Volunteers in the New Zealand city of Rotorua are in the process of sending two dozen handcrafted, infant-size coffins to the Pacific island of Samoa, which is currently in the midst of a deadly measles outbreak. The coffins are gifts to Samoan families who can’t afford them but suddenly need them. The smallest are decorated with felt flowers and butterflies.
That is one form of Samoa’s contact with the world. Another is anti-vaccination propaganda, much of it generated in the United States, that arrives through social media and discourages Samoan parents from vaccinating their children. This type of import has helped turn Samoa into a case study of “anti-vax” success — and increased the demand for tiny coffins decorated with flowers and butterflies. Samoa is a reminder of a pre-vaccine past and the dystopian vision of a post-vaccine future. Its government has declared a state of emergency. Schools have been closed. Children under 17 have been banned from public gatherings. Unvaccinated families have been asked to hang red flags outside their homes so mobile vaccination teams can find them. Like measles outbreaks generally do, the problem appeared rapidly.
A few cases in October has mushroomed into more than 4,000 today. At least 70 (mainly children) are dead. All of this was completely predictable. “In the absence of vaccination,” Anthony S. Fauci of the National Institutes of Health told me, “measles spreads rapidly among children and kills some of them. This happened consistently throughout the world, including the [United States], prior to the availability of the measles vaccines in the mid-1960s. This is exactly what is happening in Samoa today: widespread infection and death of children. . . . If you give history a chance, it will always repeat itself.”