NEW YORK – The current measles outbreak in ultra-Orthodox neighborhoods in the New York area is leading to threats, recriminations and lawsuits, and is also highlighting the lack of consensus among senior rabbis on the vaccination issue.
However, it is also leading to new approaches from medical experts trying to reach those who, in the face of nearly 130 suspected cases of the highly contagious disease, remain determined not to vaccinate their children.
There are now 113 confirmed cases of measles in ultra-Orthodox (or Haredi) communities around New York City and Lakewood, New Jersey, with another 16 suspected and under investigation by public health authorities. Two measles-infected babies have been hospitalized in intensive care units. And while it is mostly infants who have been infected, some teenagers and a handful of adults have also fallen ill.
Why has the anti-vaxxer perspective taken hold in pockets of the Haredi community? The answer, say longtime observers, has to do with long-held suspicions of government agencies, including health departments, prizing cultural isolation, reliance on their own communities for things like emergency services, and placing their trust in God to protect them.
U.S. public health authorities say the current outbreak started when Haredi families visited Israel last Sukkot and brought the illness back to their communities. An 18-month-old infant in Jerusalem’s Haredi Mea She’arim neighborhood has died and nearly 1,500 potential cases have been reported. Non-vaccination rates are high in Israeli areas with large Hasidic populations, including the city of Safed and the town of Kfar Chabad.
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Haredi immunization rates have dipped in recent years as a result of anti-immunization views taking root in the community. Now, as the number of infected Haredim grows, some within the religious Jewish community are initiating new efforts to reach Haredi anti-vaxxers.
Tensions within the community are running high.
A Crown Heights couple, Sholom and Esther Laine, is suing Yeshiva Oholei Torah – a Lubavitch boys’ school – for not allowing their unvaccinated son to start kindergarten. In the suit, Esther Laine says the school is infringing on her constitutionally protected religious right to claim exemption from the requirement of most schools, including Oholei Torah, that all students be immunized. Several attempts to contact the Laines were unsuccessful.
“The battle is getting very fierce,” says a Haredi mother, speaking to Haaretz from her home in Lakewood. “People are getting threats if they question vaccinations,” says the mother of three, who asked that her name not be published for fear of being pressured or intimidated by neighbors.
The ultra-Orthodox towns Monsey and New Square are part of Rockland County, about an hour north of New York City. There are currently 75 confirmed cases of measles and six more suspected.
In New York City, there are now 24 confirmed measles cases – all in the Hasidic Brooklyn neighborhoods of Williamsburg and Borough Park – says Dr. Jane Zucker at the Department of Health. “This outbreak would not have occurred had the children been vaccinated,” she says.
Although measles was officially declared eradicated in the United States in 2000, this is not the first outbreak of the disease in the ultra-Orthodox community. In 2013, there was a significant uptick in measles in Williamsburg and Borough Park, with 58 cases reported. There was also another minor outbreak in New York City earlier this year, which resulted in a miscarriage, pneumonia and hospitalizations, according to The New York Daily News.
Now there is a growing backlash: Those known to be non-vaccinators are being ostracized by fellow Haredim, say members of the community. “People frown upon neighbors who aren’t vaccinating; there is animus toward them,” says Alexander Rapaport, a Hasidic Jew who lives in Borough Park and is founder and director of Masbia, a kosher soup kitchen and food pantry. “You hear there’s someone in that building that doesn’t vaccinate, and now the whole building is having tsuris with them,” he says, using the Yiddish word for trouble.
Ultra-vaxxers and anti-vaxxers
Unvaccinated measles carriers convey a significant risk to others who aren’t immunized – either because they are too young or have compromised immune systems. One person sick with measles can spread it to as many as 18 others, public health authorities warn. Children typically get two doses of the MMR vaccine: one between 12 and 15 months; and another between 4 and 6 years. A child who has gotten both shots is believed to be 97 percent protected from the disease, say health experts. Now, health department authorities are urging vaccinations for children as young as 6 months, and to hasten the second dose so as many people as possible are fully protected.
Rabbis beyond the New York area are now taking steps to prevent the measles from reaching their communities. Last week, the heads of the two main Orthodox rabbinical courts in Chicago issued a letter stating that “nobody has a right to endanger others by not vaccinating their children.” An unvaccinated person exposing other people to measles during an outbreak puts the non-immunized person in the category of someone who actively poses a threat to life, they wrote, using the term rodef (lethal pursuer) – which is a serious violation of Torah law.
The rabbis urged all schools, playgroups and shuls to ban any unvaccinated child, writing, “This is nothing less than a matter of pikuach nefesh,” referring to the religious law in which preservation of human life overrides virtually all other religious considerations.
Furthermore, prominent Israeli Haredi rabbis recently issued a strongly worded decree that those who refuse to vaccinate “are causing bloodshed,” according to the ultra-Orthodox newspaper Kikar Hashabbat. Rabbi Moshe Sternbuch, head of Jerusalem’s stringent Edah HaChareidis rabbinical court, issued an order that every father “must ensure that his son and daughter are immunized immediately.”
However, other influential Haredi rabbis view the issue differently.
