Tag: tragedy

The Timeline of the Measles Epidemic in Samoa

The timeline of the measles epidemic in Samoa seems fairly easy to understand.

Vaccination rates went down, the people in Samoa got caught up in the rise in measles cases and outbreaks happening all over the world, and they soon had a measles epidemic on their hands, with lots of kids dying.

In an outbreak situation, everyone who is not immune would need to get two doses of a measles containing vaccine and that's why you need 215,000 doses of measles vaccine... And despite what Sherri Tenpenny might think, everyone on Samoa is still not vaccinated yet.
In an outbreak situation, everyone who is not immune would need to get two doses of a measles containing vaccine and that’s why you need 215,000 doses of measles vaccine… And despite what Sherri Tenpenny might think, everyone on Samoa is still not vaccinated yet.

Unfortunately, anti-vaccine folks continue to exploit the tragedy, trying to make it sound like vaccines actually caused the epidemic.

“The Samoa Measles Appeal is being launched by the Government of Samoa to receive financial assistance from partners to support national efforts to contain the outbreak, to effectively treat people who contracted measles, and to achieve herd immunity for long term protection of the population.”

National Measles Response and Recovery Appeal

They are even making up conspiracy theories about the money the Government of Samoa is requesting to help control the epidemic and prevent future outbreaks.

The Timeline of the Measles Epidemic in Samoa

Maybe what is happening in Samoa isn’t so easy to understand…

Let’s give it a try!

To truly understand what is happening in Samoa, you have to go back a little further than when the epidemic started.

In fact, we have to go all of the way back to July 2018, when two young children died very shortly after getting their routine MMR vaccines. Although they died because of a mixup between the vaccine diluent and a powerful anesthetic, the tragic deaths led to the suspension of all vaccinations in the country.

Taylor Winterstein was planning an anti-vax workshop in Samoa in June.
Taylor Winterstein was planning an anti-vax workshop in Samoa in June.

And while the suspension was eventually reversed, they continued to hold MMR vaccinations for another nine months, until April 15, 2019.

Bobby Kennedy actually wrote a letter to the Prime Minister of Samoa on November 19th making every effort to blame the epidemic on a defective MMR vaccine, mutant measles strains, or vaccine strain measles.
Bobby Kennedy actually wrote a letter to the Prime Minister of Samoa on November 19th making every effort to blame the epidemic on a defective MMR vaccine, mutant measles strains, or vaccine strain measles.

Combine that with the efforts of anti-vax folks and it is easy to see how immunization rates in Samoa eventually tumbled to a low of just 30%!

What happened next?

On October 9, we got the first report of a measles case in Samoa and that it was related to a someone who visited from New Zealand for a conference at the end of August.

But by the time of that first report, at least 86 people had already been tested for suspected measles!

“Of the 28 specimens of suspected measles cases sent to Victorian Infectious Disease Reference Laboratory Melbourne, Australia on the 30th Sept 2019, twelve (12) results have been received over the week end. Of these twelve there were four confirmed cases; one adult and three children. All have been treated and discharged with no complications.

On the 2nd of October 2019, we sent another 8 specimens of suspected measles cases. Current results received this afternoon of these eight specimens sent revealed three new confirmed cases. Of these three positive cases, two were children under five years and 1 was an adult of 22 years old. All have been treated and discharged.

A total of seven confirmed cases have been reported to date. In anticipation, we now confirm a Measles Epidemic.”

Ministry of Health Press Release 1 – Measles Epidemic (October 16)

With that many cases already, it should be obvious that the measles outbreak in Samoa started in late September. That explains why UNICEF had begun to send measles vaccines and vitamin A to Samoa in early October.

Measles cases in Samoa began in September, which is why UNICEF began sending vaccines in October.
Wait. If the outbreak is caused by the vaccine strain (A genotype), why are folks testing positive for the D8 strain?

And that should put to rest the myth that this is some kind of unnatural, vaccine induced outbreak that got started because of the UNICEF vaccines.

“The deceased child of one year two months was admitted on the 8th October 2019 with a history of febrile convulsions, cough and skin rash typical of measles associated with severe dehydration. Verification of immunization status for this child revealed that he has not been vaccinated against measles.”

Ministry of Health Press Release 1 – Measles Epidemic

Tragically, we very soon saw the first measles death (October 15) in Samoa, an unvaccinated toddler. With continued cases, they soon declared a measles epidemic on October 16.

With continued cases and deaths, the Government of Samoa closed all preschools and daycare centers on October 31.

On November 8, they lowered the age to get the first dose MMR in Samoa to 6 months.

It wasn’t long before the Government of Samoa declared a full fledged state of emergency (November 15), closing schools, restricting children from gathering in public, and making vaccination mandatory.

