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Measles death toll in Samoa rising due to anti-vaccination sentiment, according to BYUH professors

Officials in Samoa prepare plans for vaccinations throughout the island

Measles continues to spread like wildfire through Samoa, with about 50 cases being reported per day, according to the official Government of Samoa Twitter. The number of dead, as of Dec. 14, is 72, with more than 5,200 people sick. Most of the dead are children. BYU–Hawaii professors said much of the problem comes from low vaccination rates, caused by fear and misinformation being spread throughout the Pacific.

“Seeing these babies and kids very sick and some dying, it’s heartbreaking,” expressed Christina Akanoa, an adjunct professor of political science. “This is not a joke. It is not something to politicize.”

Colby Weeks, assistant professor of science, added, “There are thousands of people who are horribly sick and going to the hospitals, putting a massive strain on the healthcare system. This is imminently avoidable because of the healthcare system. Headlines always say deaths, but there is a lot more going on than those individuals. Pick the easiest route and get vaccinated.”

Line Kruse, a special instructor, explained the situation is occurring all across Oceania, but it is worst in Samoa. “There is an epidemic in Samoa. There have also been measles reported by the World Health Organization and UNICEF in New Zealand, Australia, Tonga and Fiji.

“It has been declared a state of emergency in the Kingdom of Tonga, the Republic of the Fiji Islands and Samoa. Samoa, however, is the only country in Oceania, as of this entire year, that has this many reported deaths.”


What’s going wrong

Akanoa shared the death toll is so high in Samoa because their vaccination rate is much lower than the other Pacific Islands. “This is due to a lack of understanding with parents about how important it is to vaccinate your children. There are still people out there who don’t believe in vaccination. With this outbreak, we know it is the only solution.”

According to one NPR article, the vaccination rate dropped from 58 percent in 2018 to 31 percent in 2019. The situation has become urgent, and unvaccinated homes are being marked with red flags as part of a mass door-to-door vaccination campaign by the government.

“People also rely heavily on their faith,” shared Akanoa. “When things like this happen, they have this really great faith Heavenly Father will not let anything worse happen. When children started dying, they finally realize that maybe God wants them to do something about it.”

Kruse said, “The government of Samoa has gone through several series of responses to the measles epidemic. They started to mandate vaccinations, but as of Dec. 5 and 6, they have shut down the government. They have shut down roads. They have shut down public gatherings.”

One purpose of the government shutdown, said Akanoa, is because “all the government workers in the public sector are going out to help with vaccinations and to assist families.”

The biggest argument of anti-vaccination supporters in Oceania, or anti-vaxxers, according to Kruse, is vaccinations made in India, which is where most Oceanic countries get their vaccinations, are lower quality than European-made vaccines.

“The anti-vaxxers are trying to create this false narrative that [vaccines] from India are bad for you, which is very Eurocentric and downright racist … It is reckless because there are no scientific journals that validate any deaths attributed to manufacture vaccines from India,” she explained.

One anti-vaxxer on Twitter wrote, “Talking with friends. Most are pro-vax, but none of them want to harm their children with this Indian vaccine. People are really going to be hiding their children in the attic to protect them from the government.” He attached a screenshot of a text saying, “I’d rather infect my kids with measles than inject them with those cheap Indian vaccines.”

The anti-vaccination sentiment came right on the heels of a tragic mix up in vaccines in Samoa in 2018, said both Akanoa and Kruse. The vaccine, which is supposed to be mixed with water, was combined with muscle relaxer by two nurses in Samoa, explained Kruse. Two young children were killed.

“Parents were afraid to take their kids to get the vaccination,” shared Akanoa. “[Parents] hear horror stories and freak out.”

According to Kruse, another unfortunate side effect of disasters like this is charlatans or people who use deception to obtain money from people, begin to appear. One such man, Fritz Alai’asa, showed up during the measles epidemic.

“A man has come into Samoa and set up shop,” she shared. “Kangen Water is what he had said is going to cure them. ‘Pay me 10 tala. Bring your family,’ he says. So, the family comes, and he gets this Kangen Water, this alkaline water, and he sprinkles it on them.

