A fast-moving measles epidemic led Samoa to declare a state of emergency in 2019. Outside a clinic in Apia, children and parents were photographed waiting in line for vaccination. During an intensive campaign in December, government offices and many businesses closed, unvaccinated households displayed red flags, and mobile teams travelled through communities. New Zealand’s 1News also reported people lining up to be seen by nurses at some mobile vaccination points.
Trust in immunisation had been badly damaged after two babies died in 2018 when MMR vaccine was incorrectly prepared. Low coverage left the country vulnerable when measles arrived, and the epidemic killed many children. Waiting for a shot therefore took place at the intersection of an urgent outbreak and a recent medical tragedy; the line should not be romanticised as a simple display of public spirit.
The campaign did not rely only on bringing everyone to a fixed clinic. It also moved vaccination towards households. In ordinary care, patients approach a service and wait their turn. In Samoa, a red flag could ask the service to approach them. Fixed queues and mobile teams became two ways of creating the same encounter across an island nation.