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Health officials: Vaccines create 'walls' against measles infection

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Marian Osman, of Rochester, holds her four-month-old son, Mohamed Abdi-son, while listening during the community forum about measles hosted by the Somali Health Advisory Committee on Monday, May 22, 2017, at Olmsted County Public Health Services in Rochester.

Southeast Minnesota hasn't had a single measles case since at least 1989, but health officials are on edge as the state's worst outbreak in nearly 30 years rages just 90 miles to the north.

Mayo Clinic pediatrician Nusheen Ameenuddin told a predominantly Somali crowd Monday night that she's spent a significant amount of time googling "those wacko websites" in order to know what information she needs to debunk in order to overcome vaccine hesitancy. That's the new reality as Minnesota's Somali community continues to be influenced by a controversial, retracted 1998 study from Andrew Wakefield that linked the MMR vaccine to autism.

Vaccination rates among the state's Somali population have plummeted in the last decade from about 90 percent to just 42 percent.

"The whole premise of the link between MMR and autism is based on one study, which was fraudulent," Ameenuddin said. "He lied, he violated ethics and it was too small a sample to (prove anything). But that fear is still in people's mind. Even if it's fake, once that fear is in someone's mind, it's very hard to get out."

Minnesota Department of Health's Lynn Bahta announced Monday that 69 measles cases have been confirmed since the outbreak began in April -- 59 of the cases have struck unvaccinated Somali children. More than 94 percent of the measles cases thus far have impacted the unvaccinated population.

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There were just 56 cases of measles in Minnesota between 1997-2016, according to MDH , but it's already caused 21 hospitalizations in 2017. The disease can prove deadly, though no one has died during the current outbreak.

While Wakefield's medical license eventually was revoked due to the 1998 study, its premise still haunts the Somali community.

"We have a big (vaccination) gap here, and these children are all vulnerable to measles," said MDH's Lynn Bahta, who is coordinating the state's efforts while directing a staff that's routinely been working 12-hour days without weekend breaks. "When we have a vaccinated community, we create walls against infection. When these cases are brought into the community, these walls really protect the whole community.

"I know the media has really focused on the fact Somalis have this disease, but it's not about who. It's the fact that unvaccinated people are getting this."

Hinda Omar, Bahta's Somali colleague at MDH, added: "This outbreak is the hardest thing I have ever seen."

Monday's forum was organized by the Rochester-based Somali Health Advisory Committee in conjunction with MDH, Mayo Clinic, Olmsted Medical Center and Olmsted County Public Health. SHAC also has shared information with and had dialogue with Rochester Public Schools, though no one from the school district was in attendance.

Only about 25 people attended Monday's free forum after last year's inaugural forum drew nearly four times that number, but SHAC leaders Dr. Abdirashid Shire and Nasra Giama contend outreach from the medical community is critical to combating misinformation .

That's especially important for Somali leaders, who can rebut myths and rumors in their native tongue. Sheikh Sharif Mohamed actually addressed the crowd for 10 minutes using only Somali, while interpreters were used throughout the evening.

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"Sometimes I think speaking from the heart is much better than speaking from the brain," Mohamed said before discussing the importance of vaccination and explaining Wakefield's debunked study. He also praised Ameenuddin's "aggressive approach" to debunking the alleged link between MMR and autism.

Local collaboration has been credited for Olmsted County's Somali population boasting a 75 percent vaccination rate, nearly double the state average. However, Olmsted County Public Health Associate Director Dawn Beck, who leads the local disease prevention and control program, says improving vaccination rates remains a high priority identified in the county's Community Health Needs Assessment .

Coordinated local efforts all are geared toward preventing measles from impacting Southeast Minnesota.

"I know many of you are here as concerned parents to make good decisions to protect the health of your children," said Giama, who works at the University of Minnesota Rochester. "We're also here to protect the community as a whole. We're all in this together."

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Lynn Bahta, of the Minnesota Department of Health, speaks during the community forum about measles hosted by the Somali Health Advisory Committee on Monday, May 22, 2017, at Olmsted County Public Health Services in Rochester.

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