“They go because they are Christians, and you want to have hope. Charlatans abuse people’s hope and faith in Christ.”

Alai’asa’s operation has since been shut down, Kruse said.


The response

Many organizations around Samoa are stepping forward to help with the tragedy, according to Kruse and Akanoa. One such organization is the National Council of Churches in Samoa.

Kruse shared, “They have admonished everyone to pray, but what they’ve also done … is they have urged everyone to ‘seek God’s healing of the sick, but also to act by taking your children to be immunized and to use the intellect when necessary.’ Revered Iuli said that.”

The government has also reinstituted Women’s Committees, noted Kruse. “Government dispatches liaisons to districts. The districts give information. What the status is, what they should do for medical prevention, what they should do as a people in terms of recognizing threats. It’s little medical dispatches. The women’s committee decides what needs to be done, how the information should be disseminated without large public gatherings.”

Akanoa shared how she grew up with Women’s Committees in Samoa. “Growing up in Samoa, we had these things called Komiti Tina, or Mother’s Committee. It is when a nurse comes into each village, all the way out to the rural areas. A lot of the kids who are affected in this are in rural areas. Those are the ones who are dislocated or isolated from what is going on out there.

“We used to have it where the nurses would come into the village. It was usually once a month on Mondays where the mothers would bring their babies to get vaccinated and to weigh them, making sure the kids get vaccinations and are okay.”

The Women’s Committees, described Kruse, also help the hospitals know what to expect. For parents who think their child may have measles, “The Women’s Committee sets up vehicles, transportation, lets the hospital know how many children they believe to have measles and when they will send them, so the hospital is ready to receive them.”

There are also local people organizing programs to help, Kruse shared. Eka Arp, Kruse’s cousin in Samoa, is “putting together something called the Helping Hands Kitchen. She receives donations locally and also from overseas.

“She provides snack packs and feeding to hundreds of parents, caregivers, security guards, doctors, nurses and hospitals around Samoa. She is like a local responder, but for food. She takes donations. Her mother used to be a principal at a school we have donated to. For those of us who live off-island, we can send things to her.”

Kruse stressed the importance of donations of necessary supplies, such as bandages, cotton swabs, and pillows.


How measles works

One of the worst dangers, according to Weeks, is how measles spreads easily. “You get exposed to it from respiratory droplets. You inhale it, and it infects your respiratory system and infects the rest of your body. The main problem is you spread the virus before you show the spots. You may have the sniffles, but feel okay, so you go out and spread the virus.”

The main symptoms, he explained, “are the rash on your skin, sort of like chickenpox, and spots in the back of your throat called Koplik spots. That is the one thing that for sure shows you have measles.”

There is no way to determine who will be subject to these complications, said Weeks. “It depends on a couple of factors. The young and old are much more susceptible. Kids under one are much more susceptible because they can’t get vaccinated.

“Because we are all different, our immune systems are all very different. We might get the same exact virus, and it could cause horrible complications in me, and you could just get measles, and it goes away. One complication is encephalitis, which causes infection in your brain.”

To avoid these complications, Kruse emphasized vaccinations. “It’s completely preventable through vaccinations. This isn’t something people should be fearful of going to Samoa for. You are completely prevented from contracting the disease if you had your vaccination. Children in Samoa are not at risk of dying if they have been vaccinated.”

The vaccine works, according to Weeks, by injecting a measles virus that has lost its potency into someone’s bloodstream. “Because it is weakened, or attenuated, the infection isn’t bad. It causes your immune system to recognize it and fight it off. When you are exposed to a real-world virus, your body can fight it off before it causes a serious disease.

“There is no other way, except complete avoidance of the virus, to ensure you will not get sick,” he explained. “You can avoid the virus, but it will be hard. I don’t know of any vitamin supplements or anything like that. It may lessen the disease, but once you are exposed to it, there is nothing that will really stop it.”

Kruse said students should not be afraid to go to Samoa if they are vaccinated. Akanoa said it is a personal choice, but urged students to exercise caution in deciding whether to go to Samoa, whether for an internship or to go home.

According to the Center for Disease Control, “Very few people—about three out of 100—who get two doses of measles vaccine will still get measles if exposed to the virus.”