Measles in Samoa: Thank the anti-vaccination lobby

The manner in which members of the anti-vaccination lobby have leapt upon the measles tragedy in Samoa identifies their awful, predatory cult quite well.

To completely understand why anti-vaccine activists promote such intellectually vicious lies and indeed hatred regarding an epidemic that Samoa has labelled a state of emergency I’d argue we need to first look back. Back to July last year when headlines reported the deaths of two infants following the MMR vaccination. Or rather, what we now know was thought to be MMR vaccine. We need to look back dear reader because antivaccinationists reacted in an “I told ya so” manner that was almost glee.

Despite there never being a recorded death due to vaccination or a vaccine in Australia, anti-vax profiteers who have peddled lies for years contend that death and disability after vaccination not only happens but are widespread. A vaccinologist was quoted in evidence to the No Jab No Pay Bill hearing that in Australian injuries serious enough to require compensation range between zero and five per year. I do apologise for referring to that occasion yet again. I also recommend the government publication Questions About Vaccination.

We must look back because regrettably it was the bogus causation peddled by anti-vax identities that gave them the confidence to begin commenting on this measles outbreak that hit Samoa in October this year (2019). As for facts, genuine health professionals and epidemiologists would be familiar with adulterated, out of date and counterfeit medications and vaccines causing harm in nations with health systems and infrastructure less developed than in New Zealand or Australia. Yet these events occur far less today due to safety procedures instigated across the globe.

Following investigations into the infant deaths in Samoa evidence was collated concluding “a tragic outcome from error preparing MMR vaccine”. The Immunisation Advisory Centre of New Zealand reports;

On 4 June 2019, both nurses pleaded guilty to negligence causing manslaughter. On 2 August, both nurses were sentenced to five years in prison. During the sentencing hearing, it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine. Eight Samoan speaking New Zealand nurses visited Samoa in June to provide training for vaccinating nurses at district hospitals.

The same reference informs us there has never been a death associated with this vaccine in N.Z. It also has a helpful timeline and includes under August 3rd;

Report on RNZ website: The two nurses, who pleaded guilty to negligence causing the manslaughter of two infants, have been sentenced to five years in prison.

The Samoa Observer published a detailed account of the sentencing hearing, where it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine.

The entire event effected parent confidence in immunisation. These doubts were magnified by antivaccinationists resulting in a further realisation of their aim: a reduction in vaccination. The Guardian recently reported that the WHO blames the “anti-vaccine scare” for the rise in cases and of course deaths. Kate O’Brien, director of the WHO immunisation department stressed that the rapid spread of measles in Samoa was due to the “very low coverage” of immunisation.

This resulted in the temporary suspension of the country’s immunisation programme and dented parents’ trust in the vaccine, even though it later turned out the deaths were caused by other medicines that were incorrectly administered.

O’Brien said that an anti-vaccine group had been stoking these fears further with a social media campaign, lamenting that “this is now being measured in the lives of children who have died in the course of this outbreak”.

Misinformation about the safety of vaccines, she said, “has had a very remarkable impact on the immunisation programme” in Samoa.

At least 42 fatalities can be attributed to this measles epidemic at time of writing. In the video below anti-vaxxer identity Taylor Winterstein is mentioned as having visited Samoa in June with diehard anti-vaxxer Robert Kennedy Jnr. Winterstein described herself as “pro-science” the narrator tells us. Oh, my.

Please spend some time reading up on this woman who is presently making a living scamming Wellness devotees and the ill out of their money.

Given the harrowing situation in Samoa and the speed at which measles morbidity and mortality is increasing the government has made the measles vaccine compulsory and warned those preventing community members from being vaccinated to stop.

Such as Fritz Alaiasa Neufelt, the oh-so-savvy businessman selling filtered tap water as the measles fighting “Kangen Water”. Lying as he plays with the lives of ill Samoans he claims that after a spray of his magic water;

“They’re feeling good,” he said. “The measles are already … not cured, but it’s already back to normal”.

