Fake news and the spreading of measles

“Fake news” isn’t my favourite term for the disinformation spread by antivaccinationists. However it conveys a meaning that is usefully accurate when it comes to labelling deception spread with the aim of misrepresenting the facts about vaccines.

The narrator in the US video below asks the question, “Is fake news making people sick?”. He notes that the country has broken a 25 year old record for measles cases this year. At the time of making the video there were over 700 cases across 22 states since the beginning of 2019. In states where population density is high we can expect to see the impact of vaccine induced immunity and herd immunity (or the lack thereof) in their unmistakably predictable manner.

New York city has had over 400 cases since October 2018. Some – not all – members of the orthodox Hasidic Jewish community have been avoiding vaccines. The narrator tells us this is due to “rampant misinformation around vaccines”, even though the orthodox community “overwhelmingly” believes in vaccines. One woman seems to doubt vaccine safety and efficacy. She argues that “some people question why would I subject my three year old to toxins when it’s not going to protect him or her”.

There is an increase in insular socialising habits in close orthodox communities. This ensures the successful spread of misinformation by The Vaccine Safety Handbook. Packed with the most well constructed vaccine myths, it targets these communities with well debunked anti-vaccine conspiracies, codswallop and even commentary from rabbis, specific to Jewish religious law.

WhatsApp groups have been set up to push anti-vaccine disinformation further, with some orthodox members reporting that their only source of news is via WhatsApp.

If this reminds you of the Somali community in Minnesota in 2017 and 2011, you’re not alone. 80% of reported measles cases in 2017 were of Somali children whose parents had been convinced of the risk between autism and MMR. It was the largest measles outbreak for 30 years.

What’s this got to do with orthodox Jews in New York? Well I mentioned the insular nature of close communities. In an article headed Minnesota’s measles outbreak is what happens when anti-vaxxers target immigrants, it is noted some of these Somali Americans had concerns about higher than average rates of autism amongst their children. This entire episode is indicative of the impact that calculated disinformation can have. Particularly when provided in an area of uncertainty and despite the effort and funding from health experts and government authorities.

In 2008 Somali parents stressed that there appeared to be more 3-4 year old Minnesota Somali children enrolled in the public preschool special education program for Autism Spectrum Disorder, compared to the overall percentage of Somali children enrolled in public schools [page 4].

Also a couple of years before this time MMR vaccine coverage had started to decrease in Minnesota-born Somali children from 2006 at which time rates had been above 90% [Figure 2].

Cultural differences meant that the most genuine efforts to assist the Somali-American community with this issue proved difficult. There is no word in Somali for “autism”. Indeed there is no grey area as one Somali parent put it. Mental health is seen as either “crazy” or “sane”, and this leads to the fear that a child may be called an unhelpful name within the community. A name used behind the parents’ back [page 4].

The Minnesota Department of Health (MDH) worked to re-examine enrollment data for pre-school aged children in the special education program. The results were published in a report which tended to focus on participation rates only. The report [pp 4-5];

…did not attempt to measure the true occurrence of ASD in all children, and it did not attempt to identify possible causes or risk factors for ASD. Instead, the focus was on developing a better understanding of reported differences in program participation rates among preschool-aged children enrolled in this MPS program.

The three main findings in the report confirmed parent’s observations and also raised questions as to better outreach services to Somali children vs genuinely higher levels of ASD, compared to non-Somali children accessing ASD services outside of the MPS. The proportion of Asian and Native American children participating in ASD programs was significantly lower. The cause for this remained elusive. Participation rate differences between Somali pre-school children and pre-school children from other ethnic backgrounds decreased “substantially” over the three years studied. The basis for this final point remained unclear.

Following the 2009 MDH report advocates for the Somali community called for further research. The CDC, NIH and Autism Speaks provided technical assistance and funding to the University of Minnesota. The aim was to focus on ASD in Minnesota and within Somali vs non-Somali communities. The MDH and the University of Minnesota’s Institute on Community Integration added in-kind staff and funding.

Still, we need to remember that it was 2008 when Somali parents first raised their concerns about ASD with the Minnesota Department of Health.

Enter disgraced fraud, data falsifier and ex-gastroenterologist, Andrew Wakefield, who was struck off the U.K.’s General Medical Council 21 years ago and the many-faced Organic Consumers Association. Wakefield targetted and set about convincing Minnesota’s Somali Community that MMR could not be trusted as health authorities claimed. It caused autism he lied. The rumour spread through the community. During the 2017 measles outbreak Wakefield insisted he didn’t feel responsible at all.

In short Wakefield and fellow antivaccinationists spread his anti-vaccine lies with the result that MMR vaccination fell in the Somali community for a number of years. Immigration status can be a risk factor with respect to immunisation status and this fact played very well into the hands of antivaccinationists.

Nonetheless, no vaccines cause autism.

It’s important to remember, and realise, how much damage antivaccinationists can do to public health. Yes, “fake news” is making people sick. Cities with high density and insular communities that are convinced to skip vaccination will constantly face the possibility of outbreaks. The anti-vaccine lobby and their minions will continue to spread misinformation and where possible it must be refuted.

I read a comment recently dismissing the need for any vaccine and contending that only three people had died since 2000. Forgetting that this US citizen is ignoring the rest of the world, it is just such complacency that helps drive the luxurious nonsense that vaccines are more harmful than the diseases they prevent.

Because after all, in the developed world vaccines are a victim of their own success.