NYC – End to Measles, But Not the End of Fight Against Anti-Vaxxers

Mayor Bill de Blasio and Health Commissioner Dr. Oxiris Barbot (right) at a press conference in April at the height of the measles outbreak.

Mayor Bill de Blasio and Health Commissioner Dr. Oxiris Barbot (right) at a press conference in April at the height of the measles outbreak. NYC MAYOR’S OFFICE FLICKR

NYC Declares End To Measles Outbreak, But Fight Against Anti-Vaxxers Continues

New York City’s biggest measles outbreak in nearly 30 years, which predominantly sickened ultra-Orthodox Jewish residents of Williamsburg and Borough Park, has ended.

According to Health Department officials, 42 days, or two consecutive incubation periods for the highly contagious virus have passed, allowing the city to declare itself measles-free. The last recorded infection was in mid-July. An emergency order in place since April that required measles vaccination for all people who lived, worked or attended school in four Brooklyn zip codes has been lifted.

“There may no longer be local transmission of measles in New York City, but the threat remains given other outbreaks in the U.S. and around the world,” Health Commissioner Oxiris Barbot said at a press conference on Tuesday. “Our best defense against renewed transmission is having a well-immunized city.”

Since the outbreak began in early October, 654 New York City residents got sick, 73 percent of whom were unvaccinated children. Fifty-two people were hospitalized and 16 of those people were admitted to intensive care units, according to the Health Department.

“The response to this outbreak has been nothing short of epic,” Barbot said, adding that 547 health department employees worked more than 1,000 hours. In total the response efforts cost the city more than $6 million.

Efforts to quash the outbreak were met by pushback from anti-vaccine activists at every turn, she said.

“We faced sustained resistance from anti-vaccination forces who continued to hold rallies and scare parents,” Barbot said. “These campaigns of fear and lies put New Yorkers at risk. We had to do more than the anti-vaxxers.”

While no one died in New York City’s outbreak, an Israeli flight attendant who caught the virus while traveling from New York to Tel Aviv died from complications in mid-August, according to Times of Israel. All those hospitalized have recovered, though some severe, long-term complications of measles can occur months and even years later, officials said.

The height of the outbreak occurred in April, with nearly 200 cases. Those numbers began to decline in the following months, after the city declared a public health emergency. Immunization rates for children in affected neighborhoods jumped in that time, from 88 percent before the outbreak to now nearly 99 percent in Borough Park and from 67 percent to 95 percent in Williamsburg, officials said.

As part of the city’s emergency order, people who refused vaccination for themselves or their children could be fined $1,000. The city doled a total 232 of those summonses to parents for failing to get their children vaccinated, and about 29 have had to pay fines after an administrative hearing. Some of the cases are still pending and another 159 were canceled after the family either got their child vaccinated or showed proof of measles immunity from a blood test.

In the years leading up to this most recent outbreak, ultra-Orthodox areas saw a decrease in immunization rates, and a spike in religious exemptions, Gothamist and WNYC reported. The trend was largely fueled by misinformation about the supposed dangers of vaccines, spread by a handful of anti-vaccination activists within the Orthodox community who had ties to the national, secular anti-vaccine movement, and propagated their ideas with glossy hand-delivered pamphlets, robocalls, hotlines for fearful moms and massive symposiums with hundreds of attendees.

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Measles, Number of New Cases Increases

A vial of the measles, mumps, and rubella (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. REUTERS/Lindsey Wasson/File Photo

Washington – U.S. Health Officials Record 14 New Cases Of Measles As Outbreak Slows

Washington – The United States recorded 14 new measles cases between June 27 and July 3, federal health officials said on Monday, signaling a slowdown in the spread of the disease that has infected 1,109 people this year in the worst U.S. outbreak since 1992.

The U.S. Centers for Disease Control and Prevention (CDC) said it had seen a 1.3% increase in cases since the previous week and that it has recorded cases of the highly contagious and sometimes deadly disease in 28 states.