Well-known Jewish legal expert Rabbi Shmuel Kamenetsky and his wife, Temi, are often cited for their anti-immunization stance, which was expressed in a 2014 Baltimore Jewish Times article: “Vaccines are a hoax. It is just big business,” Rabbi Kamenetsky was quoted as saying.
The rabbi’s status means his views carry weight beyond his own immediate circle. He is also a member of Agudath Israel of America’s Council of Torah Sages, which, along with the Haredi advocacy organization in general, “will not be taking a position on vaccinations or the measles outbreak,” says spokeswoman Leah Zagelbaum.
Another member of the Council of Torah Sages, Lakewood’s Rabbi Malkiel Kotler, endorses the Lakewood Vaccine Coalition, which was created last March with the aim of advocating on behalf of those who do not want to immunize their children. The coalition’s website, in the meantime, has disappeared and its phone number is out of service. An email elicited no response.
An anonymous group called PEACH (Parents Teaching and Advocating for our Children’s Health) has circulated an anti-immunization booklet throughout the religious community in the New York area and beyond. In it, an anonymous author claims that “hundreds of thousands of children’s lives have been ruined within hours of vaccines.” The idea that measles is a serious illness is “a fabrication,” it adds.
There is no identifying information about PEACH in the booklet and, with no online presence or listed phone numbers, the group is untraceable.
Changing things from the bottom up
This anonymous spreading of misinformation is frustrating to those who want to see Haredi children fully protected from communicable diseases.
Blima Marcus is an oncology nurse and president of the Orthodox Jewish Nurses Association. The OJNA is now trying to reach out to religious parents in a personal, informal way and has established an email address for those who want information.
In just the first few days, “we’ve been contacted by a few people seeking reassurance or clarification on specific vaccines,” Marcus tells Haaretz. The OJNA is planning to hold living-room gatherings soon. These will involve “no physicians, no agendas, no judgment: just frum [religious] nurses coming to listen, talk, answer questions and educate,” she says, adding, “We have 30 nurses from around the states who already volunteered their time to do this in their communities.”
Dr. Zackary Sholem Berger, an associate professor of medicine at Johns Hopkins School of Medicine, has written in Yiddish publications about medical issues in the Orthodox community. He just held a session at a Borough Park health clinic with the goal of hearing the concerns of Haredi doctors, nurses and other medical professionals.
“To see any sector of my community not vaccinate is horrifying,” says Berger. However, “If you wag your finger at anti-vaccine people, it doesn’t work.” Persuading them “has to come from the bottom up,” adds Berger, who has a doctorate in epidemiology.
Anti-vaccine views have seemingly become entrenched in some parts of Haredi communities because of aspects of ultra-Orthodox culture.
There is a general distrust of government authorities that is likely rooted in the Jewish legal prohibition against one Jew turning another into the police, say knowledgeable observers. Hasidic communities were established in Eastern Europe at a time when government authorities themselves persecuted Jews – or at the very least, turned a blind eye to those who did. Historical memory in general is prized in Haredi communities and passed down from one generation to the next, almost like cherished silver Shabbat candlesticks.
There is also an insularity in Haredi communities – particularly among women, who frequently lack access to the internet – that is viewed as a negative and dangerous influence. As a result, WhatsApp and similar phone-based chat groups are popular among Haredi women, says the OJNA’s Marcus.
Participants in one WhatsApp group Marcus belongs to said they don’t trust studies because they are funded by pharmaceutical companies, she says. Furthermore, they don’t trust the Food and Drug Administration, which must approve all medications, because they believe “the FDA is in the pocket of pharmaceutical companies,” Marcus adds.
Haredi communities are also accustomed to relying on themselves rather than the outside world for many things, notes Borough Park’s Rapaport. “They have an off-the-grid mentality, so they don’t call 911” in case of emergency, but call the Orthodox volunteer ambulance corps Hatzalah instead. And instead of calling the police, they contact the volunteer patrol Shomrim – which arrives faster anyway, he says. “It’s a mind-set which allows something like anti-vaccination to spread,” says Rapaport.
What’s more, he adds, there is a fondness for “old world wisdom” – like when people say: My bubbie [grandmother] and aunt had measles, and they lived to be 90.
But Marcus cautions that a lot of people talk about the past “as if it was a healthier or safer time – but 100 years ago many people didn’t live past 8 years old.” In the ultra-Orthodox world, “there’s a lot of misinformation as to how things were different in the past,” she says.
Marcus also notes that alternative medicine is popular among the Haredi community. “There are large pockets of homeopathy followers in Hasidic Williamsburg, in Monroe and in Lakewood,” she says.
One popular Borough Park chiropractor is distributing pamphlets in his office about the dangers of vaccines. People travel from upstate Rockland County to see him, says Marcus. The chiropractor did not return several messages left for him at his home and office, but the woman answering his office phone acknowledged that they do distribute anti-immunization information.
Finally, for some Haredi Jews, not immunizing their children is a reflection of their ultimate trust in God. “If we believe we are protected by the One above, we really have nothing to worry about,” the Lakewood mother tells Haaretz. “We try to keep restrengthening our absolute belief that nothing in the world can harm us unless it is the will of God.”