Antivaccine activists and the deadly measles outbreak in Samoa

As the long Thanksgiving weekend wore on, it occurred to me that there’s one really big story going on that normally I would have written about but, for whatever reason, I haven’t written about yet. I’m referring, of course, to the deadly measles outbreak in Samoa. Make no mistake, when I say “deadly,” I mean deadly. The latest news stories I’ve found tell the tale:

Five people have died overnight in Samoa, bringing the death toll to 60 as the measles epidemic continues to kill the most vulnerable.

Of the 60 that have died, 54 were children under the age of 15, while 25 were babies aged less than one year old. Three deaths have now been recorded for adults over the age of 19.

On the Facebook page for the government of Samoa:

The toll has been horrific, a total of 4,071 cases thus far, with 60 deaths. That’s an incredible death rate for measles, almost 1.5%, and the included table tells an even grimmer story. The vast majority of the deaths were children under 4, 52 out of the 60 deaths thus far. As surprising as this might seem to those of us living in wealthy, industrialized countries, it is not unusual for a country with the income level of Samoa to have a mortality many times higher than the 1 in 1,000 rate that is usually quoted for countries like the US.

The situation has gotten so bad that the government of Samoa is closing down for two days to dedicate itself to nothing but vaccinating its people against measles:

The government is instructing households with unvaccinated people in it to tie a red cloth or flag in front of their houses near the road to facilitate the identification of households that require vaccination. Meanwhile, international aid is pouring into Samoa:

The government’s closure is the most drastic measure Samoa has taken to combat the outbreak so far. Officials have already begun a mass vaccination campaign aimed at young children and women of childbearing years, inoculating 58,150 people as of Sunday. Schools have been closed, children are banned from large public gatherings, and parents have been urged to bring their children to a doctor at the first signs of illness.

Several countries, including Australia, New Zealand, Britain, and China have sent medical experts and aid, and organizations like the Red Cross and UNICEF are also working to mitigate the outbreak. The U.S. has dispatched a team of experts from the Centers for Disease Control to the island nation to help track the outbreak.

The cause of the outbreak is similar to the causes of measles outbreaks the world over: Low vaccine uptake, fueled by a number of factors, including antivaccine misinformation:

“This is a reflection of a whole lot of factors. People are not so confident in their health system,” Petousis-Harris said. “They have quite a culture of anti-vaccine sentiment there as well.”

Anti-vaccine activist Robert F. Kennedy Jr., a nephew of President John F. Kennedy, visited the country in June, appearing next to officials at Samoan independence celebrations. His visit was “for a program that is not government-related,” an official in the prime minister’s department told Samoan news media at the time.

Here he is with Samoan antivaccine activist Taylor Winterstein in Samoa during that trip:

Lest you doubt my assertion that Ms. Winterstein is antivaccine, here is another Instagram post by her:

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Bullying is not ok…except when you publicly question the safety of vaccines. Bullying is not ok…except when you consciously choose not to vaccinate your kids. Bullying is not ok…except when you expose the corruption of the vaccine industry. Bullying is not ok…except when you raise awareness on vaccine injury. Bullying is not ok…except when you stand for medical freedom and informed consent. This week my family have been on the receiving end of extreme bullying, hate mail, abuse and harassment. Worse than anything we have experienced before…and trust me, people have tried to bully and harass us a lot this year. Over the last 6 years of having this public page open where I've grown my audience organically and built a beautiful like-minded community…this is the first time I have ever had to 'turn the commenting off' on my posts. I am committed to sharing the truth, serving my community, planting seeds and sparking minds to get people to question and critically THINK. But I will not tolerate the nasty, vile, bitter, toxicity that continuously hijacks the comments section of my posts. If you're new here and genuine, welcome! I've been posting about vaccines for years and I hope you will take the time to observe and understand before jumping to conclusions. 💗✌

