According to the Minnesota Department of Health, 63 measles cases have been reported statewide as of May 16, and 53 of those cases were Minnesotans of Somali origin. Sixty of the reported cases involve individuals confirmed to not be vaccinated.
Public health officials blame false rumors that vaccines are linked to autism and other health problems for the high rate of unvaccinated children in Minnesota's Somali-American community.
The department's disease director, Kris Ehresmann, said anti-vaccination groups have targeted the community with events and have even translated the anti-vaccine documentary "Vaxxed: From Cover-Up to Catastrophe" into Somali.
"They have been very aggressive and are continuing in their efforts to reach out to the community with misinformation throughout the duration of this outbreak," Ehresmann said.
In interviews with Somali mothers, VOA's Somali Service found that anti-vaccine views are widespread.
"I have a baby boy who was well before the vaccine, but eventually he became autistic because of the vaccine. After him, I have never vaccinated my children," said Safia Sheikh Mohamed, a mother of four children.
Mohamed listed a number of problems she believes are associated with vaccines, including food allergies, ear infections and eczema, a treatable condition in which the skin becomes inflamed or irritated.
Another mother said she vaccinated her child, but did so later in life. "I never gave vaccines to my last born child before he turned six, during his first year of school."
A sign at the specialty clinic at Children';s Minnesota in Minneapolis alerts patients to a measles outbreak in the area, May 2, 2017. In interviews with Somali mothers in Minnesota, VOA';s Somali Service found that anti-vaccine views are widespread.
Community leaders reach out
The Minnesota Department of Health is working hard to dispel such beliefs through outreach campaigns. The department has a Somali staff member and a group of Somali health advisers who meet one-on-one with people and attend various community meetings.
'Our challenge at this point is really scalability," Ehresmann said. "If we could multiply our efforts by 10-fold or more, that would be great, but obviously there are resource challenges."
Multiple large-scale studies have found there is no connection between autism and the measles, mumps and rubella (MMR) vaccine, despite rumors to the contrary.
Ahmed Roble, a Somali-American physician who owns a clinic in Minnesota, said he and his colleagues try to dispel misinformation.
"As health professionals, our aim is not only to cure the patient but also to give them counseling,' he said. 'That is what we do for the worrying mothers and fathers who are skeptical about MMR vaccination."
Perhaps the best argument for vaccinating children is the current outbreak, which may be frightening parents into action. Prior to the outbreak, about 30 Somali children per week received the MMR vaccine in Minnesota, but, since the outbreak, that number has grown to 500 children per week.
"We know that as a result of the outbreak and perhaps as a result of seeing measles in real life there, that combined with other messaging has made an impact on a number of the parents," Ehresmann said.
Additionally, parents are beginning to see the consequences of not vaccinating children. Children who are not vaccinated are forced to stay out of daycare for 21 days if a measles case is reported and could be forced to stay out indefinitely if multiple cases occur.
State Representative Ilhan Omar, the first Somali-American elected to serve in a state legislature, invited parents, doctors, owners of clinics and community leaders to share their thoughts at a meeting on Wednesday. She called for parents who do not vaccinate their children to take responsibility.
"It will be the parents' responsibility if they don't want to vaccinate. They should go and discuss with doctors, and then, if they insist, it's their responsibility. It will be documented," she said.
However, the state is bracing for an uptick in cases as the month of Ramadan approaches in late May and June and families gather for the celebration. The final celebration of Eid al-Fitr has the greatest potential for spreading the disease.
"It would represent the biggest risk for potential transmission," said Ehresmann. 'The fact that it's bringing together kids and adults and everybody, and it's not just the population of a single mosque, it's multiple mosques coming together. That factor means that could have the potential for transmission."
Reporter Steve Baragona contributed to this report.