“The outbreaks in Samoa and Tonga are caused by the D8 strain (genotype) of measles virus. Measles vaccine coverage varies in Pacific island countries and areas, ranging from 31% in Samoa to 99% in the Cook Islands, Nauru and Niue.”

Measles Outbreak in the Pacific – Situation Report No 1, 22 November, 2019

It was at this time that more help came from New Zealand, 12 nurses to help administer vaccines. Australia also soon sent a team of 34 doctors and nurses to help at Samoa’s main hospital in the capital Apia.

“Samoa’s government is warning anyone trying to discourage people from getting measles vaccinations to stop it.”

Measles Update: Samoa warns against anti-vaxxers; issues new emergency orders

And now, although there have been some roadblocks put up by anti-vaxxers both in and out of Samoa, with lots of help, they are hopefully getting their epidemic under control.

“As of December 6th, 2019, approximately 89% of all eligible people in Samoa have been vaccinated against measles.”

National Emergency Operation Centre: Update on the measles outbreak (Press Release 21) December 7, 2019

In fact, many people were vaccinated when the Government of Samoa shut down on December 5th and 6th.

“On 03/12, the Government announced that a nationwide mass vaccination will take place on Thursday and Friday (05 + 06/12) and all public services (excluding power and water, police, and health services) as well as the private sector (with few exceptions) will be shut down from 7 am – 5 pm to enforce the mass vaccination programme. Citizens were asked to stay at their residences and await the visit of mobile vaccination teams. There are 128 teams carrying out the mass vaccination campaign during this period.”

National Measles Response and Recovery Appeal, 6 December 2019

During the door to door mass vaccination campaign, families were told to stay home and hang red flags outside their homes if they needed to be vaccinated.

Photo courtesy of the Government of Samoa.
Photo courtesy of the Government of Samoa.

Amazingly, with all of the cases and deaths, some folks resisted and didn’t want to be vaccinated and protected.

Still wondering why some parents are scared and don't want their kids vaccinated?
Still wondering why some parents are scared and don’t want their kids vaccinated?

They turned the vaccination teams away!

So much for the idea of forced vaccination, right?

There have been 70 deaths in the measles epidemic in Samoa.
The latest update from Samoa – December 9th.

Most have gotten vaccinated and protected though.

They understand that while traditional healers might still be popular in Samoa, they can not be used for life-threatening diseases such as measles.

In addition to overloading kids with vitamin C, a traditional healer working with Jim Meehan was arrested for making many claims that scared people away from getting vaccinated and protected.
In addition to overloading kids with vitamin C, a traditional healer working with Jim Meehan was arrested on December 6 for making many claims that scared people away from getting vaccinated and protected.

So what’s next?

On Nov 24, the case count jumped from 1,797 to 2,194, although they only reported 144 new cases. Were they catching up from the previous days?
On Nov 24, the case count jumped from 1,797 to 2,194, although they only reported 144 new cases. Were they catching up from the previous days?

While it isn’t over yet, hopefully we are in the ending stages of their epidemic, as many people have now been vaccinated and protected with at least one dose of a measles containing vaccine.

Hopefully everyone has learned a big lesson and this epidemic will serve as a warning to everyone to vaccinate and protect their kids.

Samoan children should have been vaccinated and protected.
Samoan children should have been vaccinated and protected.

And to not listen to anti-vax folks, especially those who would try and exploit this kind of epidemic to push their propaganda.

More on the Measles Epidemic in Samoa

A Toddler Has Died After Being Vaccinated in Cuba

No one expects to hear stories of kids dying after being vaccinated. Fortunately, these types of tragedies are very, very rare.

Still, even one is too many when it might have been prevented. After all, that’s why we vaccinate our kids in the first place. To protect them from life-threatening vaccine preventable diseases.

A Toddler Has Died After Being Vaccinated in Cuba

The Ministry of Health in Cuba released a statement a few days after her death:

“Between October 7 and 8 of this year, three one-year-old children were diagnosed with an adverse event associated with vaccination with PRS, which protects against Mumps, Rubella and Measles, this is applied according to official scheme to children one and six years old.

All had been vaccinated on October 7 at the “Betancourt Neninger” Polyclinic in the municipality of Habana del Este, province of Havana, and immediately after symptoms appeared, they were admitted and received medical attention by professionals of high scientific level in the Pediatric Hospitals ” Borrás Marfán ”and Centro Habana.

Through the active research carried out on all children vaccinated in that Health Area, two more children were detected with symptoms, which motivated their admission.

Painfully on October 9 at night, the one-year-old girl Paloma Domínguez Caballero dies, admitted to the “Borrás Marfán” Hospital as a result of complications. The remaining four children remain admitted: one with intensive attention, which is stable and the others evolve favorably.