The ABC recently reported that the “pro-science” Winterstein was a tad concerned about the governments position. No, not the position of vile Fritz spraying measles sufferers like office plants but the government.

In fact her rational, objective, pro-science mind has applied Godwin’s Law. The ABC cite her calm demeanor;

… Australian-Samoan influencer Taylor Winterstein made recent posts on Facebook and Instagram comparing Samoa’s compulsory vaccination program as akin to “Nazi Germany”.

“Forcing a medical procedure on an entire country, especially one that is proving to be ineffective, dangerous and making the virus more deadly, is straight up barbaric,” she wrote on Facebook.

So um, check it out, right. A “pro-science”, so-called “influencer” who peddles herself as a health guru has a tantrum claiming that the only known safe and effective preventative for measles is “proving to be ineffective, dangerous and making the virus more deadly”. And yeah, Nazi Germany. Pfft. Oh I’m influenced Tay. Trust me.

I’d say you can’t make this stuff up but that’s exactly what they do. Consider the increase in cases below and the time frame it covers.

© Source: virologydownunder.com

Data: Samoan Government Facebook and Ministry of Health websites and media comments. Last update 27/11/19

Preparation: Ian M. Mackay, PhD

Immunisation rates were previously far higher in Samoa. Four years ago MMR coverage was 84%. By 2017 it had already dropped to 60%. Last year (2018) it had fallen to 31%.

There is no doubt. A drop in MMR vaccination has brought Samoa to a tragedy of shocking proportions. Two doses of MMR is the recommended, clearly life saving, dose.

But still, Meryl Dorey of The Australian Vaccination Risks Network tweeted this dishonest evidence free nonsense (left) just recently. Just as Winterstein pushes the piffle that the vaccine makes the virus more deadly, Dorey tries to convince her cult that malpractice is the cause.

I would urge Meryl Dorey to have another look above at the facts and follow some of the links. Revisit what is known about these deaths. Understand that it was not the expected MMR vaccine they received before dying.

Accept two nurses are now serving five years in prison for negligence. Know it was a negligent error in preparing the adulterated mixture that led to the deaths, then an eight month suspension of MMR. Admit the facts, admit the reality. Stop your lies.

Stop your negligence.

Immunisation: Why we do it and how ‘herd immunity’ works

Denial of community immunity or herd immunity is a common feature of antivaccinationists.

In fact groups that spread harmful disinformation, such as the Australian based Australian Vaccination-risks Network (AVN), have for years been refining the denial of this evidence based fact. Notably they misrepresent what herd immunity is, primarily by referencing an aspect of herd immunity or an expected result of herd immunity.

The Australian Government Department of Health offer this definition;

If enough people in a community are immunised against an infectious disease, there is less of the disease in the community, which makes it harder for the disease to spread.

Immunisation protects both people who are vaccinated and also helps the entire community. It helps protect those who are too young to be vaccinated and those who can’t be vaccinated for medical reasons. This is known as community (herd) immunity.

Claiming that the “laws” of No Jab No Pay and No Jab No Play “are based on herd immunity”, Meryl Dorey of the AVN contends;

The theory claims that the unvaccinated are more likely to contract and transmit diseases than their vaccinated peers.

Travel to a largely unvaccinated country, get shots and you’re apparently in a protected bubble. Back home and they’d have us believe we need a 95 per cent plus vaccination rate to be protected and that a lone unvaccinated individual can be responsible for an epidemic.

Indeed rather than “claim” that unvaccinated community members will contract and transmit disease, herd immunity provides greater protection for the unvaccinated. Nonetheless herd immunity cannot protect any particular unvaccinated individual and is very important with respect to protection from measles infection.

This is why individuals who cannot be vaccinated for specific reasons or those with weakened immune systems will be better protected in a community that has a vaccination level of 95% or above. In certain communities where vaccination levels are low, herd immunity and the cluster of immune individuals doesn’t exist. In this instance measles can easily spread from an infected individual to unvaccinated individuals.

