Anti-vaccine advocates have influenced parents in New York to refuse vaccinations for their children, unleashing two of the largest measles outbreaks in recent state history, according to local health officials.
As of Thursday, 17 people in the Williamsburg and Borough Park neighborhoods in New York have been confirmed with measles, along with 53 people in nearby Rockland County, for a total of 70 cases. Further cases are currently being investigated and the number should increase.
What is noteworthy here is that all cases occur between unvaccinated or unvaccinated Orthodox Jews, mainly children. When asked why people are excluding vaccines, the city's health department has said that anti-vaccine propagandists are distributing incorrect information in the community.
The terrorists include the Brooklyn group called PEACH – Parents Teaching and Advocating for Children & # 39; s Health – which spreads misinformation about vaccine safety, citing rabbis as authorities, through a direct line and magazines. The Brooklyn Orthodox Rabbi, William Handler, also proclaimed the link between the measles-mumps-rubella (MMR) vaccine and autism. Parents who "placate the gods of vaccination" engage in "child sacrifice," he told Vox.
I spent the last few days talking with the Orthodox Jews in New York on the epidemic and their concerns about vaccines. And I learned that a minority of vaccines against mistrust – for reasons that have nothing to do with religious doctrine.
However, the fact that some Orthodox Jews live outside the mainstream, avoiding technology and giving high consideration to rabbinic opinion may leave them particularly vulnerable to anti-vaxxers.
"Being a religious Jew, you also get used to having a minority point of view," said Alexander Rapaport, CEO of the Masbia Soup Kitchen Network in Brooklyn, and a public face of the Hasidic community. "So if something is not mainstream, it does not take you away from it."
He also explained that some Orthodox Jews in Brooklyn go to school together, worship together, live and travel together. This means that some unvaccinated people living in the immediate vicinity can be dangerous. But it also means making raids with public health messages requires extra effort. "We consider that the government is investing a lot in public health awareness," said Rapaport. "But it never drips to Yiddish speakers or to people who do not own televisions".
The history of New York is familiar: other close-knit communities – such as the Somali-American community in Minnesota and Amish in Ohio – have recently fallen victim to measles epidemics following the rejection of the vaccine. So this latest outbreak is a reminder of how anti-vulnerable groups can be vulnerable to anti-vaxxers and the unique challenges for public health advocates in countering their messages in these communities.
Measles was eliminated in the United States in 2000 – but epidemics related to the rejection of the vaccine have appeared in island communities
There's a fact that makes the measles virus really scary: it's one of the most infectious diseases known to man. A person with measles can cough into a room, leave, and – if you have not been vaccinated – hours later, you can take the virus from the droplets in the air they left behind. No other virus can do it.
So if you are not vaccinated, it is extremely easy to take measles. In an unimmunized population, one person with measles can infect 12 to 18 others. It is higher than other viruses such as Ebola, HIV or Sars.
In 2000, due to widespread vaccination, the virus was declared eliminated in the United States: enough people were immunized because epidemics were rare and measles deaths were hardly heard.
But for a vaccine to be effective, it is necessary to have a certain percentage of people in an immunized population. This is what is known as "the immunity of the herd" and means that diseases can not easily spread through the populations. With the MMR vaccine, 95% of people need to get the shot. So only a few people who refuse vaccines can be dangerous.
Since 2000, we have experienced epidemics each year in populations with lower levels of vaccine intake, for a total of between 37 and 667 cases. The virus generally spreads when unvaccinated travelers visit places where measles are circulating widely and return it to other unvaccinated or unvaccinated people in a close-knit community where some parents have given up vaccines for their children.
This is what happened in two of the largest recent measles outbreaks in the United States since the disease was eliminated. In 2014, measles spread among the unvaccinated sick of Ohio after a missionary reported the virus from the Philippines. And in 2017, a traveler unleashed an epidemic in a non-vaccinated Somali-American community in Minnesota.
In New York, the current outbreaks also originated from travelers who had recently visited Israel, where there is currently a huge measles epidemic. Travelers returned to the United States and spread them among non-vaccinated or under-vaccinated New Yorkers.
But this is not an isolated incident. The Orthodox Jewish community has already faced numerous outbreaks of diseases preventable by vaccines in recent years, including pertussis and mumps. Only in 2013, another measles epidemic that involved 58 cases became the largest in the city since 1992, almost a decade before measles were eliminated, and cost the city $ 400,000 to be contained.
The reason why parents are not vaccinating in New York
Most of the people I've talked to in this story have no concerns about the safety of the vaccines and happily vaccinate their families. The point of view of the majority is also that there are no religious reasons to avoid vaccines.
"From a religious point of view, people must vaccinate," said Rabbi David Niederman, executive director and president of the United Jewish Organizations in Williamsburg. Instead, people have a duty to protect their families and the most vulnerable people in their communities. "Anything that can cause damage, you must do everything possible [avoid] that. "
Yet the rabbinical authority, and the discussion about avoiding harm, is used by anti-vaccine activists as a vehicle for spreading misinformation.