In recent weeks, the CDC has reported smaller increases in the number of measles cases, compared to a surge of more than a hundred cases reported in a single week earlier this year. It reported 18 new cases last week.

Disease outbreaks have not been reported in any new states since June 10.

The running tally of cases this year includes both active cases and those that have since resolved. No fatalities have been reported.

Health experts say the virus has spread mostly among school-age children whose parents declined to give them the measles-mumps-rubella vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Measles was declared eliminated in the United States in 2000, meaning there was no continuous transmission of the disease for a year. Still, cases of the virus occur and spread via travelers coming from countries where measles is common.

CDC officials have warned that the country risks losing its measles elimination status if the ongoing outbreak, which began in October 2018 in New York, continues until October 2019.

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Measles, Currently the Most Contagious Virus and the Misinformation Spread to Insular Communities

FEAR, MISINFORMATION, AND MEASLES SPREAD IN BROOKLYN

IT WAS OCTOBER 31, a balmy day in Brooklyn, and Alexander Arroyo was walking around his neighborhood dressed as an octopus, pushing his 2-month-old daughter in a carriage, as his wife chased their toddler through the after-school Halloween trick-or-treat crowd. As the family filled their bags with candy, Arroyo’s phone rang and he stopped to answer it, trying to hear over the din of excited children. Arroyo is the director of the pediatric emergency department at one of the biggest hospitals in Brooklyn, Maimonides Medical Center, and two days earlier, a 15-month-old girl had come to the ER with a fever and a rash. He’d been waiting for a call to confirm the diagnosis, and this was it. The test had come back positive: The girl had measles.

 

WHEN THE GIRL had arrived at the ER, she was put in a busy area, where children with earaches or broken arms typically sit. No one suspected measles, because, thanks to routine childhood vaccination, the disease was declared eliminatedin the United States in 2000. Although there had been localized outbreaks since then—among the Amish in Ohio, visitors to Disneyland in California, and the Somali American community in Minnesota—neither Arroyo nor most of his staff had seen a case firsthand. Suspecting ­measles was like thinking “maybe that’s a unicorn,” Arroyo says. “It doesn’t really cross your mind, because measles shouldn’t exist anymore.”

Still, several measles cases had been reported in a different part of Brooklyn. And after a few hours, Arroyo’s team began to worry that the child in their care might be another. They put a mask over her face and wheeled her into an isolation room, with two sets of doors and air circulating under negative pressure to prevent airborne particles from escaping.

By then, however, “the bomb had gone off,” Arroyo says. Measles is considered one of the most contagious diseases in existence. If a person with measles walks through a room with a hundred people who are not immunized, up to 90 of them will get the disease. The virus is spread through coughs and sneezes and lingers in the air for up to two hours. Some 122,000 ­people come through the Maimonides emergency room every year. The hospital, located in Borough Park, serves one of the most diverse patient populations in the country, from ultra-Orthodox Jews to immigrants whose first language might be Mandarin, Russian, Hindi, Punjabi, Arabic, or Uzbek. Many are working-class cab drivers, manual laborers, and restaurant workers who bring their children to the ER at night, when their shifts are done.

Dr. Alexander Arroyo in the waiting room of Maimonides Medical Center.

NATALIE KEYSSAR

Standing in the street that Halloween, Arroyo thought about the dozens of patients who might have been exposed—in the waiting room, the hallway, the exam rooms—from the time the girl came into the hospital until she was placed in isolation. He looked down at his daughter in the carriage, dressed as a clown fish, and thought, “She’s not vaccinated.” She was still too young, as were other babies who might have been in the ER. He knew that his team would have to figure out right away who, exactly, had been breathing the same air as the infected girl. He waved down his wife, who had been making her way down the street with their toddler, and asked her to take the baby carriage. Then he headed home to make phone calls. “I saw my life falling into a pit of measles,” he says.

Arroyo is an amateur kickboxer, lanky and athletic. He hurried down the street, talking by phone with the hospital’s infection-control nurse and mapping out a plan. At home he changed out of the octopus costume and logged on to the hospital’s electronic medical records to check what time, exactly, the girl with measles had entered the ER. He called the other doctors who had been on duty to see if they remembered any pregnant mothers or immunocompromised children who would have been especially at risk.