If not for herd immunity providing protection to those who refuse vaccination and deny their children the protection of vaccine induced immunity, many of the false beliefs held by antivaccinationists could not persist. The success of so-called natural remedies, homeoprophylaxis and so on persist simply due to the protection of herd immunity.

  • The video below was produced by the BBC and provides an accurate summary of vaccination and herd immunity.

Immunisation: Why we do it and how ‘herd immunity’ works – © BBC News

Discredited anti-vaccine conspiracy theorist Judy Wilyman has even used denial of herd immunity in her ongoing attacks on Australia’s successful vaccination policy. Wilyman wrongly contends that only public health reforms such as sanitation led to the control of vaccine preventable diseases.

Vaccines did not create herd immunity to control infectious diseases, is an open letter on her website. The monumental flaw in her fallacious claim begins with her use of only mortality, and no morbidity data.

Also, Wilyman refers to changes in public health occurring before 1950. This ignores more modern vaccines such as that for Haemophilus influenzae type b (Hib) used in Australia from 1993 and later in Kenya from 1999.

Only vaccination can explain the control of Hib and the emerging success of the HPV vaccine.

Measles outbreaks are due to low vaccination rates and antivaccinationists

The video below is from the USA. The reasons it lists for the increase in measles cases there however, apply directly to Australia.

First however I want to draw attention to the screenshot from the video. Note the high number of fatalities. In the USA measles killed around 500 children per year during the 1950’s. Also pay attention to the drop in measles cases after the 1963 introduction of the measles vaccine.

In Australia a live attenuated measles vaccine was first licenced in 1968. Since then according to the Department of Health, “the burden of measles has substantially fallen in Australia”.

Measles cases USA – Source: CDC

You may be thinking, “But… I’ve seen graphs showing a huge decline in vaccine preventable diseases before vaccines were even introduced”. Yes, yes you have… kind of. What the anti-vaccine lobbyists did to create those misleading graphs is to firstly plot mortality rate (fatalities), and not morbidity (cases). Their argument is that diet, personal and public sanitation alone controlled vaccine-preventable disease and that vaccination had no effect.

Health professionals agree that sanitation and nutrition is vital to health. Cleaner cities, homes, personal hygeine and a varied diet play a large role in keeping us healthy, aiding in recovery and in fighting off the effects of disease. Including mortality caused by disease. But the incidence, or morbidity of disease is not reduced anywhere near as dramatically. So to discredit vaccines antivaccinationists would plot mortality and not morbidity of disease.

More so, they crammed many years horizontally and a comparatively small number of fatalities vertically. This had the effect of squeezing data in so tightly that individual bars vanished and were replaced with a single contoured shape that seemed to hit zero well before vaccines were introduced. With an accompanying narrative or explanatory text the listener or reader was easily fooled into “seeing” diseases dwindle away long before vaccines were introduced.

And the best trick was to emphasize, in the true Viera Scheibner and Judy Wilyman fashion, that it’s all government data to begin with. So it must be true. But it never was. It was and is a lie. A dangerous lie that hides the truth of how dangerous vaccine-preventable diseases are and how permanent are the injuries and disabilities for many of those who contract them.

The rumour that Donald Trump would be supporting the anti-vaccine lobby and financing vaccine conspiracy theorist, Robert F. Kennedy, is all but dust. Just three days ago when asked about the measles outbreak he replied, “They have to get the shot. The vaccinations are so important. This is really going around now, they have to get their shot”.

The Australian Department of Health has a page dedicated to the current measles outbreak, Measles Outbreak 2019. It was updated two weeks ago and includes;

Anyone who is not fully vaccinated against measles is at risk of becoming infected when traveling overseas. You may also risk exposing others to this highly infectious, serious illness either while travelling, or when you return to Australia.

Measles is a very contagious viral illness that causes a skin rash and fever in some cases. Measles can cause serious, sometimes fatal, complications including pneumonia and encephalitis (swelling of the brain). Measles spreads when an infected person coughs or sneezes and another person breathes in the droplets from the air, or touches the droplets and then touches their nose or mouth.

Measles remains a common disease in many parts of the world, including areas of Europe, Asia, the Pacific, and Africa, with outbreaks often occurring.

