Public Health News Watch Wednesday: Report for May 17, 2017

This week’s Public Health News Watch focuses on what’s potentially behind the recent outbreak of measles in a Somali community in Minnesota.

Politicians and mainstream media pundits keep talking about “alternative facts”—and garnering a collective shrug from the medical community.

After all, differing “realities” and interpretations of existing science are as old as medicine itself. Indeed, cherry-picking and manipulating facts to support a specific agenda is hardly new.

“What is new is not mendacity but the public’s response to it—the growing primacy of emotional resonance over fact and evidence, the replacement of verification with social media algorithms that tell us what we want to hear,” Matthew d’Ancona, author of the book Post Truth: The New War on Truth and How to Fight Back, writes in a commentary published May 12, 2017 by the Guardian.

All of which is a fancy way of saying that, if we don’t like what we hear—from our doctors, our politicians, or the media—we tend to create a narrative we like better. And, perhaps the most recent example of this cognitive dissonance—and its consequences—centers around preventive vaccination for diseases such as measles.

As Contagion® reported on May 9, 2017, an ongoing measles outbreak in Minnesota has grown to include 48 cases (now 58), many of whom are Somali immigrants. At least 15 infected children have been hospitalized as a result of their illnesses. Officials in the state place the blame for the outbreak squarely on the shoulders of “anti-vaccine” activists, who have targeted the Somali community there after noticing that a high number of children from the African nation develop autism. Research linking autism with the measles, mumps, rubella (MMR) vaccine was published by former physician Andrew Wakefield in The Lancet in the late 1990s; however, it has since been debunked and declared fraudulent (and Wakefield has been stripped of his license to practice medicine).

“I want to be very clear that this outbreak has nothing to do with being Somali,” Kristen Ehresmann, RN, MPH, Director, Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, said in an interview with CNN. “It’s just the sheer fact of being unvaccinated…”

Recent measles outbreaks have also been reported in California and Arizona, among other regions, and most have been traced to the reluctance on the part of some parents to have their children vaccinated. While Centers for Disease Control and Prevention (CDC) statistics indicate that 91.5% majority of American children receive the MMR vaccine, which has been available and in use since the 1960s, when they are between 19 and 35 months old, a survey published last year by the journal PLoS One found that a “substantial minority” of parent respondents had refused (15%) or delayed (27%) measles vaccination for their children.

Although the PLoS One survey did not ask respondents to provide justification for their positions, it is safe to presume “alternative facts” are the likely culprit. Public health experts have long lamented that the Internet—and other forms media—have breathed new life into distorted realities such as the autism/MMR link, allowing myths to live on long after they have been disproved by sound science. A documentary touting Wakefield’s work (called “Vaxxed”) scheduled for the 2016 TriBeCa Film Festival was only pulled at the 11th hour, after a public protest by medical experts. And author d’Ancona recalls the 2007 appearance of model and broadcaster Jenny McCarthy on the “Oprah Winfrey Show.” McCarthy’s son is autistic, and she pins his condition on the vaccines he received as an infant. When Winfrey asked her to provide evidence to support her theory, McCarthy replied (as quoted by d’Ancona), “My science is named Evan, and he’s at home. The University of Google is where I got my degree from.”

“Between 2000 and roughly 2008, the Somali community in Minnesota actually had some of the highest vaccination rates for 2-year-olds of any population in the state,” Michael Osterholm, PhD, MPH, Director, Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN. “[However], by about 2008, we started to see the vaccine rates drop as the word got through the Somali community that autism was linked to measles vaccination… In the years since then, Andrew Wakefield has actually been brought in several times to the Somali community here in Minnesota to actually give presentations supporting this information, [even though] his work has been retracted.”

Are Wakefield’s disciples living in an alternative universe? No, just in an age of alternative facts. Unfortunately, you don’t have to believe in these distortions of the truth to feel their effects.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.