Consider the story of Rachel, * an Orthodox Jew in Brooklyn. When her eldest son was 18 months old, she took her baby to the doctor for the MMR vaccine. Shortly thereafter, the girl came down with a fever that rose to 106 and eventually had to be hospitalized.
"The doctor said there was no correlation with the vaccine," recalls the seven-year-old mother, aged 11 months to 15 years. But Rachel was skeptical. After that, he noticed that his daughter was getting sick all the time. "Ear infections, viruses, I lived in the doctor's office." He thought the vaccines could be the culprit.
So he read the shots in the pamphlets of PEACH, he watched the anti-vaccine documentary Vaxxedand spoke with her neighbors in her Orthodox Jewish community in Brooklyn.
"Rabbis who do not think vaccines are the right way to keep a low profile," he said, "but I could call you a bunch of them."
He read and heard about things that concerned her. The ingredients in the vaccines did not seem safe or healthy, and he heard voices from neighbors whose children had autism right after their blows. (For the record, data on thousands of people over the past fifty years have found that vaccines are largely safe and effective).
So over the years, Rachel has vaccinated her children "less and less". His two children are not immunized at all.
Today, between taking her children to school and changing diapers, her homemaker mom hosts a library in her home, where parents can borrow books about vaccines and discuss what they read. The library includes both pro- and anti-vaccine books. "People can read and decide for themselves".
His library is advertised in anti-vaccine materials that are disseminated in the Rachel community, and now he is part of the vaccine-resistant minority, one of which has helped unleash two of the largest measles outbreaks in recent US history.
"It was very difficult to dissuade the parents"
Some of Rachel's concerns are reflected in the Vaccine Safety Handbook, allegedly produced by Brooklyn from a group called PEACH – Parents Teaching and Advocating for Children & Health. (The group refused to be interviewed for this story.) The book bears the slogan "You can always vaccinate later. You can never vaccinate," pages of misinformation about the vaccines, including the linking dismantled with autism, as well as the advice of the rabbis on the "biblical commandment" to avoid putting their life or health in danger – including the danger of vaccines.
Another source of misinformation of the vaccine is Rabbi William Handler, who also believes that vaccines cause autism – and shares it with parents. "I explain to parents that health authorities like [the Centers for Disease Control and Prevention] they are not interested in individual children, "he said.The best way to avoid potential harm is to avoid being immunized, he advises."[Parents] I do not want to play Russian roulette with their children. It's like a child sacrifice. "
Although large-scale studies involving thousands of participants in different countries have not established a link between the MMR vaccine and the mental development disorder, it is the opinions on autism that the New York Department of Health feels a lot.
"Unfortunately the concern about whether there is any connection is really long and [because of] disinformation, and it was very difficult to dissuade the parents, "said Vox Jane Zucker, deputy commissioner of the New York City Immigration Office." We feel they want to wait until the baby is older, so they know that the child does not have autism, so get the child vaccinated ".
The challenge of countering anti-vaccine rhetoric in isolated communities
New York State does not allow parents to refuse vaccines Philosophical reasons, even if parents can obtain exemptions for health and religious reasons. Once children reach school, they must present proof that their children have been vaccinated, unless they have obtained an exemption.
Zucker says that vaccine levels in Jewish schools in New York City appear to be average, although religious schools have more religious exemptions than non-religious schools. And before the kids get to school, there's a problem in Williamsburg: it has one of the lowest rates of vaccination coverage among children, ages 19 to 35, in the city.
So it was no surprise to Zucker that the children currently affected by measles in this epidemic were too young to be in school. According to the city's health department, the Williamsburg and Borough Park measles cases involved only small children, aged seven months to four years. (Rockland refused to provide details about the problems, citing privacy issues.)
This means that there is a cohort of children for which state vaccine laws are not applicable and which are vulnerable to vaccine-preventable diseases.
"Once the children go to school, we know we have a good vaccine intake," Zucker said. "It is the delay, however, and it is what is connected to this epidemic".
Reaching vaccine-free parents is not easy, however. The public health department sent notifications to schools and hospitals with large Orthodox Jewish populations, made out of awareness, and published announcements and posters distributed in Orthodox articles both in Yiddish and in English.
Public health officials must intervene before the outbreaks begin
But they need to try harder, community leaders said, and to intervene before epidemics begin.
"We have a language barrier, a cultural barrier," said Rabbi Avi Greenstein, executive director of the Boro Park Jewish Town Council, in one of the affected areas, "and it only makes sense for the health department to reach [our community]".
After the outbreaks, posters on the importance of public health department vaccines will be shown in community centers and cellars in the neighborhood, said Alexander Rapaport, CEO of Masbia Soup Kitchen. But, "The city posters are reactionary," he added, and there is not enough to educate people before the outbreaks.
According to the latest data from the New York City health department, there has been a surge in MMR vaccine uptake among children in Williamsburg since the onset of the epidemic.
So maybe it's an opportunity to change people's point of view. "It's becoming increasingly clear if people take the position [not to vaccinate], I am an irresponsible person, an irresponsible parent, "said Greenstein" This is the challenge for the community ".
* We did not use Rachel's real name because she was worried about privacy and backlash about her opinions.