The Samoan capital became a “ghost town” as families were told to stay indoors and leave red flags outside their houses to request vaccinations amid a measles outbreak that has killed 62 people, which UN officials say has been exacerbated by anti-vaxxers in developed countries.
The government initiated a nationwide, two-day shutdown on Thursday, telling workers to stay at home, closing schools and blocking off roads to all non-essential vehicles.
Families were told to hang red flags outside their homes if they needed to be vaccinated, as teams began going door-to-door to administer them.
The virus – believed to have first been spread by a traveller from New Zealand – has mostly taken the lives of young people, with 54 deaths among children aged four or below.
Unicef’s Pacific Islands chief urged social-media giants like Facebook, Instagram and Twitter to crack down on “incredibly irresponsible” anti-vaxx material proliferated on their sites, which he said had exacerbated the crisis by discouraging immunisation.
“It’s quite clear that they have a corporate responsibility to step up to the plate and make sure that populations, particularly vulnerable populations, get accurate information that’s going to keep children alive,” UN children’s agency’s regional representative, Sheldon Yett, told AFP.
The World Health Organisation (WHO) blamed a digital anti-vaccination campaign for the crisis.
Mr Yett said the deadly disinformation came mainly from overseas, and urged those from Australia, the US and other wealthy developed nations posting the false material to realise they were passing a “death sentence” to children in developed nations.
“Unfortunately it’s found a ready audience in Samoa, where some people are suspicious about the quality of healthcare and may have issues with local [vaccine] providers.”
Before the outbreak, immunisation rates on the island had dropped to around 30 per cent, WHO data shows – well below the accepted practice of 90 per cent.
According to the government, more than 4,000 people have now contracted the disease. 172 people remain in hospitals, including 19 children in critical condition.
The nation declared a national emergency last month and mandated that all 200,000 citizens get vaccinated.
Prime minister Tuilaepa Sailele Malielegaoi told reporters the vaccine drive was unprecedented in the nation’s history and explained that – despite 58,000 people being immunised since the emergency was declared – an often indifferent public reaction to previous vaccination drives made the two-day shutdown necessary.
“They seem to take a kind of lackadaisical attitude to all the warnings that we had issued through the television and also through the radio,” he said.
Under the government’s orders, the normally bustling capital Apia was a ghost town on Thursday, with only birds nesting in the rooftops and stray dogs roaming the streets, the Samoa Observer newspaper reported.
The prime minister said another challenge was that citizens had been seeking help from traditional healers, who had been successfully treating tropical diseases in Samoa for some 4,000 years.
“Some of our people pay a visit to traditional healers thinking that measles is a typical tropical disease, which it is not,” he said.
The country has seen a rise in fake cures being peddled since the outbreak began, such as vitamin products or alkaline water. They are often sold online and by alternative “healers”.
The low immunisation rate can also be partially attributed to the deaths of two children in July 2018, according to the BBC.
Both died on the same day after receiving vaccinations for measles, mumps and rubella (MMR), prompting public concern about the vaccine.
It later transpired the nurses had mixed the vaccine with an out-of date muscle relaxant instead of water, and both were sentenced to five years in prison after pleading guilty to manslaughter.
“But the fact that you had two children die on the same day in the same institution, obviously caused a great deal of distrust towards the health system and towards vaccinations,” Mr Yett told the BBC.
“It provided the perfect opening for people who wanted to spread misinformation and lies.”
In the wake of the incident, anti-vaxxers stepped up efforts to push their agenda online, Mr Yett said.
The activists have also hindered efforts to control the recent outbreak, with AFP reporting that one prominent Australian-based blogger last week compared compulsory vaccinations to Nazi Germany, saying “fascism is well and truly alive in Samoa”.
Globally, the number of measles cases grew by four times more in the first quarter of 2019 than in the same period last year, according to the WHO.
In 2016, the number of measles deaths was at a record low of 89,780, having dramatically reduced since 1990, when the disease took 872,000 lives, WHO data shows.
But in 2017, deaths caused by the virus rose – for the first time in years – by 20 per cent.
While the annual figures for 2018 and 2019 have not yet been announced, the number of global cases rose four times faster in the first quarter of 2019 than over the same period in 2018, suggesting no sign of a let-up.
Additional reporting by AP