Measles sock ul­tra-Ortho­dox Jews

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

South Florida Sun-Sentinel (Sunday) - - Nation & World - By Michele Chabin Spe­cial to The Wash­ing­ton Post

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 ul­tra­Ortho­dox 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.


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

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