Thread by @kakape

One year ago today - before the rest of the world got to experience lockdown - the islands of Samoa locked down to defeat a different virus: measles


For those who speak German: We talk about this in a new @pandemiapodcast episode
For everyone: a thread
viertausendhertz.de/pan15/

@pandemiapodcast The outbreak in Samoa started in October 2019. As usual there are multiple, complex reasons that all led to vaccine coverage declining. There was complacency, there were structural changes in the health care system, there were anti-vaccine groups. And there was a terrible tragedy

@pandemiapodcast In July 2018, two children died just after receiving the measles vaccine. Nurses preparing the vaccine had accidentally mixed the powder with an anaesthetic instead of water. (They were sentenced to 5 years in prison.)
The deaths further fuelled fears about vaccines.

@pandemiapodcast Vaccination programs were suspended for months.
The result: Vaccine coverage slipped to low levels, really low levels.
In 2013 99% of Samoan infants received the 1st dose of MMR, in 2018 it was just 40%. Coverage with the 2nd dose went from 87% to 28%. (thelancet.com/journals/lanin…)

@pandemiapodcast Then measles was introduced to Samoa, probably by a traveller from Auckland, New Zealand, where measles was spreading. (Health experts had already warned of this.)
The virus spread like wildfire amongst the unvaccinated in Samoa.

@pandemiapodcast (This had happened before: In 1893 the steam ship Upolu brought measles to Samoa for the first time, also from New Zealand. “from reports obtained from missionaries and others, no fewer than 1,000 of the entire population of 34,500 died from measles” ncbi.nlm.nih.gov/pmc/articles/P…)

@pandemiapodcast As more and more people got sick and the death toll climbed, Samoa decided to lockdown the country for two days: schools and shops were closed, national exams postponed, travel and public gatherings restricted.

@pandemiapodcast In a huge immunisation campaign, teams went from house to house, vaccinating people. Residents hung red flags or sheets out of their windows to indicate anyone in the house who was not vaccinated and at risk.

@pandemiapodcast The vaccination campaign helped Samoa reach 95% coverage and the outbreak was declared over soon after.
But the impact was devastating. There were more than 5700 measles cases.
83 people died, the vast majority children under 5 years of age.

@pandemiapodcast People forget how deadly measles is.
Not just complications like pneumonia or encephalitis (incl. years later the terrible, deadly, incurable SSPE - subacute sclerosing panencephalitis).
Measles also wipes out part of the immune memory, leaving kids vulnerable to other infections

@pandemiapodcast Samoa has a population of around 200,000 people. Can you imagine what it means for more than 80 children to die there in just a few weeks?
In Berlin, where I live, the equivalent would be more than 1000 children dying within just a few weeks.

@pandemiapodcast So that is the power of measles.
And that is the power of immunisation.

@pandemiapodcast Then measles was introduced to Samoa, probably by a traveller from Auckland, New Zealand, where measles was spreading. (Health experts had already warned of this.)
The virus spread like wildfire amongst the unvaccinated in Samoa.

@pandemiapodcast (This had happened before: In 1893 the steam ship Upolu brought measles to Samoa for the first time, also from New Zealand. “from reports obtained from missionaries and others, no fewer than 1,000 of the entire population of 34,500 died from measles” ncbi.nlm.nih.gov/pmc/articles/P…)

@pandemiapodcast As more and more people got sick and the death toll climbed, Samoa decided to lockdown the country for two days: schools and shops were closed, national exams postponed, travel and public gatherings restricted.

@pandemiapodcast In a huge immunisation campaign, teams went from house to house, vaccinating people. Residents hung red flags or sheets out of their windows to indicate anyone in the house who was not vaccinated and at risk.

@pandemiapodcast The vaccination campaign helped Samoa reach 95% coverage and the outbreak was declared over soon after.
But the impact was devastating. There were more than 5700 measles cases.
83 people died, the vast majority children under 5 years of age.

@pandemiapodcast People forget how deadly measles is.
Not just complications like pneumonia or encephalitis (incl. years later the terrible, deadly, incurable SSPE - subacute sclerosing panencephalitis).
Measles also wipes out part of the immune memory, leaving kids vulnerable to other infections

@pandemiapodcast Samoa has a population of around 200,000 people. Can you imagine what it means for more than 80 children to die there in just a few weeks?
In Berlin, where I live, the equivalent would be more than 1000 children dying within just a few weeks.

@pandemiapodcast So that is the power of measles.
And that is the power of immunisation.

@pandemiapodcast (If I had kids and they would ask me what a vaccine is, I would probably tell them it gives them superpowers: It makes them invisible to the virus, so that it cannot find them.
And the best thing: If enough kids are invisible, the virus won’t bother coming to a place at all.)

Thanks to @CT_Bergstrom, @ProfHeidiLarson, @deerbrian, @AbOsterhaus and @who’s Rasul Bhagirov, who all contributed to the episode!
The podcast is a cooperation with @riffreporter who help finance it with money from the Klaus Tschira Stiftung.

riffreporter.de/corona-virus/p…