The measles outbreak across the United States has reached 1,044 confirmed cases from January 1 to June 13, 2019, according to the Centers for Disease Control and Prevention. This is the largest number of cases reported in the U.S. since 1992 — of a disease that was declared eliminated in 2000.
Since the first case hit New York City last fall, there have been 596 confirmed cases through June 17, according to the NYC Health Department. The hardest-hit neighborhood is Williamsburg, with 441 cases, followed by Boro Park with 101; the remaining cases are sprinkled across the five boroughs.
While the New York City Health Department wages an aggressive campaign to stem the outbreak, including ending religious exemptions for Williamsburg yeshivah students and mandating vaccinations for everyone in the neighborhood, community leaders and yeshivah administrators have generally supported the Department’s efforts. But they say the Department is being overly aggressive in closing yeshivos for minor or technical infractions of rules that are arbitrary and capricious and do nothing to actually stem the measles outbreak.
By mid-October 2018, when there were six measles cases in Williamsburg and seven others across New York state, the city Health Department began issuing orders aimed at halting the spread of the disease: If a student was found to have measles, no children who had not received the required number of measles, mumps and rubella (MMR) vaccine doses would be permitted to attend the school for 21 days after the last exposure — including students with religious or medical exemptions. One dose of the MMR vaccine is required for children attending day care and pre-kindergarten, and two doses are required for those in kindergarten and above.
According to the Health Department, approximately 4.77 percent of students in Williamsburg yeshivos had had religious exemptions for vaccines during the 2017-2018 school year, with the proportion varying considerably by school, ranging from 0 percent to 22 percent. The public-school religious-exemption rate in New York City was around 0.25 percent. In private schools across the city, there is great variation in vaccination rates. Religious-exemption rates for non-public schools in 2018-2019 ranged anywhere from 0 percent to 45.45 percent.
In early December 2018, with 39 cases in the city, including 38 in Williamsburg and Boro Park, the Health Department issued an order “mandating the exclusion of unvaccinated children from yeshivos and yeshivah-based childcare centers” in those two neighborhoods, regardless of whether that school had ever had a measles case.
The measles cases continued to spread over the next few months, mostly in unvaccinated children, and fueled by a small but passionate group of “anti-vaxers,” according to health officials.
On April 9, with 285 cases in New York City, a large majority of them in Williamsburg, the de Blasio administration took the drastic step of declaring an emergency order in the neighborhood, effective until the outbreak is over. Under the order, any person who lived, worked or went to school in the Williamsburg ZIP codes 11205, 11206, 11211 or 11249 and was found to be unvaccinated would be fined $1,000. And any school that allowed an unvaccinated child to attend, or that failed to provide paperwork to inspectors demonstrating each child’s vaccination history or immunity, would be closed immediately until a corrective action plan was put in place.
(In June, the state passed a bill permanently ending religious exemptions for vaccinating schoolchildren; but the emergency order in Williamsburg and the Health Department’s ability to close a school for noncompliance remain in effect.)
Administrators of the two largest Williamsburg yeshivah networks tell Hamodia that when the ban on unvaccinated students was first implemented in December, their schools had a difficult battle with some families.
“It was a long fight with the anti-vax parents until we figured out how to make it work,” says Mr. Yoel Weisz, administrator of the Central United Talmudical Academy yeshivah network. Central UTA, the network of schools of the Satmar community under the leadership of the Rebbe Harav Aharon Teitelbaum, shlita, has around 5,400 students in four Williamsburg schools, 250–300 of whom had religious exemptions for vaccines prior to the December order, according to Mr. Weisz.
Many of the unvaccinated students had received one shot as a baby, but later got a religious exemption to avoid the second shot. Now they got blood work checked, proved immunity, and were allowed to remain. Some parents had their children get the other shot(s) in the series. Others fought with the administration and tried sending their children to school unvaccinated. Still others chose to send their child to a “measles party” to get infected by someone with the disease, thereby achieving immunity without taking the vaccine.
“It was a battle. Some people are more stubborn than others,” says Mr. Weisz. He has particularly harsh words for those who sent their children to measles parties.
“If someone infects their child with measles, I think it’s murder,” he says. “I don’t judge anyone for not immunizing, but I do judge someone for infecting their child with measles.”
