measles. Moreover, we found that even a modest drop in the vaccination rate could result in the breach of the “herd immunity threshold” — that could result in breakdown of community level protection against measles.

When such outbreaks happen, it is often minority groups that get blamed for bringing disease into the country. For example during the so-called Disneyland outbreak of 2014-2015, multiple politicians expressed unfounded concerns about illegal immigrants bringing measles into the US. Then there is the not so proud history of blaming infectious disease importation and spread on ethnic and sexual minorities.

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It is in this context that many of us in public health, who also believe in civil and human rights, worry about the Minnesota Somali-American community being blamed for something bigger than the current outbreak — even though the community itself has been a victim of an onslaught of propaganda and misinformation disguised as empathy.

If there is a lesson in this unfolding tragedy, it is that public health authorities and practitioners need to work hard to build trust and resilience among minority communities targeted by vaccine skeptics. This resilience to misinformation is important for preventing and controlling outbreaks. But building resilience is also important for ensuring that frequently marginalized communities do not face xenophobic allegations in an environment increasingly inhospitable to communities of immigrants.

Saad B. Omer is the William H. Foege Chair in Global Health and a professor of global health, epidemiology, and pediatrics at Emory University.

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  • Informed consent, Full Disclosure, and Human Rights:

    Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria – Vaccine Innovation Working Group, Council of 100, Vaccine, Public Health Committee, Infectious Diseases Society of America, NVAC Maternal Immunization Working Group – Co-Chair, Pan American Health Organization, National Vaccine Advisory Committee, Pan American Health Organization

    The integrity of your professional life, including but not limited to participation in your listed groups above is predicated on your verifiable unimpeachable objectivity.

    The public is well aware of the Funding and Findings interdependency. Please disclose potential incompatible interest.

  • Statement by Isabella Thomas, mother of two boys who were part of the Lancet Study

    “It is now time for the truth to be told”

    I, as a parent of two children in the Lancet study, have had to speak out about the vicious attacks on Dr. Andrew Wakefield by his own government, the US government and the media blaming him for the measles outbreak in Wales. The Lancet study was not paid for by the Legal Services Commission and our children were referred to the Royal Free Hospital because they were very sick and would still have had investigations done even if they were not part of the Lancet research as many more children have done after the Lancet study by other consultants at the Royal Free and other hospitals in London.

    Dr. Andrew Wakefield listened to the concerns of many parents about their sick children suffering with bowel conditions and a form of Autism, a bowel condition and brain damage that was ignored by other professionals. These parents were demonstrably ‘black listed’ for saying their children became ill after the MMR vaccine.

    Parents were speaking about this situation years before Dr. Wakefield came on the scene and our government also knew about these concerns years before the Lancet study yet they did nothing to investigate, leaving hundreds of other children at risk of side effects. Our government did not listen to parents but accused them of making the symptoms up and threatening to take their children away if they did not stop making a connection with MMR vaccine. As a result, these children and young adults live in a great deal of pain to this day (one doctor saying to my son ‘we believe you believe you are in pain’).

    There is much more I could say about the experience of my family and others but I want to make it clear that the children’s claims in relation to MMR were supported by many other experts in several disciplines all of whom provided reports for the court. I attach a list of them. These experts would all have given evidence at the Royal Courts of Justice on behalf of hundreds of children we claim were damaged by the MMR vaccine had the cases been allowed to continue. In addition, the solicitors representing the claimants were in touch with and drawing on the expertise from many more than these, but many did not want to be formal experts. I don’t know how much the experts listed were paid, but they were all paid fees just as Dr. Wakefield was in the normal way that experts are paid in litigation cases (and probably much less than the defendants’ experts were paid!).