A post shared by Taylor Winterstein (@tays_way_) on

Note the common antivaccine trope that it is “bullying” to criticize antivaxers for refusing to vaccinate or for spreading antivaccine misinformation. In this post, she invokes Nuremberg, a favorite misapplication of the Nuremberg declaration beloved of antivaxers ranging from Barbara Loe Fisher to, Rob Schneider to, well, RFK Jr. himself, complete with tropes about “informed consent” (which in the hands of antivaxers is really misinformed refusal, in which a decision is made based on massively exaggerated or made up risks, made up “toxins,” and a massive understatement of benefits):

Elsewhere, Winterstein also referred to the government effort to vaccinate its population as “NaziSamoa

And here she is complaining about mandatory vaccination in the middle of a massive outbreak that is killing 1.5% of the victims and bemoaning the fact that the government is not instead treating measles victims with massive doses of vitamin A. Here’s the thing. although there is some evidence that vitamin A supplementation could decrease mortality in malnourished patients with measles, there is no evidence that it can by itself prevent measles, and it’s only recommended by some as an additional treatment, not the sole treatment. Moreover, I’d bet that the reason antibiotics are being used in these children is that they’ve either been diagnosed with or suspected of having developed a bacterial superinfection, such as pneumonia, the most common pulmonary complication of measles.

Not surprisingly, Tay’s Way Movement, Ms. Winterstein’s website, is chock full of antivaccine propaganda, nonsense like this:

Take this as your call to action to RAISE YOUR VOICE. Not just if you are vaccine-injured yourself or have a vaccine-injured child, family member or friend but for people who don’t and want to raise their voice on behalf of these precious souls too.
Together we rise. We are here in love and we will HEAR this now.
Too many families are suffering in silence and have gone unheard for too long.
This is a safe space to share from the raw, vulnerable, depths of your heart and soul.
This is a place to give us very personal insight and inspire everyone to learn the risk, investigate and educate before you vaccinate.

Of course, as is often the case, there are reasons why the people of Samoa distrust vaccines. Antivaccine misinformation couldn’t have gained such a stronghold there were it not for a recent tragedy:

Vaccination rates – meaning the number of young children covered – recently dropped to a low of only 31% in Samoa, compared to 99% in nearby Nauru, Niue, and Cook Islands.

In part, that low rate has been attributed to the deaths of two children.

In July 2018, two infants died in Samoa after receiving vaccinations against measles, mumps and rubella, raising local fears over the vaccine itself.

But the deaths were later established to have been due to the nurses mixing the vaccine with an expired muscle relaxant, instead of water.

The two nurses pleaded guilty to manslaughter and were sentenced to five years in prison.

A more detailed timeline of the tragedy can be found at New Zealand’s Immunisation Advisory Centre, and a detailed account of the trial of the two nurses can be found here.

This is a horrendous tragedy. It’s almost unimaginable how a screwup like this could happen. In particular, it took some time for the investigation to determine that these deaths weren’t due to the vaccine but rather to an error in mixing up the vaccines. I bet you know what antivaxers the world over were doing in the meantime. They were making the most of it, playing it up as more evidence that the MMR vaccine was dangerous. In the comments of the antivaccine crank blog Age of Autism, antivaxers were making comments like, “This would be called SIDS in the US of A which of course is ‘never an item for concern.'” Of course, one reading of the accounts would tell you that the deaths of these two Samoan infants was nothing like sudden infant death syndrome. Both babies rapidly deteriorated after being vaccinated. For example, the first baby started to deteriorate during the bus ride on the way home from the hospital.

Interestingly (and not surprisingly), antivaxers have been mostly quiet about the measles outbreak in Samoa. After all, it does rather put the lie to their frequent claims that measles is a harmless childhood disease. Well, most of them have been. There are antivaxers sending vitamins, particularly vitamin A, to Samoa. One can only wonder if Homeopaths Without Borders have already arrived in Samoa.

That’s not all, though. An antivaxer with whom we’ve all become familiar with over the years offered up his own brand of brain dead observations about Samoa that it might well deserve its own post. Unfortunately (for purposes of this post), we mutually blocked each other of Facebook back in the ancient mists of time, which makes it a bit more difficult, given that my backup account appears to be borked. I suspect many of you know what I’m talking about, though. Suffice to say, antivaxers are trying to find ways to blame the vaccination campaign for the high mortality from measles.