The United Talmudical Academy (UTA) yeshivah network, representing the Satmar community under the leadership of the Rebbe Harav Zalman Leib Teitelbaum, shlita, has nearly 11,000 students in 12 schools in Williamsburg. Around 400 had religious exemptions prior to the December order, according to administrator Rabbi Chaim Mandel.
Rabbi Mandel says around 80 percent of these students got vaccinated following the order; the other 20 percent of parents “were screaming, trying to fight back, but they didn’t have a choice. Some students started missing lots of school days as their parents had them try to contract measles from other kids in this neighborhood or other areas that already had measles. But we have never had any exposure inside the school.”
According to the administrators, any student who did not have proof of vaccination or immunity was placed on an exclusion list and barred from attending school. Over time, as the unvaccinated students contracted measles, the exclusion list shrank; as of mid-June, UTA’s exclusion list was down to a total of three students, and Central UTA’s was down to two.
Though inspections were made after the December order, they increased significantly following the April emergency order.
The administrators say each school is inspected once, and sometimes twice, a week. The inspectors come to the school and review the immunization and attendance records of students and staff to ensure that no unvaccinated student or staff member has been in the school. A school can be closed if it is found to have permitted an unvaccinated student or staff member to attend or fails to provide records within one hour of their being requested by the inspector.
And the devil is in these details, say the administrators, who express extreme frustration with how the inspections are conducted. Each time the inspectors come, the administrators say, the inspector reviews every record of every child and staff member in the school. Even if a school has no one on the exclusion list and vaccination records have previously been shown for every student and staffer, the inspectors will review each record every time they come.
These inspections can last hours; Rabbi Mandel says two particular inspections lasted seven and eight hours, respectively. While the inspector is in the school, a staffer must always be present to assist with the inspection.
“They come every day, for three, four, five hours or more; the staff is drained already,” Rabbi Mandel says. “Going through records again and again, counting kids in the classes — the terror is unbelievable.
“A couple of weeks ago, an inspector came into a classroom and the teacher’s attendance sheet had 25 names, but the inspector counted only 24 students. He asked the teacher, ‘Where is the 25th kid?’ They finally found him hiding under his desk, cowering from fear from the inspector.”
Rabbi Mandel says that when asked why they review the same records repeatedly, the inspectors reply, “Those are my orders.”
Additionally, the administrators say that complying with the one-hour deadline to provide the records is not always easy. By law, pre-K must keep immunization files in the school, but for school-age children, files may be kept in the organization’s headquarters. Rabbi Mandel says that in one instance, when an inspector came to a school and asked for records, the staffers asked him to go with them to UTA headquarters to pick up the records. The inspector refused, insisting that UTA staffers bring him the records.
“They want me to print out thousands of papers and bring them back to the school within an hour?” says Rabbi Mandel. “They closed one of our schools because we couldn’t bring, within one hour, the records of a thousand students.”
A Central UTA school was closed on June 11 — that network’s only closure — also because of what the school describes as the inspector’s refusal to wait a bit before receiving records. Mr. Weisz says that on the day before that particular inspection, several of his staffers files’ were in the Central UTA headquarters, as they had been needed for an unrelated issue. When the inspector came to the school and found that some files were missing, he refused to wait for them to be brought and cited the school for not having complete records.
In a statement to Hamodia, a Health Department spokesperson said, “Our enforcement is out of concern for families in the community. Measles is a serious, potentially fatal illness and one of the most contagious on earth. We’ve seen how quickly measles can spread in a community from just a few unvaccinated students being allowed back in a school. We do not take closing down schools lightly, but we will if we cannot verify that all students attending a school in the outbreak area are appropriately vaccinated.”
Regarding the specific nature of inspections, the Department says that the audit is not only to review immunization records, but also to review attendance records to ensure that all unvaccinated students are excluded. The Department says it is also necessary to continually review records because new students or staff members may join a school during the year. The Department also says that after an initial audit, it reviews files of any new children and staff as well as those previously identified as excludable, and then when a school has been proven to have consistent compliance, its inspection frequency has been reduced — statements clearly at odds with the administrators’ versions of frequent, hours-long inspections re-reviewing the same records, even in schools with no exclusion list.
UTA has had five schools closed (one twice). Two schools, Yeshiva Torah V’Yirah and UTA 212, were closed on June 13 over what Rabbi Mandel describes as an inspector suddenly changing the definition of “pre-K.”