In Australia, the majority of measles cases are due to unvaccinated individuals becoming infected while travelling to countries in which measles is either common or there are outbreaks occurring. As measles is highly contagious, these people can then spread the disease to others, causing outbreaks, often before they are aware that they have the virus.

Why Measles Is Back In The US

Don’t be fooled by claims that antivaccinationists are not to blame. That we must accept socioeconomic and language hurdles are placing a considerable downward pressure on vaccination numbers. The increased use of social media has been a boon to antivaccinationists. From spreading misinformation, to organising events to raising money and making their entire gig easier we must accept they continue to ruin lives and public health strategy.

No doubt there are socioeconomic problems that play a role. But not the role. That argument is partial evidence denial at best. In fact social media should be used more skillfully to address problems faced by members of our community who are struggling to meet vaccination schedule requirements due to genuine hurdles.

Social scientists interested in vaccination and/or resistance to vaccination may have much to offer in addressing socioeconomic hurdles to vaccination via social media.

Facts about meningococcal disease

The Melbourne Vaccine Education Centre has an excellent page on meningococcal disease and vaccines which includes comprehensive resources and the video below from the Australian Academy of Science.

Meningococcal disease is a bacterial infection which can kill in hours. It is caused by the bacteria Neisseria meningitidis. Risk groups include children under 5, teens and young adults aged between 15 – 24, smokers, those with a suppressed immune system and anyone living in crowded accommodation. Of the 13 known sub-types of meningococcal bacteria, five are vaccine preventable.

These are B and A, C, W, Y.

Over 2018 the main serotypes causing disease in Australia were B, W and Y. Variations in serotype infection were specific to Australian states. On the information page the Melbourne Vaccine Education Centre (MVEC) notes;

People with meningococcal disease can become extremely unwell very quickly. Invasive meningococcal disease (IMD) can cause meningitis (inflammation of the membrane covering the brain and spinal cord), septicaemia (infection in the blood) as well as other infections like pneumonia (lung infection), arthritis (inflammation of the joints) and conjunctivitis (eye infection). Mortality (death) can be as high as 5-10% and permanent lifelong complications can occur in 10-20% of those who survive. Disease is transmitted via respiratory droplets (sneezing and coughing etc).

Prevention is via vaccination. Three quadrivalent vaccines are available for the A, C, W and Y meningococcal serogroups. One, Nimenrix® is freely available from 12 months of age as part of the National Immunisation Program.

In September last year it was announced that the federal government will fund the addition of meningococcal A, C, W and Y vaccine for 14 to 19 year olds. From April 2019 teens aged 14 to 16 years will have free access via school based programs as part of the National Immunisation Program. Teenagers aged 15 to 19 years who do not receive the vaccine at school can be vaccinated for free via “an ongoing GP based catch up program”.

The details of access to the vaccines are clearly explained on the MVEC information page. Private scripts are available and required to purchase the meningococcal A, C, W, Y vaccine for those who don’t meet NIP criteria.

Meningococcal B vaccines are available although not yet part of the National Immunisation Program. Bexsero® is suited for use from 6 weeks of age. Trumenba® is suited for use from 10 years onward.

There is additional information in this post from September last year. Access the Department of Health immunisation information here.

Facts About Meningococcal DiseaseAustralian Academy of Science

Australian government to provide meningococcal vaccine to teens

Recently the Australian government announced that from April 2019 the meningococcal vaccine Nimenrix will be available free to teenagers aged 14-19. This will prove to be a significant public health measure against Invasive Meningococcal Disease (IMD).

Nimenrix is a quadrivalent vaccine protecting against 4 of the 13 serogroups of the bacterium Neisseria meningitidis. The four serogroups are A, C, W and Y. The vaccine Bexsero protects against serogroup B and is presently the subject of a South Australian study. The manufacturers of the vaccine, GlaxoSmithKline have confirmed they will seek to have Bexsero listed on the National Immunisation Program once they have the study results. The ACWY vaccine has been freely available to 12 month olds since July 1st, 2018. Of these five primary strains of meningococcal disease, B and W serogroups are the most common.

