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On 6 July 2018, on the east coast of Savaiʻi, two 12-month-old children died after receiving MMR vaccinations.[8] The cause of death was incorrect preparation of the vaccine by two nurses, who mixed vaccine powder with expired atracurium instead of the appropriate diluent (sterile water).[19] These deaths were used by anti-vaccine groups to incite vaccination fear on social media. This caused the government to suspend its measles vaccination programme for ten months, despite contrary advice from the World Health Organization (WHO).[20][18] The incident cost many Samoan residents their trust in the healthcare system.[21]

From October 1, 2018 to late November 2018, UNICEF provided 115,500 measles vaccines doses to Samoa, including the diluent, syringes and safety boxes, and shipped Vitamin A supplies.[22][23] UNICEF and WHO estimate that the newborn measles vaccination rate fell from 74% in 2017 to 34% in 2018.[24][25] Vaccination rates dropped to 31% in Samoa, compared to 99% in nearby Nauru, Niue, Cook Islands,[17] and American Samoa.[26] In March 2019, the WHO and UN children's agency UNICEF warned the Pacific to take proactive measures and improve immunisation rates.[27]

In June 2019, American anti-vaccination activist Robert F. Kennedy Jr. visited Samoa to meet with local anti-vaccination activists including Taylor Winterstein and Edwin Tamanese, whom he called a "medical freedom hero". Kennedy also discussed vaccines with then-Prime Minister Tuilaʻepa Saʻilele Malielegaoi,[28][29] and campaigned against the vaccine on social media.