The children of Samoa are still susceptible to measles as a large number remain unvaccinated. Mystery surrounds how this situation exists.

There is no way that the vaccines are in short supply. The Ministry of Health can attest to that. The only explanation is that parents do not think that vaccination is important. While most Pacific islands have achieved almost 100 per cent measles vaccine coverage, Samoa still lags.

This is worrying because another outbreak will once again have serious consequences.

Has Samoa forgotten that 5707 people contracted measles in the outbreak that struck at the end of 2019? In just three and a half months, 83 died and 1868 were admitted to hospital.

The vaccination rate for the second dose of the measles, mumps and rubella (MMR) vaccine remains low in the country igniting a push to cover more children. Ministry of Health is urging all parents to get children vaccinated if they are yet to receive MMR2.

According to the vaccination figures from the Ministry of Health, the MMR1 coverage rate is 91 per cent. This is mainly because MMR1 is administered at birth.

MMR2 is administered to a child at 15 months. The rate for MMR2 is at just 64 per cent. This means a large number of the population especially children are still vulnerable to measles.

The measles epidemic were dark days when children bore the brunt of a preventable disease. Preventable through vaccination. Parents have the power to ensure that no more lives are lost to measles, mumps and rubella.

According to the World Health Organisation, in 1954, a measles outbreak at a boarding school just outside Boston, Massachusetts provided an opportunity for doctors at Boston Children’s Hospital to try and isolate the measles virus, taking throat swabs and blood samples from infected students.

The culture that Dr. Thomas Peebles obtained from 11-year-old schoolboy David Edmonston successfully led to the virus’s cultivation and enabled doctors to create the first vaccine against measles.

John Franklin Enders, Peebles’s boss, often called ‘the father of modern vaccines’, developed the measles vaccine from the ‘Edmonston-B’ strain, named after David and used as the basis for most live-attenuated vaccines to this day.

Enders and his team tested their measles vaccine on small groups of children from 1958 to 1960, before beginning trials on thousands of children in New York City and Nigeria.  In 1961 it was hailed as 100% effective and the first measles vaccine was licensed for public use in 1963.

Since then, vaccines are the only way to prevent certain diseases and most importantly diseases that can kill.

Because measles has such a high infectivity rate, the threshold for community protection is also very high, requiring at least 95 per cent immunity among the population to prevent epidemics. The failure to maintain very high rates of immunization can result in outbreaks when the disease is reintroduced.

In addition to the suffering caused by measles, containing outbreaks is costly and detracts from other healthcare services. Measles deaths continue to occur in many countries, especially those with gaps in their immunization programmes.

For example, in the Democratic Republic of the Congo 2299 people died during the Ebola epidemic of 2018–2020, compared with 7,800 deaths from measles during an outbreak in the same time period.

Immunization rates declined in Samoa after two babies died on Savai'i island following measles, mumps, and rubella (MMR) vaccinations that were wrongly prepared by nurses who were later jailed.

Health officials have said that vaccination rates fell for multifactorial reasons and were already declining before this incident. WHO data show a dramatic dip in coverage in 2004, which recovers, then drops again from 2014 onwards.

In this period, families were moving to the Apia urban area away from their villages, which had historically supported immunization through the local, influential women's committees. By far the area worst hit by the outbreak was the capital and its surroundings.

Maybe it is time for the Ministry of Health to have a more vigorous immunization campaign through mobile clinics targeting all villages including Manono and Apolima. As much as people are shying away and avoiding protecting their children, let’s take the vaccines to them. This may require some extra money to be spent but what is the value of a child’s life?

Similarly for parents. Do you not value the lives of your children enough to get them vaccinated and follow the immunization programme that has been successfully protecting children around the world to be safe from diseases which could end up killing them?

Everyone has seen what the lockdowns did to the country. Economically and socially, no one in their right mind wants to go back to that period.

Take the advice given by the Ministry of Health and get your children vaccinated if you have not already. There needs to be a united approach because that is the difference between life and death.