He also called the hospital’s IT department to help backtrack through medical charts. His team generated names of 55 children who had potentially been exposed to the disease, then asked the New York City Department of Health to cross-reference it with vaccination records. For the MMR vaccine (against measles, mumps, and rubella) to be effective, the immune system has to be mature enough to produce antibodies to the virus. Young babies’ immune systems are not sufficiently developed, so children generally receive an MMR vaccine at 1 year old and another at age 4 or 5; those who had come through the hospital but had not completed both doses were considered at risk.

On the Maimonides list were a 12-month-old, a 10-month-old, and three babies younger than 6 months, including one who was just 17 days old. All were vulnerable, and Arroyo realized he was already running out of time. To prevent infection, the children needed to receive MMR shots within 72 hours, and young babies would have to be given immunoglobulin, a form of temporary protection, within six days. The infection-control nurse began making calls to those babies’ parents.

 

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Yeshiva Kehilat Pupa, NYC’s $2M Measles Bill and an Armed Anti-Vaxxer Movement

One Williamsburg school ‘ignited’ NYC’s measles crisis

The outbreak has cost the city roughly $2 million.

June 25, 2019 Scott Enman
Yeshiva Kehilath Yakov Pupa in Williamsburg failed to bar unvaccinated children from attending class, Health Department officials said. Image via Google MapsYeshiva Kehilath Yakov Pupa in Williamsburg failed to bar unvaccinated children from attending class, Health Department officials said. Image via Google Maps

A single school’s decision to allow an unvaccinated child to attend class led to more than 40 measles cases and the eventual proliferation of the disease across New York City, a top health official said on Monday.

Demetre Daskalakis, deputy commissioner of the city’s Department of Health, revealed at a conference hosted by NYU Langone that Yeshiva Kehilath Yakov Pupa in Williamsburg was the catalyst for what would become the worst outbreak in decades — with 609 confirmed cases as of Monday.

“One school failed to exclude people in Williamsburg,” Daskalakis said. “We had one measles case in that school, and subsequently every unvaccinated child who was not excluded came down with the measles, creating really the spark that ignited Williamsburg and created a true fire of measles in that neighborhood.”

The infected child had the disease but had not yet begun showing symptoms when he showed up for class at the yeshiva, an ultra-Orthodox Jewish private school, in late January.

The school did not immediately respond to a request for comment.

The outbreak began spreading in the fall of 2018, when Health Department officials announced that six Brooklyn children had contracted the disease. The initial Brooklyn case was acquired by a child on a visit to Israel, where a large outbreak was taking place.

The epidemic has been contained mostly to the Orthodox Jewish communities of Williamsburg and Borough Park, with more than a dozen confirmed cases also in Sunset Park among the Latino population.

Mayor Bill de Blasio declared a public health emergency on April 9 requiring mandatory measles-mumps-rubella vaccinations for residents who live in the northern Brooklyn ZIP codes of 11205, 11206, 11211 and 11249.

Gov. Andrew Cuomo signed a bill on June 13 banning any non-medical exemption to vaccinations, including religious exemptions.

The outbreak has cost the city roughly $2 million, according to Daskalakis. He said that despite their greatest efforts to send out exclusion letters, monitor schools and audit them, the disease has still led to dire consequences, including 50 hospitalizations and 18 ICU visits.

“We’ve had a lot of close calls with kids who have been very very sick,” he said.

The panel on measles was held at NYU Langone. Eagle photo by Scott Enman
The panel on measles was held at NYU Langone. Eagle photo by Scott Enman

As of June 14, 11 institutions had been shuttered by the city for failing to adhere to the emergency order. (UTA of Williamsburg – Yeshiva Torah V’Yirah at 590 Bedford Ave. was closed twice.)

Daskalakis said that further exacerbating the outbreak, and likely influencing the operators of lone wolf yeshivas, was a highly sophisticated campaign of anti-vaxxersseeking to undermine the city’s order through misinformation.

