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Public health workers push back against anti-vaccine claims at Somali community meeting

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A Somali-American woman records video with her phone as Mark Blaxill, chair of the nonprofit advocacy group Health Choice, speaks at Safari Restaurant in Minneapolis on Sunday. Matt Sepic | MPR News

MPR — Asia Dahir of Spring Lake is convinced that a measles shot her now 14-year-old son Adam received as a baby is responsible for his autism. No scientific studies have found proof of a connection. But Dahir says parents should make inoculation decisions themselves — and not give in to what she says is “bullying” by the medical establishment.

“If the consequences are greater than the benefits, it’s better to leave it alone,” Dahir said.

Dahir was among 90 people — many of them also Somali-American — who came to a Lake Street ballroom in Minneapolis Sunday night for a meeting organized by five anti-vaccine groups. Their message: autism is the real epidemic, not measles.

For an hour they listened as businessman and vaccine skeptic Mark Blaxill downplayed the risk of dying from measles. Blaxill, whose adult daughter has autism, repeatedly emphasized the purported but discredited link between vaccines and autism. And he claimed public health research on the matter is rife with fraud.

“It is a fact that vaccines can cause autism,” said Blaxill. “That’s not the controversy. The controversy is how many cases of autism are caused by vaccines.”

Not true at all, says Dr. Andrew Kiragu of Hennepin County Medical Center. Kiragu was one of at least three pediatricians who sat in the audience quietly fuming as Blaxill clicked through his Powerpoint slides.

At the end, Kiragu took the microphone and told the audience that the autism-vaccine link is bogus.

“When you talk about fraudulent activity, this is fraudulent activity,” said Kiragu. “This is a travesty. I understand people have concerns about vaccinations. People have concerns about autism. But linking the two, especially in a situation like this, I feel is extremely sad.”

Dr. Andrew Kiragu

Hennepin County Medical Center pediatrician Dr. Andrew Kiragu refutes claims by Mark Blaxill, seated at right, that the MMR vaccine can cause autism. Matt Sepic | MPR News

At least 34 Minnesota children have contracted measles since an outbreak began in Hennepin County last month. The state health department reports nearly all of the cases are in Somali-American children ages 5 and younger. Public health officials and Somali community leaders urge parents to get their kids vaccinated immediately.

Public health officials say the vaccination rate among 2-year-olds in Minnesota’s Somali-American community is just 42 percent, compared with 88 percent of non-Somali kids.

The rates started falling a decade ago after reports suggested a higher incidence of autism among Somali students in Minneapolis than in the population as a whole. Around the same time, anti-vaccine advocates began spreading word of a link.

Anab Gulaid is Somali-American and an adviser to the state health department. She also researches autism at the University of Minnesota. Gulaid said because the disorder is often diagnosed around the same time kids get their shots, some parents draw erroneous conclusions.

“When a parent says ‘my child was saying words, and after the immunization my child stopped saying words,’ they link the two,” said Gulaid. “That’s ultimately what makes sense to them.”

Gulaid said unlinking autism and vaccines has been challenging. But public health officials are getting the word out with the help of community leaders.

Dr. Michael Osterholm said the fight against pseudoscience is quite literally a matter of life and death. He heads the Center for Infectious Disease Research and Policy at the U and was state epidemiologist in 1990 when a measles outbreak sickened 460 people in Minnesota and left three dead.

Osterholm also attended the presentation Sunday night, and said downplaying the potential lethality of measles is irresponsible because the virus can kill vulnerable people — especially those with compromised immune systems.

“This is a very serious situation,” said Osterholm. “And when I watch what I saw tonight, and I see these people preying on a community that wants answers, I find this just abysmal. It’s the worst of human behavior.”

Osterholm said he expects the outbreak to grow. State health department infectious disease division director Kris Ehresmann reports two people not of Somali descent have contracted measles.

But the good news, she said, is that the estimated 1,500 people exposed to the virus in the last two and a half weeks have not contracted the disease, indicating the measles vaccine is working.

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Minnesota vaccination activists now are seeking political allies

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A severe measles outbreak sickened dozens of Minnesotans last year and threw a harsh light on activists with vaccination concerns, but now they are back, believing they have gained the political clout to push through legislation that would alert parents to the rare but documented risks of vaccines.

At a forum for state legislators on Wednesday, leaders of the Vaccine Safety Council of Minnesota hope to persuade lawmakers to support an “informed consent” bill, which would require doctors to discuss risks with parents before vaccinating babies.

