Wednesday, September 18, 2019

Before inoculation against measles began on a large scale in the 1980s, the World Health Organization reported that the disease killed 2.6 million a year, on average. The extremely infectious illness causes serious respiratory distress as well as a rash and fever, and is dangerous mostly to children under 5 and those with compromised immune systems. “While global measles deaths have decreased by 84% worldwide in recent years — from 550,100 deaths in 2000 to 89,780 in 2016 — measles is still common in many developing countries, particularly in parts of Africa and Asia. An estimated 7 million people were affected by measles in 2016,” WHO said.

Two years ago, in 2017, a resurgence of the illness began to be seen in Israel, and in small groups of people who traveled from Israel to New York’s Orthodox Jewish enclaves in Rockland County and Brooklyn. Since then, pockets of people who are unvaccinated due to religious or philosophical reasons—many of whom are said to believe now-debunked claims that the MMR vaccine is linked to autism—have contributed to the spreading of the illness, which is now on track to be at the highest levels in years. From January 1 to April 11, 2019, there have been 555 cases of measles reported in 20 states, according to the Center for Disease Control. That’s compared to the 2014 outbreak, in which the entire year saw 465 cases. 

The Jewish community’s response, particularly in Northern New Jersey and Westchester, has been strong and united in the view that vaccinations are obligatory for public and community health, for those who rely on herd immunity (those who cannot be vaccinated for medical reasons), and in fact parents have a halachic obligation to vaccinate. While there have been 13 confirmed cases in New Jersey so far in 2019, last week’s reporting of eight cases in Westchester County, added to the 180 cases Rockland County has had since October and Brooklyn’s over 250 cases, have brought the levels of concern even higher. 

Rabbi Dr. Aaron Glatt, an infectious disease specialist in Hewlett, New York, and a trusted advisor to Orthodox and ultra-Orthodox communities on medical issues, wrote the following strong statement on behalf of the Rabbinical Alliance of America: “HaRav Asher Weiss, shlita, posek for Shaare Zedek Hospital, maintains that it is a mitzvah and chiyuv (obligation) to get vaccinated. HaRav Weiss further states that yeshivas have the right – and even the obligation – to protect students and refuse admission to unvaccinated children. HaRav Yitzchok Zilberstein, shlita, and HaRav Elyashiv have ruled that parents may insist that unvaccinated children be excluded from class so that their children are not put at unnecessary risk. HaRav Moshe Shternbuch, shlita, head of the Eidah HaCharedis in Eretz Yisroel, has written an extensive teshuva stating exactly the same psak. Almost all other gedolei Yisroel – including HaRav Shlomo Zalman Auerbach, zt” l, HaRav Yehoshua Newirth, zt” l, and, yibadeil bein chayim lechayim, HaRav Elya Brudny, HaRav J. David Bleich, HaRav Reuven Feinstein, HaRav Hershel Schachter, and HaRav Mordechai Willig, shlita– have all ruled that there is no basis in halacha for suggesting that vaccinations be avoided. All strongly require children in our outbreak setting to be vaccinated immediately.

“It is downright dishonest to officially attest that Jewish law forbids vaccination, which is the only way to avoid mandatory state vaccination laws in New York and New Jersey. No posek ever has stated that vaccination is against Jewish law,” wrote Rabbi Dr. Glatt.

However, Agudath Israel of America expressed concern that there is a disconnect and misinformation that there is a higher percentage of Orthodox Jewish unvaccinated children in relation to the rest of the population. That, in large part, is not the problem; rather, they feel that the tiny pockets of unvaccinated children in Jewish communities are making the rest of America’s Jews look bad and are encouraging bias against and hatred of Jews. “Indeed, the overwhelming majority of children enrolled in Jewish schools are vaccinated. Governmental records indicate that the measles vaccination rates in yeshivas in Williamsburg, Borough Park and across New York State are high, with yeshiva averages statewide exceeding 96%. Similarly high rates were obtained in areas around the country with large Jewish populations. While vaccination rates in certain schools and for preschoolers may be lower, vaccination is the clear societal norm in Orthodox Jewish communities,” Agudath Israel wrote in a statement.

