I think that it is strange how a country like India is achieving so much with its vaccination campaigns, while ‘developed’ countries, like the US, seem to be backtracking on their achievements.
Social media, and the ability to share and campaign for one’s personal beliefs about any and all subjects, has led to an anti-vaccination movement among some parents. This phenomenon is not a new one, however, it is gaining rapid popularity in recent years leading to rates of unvaccinated children to quadruple since 2001. This trend is ongoing despite programs in place for uninsured children to receive vaccines for free.
A recent measles outbreak in New York, both in the Brooklyn and Queens area of New York City, and in the Rockland County located slightly north of Brooklyn, has yet again brought the anti-vaccination issue to the forefront of the media.
Measles is a disease that generally starts with a high fever and cough followed by the development of a rash. It is often coupled with fever spikes of 40℃ (104℉) or higher. Complications can include ear infection that leads to permanent hearing loss, seizures, deafness, or brain damage causing intellectual difficulties caused by encephalitis, and, in rare cases, even death may occur.
The most vulnerable population for measles are children under the age of 1 year, due to being unvaccinated since the recommended age for initial vaccination is one. Those most likely to suffer complications such as those previously listed are children under the age of 5 and adults over the age of 20.
Since the introduction of the measles vaccination, measles cases with US origins have been eradicated. So, why did the recent outbreaks in New York happen, among other areas in the US, including Disneyland?
In both New York outbreaks, from October 2018 to date, patient zero was an unvaccinated individual who traveled outside of the US, specifically to Israel. Several other patients contracted measles while traveling to Israel. These unvaccinated travelers brought measles back to the US and spread it to others in their community.
Since symptoms of measles can take up to 21 days to appear, it is very reasonable that a traveler would unknowingly spread the disease upon their return. In addition, the initial symptoms of measles are common to several other illnesses such as the common cold and flu. It is not until the rash develops that measles could be suspected as the cause of the illness. Measles is spread by airborne means, for example, coughing and sneezing, which facilitates the ease of which it may spread.
One could argue that measles may be spreading despite vaccination rates. However, measles had been declared eradicated in the US in the early 2000s, so the appearance of the disease in recent years shouldn’t have happened had all people – falling under the age brackets to be vaccinated – had done so.
In fact, the exposure of one unvaccinated individual who contracted the disease while abroad has not necessarily spread to vaccinated individuals. In fact, Rockland county reports that 81% of cases occurred in unvaccinated individuals. Further, only 3.3% of cases occurred in fully vaccinated individuals.
With over 400 cases occurring in Rockland County and Brooklyn, a closer inspection of the outbreak showed that the majority of those cases occurred among the orthodox Jewish communities, hence the Israel travel-related origins of the outbreak.
Another question that may arise in reference to this outbreak is the possibility of religious exemption for vaccinations. Do orthodox Jews avoid vaccination due to religious beliefs? In short, the answer is no. In fact, the majority of religions do not prohibit vaccinations, among them such religions as Buddhism, Hinduism, Jehovah’s Witness, Scientology, and other mainstream Christian religions. A few fringe Christian groups do cite religious belief as a reason to refuse vaccination such as the Church of Christ Scientist, Dutch Reformed congregations, and Faith Healing groups.
Islam and Judaism could cite the use of porcine gelatin as a case for a religious exemption for vaccination, since pork is considered haram or treif, respectively. However, both religions have stated that the use of porcine gelatin for the administration of vaccines is acceptable, without religious repercussions.
In fact, among Judaism, orthodoxy included, the practice of Pikuakh nefesh is held in the highest regard. This is the practice of saving a life, whether one’s own or another individual’s. Since vaccinations can, and do, save lives they are encouraged among those practicing orthodox Judaism.
This leads to another potential cause for the high rate of unvaccinated orthodox Jews in the New York area, political leanings. Are conservatives more likely to refuse vaccination on the basis that it is government overreach? While the majority of orthodox Jews do self-identify as conservative Republicans at almost 60% of the population. However, research done by Cornell has shown that non-medical-exemptions are about equally distributed among far-right conservatives and far-left liberals in the US.
Finally, the most recent findings are pointing at a group called Parents Educating Advocates for Children’s Health (PEACH). It has been found that the group, which is anonymous, has been targeting the Orthodox Jewish community for years by spreading misinformation, specifically medical-related information, among the community of Orthodox Jews.
How they accomplish this is unique in this era of the internet and social media: Prior to the measles outbreak, PEACH distributed a magazine among the orthodox community in Brooklyn and Queens. This magazine was filled with information about vaccines, citing studies that have been disproved including the infamous Wakefield study (Wakefield falsified documents, rigged outcomes in studies, and eventually lost his medical license and all qualification such as medical degrees due to his dishonesty regarding vaccines and autism).
PEACH created legitimacy for their false vaccination information by linking it to more common practices and beliefs, such as alternative medicine or historical events such as the medical ‘studies’ done to Jews by Nazi Germany at concentration camps.
It would not be a far stretch to assume that PEACH also cited the practice of keeping kosher, although as previously discussed the use of porcine gelatin in vaccines is exempt due to the higher emphasized concept of Pikuakh nefesh.
While the recent outbreaks of measles, a disease thought to have been eradicated in the US, can be a cause of concern for everyone, especially those with young children or medical exemptions from vaccinations, all it takes is some research and critical thinking to determine that the risk of being infected are minimal. Although the best practice would be to seek immunization, steps such as washing hands and avoiding close contact with others need to be followed to slow down the spread of measles.