In early December of 2019, I called Faimalotoa Kika Stowers, the health minister of Samoa. The measles outbreak that had begun earlier that fall on her small Pacific island nation had spread out of control and become an epidemic that threatened to overwhelm the country. The deep bond Hawaii shares with Samoa meant this was a shared crisis. As the lieutenant governor of Hawaii at the time and a practicing physician, I knew we needed to act quickly to save lives.
Almost 20 years earlier, I had arrived on Hawaii’s Big Island as part of the National Health Service Corps to practice medicine at a small clinic in a remote community. I learned the value of preventative health care for rural, low-income patients, and the essential fact that vaccines are one of the most effective tools we have to prevent illness and save lives, especially those of children. As a rule, keeping vaccination rates above 95 percent can protect an entire population from infectious diseases like measles.
But when vaccination rates fall, preventable diseases can regain a foothold and pose a new danger. And that’s precisely what happened in Samoa, after misinformation spread by anti-vaccine activists eroded trust in vaccines and led to the 2019 outbreak. Thousands of preventable cases of measles sprung up, leading to the deaths of 83 people, mostly children. One of the most prominent voices behind the anti-vaccine campaign was Robert Kennedy Jr.
Vaccines and public health vaccination programs are not just medical interventions, they are also moral imperatives. They embody our commitment to saving lives, ending disease and protecting the health and well-being of future generations. If Mr. Kennedy is confirmed as secretary of the Department of Health and Human Services under President-elect Donald Trump and serves as our nation’s chief health care officer, there is a real danger that he will continue to spread doubt and misinformation, potentially causing vaccination rates to fall and leading to more preventable deaths. America can’t allow that to happen.
The tragedy in Samoa five years ago shows not just how lower vaccination rates can lead to a public health crisis, but also how renewed vaccination campaigns can end such crises. Back in 2019, I recall offering Ms. Stowers our immediate assistance, pledging five doctors from Hawaii and 5,000 doses of the measles vaccine. She asked if we could do more.
Within 48 hours, we assembled an extraordinary emergency medical team of about 75 volunteer nurses and doctors to fly to Samoa. Organizations such as UNICEF and the Health Care Association of Hawaii provided essential medical supplies, including vaccines. The team’s willingness to drop everything to help a neighboring Pacific nation was nothing short of extraordinary.
Our plane landed in Samoa on Dec. 4, 2019, first thing in the morning. Over the next day and a half, alongside a few hundred Samoan health care workers, our team traveled from village to village and vaccinated tens of thousands of people. By the time our plane took off for Hawaii the next afternoon, we had helped curb the measles epidemic. Health data released later that month showed a dramatic decline in cases, the result of Samoa’s vaccination rate reaching 95 percent.
But we also witnessed the deadly consequences of the anti-vaccine campaign. We arrived at one home just minutes after a toddler girl had died from measles, her mother bursting into tears as we approached. The child was lying absolutely still on a makeshift bed in the middle of the family’s one-room house, her face still red from fever. I put my hands on her face and could feel the warmth in her skin, but her eyes were fixed and glazed over. My stethoscope confirmed she was no longer breathing.
In spite of her severe case of measles, her family was caring for her at home because the hospital was filled beyond capacity and there weren’t enough doctors, nurses or beds available to accommodate her. We shared a moment of mourning for her with her parents, and then proceeded to vaccinate her family members at the parents’ request before we had to move on to continue our mission.
The measles epidemic in Samoa was a heartbreaking example of how quickly things can go wrong when vaccination rates are allowed to fall. A tragic human error in 2018 involving improperly prepared vaccines led to the deaths of two local infants, shaking public confidence. Though the vaccine was confirmed to be safe, many parents became hesitant to immunize their children.
Mr. Kennedy and others fanned the flames of this fear with misinformation. The people of Samoa shared with me that they got very little news from outside their community, but in the months before the 2019 epidemic they had been bombarded with social media posts claiming that vaccinations were unsafe and would harm or even kill their children. Activists from other countries, including Mr. Kennedy, claimed vaccines were dangerous. Many Samoans were afraid to vaccinate their children, and by late 2019 the epidemic was raging, overwhelming Samoa’s national health care system.
The experience in Samoa was fresh in my mind when the Covid-19 pandemic reached Hawaii in early 2020. As lieutenant governor, I took on the responsibility of keeping our people informed with constant updates and factual information. That steadfast approach continued when the Covid-19 vaccine became available and anti-vaccine propaganda continued to spread rapidly online. Hawaii’s vaccination rate was among the nation’s highest and its mortality rate among the lowest, saving thousands of lives in our state. Like our emergency medical mission to Samoa, Hawaii’s Covid response was a testament to what we can achieve when our public health efforts are ambitious and based in scientific fact.
Vaccination programs are one of the greatest public health achievements in human history. Vaccines have saved more than 150 million lives over the past 50 years and cut infant mortality by 40 percent worldwide. Because of international vaccination programs, we have eradicated smallpox and reduced polio cases by more than 99 percent. The measles vaccine alone has saved an estimated 94 million lives globally since 1974, virtually eliminating the disease in the United States since 2000.
Yet, despite the overwhelming evidence for their safety and the record of their lifesaving power over the past 50 years, figures such as Mr. Kennedy continue to spread misinformation about vaccines. On a podcast appearance in 2023, he made the claim that “There’s no vaccine that is safe and effective.” This is false. Such rhetoric is reckless and dangerous. I saw this for myself in Samoa.
As we look to the future, the possibility of Mr. Kennedy being confirmed as the secretary of Health and Human Services is cause for grave concern. I worry he would jeopardize half a century of progress and success gained by the United States as a result of vaccination programs. Too much depends on our commitment to truth and the lifesaving power of vaccines to entrust Mr. Kennedy with the direction of these programs. Our children’s lives depend on it.
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