“There’s been a shift in this country,” said Jennifer Larson, a leader of the nonprofit council and an organization called Healthchoice that organized the forum. “I think it’s tough for anyone to say more information is not better.”

Larson said her group is not anti-vaccine; they believe consumers just need more upfront information about risks. But state health officials worry that opponents want to promote unproven claims that could unnecessarily scare people away from vaccinations.

With 79 confirmed cases, last year’s measles outbreak was Minnesota’s largest in 27 years, and falling vaccination rates in the state’s Somali community played a role, said Kris Ehresmann, who directs vaccination programs for the state Health Department.

“Seventy-one of 79 were unvaccinated,” she said. “It was very much an outbreak driven by lack of vaccination.”

State records show that more than 90 percent of Minnesota children enter kindergarten vaccinated for infectious diseases such as tetanus, measles, hepatitis B, and chickenpox.

But survey data from the U.S. Centers for Disease Control and Prevention show a small decline in certain immunizations. And President Donald Trump proposed a safety commission to address vaccine concerns, though plans for that panel have stalled and the president didn’t mention vaccines in his State of the Union address last week.

Public health officials also found themselves on the defensive after a report out of Australia late last year, while not related directly to pediatric immunizations, that found that the seasonal flu vaccine is only 10 percent protective. CDC estimates for the effectiveness of the flu vaccine between 2004 and 2017 ranged from a low of 10 percent to as high as 60 percent in any one flu season. The vaccine effectiveness fluctuates because the predominant flu strain is not the same each year.

Anxiety about the safety of vaccines has created an active coalition that includes some Minnesota refugee families, proponents of “natural” medicine, and parents who believe disabilities in their children can be traced back to shots they received.

Larson is the owner of an IT business and an autism treatment center, and recently was named finance chair of the Republican Party of Minnesota, though she stressed in an interview that the new role is separate from her advocacy on vaccines.

Larson said she took on the issues of vaccine administration and informed consent after her son, now 17, developed autism following his infant vaccinations.

“My son had a very clear reaction,” she said.

The autism theory has bedeviled public health advocates, because no broadly accepted studies have proved a link between vaccines and the developmental disorder. Some who have claimed this link have been discredited. But the mere thought of a link has scared some parents into refusing or delaying vaccinations for their children, because autism is more alarming to them than diseases such as polio that largely have been eradicated by vaccination campaigns.

Larson said she believes health officials have exaggerated the safety of vaccines. She noted that the federal government’s National Vaccine Injury Compensation Program has paid $3.8 billion since 1988 to people who claimed vaccine-related illnesses or reactions. “Parents want to be told everything before they inject something into their child,” she said.

Speakers at the legislators’ forum this week will include Del Bigtree, who directed “Vaxxed,” a movie about a federal whistleblower who alleged that the government suppressed information about an autism link, and a Minneapolis woman who received federal compensation after she claimed that her son suffered a disabling reaction from the pertussis vaccine.

Larson supports legislation authored by state Rep. Cindy Pugh, R-Chanhassen, that would require doctors to disclose that neither they nor vaccine manufacturers are liable if they give shots that cause complications, and that scheduled combinations of vaccinations at single office visits haven’t been studied for safety.

Pugh did not comment for this article.

Ehresmann said federal law already requires doctors to give “vaccine information statements” to parents, and the state checks to make sure pediatricians are doing so. The statements refer to vaccine risks and the compensation fund, but also the benefits of vaccine and the threats caused by the infections they target.

“These [vaccines] protect children against some serious diseases,” said Ehresmann, recalling the case of a severe Hib (Haemophilus influenzae B) infection that occurred after parents delayed their child’s shots.

The Minnesota Medical Association, which represents the state’s doctors, opposes Pugh’s bill, according to a spokesman, because it only requires vaccine-risk information that would discourage parents, and does not require information about the risks of children being unvaccinated.

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Somalis Train to Improve First Aid Response Skills

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VOA — Somalia’s capital, Mogadishu, has been rocked by explosions for years set off by Al-Shabab militants battling to overthrow the weak U.N.-backed government. The frequent bombings have killed or injured thousands of civilians. Now, first responders are offering first aid classes to help Somalis learn how to help their neighbors before the ambulance arrives. Faith Lapidus reports.

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Somali woman researches health risks of skin-lightening practices

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Ibrahim Hirsi

For some Somali women, having lighter skin tone is the ultimate beauty goal and they use skin products containing dangerous chemicals to reach that goal, according to a new University of Minnesota study.