    MMR Claimant Experts (who produced reports that were served)

    Professor M B Abou-Donia

    Professor of Pharmacology and Cancer Biology and a Professor of Neurobiology, Duke University Medical Centre

    Pharmacology and Neurobiology

    Dr Kenneth Aitken

    K.Aitken Consultancy, Independent Consultant

    Child Clinical Neuropsychologist

    Professor William Banks

    Professor in the Department of Pharmacology & Physiology, both departments at Saint Louis University School of Medicine

    Pharmacology and Physiology

    Dr. Edward Bilsky

    Associate Professor of Pharmacology, University of New England College of Medicine

    Pharmacology

    James Jeffrey Bradstreet, MD, Fellow, AAFP

    International Child Development Resource Center Adjunct, Professor of Neurosciences, Department of Psychology, Stetson, University Celebration, Florida

    Child development

    Vera S. Byers, M.D., Ph.D

    President of Immunology, Inc

    Immunologist

    Professor Neal Castagnoli, Jr.

    Peters Professor of Chemistry, Virginia Tech, Blacksburg, VA

    Chemistry

    Dr A Peter Fletcher MB BS PhD FFPM (Dist)

    Former regulator Industry Expert

    Professor Noam Harpaz

    Associate Attending Pathologist, The Mount Sinai Hospital, Director, Division of Gastrointestinal Pathology, The Mount Sinai Hospital, and Associate Professor of Pathology, The Mount Sinai School of Medicine, New York

    Pathologist

    Professor Ronald C. Kennedy, Ph.D

    Professor and Chairman of the Department of Microbiology and Immunology at Texas Tech University Health Sciences Center located in Lubbock, Texas

    Immunologist

    Marcel Kinsbourne, D.M. (OXON), M.R.C.P. (LOND).

    Research Professor of Cognitive Studies at Tufts University and Professor of Psychology at the New School University in New York

    Neurologist

    Arthur Krigsman MD New York University Hospital

    Pediatric Gastroenterologist

    Dr John March

    Head of Mycoplasmology at the Moredun Research Institute (MRI), Edinburgh Vaccine development

    Molecular Biologist

    Professor John J Marchalonis

    Professor and Chairman, Department of Microbiology and Immunology, University of Arizona, College of Medicine, Tucson, Arizona

    Microbiologist and Immunologist

    Professor Johnjoe McFadden

    Professor of Molecular Genetics at the School of Biomedical and Life Sciences, University of Surrey, Guildford

    Genetics

    John H. Menkes, M.D Professor Emeritus of Neurology and Pediatrics, University of California, Los Angeles Director Emeritus of Pediatric Neurology, Cedars-Sinai Medical Center

    Neurologist

    Dr Scott M Montgomery

    Karolinska Institutet, Stockholm, Sweden

    Epidemiologist

    Professor John J. O’Leary, MD, DPhil, MSc, BSc, FRCPath, FFPathRCPI

    Professor of Pathology at Trinity College Dublin and Consultant Histopathologist, St. James’s Hospital, Dublin and the Coombe Women’s Hospital

    Pathologist

    Professor Samuel Shapiro MB, FRCP(E)

    Visiting Professor of Epidemiology, Mailman School of School of Public Health, Columbia University. Emeritus Director, Slone Epidemiology Center, Boston University School of Public Health

    Epidemiologist

    Dr Orla Sheils

    Senior Lecturer in Molecular Pathology, University of Dublin, Trinity College (TCD).

    Molecular Pathologist

    Dr Fiona Scott BSc (Hons) PhD C.Psychol

    University of Cambridge

    Chartered Psychologist

    Dr Carol Stott BSc (Hons) PhD (CANTAB) C.Psychol

    University of Cambridge

    Chartered Psychologist

    Professor SAMY SUISSA

    Professor of Epidemiology and Biostatistics, McGill University and Royal Victoria Hospital Montreal, Canada

    Statistician

    Professor Richard Tedder

    Head of the Joint Department of Virology, University College London. Also Clinical Lead for the UCLH NHS Trust Department of Virology and Clinical Head of Microbiology Services UCLH NHS Trust

    Virologist

    Professor Edward J Thompson Doctor of Medicine (MD, FRCP,FRCPath) and a Doctor of Science (DSc,PhD)

    Head of the Department of Neuro-Immunology at the National Hospital for Neurology & Neurosurgery

