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Monday, March 28, 2011

A Vaccine Forum, and Somalis in Minneapolis

At The Minneapolis Star-Tribune, Maura Lerner reports:

A panel of health experts and opinion leaders spent nearly two hours at a Somali community forum Saturday night, trying to convince skeptics that the measles vaccine is safe and necessary.

But by the time it was over, there was little sign that anyone's minds had been changed. And a vaccine clinic, set up outside the meeting room at the Brian Coyle Center in Minneapolis, was still awaiting its first customer.

More than 50 people turned out for what was described as an educational forum prompted by the current measles outbreak in Hennepin County, which has sickened 11 people, including five Somali children, since February.

Dr. Abdirahman Mohamed, one of two Somali physicians on the panel, warned that families who don't vaccinate their children are putting their lives in danger. He said he knows of six Somali-American children who have caught measles and died during visits to Africa since 2008, including two children from Minnesota.

Also according to Lerner, Andrew Wakefield had spoken to the community a few days earlier:

Dr. Andrew Wakefield, a controversial British doctor whose research purported to link vaccines to autism, met privately with a gathering of Somali parents in Minneapolis on Wednesday night.

Wakefield, who arrived amid the city's first measles outbreak in years, declined to answer questions about the purpose of his visit. Reporters were barred from the meeting, which was described as a "support group" for parents of autistic children.

Health officials say that vaccination rates have been dropping in the Somali community because of fears about vaccine safety, fueled by Wakefield's now-discredited research

But not everyone in the community takes Wakefield's side. On Friday, Lerner wrote of autism mom Hodan Hassan:

In December, she said, she turned out to hear Andrew Wakefield, the hero of the anti-vaccine movement, at a Somali community meeting in Minneapolis. Wakefield conducted a now-discredited 1998 study suggesting a link between autism and the measles, mumps and rubella (MMR) vaccine.

Later, Hassan said, a local doctor challenged her to do her own research on Wakefield, who was accused of scientific misconduct in connection with the study, and ultimately stripped of his medical license in England.

Now she is one of his biggest critics. "I was shocked when I found out people used to die [of measles]," she said. Many still do in her native Somalia, she noted, and in other in parts of the world where vaccines are not available.

"If we could all go back in time, we would have appreciated it," she said.

Just this week, Wakefield returned to Minneapolis for a private meeting with Somali families. Members of the news media were barred from Wednesday's gathering, which reportedly drew only about a half-dozen Somali parents.

But one of the organizers, Patti Carroll of Shoreview, said she doesn't believe parents are worried about the measles outbreak.

"They'd rather have them get the measles than deal with the effects of unsafe vaccines," said Carroll, a volunteer with Generation Rescue, an autism advocacy group.

Last year, at his On Risk blog, David Ropeik wrote more generally of the perceived risk balance of autism and vaccines:

Several risk perception factors are at work here. Those who refuse to acknowledge the overwhelming evidence that there is no link between autism and vaccines don’t trust the government and pharmaceutical industry, and mistrust fuels fear. Parents with autistic kids have so little control over their children’s fate, and lack of control fuels fears. And any risk to kids evokes more fear than the same risk to adults. These risk perception factors are real, as real as the evidence disproving the autism-vaccines link. So despite a mountain of such evidence, the fears persist, and fuel a rising doubt about vaccines in general. I observed that this Perception Gap between the fear and the facts is dangerous, not only for parents who choose not to vaccinate their kids, but for everyone else, since herd immunity is important to keep largely defunct diseases like measles from spreading again.


There is another risk perception factor at work here too. Risk v. Benefit. Not long ago when measles and other childhood diseases were widespread, and lethal in hundreds of cases, the benefit of the vaccines outweighed their risk. Now the risk of the diseases has become so low that we only worry about the drugs. Curious. Because they’ve succeeded, we worry more about the vaccines than the diseases from which they are protecting our children.