By Brett Boese | Postbulleting,

Nasra Giama and Abdirashid Shire created the Somali Health Advisory Council in Rochester about seven years ago. It’s now playing a critical role in the state’s ongoing effort to educate Minnesota-based Somali Americans about the importance of vaccinations.

The two Somali health care professionals met last week with officials from Mayo Clinic, Olmsted Medical Center and Olmsted County Public Health to discuss education and vaccination efforts within the local Somali community.

Vaccination has been a hot topic since Somali vaccination rates began plunging in Minnesota a decade ago — from 90 percent in 2006 to just 42 percent in 2016 — but has become more urgent in recent weeks as the Twin Cities struggles with its second measles outbreak since 2011. Minnesota Department of Health issued an expanded alert Thursday as the outbreak has gained momentum.

“I applaud Olmsted County, Mayo Clinic and OMC because they’re taking this step before there’s even an outbreak (here),” said Giama, a professor at the University of Minnesota Rochester and a Mayo Clinic researcher. “It shows they value us and understand the community’s needs.”

41 confirmed cases

According to Minnesota Department of Health, 41 measles cases have been confirmed, and “almost all” of the victims are unvaccinated. More than 2,500 people have been exposed to the disease, and more cases are deemed likely in the weeks ahead.

The Centers for Disease Control and Prevention declared measles eradicated in the United States 17 years ago, but it’s become an increasing concern with more than 1,500 cases now reported since 2010.

While local health officials haven’t reported a measles case in years, they remain on high alert because of about 5,000 Somalis living in Olmsted County and their increasing resistance to having children vaccinated due to lingering autism fears. Those issues led to the recent health care summit and the creation of a vaccine fact sheet that’s now being circulated throughout the local Somali community.

“If we want to change this narrative, we absolutely need more engagement and asking simple questions,” said Dr. Shire, director of Health and Research Institute for Somali Americans. “If we ask questions of parents who are declining the MMR vaccine, I don’t think they’ll have solid data. They’ll have anecdotal examples, so if we present proper data, I think they’ll be more inclined to (vaccinate their kids).”

Debunked claims

Giama and Shire both continue to blame controversial researcher Andrew Wakefield’s retracted and debunked 1998 study, which led to his medical license being revoked, for continuing misconceptions within the Somali community. They say Wakefield’s 2011 visit to Minneapolis further inflamed fears that the MMR vaccine causes autism, a claim that repeatedly has been debunked by other researchers — including Mayo Clinic’s Robert Jacobson through the Rochester Epidemiology Project in 2005.

However, Giama suffered a case a deja vu last weekend while attending another forum in Minneapolis. Mark Blaxill, of Health Choice, told a large group of Somali parents Sunday that vaccines and autism may be linked, according to the Star Tribune.

She said the panel of speakers included no medical professionals, and a translator was not provided, which she and Shire argue is a critical component in erasing existing misconceptions within the Somali community.

“I left after an hour because I couldn’t stand (Blaxill) anymore,” Giama said. “I was getting really upset. It was a complete setup. They were playing with people’s emotions … and anti-vaccine groups are taking advantage of that. It’s such a tender subject.”

May 23 public forum

Giama and Shire are finalizing plans for a public forum to combat misconceptions about vaccines and autism, specifically targeting messages from Wakefield, Blaxill and President Donald Trump, among others. It’s tentatively been scheduled for May 23 in Rochester and likely will include officials from MDH, Mayo Clinic and Olmsted County Public Health. A similar meeting last year drew about 100 from the Somali community.

Shire hopes to see representatives from Rochester Public Schools and other local groups to build on the current level of engagement with the largest outstate Somali community in Minnesota. Kari Etrheim, communications director at public health, said it’s important that everyone work together to “encourage outreach to our Somali residents with infants and children to get vaccinated and dispel myths about a link between certain vaccines and autism.”

In an interview conducted before the current outbreak, MDH Infectious Disease Director Kris Ehresmann said her department has been conducting “targeted outreach” to the Somali community for years in response to plummeting vaccination rates. That includes many one-on-one meetings to reinforce the idea that “vaccinations are the normative behavior in Minnesota.” Minnesota’s MMR vaccination rate among non-Somali children has remained between about 85-90 percent since 2004, according to MDH data.

“Once measles begins to spread in unvaccinated populations, it can be very difficult to stop,” Ehresmann said Thursday. “We would not be surprised if we saw additional cases in other parts of the state where there are clusters of unvaccinated people before this is over.”

Shire dreams of eventually creating a center for vaccine-preventable diseases, which would be focused on outreach and education to prevent future outbreaks. For now, he and Giama intend to redouble their own efforts while continuing to collaborate with health care experts to reverse the trends that have emerged during the last decade.

“We really need to do more as health care professionals because we’re not as visible as we could be,” Giama said. “When you get a case of autism, that speaks a lot louder than a vaccine. This requires continued engagement. Our message has to sink in … and that requires (repetition). Right now that image of a child with autism is speaking much louder than our public health officials.”