This week the City of New York declared a public health emergency because of a measles outbreak that had been escalating since the fall in ultra-Orthodox communities in Brooklyn and finally reached the point of crisis. In December the Health Department had made an effort to contain the disease, ordering yeshivas and child care centers in affected neighborhoods to keep all unvaccinated children from going to school or day care. Then, in January, at least one yeshiva in Williamsburg ignored the mandate. This failure of compliance led to an eruption of dozens of new cases.
Like well-off bohemians who might send their children to Waldorf schools, where an anti-vaccination culture is baked in the warm ovens of so many sprouted-wheat snacks, many among the ultra-Orthodox resist the incursions of modernity. A distrust of immunization had long ago taken hold in some sectors of the Hasidic community, but this year various religious neighborhoods in Brooklyn were hit with a propaganda campaign meant to breed even more skepticism and fear.
As it happens, 2019 is turning out to be a record year for measles outbreaks, with 465 cases reported in 19 states, according to the Centers for Disease Control and Prevention. A vast majority of these have occurred in Brooklyn and in counties in upstate New York and New Jersey with substantial ultra-Orthodox populations. Approximately 115 cases, though, have been discovered in Michigan and Washington, among the 17 states in the country where it is possible to seek a “personal belief” exemption from otherwise mandatory vaccines for school-aged children, meaning that immunization essentially violates your parenting philosophy as if it were Fortnite or a bag of Cool Ranch Doritos.
Where there are no such vague clauses in vaccination law, there are typically exemptions available to those who claim that they oppose vaccination on religious grounds; 47 states have these, including New York. They are problematic for a number of reasons. First, there is virtually no canonical basis for vaccine avoidance among the world’s major religions, most of which came into being before Edward Jenner developed the first widely used vaccine, against smallpox, at the end of the 18th century. Rabbis since then have repeatedly stressed the importance of protecting children through vaccination. Regardless, religious waivers provide cover to those who resist vaccines simply because they chose to question established science.
Last month, for example, when the Rockland County Health Department in upstate New York was sued by parents of unvaccinated children at a local Waldorf school who were barred from attending during a measles outbreak in the area — Rockland County is also home to a large ultra-Orthodox community — the district attorney, Thomas Humbach, pointed out these dubious religious objections. At the time he said that he expected several of the exemptions granted at the school to be challenged as insincere.
A few years ago after a measles outbreak linked to Disneyland, California got rid of its belief exemptions, leaving no parent able to excuse a child from certain shots because of hippie misconceptions or arguments about religious necessity. In November a study looking at the effects of the legislation found immunization rates of children entering kindergarten in California to have reached a near all-time high.
And yet despite that, there is not overwhelming political will to implement similar legislation elsewhere. Although there is a bill in the New York State Legislature right now that if passed would end religious exemptions for vaccines, it became clear what it was up against this week. As soon as Mayor Bill de Blasio announced that the city would issue violations and possibly fines to individuals living in certain parts of Brooklyn who refused to vaccinate, Gov. Andrew Cuomo weighed in to say that he found the move “legally questionable.”
Ultra-Orthodox communities provide a voting bloc just as reliable as evangelical Christians, who in some cases also question the wisdom of immunizing children. Last month, Rand Paul, the Republican senator from Kentucky, himself a physician, criticized mandatory vaccines as “not consistent with the American story.” And yet the Supreme Court has repeatedly ruled such mandates to be constitutional.
Certainly an opposition to vaccines is quite consistent with the American story, however. In 1855, Massachusetts became the first state in the country to make smallpox vaccination mandatory for public schoolchildren. By the early 1890s, a pamphlet titled “Vaccination Is the Curse of Childhood” was circulating in Boston, advising parents to find doctors who would proclaim that their children were “unfit for vaccination.” Around the country, parents were faking vaccine scars or keeping their children from school or wiping vaccines from their arms as soon as they were administered.