Some residents were also deliberately attempting to have their children contract measles to build up a natural immunity to the infection. “Rather than the spark igniting the kindling, we had the kindling actually looking for the spark,” Daskalakis said.

Although the disease is primarily affecting the Orthodox Jewish community, Daskalakis wanted to break the myth that the general Orthodox Jewish community is resistant to vaccines. “It’s not true,” he said, citing the fact that after the outbreak was announced, vaccination rates in Williamsburg rose from around 70 percent to about 92 percent.

Pro-Vax Mom Ensnared in Measles Law When Youngest Not Medically Cleared to Vaccinate

NYC’s Measles Crackdown Snares Pro-Vax Mom With Sick Baby

On Tuesday, April 30th, at around 10 p.m., armed officers with the Kings County sheriff’s department showed up at the door of a Williamsburg apartment to serve an Orthodox Jewish woman with a summons for failing to vaccinate one of her nine children.

The woman, identified as Jane Doe at an administrative trial Wednesday morning, is the first person to appear before a judge since the city declared a public health emergency 11 weeks ago. The declaration required everyone over the age of six months who lived, worked, or attended school in four Brooklyn zip codes, including the one where Doe lives, to be vaccinated against measles or show that they are already immune.

But even though much of the blame for the city’s measles outbreak has fallen on people who refuse to vaccinate their children, Doe is pro-vaccine. She testified at the hearing that all of her other eight children are vaccinated for measles. The summons she received that night was for her youngest, her eight-month-old son, who’d been sick for several weeks with fevers and ear infections.

I’m a very responsible mother…I was very hurt about this whole thing,” she told Gothamist/WNYC. “I feel they’re coming very strong on me because of the public and because of the anti-vaxxers.”

Doe submitted medical records to Administrative Law Judge Didi Skaff showing she’d taken her son repeatedly to the doctor’s office in late March and April. Her pediatrician had recommended postponing the shot until he recovered, Doe testified. The baby was finally given his first dose of measles, mumps, and rubella vaccine last week, she said.

“I do think I got the summons very unfairly,” she said at the hearing. “All my children are vaccinated.”

In order to attend day care or nursery school, babies are required to get their first dose of the measles vaccine when they turn one year old, according to New York State’s immunization requirements. But the city’s emergency order in April applied to everyone above the age of six months. The change in the minimum age has also confused some day care facilities that said they were not directly notified about it.

Doe said until the sheriffs showed up at her door, she was not aware that children in her Williamsburg neighborhood younger than 12 months old were supposed to be vaccinated.

“We watch no TV. Most of [us] have no internet connection,” she said, speaking of her religious Orthodox Jewish community in North Brooklyn.

“None of my friends knew, none of my sisters knew,” she said. Nor did her doctor mention it when she took her baby there on April 20, 11 days after the emergency order went into effect, she said.

For days after she was issued the summons, her children were still asking why people had shown up at her apartment with guns.

“It’s ridiculous that you have sheriffs knocking at your door in the middle of the night,” she told the hearing officer. “The children were all really terrified.”

She eventually quelled their fears by telling them the men had come to sell furniture, she said: “That’s how I got them not to be afraid.”

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An Opinion – There is No Religious Right to Refuse Vaccines

There Is No Religious Right to Refuse Vaccines

avatarby Alan Dershowitz

OPINION FROM THE ALGEIMEINER –
REPRINTED IN PART WITHOUT PERMISSION WITH ATTRIBUTION. IF ASKED TO REMOVE, WE WILL TAKE IT DOWN. THIS IS NOT TO BE DEEMED AN ENDORSEMENT OF OUR BLOG BY THE ALGEMEINER OR MR. DERSHOWITZ.

New York just eliminated all religious exemptions for mandatory measles vaccination. It was the right thing to do. There is no constitutional basis for requiring a religious exemption. Nor, in my view, are there any plausible religious arguments against mandatory vaccinations to stop the spread of communicable and potentially lethal diseases.

Let’s begin with the religious arguments: ______________.