“To be a beautiful Somali woman, one has to have lighter skin color,” Amira Adawe, co-author of “Skin-Lightening Practices and Mercury Exposure in the Somali Community,” said in a recent interview describing the attitude of some women.

Several Somali women who were interviewed for the study published in July said they mix products that include lemon herbal whitening cream, lulanjina, diana and dermovate — some of which have mercury, a poison that can damage the nervous system, according to the study.

“These chemicals are proven neurotoxins and have been linked to birth defects if used by women during the prenatal period,” stated the study. “Inorganic mercury exposure is associated with rashes, skin discoloration, scaring, secondary bacterial and fungal infections, and even renal impairment and damage to the nervous system.”

The study added: “It should also be noted that mercury … can be transferred from mother to infant through breast milk.”

The Minnesota Department of Health recently tested 27 bleaching products, 23 creams and four soaps. The department found that 11 products contained mercury levels ranging from 135 to 33,000 parts per million. “This has prompted both state and federal health officials to issue warnings about the use of these products,” according to the study.

Although Minnesota law bans beauty products that contain mercury, the study said that immigrants have been smuggling the cosmetics from Latin America, Asia, the Middle East and Africa. The products are then secretly sold in Twin Cities-area stories.

“This is not practiced by only Somali women,” said Adawe, a health educator at St. Paul-Ramsey County Department of Public Health. “It’s widely used by Hispanics, Asians and African-Americans.”

Skin-lightening practices

There are various reasons some Somali women rub their body twice a day with skin-bleaching substances, the study stated. Some of them use the chemicals to get rid of the facial masks of pregnancy, which are pigments women develop during pregnancy.

These pigments often appear on cheekbones, forehead, nose, forearms and other parts of the body that are exposed to the sun. Women with darker skin are more prone to skin pigmentation than those with fair skin tone, health reports suggest.

The study indicated that women also use skin-lightening products to attract men. “They see having light skin as more socially acceptable and believe it will increase their chances of finding a husband,” according to the study.

Adawe, who was born in Somalia, said she knows many Somali women who use the products. “You can tell who uses it and who doesn’t,” she said. “You can’t mistake it with naturally light-skin people. These creams give people more of yellowish color.”

Adawe said the women who use the products often aren’t open about the practice. “Actually, they’ll deny when you ask them,” she said.

How study began

Growing up in Mogadishu and in Minneapolis, Adawe said she encountered many women who regularly used the skin-lightening products. She said became involved in the study a few years ago after coming across an article about bleaching cosmetics that reportedly contained mercury. Adawe said he began to worry about the health of women she knew who used these products, so she started investigating the issue in 2011.

After several interviews with Somali women in the Twin Cities, Adawe learned that some of the women used products containing mercury. Adawe then took her findings to officials at the St. Paul and Ramsey County health department. Soon after, the FBI raided stores in Minneapolis and found Minnesota-banned skin-lightening products and took action against owners, said Adawe, a public health graduate student at the University of Minnesota.

Adawe’s investigation prompted the study, thanks in part to her professor and mentor, Charles Oberg, who co-authored the research paper.

Public awareness efforts

Adawe’s is working to tell others about the dangers of skin-lightening practices by speaking out at community and educational forums, appearing on radio and television shows, and meeting with leaders and activists of the Somali community.

Adawe also engages in conversations with 244 members of the Somali community on a Facebook page she created named “Skin-lightening practices & chemical exposure among Somali women.”

Members share articles, videos and studies about the risks of skin-lightening practices, and they discuss ways they can help limit such practices.

On June 11, Adawe posted on the page: “To those of you who are scholars or know the Islamic religion well, can you please educate us about what Islam says about skin-lightening practices?”

Awil Egal, a group member, replied: “Islam has forbidden men or women to change the creation of Allah: Skin color, hair color and the likes. ”

Egal added: “Using cosmetics, creams and other things that are made from chemicals or impure substances and which may have dangerous side effects is definitely haram [forbidden]. It is also another form of deceiving that can create mistrust between people.”

Other members wrote simple lines of encouragement. Khadijo Abdi, for instance, posted: “Beautiful people, leave your skin as God intended!”

Adawe is optimistic the Somali community will understand the risks of the chemicals. And with social media, she said, she’s even more hopeful that the people will be informed faster.

“Everybody is on Facebook and Twitter these days,” Adawe said. “Social media is a great tool to use for spreading awareness on issues like this one.”

Adawe said there are significant numbers of Somali women satisfied with their natural skin tone and don’t consider using the skin products.

“It all depends on their confidence and level of education,” Adawe said. “Uneducated people tend to use these products more often.”

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