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Fear in Minnesota’s Somali community is complicating efforts to improve measles vaccination coverage, public health officials and local community leaders said, describing a convergence of misinformation, access barriers and heightened anxiety tied to immigration enforcement in Minneapolis. They said even before federal immigration authorities began a crackdown in the city, leaders were already seeing measurable declines in uptake, and that residents are now more likely to avoid clinics and routine medical visits.
Munira Maalimisaq, a nurse practitioner who runs the Inspire Change Clinic, said the fear is reshaping day-to-day decision-making. “People are worried about survival,” Maalimisaq said, adding, “Vaccines are the last thing on people’s minds. But it is a big issue.” In the clinic’s Somali Motherhood Circles, she said that when people do gather or connect, urgent questions about immediate family needs can crowd out discussion of immunizations.
Community-based support structures have been disrupted as well. Maalimisaq said a discussion group for Somali mothers at Inspire Change shifted online indefinitely, and that in community WhatsApp groups and other channels, parents have focused on questions such as who will care for children if they cannot attend school and how families can safely obtain groceries and prescriptions.
State vaccination data underscores how challenging the situation has become. Maalimisaq said Minnesota Department of Health figures showed that in 2006, 92% of Somali 2-year-olds were up to date on the measles vaccine; she said the current rate is closer to 24%, and that advocates aim for 95% coverage to help prevent outbreaks of measles, a disease widely described as extremely contagious. She said community vaccination efforts also tend to move in cycles, with initiatives beginning and stopping over time.
Imam Yusuf Abdulle said the immigration crackdown has intensified the pause. “People are stuck in their homes, cannot go to work,” he said. “It is madness. And the last thing to think about is talking about autism, talking about childhood vaccination. Adults cannot get out of the house, forget about kids.” Abdulle and other leaders said that with many families avoiding healthcare settings, the usual touchpoints that support vaccination decisions are harder to reach.
Beyond access, community leaders said vaccine misinformation has long circulated and has kept measles vaccination vulnerable to delays. They pointed to beliefs linking the MMR vaccine—used to protect against measles, mumps and rubella—to autism, as well as claims about autism rates that, researchers said, are not explained by clear biological mechanisms. Mahdi Warsama, CEO of the Somali Parents Autism Network, said parents want answers about why autism appears more common in their community and that some residents connect those fears to widely disputed vaccine narratives.
Warsama said he has seen anxiety fueled by unproven claims about autism that spread beyond Minnesota, including fears raised after Donald Trump made comments last fall that taking Tylenol during pregnancy could cause autism. Warsama also said the idea of splitting the MMR shot into three vaccines has circulated, even though no standalone shots are available in the United States. He traced the autism-linked narrative in part to Andrew Wakefield’s widely discredited MMR study—later retracted—and said Wakefield visited Somali residents in the Twin Cities in 2011. “The misinformers will always fill the void,” Warsama said.
Local health officials have said their outreach has relied on best practices that include community champions, mobile clinics and support for Somali health providers such as Maalimisaq. But officials also acknowledged that efforts have often been inconsistent and that federal funding cuts have affected the work. Carly Edson, the state health department’s immunization outreach coordinator, said measles remains close to the community because of travel and because outbreaks can flare if enough people go unvaccinated. “Measles is just a plane ride away, and measles is going to find the unvaccinated,” Edson said. “We are always at risk.”
Doctors and educators said some strategies are designed to meet parents where they are. Fatuma Sharif-Mohamed, a Somali community health educator, said short appointments do not give parents the time they need. “That 15 minutes will not change the mind of a parent,” she said. She and others said changing a family’s view can require multiple visits, and that it can take years of engagement to build trust.
Some clinicians also described shifting communication beyond the exam room. Dr. Bryan Fate, leader of a Children’s Minnesota vaccine confidence committee, said new strategies include social media videos from doctors and possible prenatal classes for expectant parents. He said he tells hesitant parents, “I’m going to call you in five days,” and that “there’ll be no changes to this speech.”
Statewide, Minnesota’s kindergarten MMR rate has dropped, officials said, and they said the decline has been sharper for Somali children than the national pattern. Leaders said that while many Somali families eventually vaccinate, some prefer to wait until age 5, even though community leaders said evidence does not support the idea that delaying the shot reduces autism risk. Doctors said they remain especially concerned about young children who are not yet protected, because severe measles complications—including pneumonia, brain swelling and blindness—occur more often in the unprotected.
In the community, leaders said religious and social networks play a role in what parents decide to do. Abdulle said that when parents ask him about the vaccine, he describes his own experience: he said he was not opposed to vaccination but decided to wait, after which his son was diagnosed with autism at age 3 and later vaccinated. He also said, when discussing the evidence, that correlation is not causation.
Abdulle said the community does not want to be portrayed only as a source of disease but acknowledges that measles outbreaks have affected it in recent years and that the virus remains a persistent threat. He said outbreaks occurred in 2011, 2017, 2022 and 2024, and he described the impact in human terms. “Our kids are the ones who are getting sick,” Abdulle said. “Our community is suffering.”
Last year, Minnesota logged 26 measles cases, the state health department said, describing them as occurring across several different communities with pockets of unvaccinated people. In Maalimisaq’s Motherhood Circles, she said, parents sometimes find the most persuasive messages come from fellow parents, such as Mirad Farah, whose daughter was born premature. Maalimisaq said Farah worried the MMR shot would be too much and delayed vaccination, but that the child later developed autism. “So what did that tell me?” Farah asked the room. “It confirmed that autism is not from the MMR.”