Baltimore Sun Sunday

Measles sock ultra-Orthodox Jews

Rash of new cases rises in Israel, U.S.

- By Michele Chabin

JERUSALEM — UltraOrtho­dox Jews in Israel have been hit especially hard by the country’s yearlong measles outbreak, which has spread to some ultra-Orthodox communitie­s in the United States.

The reason, health officials say, has nothing to do with religion and everything to do with the ultra-Orthodox way of life and public health services that don’t meet the needs of large families.

“Most rabbis encourage vaccinatio­n based on the Torah commandmen­t to protect one’s life,” said Rabbi Yuval Cherlow, founder and head of the ethics department of the Tzohar Rabbinical Organizati­on in Israel. “In Judaism, the majority has the right to dictate what takes place in the public space to ward off danger.”

Still, “there is no pope in Judaism, and no one can force you to vaccinate,” Cherlow said.

In 2018, Israel’s Health Ministry reported 4,000 cases of measles, compared with 30 the year before. In the United States this year, nearly 400 cases have been reported through March, compared with 372 during all of 2018, according to the Centers for Disease Control and Prevention.

Vaccinatio­n rates among ultra-Orthodox Jews in both countries have risen in recent months, following calls by rabbis for their community’s children to be vaccinated and even bans on unvaccinat­ed individual­s from schools and synagogues.

But new cases are being reported in some particular­ly insular ultra-Orthodox communitie­s in Israel, New York and New Jersey, where rabbis believe more in the will of God than in the authority of health officials.

In late March, Ed Day, county executive of Rockland County, N.Y., declared a state of emergency intended to bar unvaccinat­ed children and teenagers from public places. About 6,000 unvaccinat­ed children, many of them ultra-Orthodox, attend schools in the county.

But Friday, a state judge put that injunction on hold.

The ban was an effort to address the outbreak in Rockland County, where 167 confirmed cases of measles had been reported as of Friday.

In 2018, three outbreaks in New York state, New York City and New Jersey occurred, mostly among unvaccinat­ed people in Orthodox Jewish communitie­s, associated with travelers who brought measles back from Israel, according to the Centers for Disease Control and Prevention.

Despite outbreak clusters, the majority of American Jews, like their Christian and Muslim counterpar­ts, have been vaccinated, said Joshua Williams, an assistant professor of pediatrics at the University of Colorado who studies the role of clergy in the vaccinatio­n process.

Ultra-Orthodox Jews who refuse to vaccinate their children “tend to cite secular concerns about the safety of vaccines, the risk of autism and side effects, and not religious doctrine,” Williams said.

Hagai Levine, head of the environmen­t health track at the Hebrew University­Hadassah Braun School of Public Health and Community Medicine, said vaccinatio­n refusal in the Israeli ultra-Orthodox community is “very rare” and that about 96 percent of Israeli children are vaccinated.

That number rises to nearly 100 percent in Israel’s Christian and Arab Muslim communitie­s, which generally follow the recommenda­tions of their leaders.

When ultra-Orthodox parents do not vaccinate their children, it’s usually because health services aren’t tailored to their specific needs, Levine said.

“We know from research from past and current measles outbreaks that in families with many children, where the mother is out working and the father is studying Torah full time, it’s very difficult to get all the children immunized on time. They are not anti-vax,” he said.

In Israel, where the average family has three children, ultra-Orthodox families have seven children on average, though having 10 or 12 is not uncommon. Half of ultra-Orthodox Jews live below the poverty line.

Levine said Israel’s universal health care system could do more to prevent measles.

He would like to institute home visits for the purpose of vaccinatio­n or extend the hours of operation for clinics.

Prevention in the tightknit ultra-Orthodox community is vital, Levine said, because of its overcrowde­d conditions and the high percentage of babies too young to be vaccinated.

“Because measles is so contagious, a vaccinatio­n rate of 80 to 85 percent isn’t enough to contain it,” he said.

Levine emphasized that Israel’s measles outbreak is fueled by outbreaks in other countries in Europe.

“The problem didn’t start with us, but we weren’t protected enough, and now we have an outbreak,” he said.

Washington Post contribute­d.

 ?? SETH WENIG/AP ?? Signs about the measles vaccine are displayed March 27 at the Rockland County Health Department in Pomona, N.Y.
SETH WENIG/AP Signs about the measles vaccine are displayed March 27 at the Rockland County Health Department in Pomona, N.Y.
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