The Samoa government is being accused of ignoring mass vaccination advice from its own medical experts ahead of the deadly measles epidemic in 2019.
The outbreak killed 83 people in the country, most of them babies and young children.
This picture released from UNICEF Samoa shows a girl receiving a vaccine during a nationwide campaign against measles in the Samoan town of Le'auva'a. Photo: ALLAN STEPHEN / UNICEF / AFP
Two consecutive health reports, one a 2018 health ministry study and the other a Commission of Inquiry report delivered early in 2019, urged the government to conduct a mass vaccination drive to counter the country's low herd immunity amid a growing global measles pandemic.
However, it took the government another seven months to start rolling out a mass vaccination policy resembling the recommendations, but by then the highly contagious respiratory illness had already taken hold.
Samoa Observer journalist, Sapeer Mayron, helped break the story and said people were still hurting.
"I think there is a lot of shock still. This is certainly going to be opening a wound that has probably not healed but with the pandemic currently going, it almost feels like measles happened yesterday, the epidemic," said Mayron.
"So, I imagine they'll all be feeling pretty shocked that this could have been avoided and that the graves in front of their homes, maybe, could not have been there."
The 2019 Commission of Inquiry report was a response to the deaths of two infants in July 2018 following routine jabs with the MMR, (measles, mumps and rubella), vaccine. The deaths led to a suspension of the programme and a loss of confidence in the vaccine by parents.
The report recommended an immediate mass-vaccination special programme "to minimise the risks and to ensure as many children as possible are protected."
The commissioners, retired Judge Tuiloma Neroni Slade, paediatrician Leo'o Dr John Adams and the Samoa Family Health Association's Lealaiauloto Liai Iosefa-Siitia, drew "attention to the likely risks for Samoa, especially for children without MMR vaccination protection."
The report was never made public after its 2019 release but a copy made available to the Samoa Observer showed the commissioners were concerned about outbreaks in New Zealand and the USA.
At the time of the report's release, global measles cases had grown 300 percent between the first quarters of 2018 and 2019 and there were already 64 reported cases in New Zealand, including 20 patients who were in hospital.
The MMR programme was re-started in April but only at hospital clinics despite the concerns and warnings.
By October when a mass-vaccination policy was being implemented 16 people, mostly infants, had died and 700 cases were confirmed as the epidemic was formally declared.
It wasn't until November 2019 that a mass-vaccination programme kicked off in earnest and a month later the border was closed. By this stage 60 lives were lost and 5,357 people were infected with daily infection rates in their hundreds.
The epidemic ended up with a death toll of 83.
Samoa extends the state of emergency Photo: Samoa Government