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Saturday, December 7, 2019

On Thursday local time, the government of Samoa began a planned two-day shutdown to make way for a nationwide vaccination campaign to combat the measles outbreak that had, by reports, infected over 4,200 of the island nation's roughly 200,0000 residents since October and killed at least 62, including, according to government reports, 54 small children. Residents were told to stay off the roads and businesses and ferries were closed to make way for vaccination teams.

A single measles virion shown via transmission electron microscopy.
Image: Centers for Disease Control and Prevention.

File photo of Prime Minister Tuilaepa, 2008.
Image: United States Embassy to New Zealand and Samoa.

Samoan Prime Minister Tuilaepa Sailele Malielegaoi noted on Monday, the fatalities were all unvaccinated.

The only civil servants not assigned to assist in the vaccination effort were those working on water and electricity.

In remarks to the Agence France-Presse news service, Sheldon Yett of UNICEF observed, "I've seen mass mobilisation campaigns before, but not over an entire country like this[.]"

Households with at least one unvaccinated person were asked to place a red flag somewhere visible. This included the home of Prime Minister Tuilaepa, who told the press his nephew needed a dose.

The vaccination drive itself started November 20. According to the World Health Organization (WHO), vaccination before the outbreak began covered only about 31 percent of Samoans. Al Jazeera reported on Thursday, coverage had risen to 55 percent. According to Yett, the goal for the two-day shut down was to exceed 90 percent.

Earlier this week, an official government Twitter account made the following announcement: "Latest update: 3,728 measles cases have been reported since the outbreak with 198 recorded in the last 24 hours. To date, 53 measles related deaths have been recorded. Since the Mass Vaccination Campaign on 20 Nov 2019, the Ministry has successfully vaccinated 58,150 individuals." Since then, the government has reported more cases of measles, including 165 in the single day before the shutdown began.

When announcing the shutdown on Monday, Prime Minister Tuilaepa called on "village councils, faith-based organizations, and church leaders, village mayors and government women representatives" to instill confidence in vaccines in the public.

Samoan vaccination rates dropped in 2018 after two small children died from a faulty vaccine. According to Samoa Observer editor Keni Lesa, the anti-vaccine movement was able to tap into the resulting public mistrust and "really hammer home their message."

The Samoan government declared a state of emergency on November 15, shut down all schools as of November 17, and later banned children from public gatherings in an effort to curb the spread of the disease.

According to the WHO, the number of cases of measles globally in the first half of this year exceeded those of any other whole year since 2006. Various countries, including the United States, have seen marked increases in measles cases in recent years.

Measles affects the respiratory system. It often involves rashes and fever but it can be much more serious. According to the Centers for Disease Control and Prevention in the United States, one out of every thousand children who contract measles develop encephalitis, which can cause deafness or brain damage.

Measles is one of several diseases that drastically reduced the indigenous population of Pacific island nations and the Americas after first contact with Europeans. The first measles vaccine was introduced in the 1960s, and the incidence dropped, in some cases to almost zero, in parts of the world in which its use became widespread. It has since seen a resurgence partly due to vaccine hesitancy and vaccine inaccessibility.

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Joshua Berlinger and Isaac Yee. "Samoa measles outbreak: Government shuts down so everyone can get vaccinated" — CNN, December 5, 2019
"Samoa shuts down in unprecedented battle against measles" — Al Jazeera, December 4, 2019
"Measles History" — Centers for Disease Control and Prevention, December 3, 2019 (date of access)
Vanessa Romo. "Samoan Government to Close Its Offices Amid Measles Crisis That Has Left 53 Dead" — NPR, December 2, 2019
Joshua Berlinger and Carly Walsh. "Samoa to shut government to deal with deadly measles outbreak" — CNN, December 2, 2019
Matt Pearce. "The history of measles: A scourge for centuries" — LA Times, February 5, 2015

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