MMR

In case you don’t avidly follow news of epidemics there had been almost a thousand measles cases nationwide since January. That is the highest number of cases since 1994, according to the Centers for Disease Control and Prevention (CDC).

If you guessed that most of the cases are in New York City, then you’re absolutely right! The current outbreak started in New York when one unvaccinated child got the disease while visiting Israel and brought it back to the United States. According to health department officials there have been 550 cases in New York City alone and 77 percent of those cases are in Williamsburg, many are also in Borough Park, and most of them involve members of the Orthodox Jewish community. In April, the city ordered mandatory measles vaccinations for all people living and working in four Williamsburg zip codes. People face fines of up to $1,000 for noncompliance.

And now Sunset Park is included in that mandatory order. Last week there were 12 confirmed cases in the area, all involving people outside the Orthodox community.

It was only a matter of time. Sunset Park is right next to Borough Park, which is home to a densely populated Orthodox community. While the Orthodox community is insular there are plenty of non-Orthodox people who work in Borough Park, though, and many of them are Latin American immigrants who probably live in Sunset Park. I always see Latinos working at the Orthodox grocery stores and non-Orthodox drive the buses that take the Orthodox children to Yeshiva, and many Orthodox count on their closest non-Orthodox neighbors to turn off their lights and electrical appliances during the Sabbath.

Most of the Orthodox do vaccinate their children, but in high-density communities, even a one percent decrease in the vaccination rate yields thousands of potential hosts for a highly contagious disease like measles. Measles is so contagious that nine out of ten unvaccinated people will fall ill with the disease if exposed to it. If a sick person goes to a restaurant, sneezes and  leaves, the whole vicinity will be contagious to anyone who visits up to two hours after the sick person was there.

I’ve read various news articles about measles because I had to write about it for my job. The Yeshivas throughout the city that the Orthodox send their children to report varying degrees of vaccination–some yeshivas are on par with public schools, some have 100 percent vaccination rates, and a handful have rates of 80 percent–definitely not enough to grant the population herd immunity.

Other private schools with abysmal vaccination rates are the Waldorf schools that affluent people with a combination of hippy and luddite leanings send their children to. Their children have been spared the measles simply for the fact that they probably don’t mingle with the Orthodox community. The parents of children at Waldorf schools most likely don’t work at Orthodox grocery stores or drive school buses for Orthodox children.

Many of the anti-vaccine Orthodox who are interviewed by the media say that their children have gotten the measles and they’ve been just fine.

“My children have recovered beautifully,” said one Williamsburg woman interviewed by NY1.

And in fact, that is the case for most people in developed nations. In the decade before the vaccine, four to five billion children got the measles and 400 to 500 of them died, according to the CDC.  For the average individual, the risk of death is .2 percent. If a person is malnourished, the risk rises to 10 percent. In its guidelines for measles vaccination, the CDC says the people born before 1957 don’t need the vaccine because people born before then most likely got the measles and are therefore immune. That’s a lot of people who are just fine! Including my parents, probably your parents, and you, if you’re reading this and you were born before 1957. In fact, there’s a Brady Bunch episode where all the kids get sick with the measles. Carol Brady describes her one of kid’s symptoms as “a slight fever, a lot of dots and a great big smile,” because her kid got to stay home from school.

On the other hand, billions of people have gotten the MMR vaccine and have been just fine! Including Boo Boo, myself, my sisters, Jer-bear, and probably you! Not only were we fine, but our parents probably did not have the luxury of staying home from work to take care of us. Stay-at-home moms like Carol Brady are a rarity these days. 29 people in the current New York City outbreak have been hospitalized. Not everyone has the money and insurance to take their kid to the doctor if they or their kid gets sick.

In response to the recent outbreak in Sunset Park a vaccination clinic was set up at a local church. Anyone who dropped by could get the shot for free. Literature about the event was in English, Spanish and Chinese. I decided to go because when I was pregnant with Boo Boo the doctors could not verify if I was still immune to Rubella in a routine blood panel done for pregnant women. Rubella is pretty harmless to most people, but can cause severe birth defects if a pregnant woman gets sick with it. But the MMR (measles, mumps and rubella) vaccine is a package deal, and if I do not have clear immunity to rubella, then who knows about my measles status.

When I spoke to the people at the clinic, they told me that most of the measles cases that require hospitalization and time in the intensive care unit are babies who are too young to get the MMR shot–which is typically given when a baby is one. I’m glad that Boo Boo’s first year check-up happened before the measles reached Sunset Park.

What worries me is that Sunset Park is also densely populated. Many people don’t know their vaccination status–including myself. I know I got one shot, but some articles have said that people born before 1989 might not have gotten a booster, which became commonplace after 1989. I could call my mom to verify, but she’d just as soon tell me she didn’t remember for fear of misleading me to think I don’t need a shot when maybe I actually do, thereby possibly exposing myself to the measles, in which case she’ll never forgive herself. If I call Missouri’s department of health, they’ll tell me they’ll need two weeks to search a whole limestone cave for my medical records. I’m not even kidding. Missouri’s medical records are kept in caves. Two weeks is too long to wait for a disease that spreads as fast as the measles.

In Sunset Park 22 percent of the community lives in poverty and I’m guessing a lot of people don’t have insurance. If you’re living outside the system, especially when a significant portion of the neighborhood has a legitimate fear of being randomly picked up by ICE, then everything about the system is intimidating and oftentimes inaccessible, which is why those of use who do have a status here, who do have insurance and who do have time, should do what we can to protect ourselves–because by protecting ourselves we’re protecting others.

I understand where people are coming from when people say that the measles is “no big deal” and that’s probably the case for most people who get it, but the thing is in New York City, where there are eight million people, five million of which share the subway everyday (including babies too young for the vaccine) and where there is an average of 27,000 people per square mile, it is really hard to separate the people for whom the measles is no big deal from the people for whom it would be a really big deal–as proven by the fact that the disease has finally escaped the insular Orthodox community. It is one of the most highly contagious diseases on Earth.

If you want more information about the current outbreak, as well as information about the MMR vaccine, please visit the NYC Department of Health’s website.

Stay healthy everyone!