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In California, high school students were sent home because of infected classmates.

One patient who was unknowingly infectious visited a hospital and exposed dozens of pregnant women and babies, including those in the neonatal intensive care unit.

The 23-month-old was on an IV for fluids and had repeatedly pulled out the oxygen tube in her nose. Patti Carroll, a member of the Vaccine Safety Council of Minnesota, described its goal as giving parents more information, including about their right to refuse to vaccinate. Other studies have found that alterations in brain-cell development related to autism may occur before birth.

Her older brother, almost 4, endured a milder bout. The children now have antibodies to protect against measles, but they still need the vaccine to prevent mumps and rubella. People have been “bullied big-time” by doctors and public health officials, she said. There are some genetic risk factors for autism, and advanced parental age has been associated with the condition.

Fear of autism runs so deep in the Somali community that parents whose children have recently come down with measles insist that measles is preferable to risking autism. You don’t know what you are talking about.”While scores of studies from around the world have shown conclusively that vaccines do not cause autism, that is often not a satisfactory answer for Somali American parents.

Soon there was a full-blown outbreak, one of the starkest consequences of an intensifying anti-vaccine movement in the United States and around the world that has gained traction in part by targeting specific communities.“It’s remarkable to come in and talk to a population that’s vulnerable and marginalized and who doesn’t necessarily have the capacity for advocacy for themselves, and to take advantage of that,” said Siman Nuurali, a Somali American clinician who coordinates the care of medically complex patients at Children’s Hospitals and Clinics of Minnesota.Another adult patient was hospitalized and on a breathing machine for three weeks.Federal guidelines typically recommend that children get the first vaccine dose at 12 to 15 months of age and the second when they are 4 to 6 years old.Measles, which remains endemic in many parts of the world, was eliminated in the United States at the start of this century.It reappeared several years ago as more people – many wealthier, more educated and white – began refusing to vaccinate their children or delaying those shots. A 2014-2015 measles outbreak infected 147 people in seven states and spread to Mexico and Canada.

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