2019-04-20_New_Scientist

20 April 2019 | NewScientist | 23

Minnesota, resulting in 75 cases.
“At the time of the measles
outbreak, it was the holy month
of Ramadan, so when I was
speaking to parents, I was asking
them to please stay home and not
go to the mosque if they don’t
want to vaccinate their child,” says
Fatuma Sharif-Mohamed at the
Minnesota Department of Health.

Trusted information

Sharif-Mohamed is Somali-
American herself, and the
department relied on her and
other Somali-American staff to
act as sources of information that
the community could trust. “You
have to make them understand
in their language,” she says.
Lynn Bahta, who also works at
the Minnesota Department of
Health, says that appealing to
people’s faith helped sway some
to vaccinate their children.
“They believe that if you’re sick,
you stay home and don’t spread
it to others. The cultural element
of that faith was to the advantage
in this kind of outbreak,” she says.
The department made the
recommendation that parents
keep their children out of school
and public places, but didn’t have
to go so far as to mandate it.
Similar steps were taken in
Ohio in 2014, during a measles
outbreak centred on the Amish
community. There were
383 measles cases across nine
counties. Amish tradition doesn’t
explicitly forbid vaccinations,
although many people hadn’t
been immunised. Public health
officials in Ohio worked with
local leaders to gain the trust of
parents and ultimately vaccinate
a third of the Amish community.
While these approaches were
successful, the anti-vaccine
movement and the resulting
decline in vaccination rates
around the country has meant
that public officials are faced with
taking harsher action.
“We have received reports
that there are people attending
so-called measles parties,

bringing people together to

purposely get exposed,” said

Herminia Palacio, New York City’s

deputy mayor for health and

human services, at the 9 April

press conference. “We have

seen people who have been

hospitalised, people who have

had to be admitted to the

intensive care unit due to

complications. Thank goodness

we haven’t seen a death, yet.”

The emergency vaccine

mandate in New York City goes

even further than a controversial

measure taken in nearby

Rockland County a few weeks

earlier. As of 8 April, there were

168 confirmed measles cases in

the county, which is about

65 kilometres north of New York

City and also hosts a large

Orthodox Jewish community.

On 27 March, county public

health officials issued a

month-long ban on unvaccinated

children in public places. Those

in violation faced a $500 fine or

up to six months in jail.

John Lyon, a spokesperson for

Rockland County, says the order

resulted in almost 700 new MMR

vaccinations. “The final number

is likely to be higher than that,

because doctors have up to two

weeks to update the state on those

vaccinations,” he says. “We did

hear anecdotally that a lot of local

doctors’ offices were very busy

in the days following the state

of emergency declaration.”

Ten days after the ban was

ordered, a judge blocked the

county from enforcing it, in

response to a lawsuit brought

by parents. The judge deemed

the ban too broad and said the

outbreak doesn’t constitute a

disaster in which emergency

powers should be used.

Efforts to dismantle the

anti-vaccine movement are likely

to face similar hurdles. Hotez says

removing NMEs, as West Virginia,

California and Mississippi have

done, will be a key battleground.

“Children have a fundamental

right of access to vaccines to

prevent serious or deadly

infections and we shouldn’t

take that right away,” he says.

But Bahta says that may pour

fuel on the fire. “Some days I think

we should take away all NMEs,

and other days I think having that

leeway probably de-intensifies

the militant nature in people who

have really strong anti-vaccine

sentiments,” she says.

Forcing people to comply may

make them resist. Treating them

as parents who are concerned for

their children’s health, and letting

them know you have that shared

goal, may be more effective.

In the end, we will have to wait

and see whether compassionate

education or regulation is the

better approach. It is likely to be

a little bit of both. ■

“Children have a right

of access to vaccines

to prevent serious or

deadly infections”

For daily news stories, visit newscientist.com/news

Anti-vaccine messaging has

spread like wildfire – with social

media the tinder. As measles cases

have surged in recent months, tech

companies have announced policies

to try to curb vaccine misinformation.

Facebook and Instagram won’t

remove incorrect content, but will

aim to stop promoting it. YouTube

announced that it will stop selling

adverts on videos with false vaccine

information, and Pinterest won’t

return any results if a user searches

for any information about vaccines.

While failing to remove false

information does little to help

matters, getting rid of vaccine

content all together could end

up being even worse.

“What Pinterest did is the wrong

thing to do,” says Peter Hotez

at Baylor College of Medicine in

Texas. “They quashed all the

pro-vaccine stuff, too. It sends

a chilling message that there’s

an equivalence between the

anti-vaccine movement and what

the medical community is saying.”

COMPUTER VIRUS

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A 2018 study mapped US counties where more than 400 pre-schoolers were opted out of vaccination

programmes due to religious or personal beliefs. Many measles incidents in 2019 were in these

counties or those close by

counties where 400+ pre-schoolers were opted out neighbouring counties affected

Clark County, WA

Salt Lake County, UT

Utah County, UT

Travis County, TX

Multnomah County, OR

Jackson County, MO

Tarrant County, TX

Collin County, TX

Harris County, TX

Oakland County, MI

Wayne County, MI

Macomb County, MI

Allegheny County, PA

Maricopa County, AZ

Pima County, AZ

King County, WA

Spokane County, WA

2 cases

39 cases

1 cases

4 cases

SOURCE: doi.org/gdx6rd

1 case

73 cases

6 cases

1 case