    Neuro-Immunologist

    Professor John Walker- Smith

    Emeritus Professor of Paediatric Gastroenterology in the University of London

    Paediatric Gastroenterologist

    Dr. Troy D. Wood

    Associate Professor in Chemistry and Adjunct Faculty in Structural Biology at the University at Buffalo, State University of New York, Buffalo, NY, USA

    Chemistry and Structural Biology

    The court case was not heard and parents did not lose. Legal Aid decided to pull their funds for the sick children at the last minute. Legal Aid is government run and the government took out an indemnity to protect the drug companies from parents suing and we as parents had no idea that the litigation case was set up to fail right from the start. The government could not afford for the children to win and thus they could not afford for the statements from the experts to be read out in court. I have these reports and am told they are sealed and I am not allowed to produce them here, however tempted. Below is a ‘summing up by Justice Keith when a few of us parents tried to continue the case without the support of Legal Aid and spoke in front of a room full of drug company representatives about our sick children at the Royal Courts of Justice. I was very proud to be part of that group.

    “It is important for the claimants’ litigation friends to understand why their children’s claims are not being allowed to proceed. It is not because the court thinks that the claims have no merit. Although this litigation has been going on for very many years, the question whether the claims have merit has never been addressed by the court. The reason why the claims have not been allowed to proceed is because everyone has realistically recognised for some time that it is just not practicable for the claims to proceed without public funding. With no realistic prospect of public funding being restored for any of the claims save for the two which are now to proceed as unitary actions, the dissolution of the litigation became inevitable.

    Before leaving the litigation, I wish to express my thanks to the defendants’ legal teams for the assistance they have given the court. Although at all times advancing the interests of their clients as is to be expected in adversarial litigation, they recognised the needs of the claimants’ litigation friends, and provided them with all the information they needed, as well as affording them the occasional indulgence. The assembly of the various bundles of documents, and the preparation of the skeleton arguments, were of an exceptionally high order. But my final words must go to the claimants’ litigation friends. As I said in an earlier judgment, no-one can fail to have enormous sympathy for the parents of the children to whom this litigation has related. They have spoken eloquently and with great feeling of the tragedies which befell them when their children became ill. They blame the vaccines produced by the defendants for damaging their children, and they are bitter over their inability to proceed with their claims. But when they came to court, they always expressed themselves in a measured and moderate tone, despite their disenchantment with the Legal Services Commission which they believe has let them down, and at all times they treated the court with courtesy and respect. They made my difficult task less wearing that it might otherwise have been. I am grateful to them for that.” Justice Keith.

    Dr Andrew Wakefield has made front page news over the last few days in some of the national papers prompting an immediate reaction that it is lunacy to give him space, and that what he says is “balderdash”. What is highly questionable (and vindictive) is to blame him for all the ills of MMR vaccine because he published a paper in the Lancet 15 years ago (which has neither been “discredited” nor did it claim that MMR causes autism) and because he suggested that children should be given the single measles vaccine.

    The association between autism and MMR was never assessed by the UK courts because of the withdrawal of legal aid. In the USA and Italy the courts have awarded compensation for MMR vaccine damage. The USA also has an expert committee for assessing claims of vaccine damage and they have compensated other parents for damage caused by MMR which did not then need to go through the full legal process.

    How long does it take the UK government to learn that cover-up is invariably a more serious matter than the original crime or mistake? It’s time the spotlight was turned on Professor David Salisbury, who had little or no background in immunization and had only been in post a short time when he reassured his committee that they did not need to worry about the adverse effects of Pluserix despite its withdrawal in Canada and serious reports from Japan. It’s time to turn the spotlight on the process by which I believe Brian Deer was recruited by the Department of Health to help rescue their MMR programme. It is, of course, easy to conjecture and it needs a full enquiry which must come sooner or later, the results of which demand full media attention.

    I am aware that in 1992 two of the three brands of MMR were withdrawn overnight on the safety ground that they caused viral meningitis and that when MMR was first introduced the Department of Health stated that the single vaccine would continue to be available. For their own reasons they changed their minds later. Had they not done so, those who had concerns could have continued to protect their children from measles and this present outbreak would not be happening.