“There may be reasons why, despite the high percentages of immunization, Orthodox Jewish communities are more susceptible to an outbreak of measles. Epidemiologists have chronicled how international travel by Orthodox Jews to outbreak areas, closely interrelated Orthodox social networks, and high numbers of Orthodox children at ages most susceptible to a highly contagious disease are key factors in the spread of diseases of this kind. These are all reasons it is imperative to build on the Orthodox Jewish community’s already high vaccination rate, not to spread a contagion of hate,” Agudath Israel stated.

In advance of the upcoming Passover holiday, many communities have posted announcements and sent out emails regarding their vaccination policies. In Passaic: “It is the policy of the Young Israel of Passaic Clifton that children of members or guests may not participate in youth groups or programs and adults or teens may not lead youth groups and activities if they are not up to date on all appropriate vaccinations,” the shul wrote on its Facebook page.

In a letter to his congregants at Teaneck’s Congregation Shaare Tefillah, Rabbi Kenny Schiowitz noted that coming to shul unvaccinated could be even more dangerous than going to school, “because there can be more people who are elderly, sick or otherwise immunocompromised and unable to protect themselves.” Rabbi Schiowitz, the president of the Rabbinical Council of Bergen County, was the original drafter of a December letter signed by 29 member rabbis of the RCBC and 12 Bergen County area-based school heads that stated the following: “We are disheartened that some Jews have cited a ‘religious exemption’ to evade their responsibility to vaccinate. This has no basis in Judaism. Not only are vaccinations permitted by Jewish law, they are obligatory. We oppose the citation of such an exemption and do not accept it in our institutions,” the statement said.

Moshe Mirsky, president of Westchester County’s Young Israel of White Plains, also sent out an email to his community. “Due to the recent outbreak of measles and the fact that there have been cases of measles in Westchester County, and specifically in the Orthodox Jewish community, anyone who is of the appropriate age to be vaccinated and has not done so should not be attending services until properly vaccinated,” he wrote.

Rabbi Eliezer Zwickler of Congregation AABJ&D in West Orange, saw the situation from a uniquely spiritual angle. “We are fortunate to be living in a time of history where we are the beneficiaries of His kindness in many areas.  One of these areas is the advancement of science and medicine, where Hashem has opened the door and allowed us to glance at His handiwork. He has gifted us with the ability to prevent disease,” he wrote in a letter to his community.

“Many leading rabbis have stated unequivocally that not vaccinating one’s child is in violation of halacha as it puts the child’s life as well as the lives of other children in danger.  As such, shul leadership has decided that in order to ensure the safety and comfort of our membership and visitors, those children and adults who are not vaccinated may not enter our shul building at any time. This includes the shul playground. May we continue to benefit from Hashem’s benevolence and remain a healthy community,” wrote Rabbi Zwickler.    

The Jewish Orthodox Women’s Medical Association, a self-described group of Orthodox and ultra-Orthodox Jewish female physicians, also released a statement on the obligation of vaccination. “Non-vaccination, altered vaccination schedules, anti-vaccination and delayed vaccination all pose significant threats and endanger the lives of infants, children and adults.

There are no individuals who are safe from the medical risks posed by measles,” they wrote.

Virtually all Jewish day schools and yeshiva high schools in Bergen, Passaic, Westchester and neighboring counties require vaccination and allow only medical exemptions regarding vaccines: an article by the Jewish Telegraphic Agency made it seem as though a community school in Tenafly accepted students with religious exemptions. The claim was vigorously disputed here: http://tinyurl.com/y4nm5bnp).

However, in neighboring Englewood, the Moriah School decided to take even more proactive steps after the cases in Westchester effectively meant measles surrounded Bergen County on all sides. “This epidemic just hit Westchester County so it is getting closer and may just be a matter of time until it reaches Bergen County,” wrote Nurse Toby Eizik in a letter to the school’s staff. “On Monday, April 15, and Monday, April 29, all staff members will be tested to see whether or not you have antibodies to measles. This will be done by way of a blood test. This way we will know if any of our teachers are at risk because of an insufficient level of antibodies in your blood. You will then be given release time to receive the MMR vaccine so that we have documentation that everyone in the building is covered.”

While children are on annual vaccination schedules and must have regular updates to their records, and while health care workers and pregnant women get their titers checked at various points to determine proof of immunization, adults born after 1959 may only have had one dose of the recommended two doses of the MMR vaccine to establish measles immunity. Those living in areas of exposure who are interested in further information should refer to the CDC schedule for adult vaccinations at this link: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html

By Elizabeth Kratz

 

 

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