New York City has declared a public health emergency over the growing measles outbreak with 285 confirmed cases in New York City since the fall. The “epicenter” of the outbreak is in Williamsburg, Brooklyn, where vaccination rates among Orthodox Jews are particularly low. The emergency order was declared in an effort to curtail the outbreak and protect others. As part of the emergency order, all residents of four Williamsburg zip codes — 11205, 11206, 11211 and 11249 — must be vaccinated against measles, mumps and rubella if they are not already.
Those found to be in violation of the order could face up to a $1,000 fine, officials said. Under the mandatory vaccinations, members of the city’s Department of Health and Mental Hygiene will check the vaccination records of any individual who may have been in contact with infected patients. Those who have not received the MMR vaccine or do not have evidence of immunity may be given a violation and could be fined $1,000. New York’s MMR vaccination rate is at 91.1 percent, below the 94 percent requirement to achieve herd immunity.
The NYC Health Department recently issued an order banning all unvaccinated members of the Orthodox Jewish community in Williamsburg from entering yeshivas and day care programs. Non-compliant schools could be subject to closure. Roughly 1,800 children in Williamsburg remain unvaccinated. The city will help unprotected individuals secure affordable and accessible vaccination, and emphasized that vaccination is safe and effective. In February, the department increased the recommended MMR vaccine dose for children between ages 6 months and 11 months who live in Williamsburg and Borough Park. Infants are advised to get immunized prior to international travel.
The Williamsburg outbreak started when an unvaccinated child acquired measles on a visit to Israel, where a large outbreak of the disease is occurring. There have been additional people from Brooklyn and Queens who were unvaccinated and acquired measles while in Israel according to the health department. Most of the Williamsburg cases involve members of the ultra-Orthodox Jewish community, many of whom live by the Torah teachings that followers should not cause the body any damage since it is a gift from God.
Last month, in Rockland County, NY, near the city, county health officials declared a state of emergency and barred unvaccinated children from public spaces for 30 days. The order was temporarily halted last week after a judge ruled against it. Outside of New York City and Rockland County, measles outbreaks are underway in the Pacific Northwest, California, New Jersey and Michigan. The U.S. Centers for Disease Control and Prevention reported at least 465 individual cases of measles in 19 states in the past three and a half months. This outbreak has the second greatest number of infected individuals since measles was declared eliminated in 2000.
An analysis published in PLOS Medicine has shown that non-medical exemptions increased in 12 out of 17 states with relaxed laws on immunization. Arkansas, Arizona, Idaho, Maine, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, and Utah gave leeway for philosophical beliefs as a basis to refuse the vaccine. Authorities said they are now reviewing a bill to ensure that only patients with a qualified medical history like chemotherapy or organ transplantation will be given an exemption.