Measles is characterized by the swiftness of its transmission, infecting 9 out of 10 unvaccinated people if exposed to them. Symptoms consist of a combination of a rash and fever, and it may also produce cold-like symptoms. In severe cases, measles can lead to brain damage, diarrhea, and pneumonia (The Measles & Rubella Initiative, 2019). This means children are particularly vulnerable to measles and at risk if not vaccinated. Decision-makers should pass legislation mandating the vaccination of all pre-school and school-aged children to combat this risk (The Measles & Rubella Initiative, 2019). This could create a vaccination “herd effect” by limiting the spread of measles in a community, which has spillover effects for any non-vaccinated individuals. Furthermore, measles outbreaks can be identified through a global surveillance system. Such a system would benefit from tracking the genetic sequence of the measles virus around the world. Despite the global efforts, millions of children have not been vaccinated in 2018 alone (“Over 13 Million Children”, n.d.). Due to the risk to infants associated with measles, vaccination is on the primary level of Public Health practice.
History of Samoa Measles Outbreak
The measles outbreak has affected many countries around the globe. The Independent State of Samoa is a Polynesian island country comprised of two central islands, Savai’i and Upolu, and numerous small deserted islands (“Samoa Country Profile,” 2019). Despite the number of islands forming the country, approximately 195,000 people live in the state of Samoa. Samoan and English are considered to be the two official languages. Traditionally, Samoans participate in a communal way of living, engaging in projects, and daily-routines collectively. The central religion of the Samoan society is Christianity.
Moreover, the country has been shocked by the deadly measles outbreak in 2019. The virus spread over the state with 5,707 confirmed cases and 83 deaths (“2019 Samoa Measles Outbreak”, 2020). The vaccination helps prevent this extremely contagious infection; however, just 31 percent of Samoans were protected when the virus hit in October (McNamara, 2019). Such a vaccination rate was prompted by the anti-vaccination campaign that developed in 2018. The movement started when two newborns died after nurses mistakenly mixed the vaccines with different medications (ZDoggMD, 2019). The event intensified the global spread of conspiracies related to vaccines. Currently, the measles vaccine is compulsory in the state of Samoa. Health professionals worldwide have been mobilized to vaccinate the population quickly. Samoan government reports that 93 percent of Samoans were successfully vaccinated (McNamara, 2019). Various international organizations, including UNICEF, have used the emergency fund provided by the United Nations to vaccinate parents and infants contaminated with the virus.
Global Response and Public Health Interventions
In response to the large-scale measles outbreak in Samoa, the local authorities declared a state of emergency on November 15. Under this state of emergency, quarantine-like measures were introduced, including banning children younger than 14 from attending public events. Additionally, any child younger than 14 traveling between islands must show proof of immunization before they are allowed to board any boats or ferries (Schnirring, 2019). This is an individual/family level screening intervention as families would need to acquire proof of immunization to be allowed to move between islands (Schaffer & Strohschein, 2019). Such measures, in turn, would encourage families to vaccinate themselves.
Furthermore, the Samoan government limited most public utilities so that government workers would be free to assist with a compulsory vaccination effort. Priority was given to young people and international travelers (Montgomery, 2019). This is a systems-level policy delegated functions intervention as it required non-medical workers to temporarily switch to medical work at a governmental level (Schaffer & Strohschein, 2019). The goal of this intervention was to limit further risk to inhabitants of Samoa by vaccinating the population as soon as possible.
Lastly, the Samoan government instituted international travel restrictions, mandating that incoming travels must show proof of immunization. Without such confirmation, travelers would not be allowed in Samoa. This intervention targeted all potential travelers to Samoa. This is systems-level policy development and enforcement intervention as it must be enforced by Samoan port and air travel officials and agencies (Schaffer & Strohschein, 2019). The goal of the intervention was to contain any new influx of measles within the country.
HP 2030, US Measles Risks and Conclusion
The measles outbreak is not only a danger to island states but an emerging global threat due to the misinformation. The Healthy People 2030 target figure for the United States is zero epidemic cases (Office of Disease Prevention and Health Promotion, n.d.). In comparison, in 2019, the reported number of measles cases was 1282 and 12 cases in 2020 (Center for Disease Control and Prevention, 2020). To summarize, the United States is far from reaching the desired goal, as the numbers increase yearly. The measles, mumps, and rubella (MMR) vaccine was confirmed to be an extremely efficient way of preventing outbreaks (Slisco, 2019). Medical experts believe that a contemporary rise in the anti-vaccine thinking has possibly contributed to the high number of cases in the United States. Lastly, pre-school parents should be exposed to an essential public health message that measles cases must be cut down from thousand to a zero.
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McNamara, A. (2019). Measles outbreak in Samoa kills 72, most of them children. CBS News. Web.
Montgomery, B. (2019). CDC goes to Samoa to battle measles & U.S. anti-vax disinfo. Daily Beast. Web.
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Over 13 million children did not receive any vaccines at all even before COVID-19 disrupted global immunization – UNICEF. (2020). The Measles & Rubella Initiative. Web.
Samoa country profile. (2019). BBC. Web.
Schaffer, M., & Strohschein, S. (2019). Public health interventions: Applications for public health nursing practice. (2nd ed.). Minnesota Department of Health. Web.
Schnirring, L. (2019). Samoa extends measles emergency. Center for Infectious Disease Research and Policy. Web.
Slisco, A. (2019). Measles patients passed through airports in Chicago, Virginia, Texas, LA and Denver this month, officials warn. Newsweek. Web.
The Measles & Rubella initiative. (2019). Web.
ZDoggMD. (2019). Measles Kills Children In Samoa | A Doctor Reacts To Anti-Vax Lies [Video]. YouTube. Web.