specific delivery time for the availability of potent vaccines, laboratories worldwide are in a race to develop a vaccine for COVID-19, with governments exercising containment and mitigation strategies to slow down the spread of the disease. For countries with under resourced health systems, limited water supply, suboptimal sanitation and hygiene facilities, and aging populations, the ability to vaccinate against COVID-19 would be cause for public health celebration. Acceptance of the vaccine is important to its success and with the rise of the antivaxxer movement, increasing public education and awareness is urgently needed. Samoa can be used an example of the impact of a vaccine preventable disease on an under vaccinated population, there were 81 reported deaths and 5,675 reported cases 2 of measles from an epidemic in 2019.
Although no inquiry into the government's management of the outbreak was approved or conducted, several weaknesses were highlighted in the public media. These included delays in declaring the outbreak and state of emergency, unavailability of measles diagnostic tests locally, poor communication and leadership, lack of a decentralized vaccination response and among some the cultural preference for traditional healers. Additional significant challenges were the misinformation on vaccinations that was largely promoted by anti-vaxxers on social media; and public mistrust after the tragic deaths of two babies one year earlier after receiving a mixture of the MMR vaccine and an expired anesthetic 3 . Although the deaths were found to be due to human error, the combination of misinformation and mistrust contributed in part to people seeking medical attention and treatment late. In response to anti-vaxxer promotion activities, the government imposed fines and potential jail penalties for persons who actively attempted to dissuade people from receiving vaccines. One person was charged with incitement against the Samoan Government's vaccination order and the case will be seen by the courts later in 2020. 4 Unfortunately, penalties do not change anti-vaxxer sentiment but drive the discussion underground, with studies indicating that social networking applications such as Facebook can be used to spread misinformation. 5 To stem the epidemic, the government implemented a mass vaccination campaign across Samoa vaccine is an unknown time away, but involving the anti-vaxxer community now is imperative to high vaccine acceptability when it is discovered.