Though the chassidishe yeshivos use different names than other schools in their grading system, UTA considers its youngest age group, with children in the range of four and a half to six years old, to be pre-K, requiring only one MMR shot, and say the Health Department has never disputed this — until one day that week, when an inspector showed up to those two schools, and issued violations for the five-year-old children who had only had one shot. Both schools were closed.
When staff objected, telling the inspector that the school had been considered pre-K all along, the inspector replied, “It’s my higher-ups; it’s not me.” One of the schools had just had an inspection a few days earlier, which had confirmed that the grade in question qualifies as pre-K, Rabbi Mandel says.
One school was also cited for having a staffer without proper records. Rabbi Mandel says this was not a regular school staffer, but a person who worked in UTA’s headquarters who came to the school that day specifically to assist the inspector with paperwork. The inspector asked this individual for his own immunization record. When the individual replied that he did not have one on him because he was not a regular school employee, the inspector told him he must leave. Once he was forced to leave, the school no longer had a person on site to assist the inspector, as required.
Rabbi Mandel says that with the exception of the dispute over the definition of pre-K, all the UTA closures were over issues of record-keeping or -producing, never for allowing an unvaccinated child or staffer in the school.
Rabbi Weisz says one Central UTA school was issued a violation because an inspector saw two women in the building who could not produce immunization records. These women did not work in the school, but had come that day as volunteers to check students for lice.
Both the UTA schools closed over the pre-K-definition dispute were allowed to reopen the next day after an agreement was reached whereby any child who has turned five at the start of the school year must have two MMR shots (or demonstrate immunity), while one shot is sufficient for those who have not yet turned five before the school year begins.
The Health Department told Hamodia that since the April order, it had told school administrators that classrooms serving five- and six-year-olds are defined as kindergarten age.
All Williamsburg yeshivos that have been closed (11 schools in all, one of which was closed twice) reopened several days later after having instituted a corrective action plan. But the school closures cause great difficulty for the community.
The administrators and community officials who spoke with Hamodia say they are frustrated because they are pro-vaccine and committed to doing all they can to eradicate the measles and comply with regulations, but that the inspections have become unreasonable, and the Department is closing schools for minor technical violations.
“We support vaccinations; even before this outbreak, UTA’s vaccination rate was 96.5 percent,” says Rabbi Mandel. “Now we put in hundreds of thousands of dollars for the new computer system for keeping records. Work together with us. You have an issue with pre-K? Fine. Come over to me, say you have an issue and want to change. No problem, give me a week, I’ll make sure all those kids get the second shot. We’re not in a fight here; we’re trying to support you. But when the Health Department closes down a school with 1,100 students because three five-year-olds did not have the second MMR shot, does that make sense?”
Rabbi Weisz says he believes the Department is acting so aggressively “because they are under pressure.”
“This outbreak has been around for eight months; they are facing pressure from the media and the public, and they have to show that they’re doing something. They don’t have a solution, so they’re just pressuring the schools.
“Am I their policeman?” he asks. “When the mayor came to Williamsburg in April and issued the emergency order saying each person is responsible to get vaccinated, for the first time we felt that some pressure was being taken off us school administrators — now we were no longer responsible to be the city’s policemen! But they keep up with these unreasonable inspections, again and again. They are under pressure, they don’t have a solution, so they found a scapegoat.
“I have no objection with the overall push to get people vaccinated and eradicate the disease. I don’t love the idea that just because I run a school system I have to be the city’s policeman — but I can live with it. But what we absolutely object to, what is making our lives so unnecessarily difficult, are the frequency and uncompromising nature of inspections and closures.”
Rabbi David Niederman, President of the United Jewish Organizations of Williamsburg and North Brooklyn (UJO), which has worked with the city to push for vaccinations in Williamsburg, expresses similar sentiments.
“I hope that the worst of the outbreak is over and that the community understands and appreciates the Health Department’s efforts to stop the spread of measles — and that is our concern as well,” says Rabbi David Niederman. “At the same time, our combined interests can only be met if the Department will also appreciate the severe impact of the closure of a school, which hits the community very hard. Parents are trying to make a living, and when a school closes they cannot go to work.
“When there is a health hazard, we understand that there can be zero tolerance. But when something happens like an unintentional paperwork infraction or a decision that has been changed regarding the definition of pre-K, there shouldn’t be a school closure, but a chance to rectify the infraction instead — which the school administrators will gladly comply with.”