    I know that it is officially denied that there is any link between the vaccine and any form of autism (even though American and Italian courts appear to have accepted the link). What is not denied is that the rate of autism has increased substantially since the 1990s (from about one in 2500 to as many as one in 50). Instead of blaming Andrew Wakefield every time there is a measles outbreak why does the Government not put funding into finding the cause of this distressing condition? If it can be shown that the cause of the increase in autism has absolutely nothing to do with vaccines, then that will remove the suspicion that it does and you can all forget that Andrew Wakefield ever existed.

    Governments should be putting huge resources into finding out what is causing this disabling condition which is putting an immense strain on families and draining the welfare resources of the UK and other countries, and attacking doctors and parents of telling lies

    By not listening to the Experts, families and more importantly to the children then this in my opinion has to come into the category of “child abuse”.

    Professor John Walker Smith, who was part of the Lancet team, was exonerated in March 2012 in the Autism MMR GMC Case. The GMC issued the following statement following the judgment “Mr. Justice Mitting has made a number of criticisms about the inadequacy of the reasons given by the panel for the decisions they made on the charges facing Professor Walker-Smith. The panel of medical and non-medical members, having heard all the evidence, were required to set out very clearly why they reached the decisions they did. They failed to do that in relation to key questions, including whether Professor Walker-Smith’s actions were undertaken for the purpose of medical practice or medical research and whether procedures performed on the children were clinically necessary. These were important points that needed to be addressed by the panel in the determination and the failure to do so was the major cause of Mr. Justice Mitting allowing the appeal”. (Extract of official GMC Statement).

    In my opinion, this also stands for Dr. Wakefield who did not have the funds to challenge the GMC as Professor Walker-Smith did.

    Isabella Thomas.

    Mother of two boys who were part of the Lancet study

    • Isabella, None of what you just typed in means anything. Wakefield was discredited and debunked time and again. Here’s the problem with the false autism link: kids are getting vaccines right when a person would start to exhibit autism symptoms, but correlation does not equal causation. Parents just don’t want to admit their kids are “flawed” in some way. It’s ok, we’re all flawed. You don’t have to blame someone or something. My son was going to get a flu shot, flinched when he saw the needle about to go into his arm. Immediately broke out in hives. Was it a vaccine “injury”? Is he allergic? NO, because NOTHING was injected. It was a stress reaction. My daughter almost faints before, during and after vaccines. Again, a stress reaction. Vaccines do NOT cause autism!

    • No, vaccines eradicate disease. You have missed out on seeing the ravages of these diseases because most of us are smart and get vaccinations. All you anti-vaxxers are doing is putting your children at risk and creating a generation of unprotected adults. Measles, for example, can cause stillbirths and birth defects if the mother contracts measles during pregnancy. YOU are playing with fire. I would bet that if Ebola was running rampant where you live you would be first in line to get a vaccine if one was developed.

  • Many years ago, I lost a sibling to a childhood disease now virtually eliminated by vaccines, but I have never heard of or read about children being hurt or killed by vaccines except from the dishonest Wakefield and other uncreditable sources. All properly done studies shown vaccines are safe and beneficial.

    • Parmelee, sorry for your loss.

      Unfortunately, there have been many children who have died or have been seriously injured from vaccines. Pharma, the medical community, and media report that those injuries are rare. But they do happen.
      Your assessment of Wakefield is your opinion. And he never claimed that the MMR was linked to autism. That was the media and Pharma manipulating the facts.
      What we are missing in this discussion is the lack of medical outcome studies of the injured and why that is happening. Yet our government is mandated to conduct this studies in the NVICP. We just do not know why one child has a severe reaction to a vaccine, an acute encephalopathy, or suffer seizures.

    • Wayne, you are wrong. Parmalee’s assessment of Wakefield is not his/her opinion. Wakefield was found by a five member statutory tribunal to have “failed in his duties as a responsible consultant”, acted both against the interests of his patients, and “dishonestly and irresponsibly” in his published research, and was barred from practicing med in the UK. There have not been many children who have died or have been seriously injured by vaccines.