The system of active surveillance of the events associated with vaccination carried out in the country has not identified any other children with symptoms.

The PRS vaccine has been used for years in Cuba, imported from India, is endorsed by the World Health Organization and certified by the Center for State Control of Medicines, Equipment and Medical Devices (CECMED).

A Commission of the Ministry of Public Health investigates the causes that caused this unfortunate event.”

Official Note from the Ministry of Public Health on adverse event associated with vaccination with PRS (computer translation)

So what happened?

Tragically, either because of errors or contamination, vaccines can rarely cause people to get sick, either if:

  • a reconstituted vaccine was used much after six hours – live vaccines can quickly become contaminated if they are kept and used for too long a time
  • vaccine diluents were mixed up – some vaccines need to be mixed before use and vaccination tragedies can occur when a dangerous medication is used instead of a vaccine’s standard diluent
  • vaccines were improperly handled – breaking the cold chain – or allowed to expire
  • a vaccine is given to someone with a true medical contraindication

In Samoa, the recent tragedy in which two toddlers died, we know that the vaccine diluent was mixed up with a powerful anesthetic.

It doesn’t sound like a diluent mixup happened in Cuba though.

“The mother told the news portal CiberCuba that the daughter’s arm began to swell the same day she was vaccinated. Then the vomits arrived. Less than 24 hours later I was already in intensive care, from where I did not come out alive again.”

Vacuna en mal estado suministrada en Cuba podría haber dejado 25 niños en estado de gravedad

With reports that the vaccines were possibly expired and the child getting sick later in the day, with swelling in her arm, it is more likely that there was some contamination, maybe in a vaccine vial itself.

A 10 dose vial of MMR from the Serum Institute of India Pvt. Ltd.
A 10 dose vial of MMR from the Serum Institute of India Pvt. Ltd.

Which vaccine?

The report says that it was the PRS vaccine – Parotiditis, Rubéola, and Sarampion – or MMR, which is usually available in 5 or 10 multi-dose vials when one dose vials aren’t available.

It was imported from India, which makes many of the vaccines that are used throughout the world, but any contamination likely would have occurred well after it was manufactured and shipped to Cuba.

In all of these cases, there is typically nothing inherently wrong with the vaccine itself.

“Cuba, a relatively poor and small country (population 11.2 million), has managed to bring about remarkable achievements in health in the past 30 years despite difficult fiscal restraints and limited resources.”

MacDonald et al on Infectious Disease Management: Lessons from Cuba

Interestingly, Cuba actually makes most of their other immunizations.

So why would they be using expired vaccines?

Was it a mistake?

Did someone use a leftover vial that had become contaminated with bacteria? Were the vaccines not refrigerated properly? Is it an isolated issue or part of a bigger breakdown in their healthcare system?

With four other sick kids, the use of a contaminated leftover vial that was part of an original 10 dose vial becomes one possible scenario.

We might get some answers if the vaccine vials had not been thrown away after they were used, and are still available for testing.

In Chapias, Mexico, after two infants died in 2015 after getting multiple vaccines, a vial was found to be contaminated with the Staphylococcus hominis bacteria.

A few years later, in 2017, 15 children died in South Sudan when unrefrigerated vaccine was mixed with a syringe that was reused over and over for four days and given to kids by untrained workers.

Again, these are very rare and isolated cases. Remember that billions of doses of vaccines are given each year without problems, saving millions of lives.

Hopefully we will soon learn what really happened to these children in Cuba, especially as that will hopefully help to make sure it doesn’t happen again.

Most importantly, don’t let these very rare tragedies scare you away from vaccinating and protecting your kids.

“The Cuban government has confirmed that five children suffered severe reactions and one of them — a 1-year-old girl — died after receiving a vaccine. The serum came from the same company in India that produced vaccines linked to the deaths of three other children following inoculations administered in Cuba in 2002.”

Child dies in Cuba after receiving vaccine made in India. It’s not the first time

We should remember what happened following the tragedy in Samoa. All vaccinations were unnecessarily suspended in the country for a time and MMR vaccinations were suspended for nine months!

What came next?

A measles epidemic that has already seen the death of one toddler!

The death of the girl in Cuba is a terrible tragedy, but folks shouldn’t make it any worse. There is almost certainly nothing wrong with the vaccines from India or any other vaccines in Cuba or anywhere else.

Vaccines are safe, with few risks.

Hopefully we can continue to work to eliminate even the rare risk of these kinds of awful tragedies too.

And no, this is not the MMR vaccine that is used in the United States in case anyone is wondering.

More on Vaccination Tragedies