The incidence of meningococcal disease and the serogroup responsible fluctuates over time. According to the National Centre for Immunisation Research and Surveillance (NCIRS), serogroup B (MenB) was the most common cause of IMD from 2006 to 2015. Over this period MenB accounted for 63% to 88% of annual notified cases where a serogroup was identified. An NCIRS fact sheet notes that since 2013 serogroup W (MenW) has increasingly caused IMD.

In that year 17.4% or 17 cases with an identified serogroup were responsible for the disease. By 2017 MenW was identified as responsible for 38.1% or 139 cases. It is also clinically interesting that the NCIRS have reported, “many of the MenW cases have been due to a single clone of meningococcus, the ST-11 strain type”. This suggests sustained person to person transmission. MenW appears to have a higher fatality rate (9.3%) than MenB (5%).

With serogroup Y there has been a “smaller but notable” increase. In 2014 there were 7.4% or 12 cases of those with an identified serogroup, increasing to 20.5% or 75 cases in 2017. IMD due to serogroup Y is more common in older Australians. 61% of the 75 notified cases in 2017 were in adults ≥ 45 years or older. The decrease in cases due to serogroup C (MenC) is an indication of the efficacy of immunisation programmes.

The MenC conjugate vaccination programme began in 2003. The number of MenC cases with an identified serogroup was 225 in 2002, falling to 14 (3.8%) in 2017. The NCIRS observe that, “serogroup A disease remains rare in Australia”. Nonetheless overall meningococcal disease and death from different serogroups has increased in recent years.

Reporting recently on the government intention to soon provide the quadrivalent Nimenrix vaccine to teens, both SBS and Fairfax published the following figures on IMD for 2015 – 2017.

  • 2015: 182 cases, 12 fatalities
  • 2016: 252 cases, 11 fatalities
  • 2017: 382 cases, 28 fatalities

The Fairfax article was published at 12.00am on September 25th and noted that there had been ten fatalities from meningococcal “so far this year”. A little over 44 hours later at 8.07pm on September 26th the Moree Champion reported;

Laboratory tests have confirmed meningococcal disease as the cause of death in a 25 year old woman in the New England region. The young woman collapsed at home on Saturday, September 22 and was taken to hospital by ambulance, but was unable to be revived.

Meningococcal disease can kill within 24 hours if not treated in time. The audio below is from Meningococcal Australia and addresses important points regarding infection, symptoms, prevention and treatment.

The Meningococcal Australia website notes;

10% of those infected will die, and around 20% will have permanent disabilities — ranging from learning difficulties, sight and hearing problems, to liver and kidney failure, loss of fingers, toes and limbs and scarring caused by skin grafts.

It is important to access reputable information with respect to diseases such as Invasive Meningococcal Disease. IMD from the five primary serogroups A, C, W, Y and B can be prevented by vaccination. This makes it a target for misinformation from the anti-vaccination lobby. In Australia the most vocal group is the Australian Vaccination-risks Network, or AVN.

Meningococcal bacteria can live harmlessly in the throat and nose in 20% of people and IMD is one of the less common bacterial diseases. Antivaccinationists use this information to wrongly assert there is no need to be vaccinated. Yet the reality is that in cases of meningococcal disease the bacteria enter the bloodstream and multiply rapidly, causing septicaemia and damage to blood vessel walls. This leads to bleeding into skin tissue producing the dark purple rash associated with meningococcal disease.

Bacterial meningitis caused by meningococcal disease is the most dangerous type of meningitis. Meningitis is a serious inflammation of the meninges – the lining of the spinal cord and brain. Thus the argument that humans “naturally” carry meningococcal bacteria and should avoid vaccination is based on deceptive reasoning and is dangerously misleading.

Vaccines are demonstrably very safe. The testing of vaccines before approval for use in Australia can take over a decade. Their ingredients are well understood and are themselves tested for safety.

The introduction of the quadrivalent meningococcal vaccine Nimenrix is a positive for Australian public health.