  • Stewart, what would you do if your child was vaccine damaged? What would you do Stewart if your child became 24 hour care, was in so much pain he would rather not live in this world, is not independent, fits, was normal until a few hours after the vaccine and your doctor believes you but says he is too frightened to say anything because he has a mortgage to pay. What would you do? Do you not realise parents gave their children and babies vaccines jut like you did. The only difference is that our children suffered badly and are not reconised as collateral damaged. So very sad Stewart and thank god this has not happened to you as I would not wish this life on my worst enemy.

  • We live in Medieval Ages when it comes to health in America, vaccination program being one of the greatest crimes against humanity committed by the big pharma. It is the only industry exempt from litigation because of so many law suits directed at their vaccination practices that it asked Congress for protection or it would cease making vaccines alltogether. So now we are stuck with massive amounts of vaccine damaged children and ruined lives of their parents from industry that can not be even held accountable for its crimes. 69 forced vaccines filled with mercury, aluminum, live viruses and mutated genes and never ever tested for cancer causing properties and we are forced to have it injected into newborns? Insanity of the kind world has never seen.

    • No, we do not live in Medieval ages. We no longer have polio, a horrible disease that left thousands disabled or dead. The reason you and your kids did not get polio is because immunizing everyone eradicated the virus. And yes, strangely enough, a FEW children have adverse serious reaction to vaccines, but those numbers are very small compared to all the lives saved from polio, measles, chicken pox, hepatitis B. Moreover, a lot of these “adverse reactions” are no more than associations in the greater majority of cases. Today’s vaccines have no mercury and no relationship has ever been made with them causing cancer. HOWEVER, hpv and hbv vaccines PREVENT CANCER. Crazy huh?

    • Vidvuds, we DO NOT have “massive amounts of vaccine injured kids”. It’s just not true. Furthermore, per the CDC: In the United States, vaccines against measles, mumps, rubella, chickenpox, rotavirus, polio, and seasonal influenza vaccines do not contain added adjuvants(aluminum). Futhermore, thimerosal (mercury), has not been used in childhood vaccines since 2001. Vaccines are not “filled” with all this stuff.By the way, thimerosal is not the same kind of mercury you find in fish. Thimerosal doesn’t stay in the body like that kind of mercury. Lastly, vaccines are not “forced”. You do have choices. Quit spreading lies and hysteria.

  • All parents of vaccine damaged children too their children and babies to their doctors to have them injected with vaccines so how can you call them ‘anti-vaccine’ These same parents then watched as their children and babies die and hundreds injured by these vaccines. What do you expect them to do? Go to their doctor for help, they did but got none. Put yourself in their shoes, what would you do? They watch their children and babies suffer every day in pain with no help into why this happened. Too many parents reporting vaccine damage and ignored. This is tragic. Do you think parents want to believe vaccines caused their children to suffer? Parents were ‘eye witnesses’ to this tragic event. Look at the side effects leaflet that comes with the vaccines and not the one the government give to parents, you will be shocked to see the difference.

  • Article is crap
    Safety advocates providing info on legal exemptions
    MDH got caught ignoring community intil late 2008
    And a current 220 + whooping cough outbreak in the state. No mention of vax failure.

    • Wayne, no vaccine is 100% effective. Everyone knows that. It’s simple probability and statistics. The more who are vaccinated + boosters, the less chance you will contract the disease and the less chance it will spread. You are also protecting infants who can’t get vaccinated yet, people who are sick who can’t get vaccinated at the present time, and immuno-compromised individuals who may never be able to get a vaccine. Vaccinated adult women will be less likely to contract measles while pregnant and have stillbirths or children with birth defects. See how that works?

    • What about the kids that die or are harmed from vaccines? Why do you get to choose for everyone what level of risk is acceptible?

    • Zane Shaw: Counterparties to objective reasoning obscure truth with elaborate fact aliases. Interrogation of ones knowledge is the only “vaccine” protecting you from Pharma’s Bitches. It’s also the only cure….

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