On September 20th, the Institute for Religion, Culture, and Public Life teamed up with Columbia Religious Life to host a forum on the recent measles outbreak in New York’s ultra-orthodox Jewish communities. The recent outbreaks are a result of poor vaccination rates in the community, especially among children. Guest Bwogger Ohad Klopman reports.

A panel of five experts in public health, disease control, and community outreach gathered to discuss their research and potential steps to prevent future outbreaks. Ayala Fader, professor of anthropology at Fordham University, moderated the discussion. Fader’s research includes childhood language development and community organization in Jewish communities.

The panel began with a presentation by Blima Marcus, a nurse from Borough Park’s ultra-orthodox community who has been leading pro-vaccine communication efforts in the area. Marcus clarified that mainstream Jewish thought does not advocate against vaccines; on the contrary, the Talmud (the written code of Jewish law and thought) tells Jews to value life and health above all else, even if that means breaking other Jewish laws.

Marcus went on to explain that the organization of ultra-orthodox communities contributes to the risk of infectious diseases. Ultra-orthodox Jews live by strict religious rules that make it difficult to live individually, leading many communities to become tight-knit and insulated from outside groups and influences. The closeness of the communities makes it easier for disease to spread, but it also allows anxiety and anti-vaccine rhetoric to take hold more easily.

“A woman told me, ‘My cousin’s mother gave him the vaccine, and the next morning he wasn’t speaking properly,’” Marcus said. Ultra-orthodox communities tend to trust themselves most of all, often relying on personal anecdotes over information from strangers. Anti-semitism could be involved, too: according to Marcus, the rise of visible acts of anti-semitism has reminded orthodox communities that the best people to trust are other Jews, especially Rabbis and other orthodox leaders.

Zackary Berger, a professor of medicine and bioethicist at Johns Hopkins University, followed Marcus with his research on patient decision-making.

“Mistrust is the natural state of the patient, as well as the practitioner,” Berger argued. Orthodox Jews, especially, have significant reason to mistrust others, and for that reason, we should not be surprised when a patient refuses a vaccine. “As a physician, a parent, and a Jew, I support vaccines,” Berger affirmed, but more research is necessary to find the best ways to communicate with skeptical patients.

Alyssa Masor is the NYC Department of Health’s liaison to the orthodox Jewish community. In her role, she contended with the fears many orthodox Jews have regarding vaccines and mandatory vaccination laws. These fears are influenced by false information, both from within Jewish communities and from outside anti-vaccine campaigns.One damaging threat to public health is a magazine distributed in the area called PEACH (Parents Educating and Advocating for Children’s Health). Copies of the PEACH magazine contain fabricated data, anti-vax rhetoric, and personal narratives to orthodox Jews. Paper-based media is especially potent in the community, which tends to avoid technology for personal use.

Masor noted that the magazine was written by authors under a pen-name and using sources that could not be verified by Masor and her team. That anonymity made it difficult to track down and correct the false information.

Their solution? Publishing their own magazine.

Masor and her time corrected every false claim in the PEACH magazine, turning it into a new piece of literature they called Pie. The team has distributed over 100,000 copies of their pamphlet version, A Slice of Pie, since April of this year.

Masor ended her statement with a call for research on outreach techniques. She addressed the issue of mistrust, claiming that the best way to move forward is to find new ways to facilitate communication in ways that help vulnerable patients feel safe, listened to, and cared for. Masor noted that ultra-orthodox women in particular are receptive to literature and new information, but still tend to turn to familiar sources.

Last to speak was Michael Yudell, professor at the Drexel Dornsife School of Public Health and chair of the Department of Community Health and Prevention at Drexel. Yudell gave context to the recent outbreak, noting that anti-vaccine sentiment is as old as vaccination and its predecessor, inoculation (deliberately exposing someone to a disease to build immunity).

Yudell and other historians believe inoculation was first used in Africa or the Middle East. Inoculation first arrived in the United States from enslaved Africans during the colonial era. Anti-inoculation sentiment in the U.S. emerged out of racism, although historians have found evidence towards religion as another argument against inoculation.

Today, modern anti-vax rhetoric usually takes the form of opposing mandatory-vaccination laws. Yudell is also the chair of Pennsylvania’s Newborn Screening and Follow-up Technical Advisory Board, a program where doctors and nurses screen newborns and take small blood samples to test for rare diseases.

“The program works so well because people don’t know it exists,” Yudell joked. But it wasn’t really a joke; Yudell spoke about how anti-government sentiment, like the backlash against mandatory vaccination laws, is making the Advisory Board’s decision to promote the program more difficult. If more families know it exists, they might oppose the screening process, Yudell worries.

To close, Bwog asked the panel what students can do to help promote healthy vaccination choices in their local communities.

“Know the information, and engage with people, especially on social media,” Blima Marcus replied, prompting affirmations from the panel. “You might not get the anti-vaxxer, but the twenty-five other parents watching leave with a whole new message.”

Image via Bwog Staff