I have left this blank because there are none. I read widely in religious literature, especially in Jewish literature. I have never come across a coherent religious argument against mandatory vaccination for deadly contagious diseases.

Jewish law has an overriding religious concept called “pikuach nefesh,” which elevates the protection of human life over virtually every other value.

 

The Jewish Bible is scrupulous in demanding protection against communicable diseases such as leprosy. There is nothing in Jewish law that requires the parents to turn their children into “typhoid Marys,” infecting friends, family, classmates, and neighbors.

The claimed religious argument is rejected by the vast majority of rabbis of every denomination, including by the vast majority of ultra-Orthodox and Hasidic rabbis. Only a handful of marginal rabbis preach this anti-Jewish and anti-life philosophy.

I challenge any rabbi to debate me on the Jewish religious law regarding vaccination and communicable diseases. He will lose the debate, because there is simply no basis in Jewish law for any such argument. Religion is being used as a cover for a misguided political, ideological, conspiratorial, and personal opposition to vaccination. Don’t believe any rabbi who tells you otherwise.

Now we can turn to the Constitutional argument: ______________.

Another blank, because there is none that would permit parents to refuse to vaccinate a child against a communicable disease, even if there were plausible religious reasons for their decisions (which there are not).

There are three basic categories of compelled medical intervention about which the Constitution has something relevant to say:

The first category involves compelling a competent adult to take lifesaving measures to prevent his own death. There are strong Constitutional and civil liberties arguments against such compulsion. It really doesn’t matter whether the opposition to such measures is religious or philosophical. An adult Jehovah’s Witness may have a strong First Amendment claim against receiving a blood transfusion to save his or her life. But an atheist would also have a compelling argument. Indeed, Jewish law is more protective of life than American Constitutional law: Jewish law prohibits a competent adult from refusing a life-saving medical procedure. It also prohibits suicide.

The second category is where a parent is being compelled to employ lifesaving medical procedures to save the life of a child. The courts generally require the parent to save the life of the child. So a Jehovah’s Witness child could be compelled to receive a blood transfusion without regard to their parents’ religious objections.

Now we get to the third category, the one about compelled measles vaccination. A parent does not have a Constitutional right to refuse to vaccinate a child against a highly contagious and potentially lethal disease that might kill that child (category 2) but might also kill a friend or neighbor who doesn’t share the parents’ religious view (category 3).

That is about the easiest Constitutional question I have ever confronted. There is no compelling argument against requiring a child to be vaccinated against communicable diseases regardless of the parents’ wishes and regardless of whether their objections are religious or secular.

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A version of this post was originally published by The New York Daily News.

Unvaccinated Children Turned Away… Spring Valley, NY

Dozens of unvaccinated students in Spring Valley turned away from entering school

Posted: Jun 20, 2019 5:35 PM EDTUpdated: Jun 20, 2019 5:51 PM EDT

SPRING VALLEY – 

News 12 has learned that dozens of students at a Spring Valley yeshiva were sent home in tears Tuesday because they weren’t vaccinated against the measles.

Sources close to school officials say dozens of students from both the boys and girls schools at the United Talmudical Academy on South Main Street were turned away from even entering.

Yeshiva officials confirmed the incident by phone, but refused to speak on camera.

A parent who didn’t want to talk on camera also told News 12 it was true, and that he agreed with the decision.

Those who work nearby say the yeshiva should have taken action earlier.

“I think that’s the wrong approach from the school’s perspective. I think they should have dealt with that earlier on in the school year,” says George Dahdouh.

The yeshiva is located in one of two zip codes where schools were mandated by the county Health Department back in April to send home all unvaccinated students who didn’t have religious or medical exemptions.

News 12 was told that the yeshiva may be acting now because the school hosts the same students over the summer for day camp, and that officials there wanted to send a message to parents to vaccinate before camp begins.

The Spring Valley yeshiva, part of the same network as two other United Talmudical Academies in Brooklyn, shut down earlier this spring for failing to provide vaccination records to the New York City Department of Health.

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