Vaccine Hesitancy

Immunization is generally well received by refugee groups, including Somalis. In recent years, some Somali community members in the United States have expressed concern about the disproportionately high number of Somali children enrolled in early childhood special education programs for autism. Community members were drawn to information promoting the misconception that autism was linked to the MMR vaccine. Additionally, anti-vaccine proponents reached out directly to the Somali community, bolstering fears that MMR vaccine caused autism, and encouraging Somali parents to refuse vaccination.

From 2004 to 2010, MMR vaccine coverage among Somali children in Minnesota dropped from 91% to 54% [55]. More recently, coverage rates have begun to improve, and the majority of new Somali arrivals support MMR vaccination [14]. In early 2017, Minnesota health officials reported an outbreak of measles in the Minneapolis-St. Paul metropolitan area. As of August 2017, Minnesota had recorded 79 confirmed measles cases. Of those, 64 were in Somali Minnesotans, and most (n=74) were in unvaccinated or undervaccinated individuals [58].

Clinicians who administer childhood vaccines should be respectful of parent concerns, and should approach discussions about immunization with cultural humility and empathy [59]. Clinicians should also be aware that vaccination decisions may be made outside a clinical setting. Somali parents may be influenced by community members, including persons they may not know personally but who belong to and identify with the local Somali community. Clinicians should aim to build trust with patients and their families, as well as build relationships with leaders in the Somali community [14].

Additional Resources for Providers:

References

  1. Ashkir A, Mohamed F. Vaccine Hesitancy in the Somali Community. Washington State Refugee Health Conference. 2017.
  2. Gahr P, DeVries AS, Wallace G, et al. An outbreak of measles in an undervaccinated community. Pediatrics 2014 Jul;134(1):e220–
  3. Minnesota Department of Health. Measles (Rubeola). 2017 [cited 2017 July 31]; Available from: http://www.health.state.mn.us/divs/idepc/diseases/measles/#1External.
  4. Vaccine Confidence Project. USA: Cultural approach to vaccine hesitancy essential for ethnic communities. 2016 December 2; Available from: http://www.vaccineconfidence.org/usa-cultural-approach-to-vaccine-hesitancy-essential-for-ethnic-communities/External.
  5. Minnesota Department of Health. Measles (Rubeola). 2017 [cited 2017 July 31]; Available from: http://www.health.state.mn.us/divs/idepc/diseases/measles/#1External.
  6. Vaccine Confidence Project. USA: Cultural approach to vaccine hesitancy essential for ethnic communities. 2016 December 2; Available from: http://www.vaccineconfidence.org/usa-cultural-approach-to-vaccine-hesitancy-essential-for-ethnic-communities/External.