Ending the Current Measles Epidemic

With a call from a Haredi family in Meah Shearim to Hatzala regarding their 18-month-old daughter, the current measles epidemic in Israel recently reached a frightening new level. The family believed their daughter had fainted, but when the paramedic arrived, the situation was far worse than they thought. The toddler was unconscious with no pulse, and had stopped breathing. The family reported that she, like some of her siblings, had been infected with measles. As the paramedics worked to resuscitate her, her family stood in an adjacent room and prayed for her recovery. For over an hour, doctors made every effort to bring her back to life, but they were unsuccessful. The tragedy of this toddler’s death is compounded by the fact that her death could have been prevented had she been vaccinated against measles.

In 2000, the United States declared that measles, a highly-contagious virus, had been eliminated, although reports associating the vaccine with autism emerged in 1998. While these claims have been dispelled by rigorous scientific research, parents began to question the safety of the vaccine and some even refused vaccination. Sadly, measles has returned both in Israel and abroad and the rate of infection in the current epidemic is alarming. In 2016, there were only nine cases of measles in Israel, and in 2017, the rate rose to 33. As of last week, 1,401 cases have been reported this year in Israel, of which 838 were found in Jerusalem alone, primarily in haredi neighborhoods. Only 5% of those infected had been previously vaccinated. A similar outbreak is occurring in the United States and Europe. Rates of infection are particularly high in haredi communities where the rates of vaccination are lower. The low rates may be attributed to a belief among religious Jews that they are protected from infection by the relatively insulated nature of their communities, unsubstantiated beliefs regarding the dangers of vaccination, disproportionate number of young babies in the haredi communities who are too young to be vaccinated (the vaccine is not recommended until 12 months of age) and a lack of access of these families to vaccination. It can be particularly difficult for a haredi family to get to Tipat Halev if they do not have a car or work during the day when the vaccination clinics are open. In addition, as the number of children in the family increases, the vaccination rate decreases, perhaps because mothers with large numbers of small children may decide to delay vaccination or consolidate vaccination visits so that all the children in the family undergo vaccination when the youngest reaches age one. In the interim, the older children lack immunization. Once someone in the community is infected, the virus will spread rapidly due to crowding and the high concentration of people living in these neighborhoods.

Contemporary rabbinic authorities have taken a strong stand on the obligation to vaccinate, including Rav Yosef Shalom Elyashiv who considers parental refusal to vaccinate against measles as negligence, Rav Asher Weiss who defines the obligation to vaccinate as a form of communal responsibility, and Rabbi Mordechia Halperin who classifies a person who refuses vaccination as an indirect murderer and a mazzik—one who damages, a subcategory of gezel (theft). Rabbi Herschel Schechter has stated that the obligation to vaccinate stems from the principle dina d’malchuta dina, the obligation to follow the law of the land. However, the most recent statements issued by haredi rabbis, particularly in Israel, take an even stronger position on vaccination, calling for vaccination in the strongest terms and severely vilifying those who refuse. Their position is unequivocal. Everyone must vaccinate and they must vaccinate immediately.

Less than one week after the death of the Meah Shearim toddler from measles, a group of senior haredi rabbis in Israel responded to this public health crisis. Their call to action began with a statement from respected Israeli physicians that in light of the current measles epidemic, all unvaccinated children should be vaccinated immediately. Then, the rabbis declared, “The Shulchan Aruch states that the Torah gave physicians the permission to heal, which is a mitzvah and pikuach nefesh. Whoever isn’t vaccinated is a murderer…Every father must ensure that his son and daughter are immunized immediately, because the epidemic will G-d forbid spread. A father has no right to prevent vaccination. All of Israel should hurry to fulfill this obligation. May G-d remove all disease and may we receive the Messiah in the coming days.” The statement was endorsed by Rabbi Yitzchak Zilberstein, Rabbi Shimon Ba’adani, Rabbi Yisrael Rosenberg, and Rabbi Menachem Mendel Lubin. These rabbis should be commended for the promptness, forcefulness and courageousness of their statement.

In the United States, after 17 children in the Orthodox Jewish communities of Williamsburg and Borough Park were diagnosed with measles, Rabbi David Niederman, President of the United Jewish Organizations of Williamsburg and North Brooklyn said in a statement issued by the New York City Department of Health on November 2, 2018, “It says in the Torah ‘V’nishmartem Meod L’nafshoseichem,’ that a person must guard their health. It is abundantly clear on the necessity for parents to ensure that their children are vaccinated, especially from measles.” In Rockland County, New York, two heavily ultra-Orthodox towns, unvaccinated children have been barred from schools. One Lakewood, New Jersey, synagogue has forbidden the unvaccinated from entering the synagogue under any circumstances. Last Friday, in a joint report, the Orthodox Union and the Rabbinic Council of America, organizations composed primarily of rabbis who identify themselves as modern orthodox, issued a similar though somewhat less forceful statement encouraging vaccination.

As a society, we are all collectively complicit in this epidemic, having allowed for the resurgence of what should have been an extinct disease. However, so often, haredi rabbis are criticized for their rejection of the modern world, insular nature and refusal to protect their followers. I would like to take this opportunity to acknowledge the most recent responsiveness and wisdom of these haredi rabbis and to commend them for taking a strong stand on vaccination—even stronger than their more centrist orthodox counterparts. Rather than rely on prayer, or the principle that G-d protects the simple to eliminate this epidemic, these rabbis have opened their eyes to the world around them and acknowledged the obligation to defer to the recommendations of modern physicians, and in so doing, have protected the lives of their disciples and ensured the safety of their communities. Their absolute mandate to vaccinate reminds us that we must do whatever is necessary, no matter how unpopular or untraditional, to eliminate this scourge. May their courage serve as a lesson and a call to action to us all to protect our children and our neighbor’s children by vaccinating immediately.