Yesterday, while at the Hasidic medical center with my son, I picked up a magazine with a black cover and the title “Tzim Gezint“. It was free for patients to take, so I took it — of course! This was the formal, official, Hasidic publication on vaccines, and I’ve wanted to understand the measles outbreak ever since it has been all over the news. I wrote earlier this week that I’d check back in a year or two with more facts about what caused the measles epidemic. So guess what – it was kvitzes haderech; the Hasidic concept of magical speedy travel. I think I get it now.
This black mag was published by the Hudson Valley Health Coalition, a collaboration between Kiryas Joel health practitioners and the Orange County Department of Health. Kiryas Joel is in the New York suburbs, a bit far from the comparatively modern Borough Park, but also, it’s my home town. It’s where I lived the first twenty five years of my life. In fact, here’s a tangential piece of nostalgia:
Dr. Alan Werzberger, a pediatrician who is one of the primary voices in the publication, was my pediatrician all through my childhood. He started to practice the year I was born. My memories of him are mostly of the long, endless wait times in his waiting room. It could take five hours to see him. I never felt like I knew him at all, the doctor who rushed in and out. But when my son Seth was born, after I had a stillborn a year earlier, he showed up in my hospital room in Columbia and gave Seth his first check-up. I remember how surprised
I was when Dr. Werzberger walked in. I had been writing on the laptop, and he said “A woman from Kiryas Joel with a laptop. I’ve never seen that before.” And I acted so guilty, he mumbled something to the effect that he didn’t mean anything by it.
Anyway. There – Grandpa Simpson and I and long side-stories…
The book had some really interested insights into the issue with vaccines. It was an educational component of the Hasidic community’s efforts, and not surprisingly, the official stance is very pro-vaccine. But I also got to understand a little bit about how the secular anti-vaccine trends is affecting this demographic.
Here are my Cliff’s Notes:
1. First, the numbers: The heads of both major schools in Kiryas Joel wrote about what they see with regards to vaccines in schools. UTA reports that 2% of the students have religious exemptions, While V’Yoel Moshe says the school has 1,000 families and not one letter of exemption on file, with 95-98% compliance.
2. Religious exemptions doesn’t mean people are not vaccinating for religious reasons. Kornbluh from the UTA says that “A lot of parents are worried about confidentially They don’t want the community to be aware of their child’s illness, so they’ll bring a religious exemption instead of medical.” In other words, people are concerned about their reputation, about their children’s marriage prospects, and are getting religious exemptions to cover whatever booboo the child has that might prevent them, medically, from getting vaccinated.
3. Still, reluctance to vaccinate *is* a problem. This is where the anti-vaccine issue comes in. From reading the reports of doctors and administrators, I’ve seen that they are dealing with a new wave of parents who are afraid of vaccines. No, it’s not a whole community of fanatics rejecting modern science, but it seems to be a real trend. Kornbluh from UTA says that “two or three years ago, we had less than 1% [exemptions from vaccines]. I blame the rise on misinformation; it’s been a terrible influence. For example, a popular hotline listened to by many women, has been the source of a lot of negative and unsubstantiated claims about vaccines.”
4. A recent influx of anti-vaccine scaremongering: Dr. Werzberger says that “twenty-five years ago, there was no such thing as not giving vaccines on time! Except if someone had a cold.” Another doctor said that people are becoming more hands on. They are more invested, they question authority. They don’t just do as the doctor says. They’d come to the doctor and say “I’ve done my research” even if the research is from shabby sources.
5. Refusing vaccines on the basis of “health”, not religion. Per Dr. Werzberger, “Even in an insular culture, like Kiryas Yoel, the secular way of thinking will influence the community… Mothers think that vaccines negatively affect the immune system.” The irony here is terrific. Because of the small-town, insular ways of the Hasidic community, it is easier for babba maysos to spread. Yet of all the babba maysos to spread, it’s the ones from the secular nuts.
6. Why the Hasidic community is more susceptible to fears of vaccines: the takeaway is that a few things come together to make vaccine-refusal catch on. First, vaccines have been so successful, people forget how terrible the illness it curtails is, while they hear all about its side effects. Almost as if the crisis is over, no need for precautions anymore. Hasidim are not doctors or nurses, so misinformation is ripe for the spreading. The small-town feel means this yenta tells this friend and that person and it’s all confirmed: the cat was a spirit carrying news about the cancer the neighbor’s sister had because of vaccines. There is also that a few fringe people were peddling stories that scared people, and the community didn’t organize to respond to them and squelch people’s fears. You see this with other issues too — the proactive education isn’t there vis a vis health until things get really rough. My hunch is that this is why the lead problem affects the Hasidic community too; because the information about the dangers of lead paint and such doesn’t reach people. It’s clear from this publication that there is finally an effort to take mother’s fears seriously and explain to them what the issues are. There is also the aspect that, according to the administrator of V’Yoel Moshe school “Anti-vaccine movements catch up with these very, very overwhelmed mothers and provide an excuse not to vaccinate.” The V’Yoel Moshe school claims they had success by coordinating vaccines with the doctors office. In other words, when you have a lot on your plate it can be the path of least resistance.
7. It’s obviously not all anti-vaccines. Even though this magazine is primarily geared towards educating and encouraging those fearful of vaccines, it touches on some other issues that might make the Hasidic community vulnerable to an outbreak. This school principal writes that “we are so bonded together, so many kids in one classroom, so many bochurim sitting across from each other in Bais Medrash, we must be more vigilant than anyone else. He also writes that “since we are a frum mosad (a religious school), we must let all children in.” I won’t go into the hypocrisy of this rule being cut off for those who don’t comply with religious requirements… The point is that the children who are not vaccinated are not homeschooled, they are around to pass contagions around. The doctors offices also (most of them) will accept patients even if they refuse to vaccinate. So between those who can’t vaccinate and those who won’t and those too young, the risks are surely higher in the Hasidic community.
I like the publication. I like it a lot. Instead of screaming “anti-vaxxers!” and pointing fingers and making it as if anyone who has ever questioned vaccines is the enemy of vaccines, it takes Hasidic mothers seriously. It believes that education and community coordination can solve the problem. Which — I think it will. The question is if the community will learn for next time to be proactive, before the quacks and witch doctors return to town and again set up voodoo shop and sell their snake all to every woman’s deepest anxieties.