Brooklyn Haredi Measles Outbreak Continues, Health Department Now Urges Vaccination For All Haredi Children 6 Months Old Or Older

"Because measles cases continue to occur, particularly among young infants, healthcare providers should now administer the first dose of MMR vaccine to all Orthodox Jewish children aged 6 months and older living in Borough Park, Williamsburg, and Crown Heights."

File photo: a child with measles

From: <DOHMH.Alert@dccnotify.com>
Date: Jun 4, 2013 10:45 AM
Subject: NYC DOHMH Alert # 15 - Update on Measles in New York City: New Vaccine Recommendations
To:
Cc:

Dear Health Alert Network (HAN) Subscriber:

June 4, 2013

ALERT # 15: Update on Measles in New York City: New Vaccine Recommendations

1)    48 cases of measles have occurred in the Orthodox Jewish community residing in Borough Park and Williamsburg, Brooklyn.
2)    Because measles cases continue to occur, particularly among young infants, healthcare providers should now administer the first dose of MMR vaccine to all Orthodox Jewish children aged 6 months and older living in Borough Park, Williamsburg, and Crown Heights.

Distribute to All Primary Care, Infectious Disease, Emergency Medicine, Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Laboratory and Infection Control Staff


Dear Colleague,

There continues to be ongoing measles transmission among the Orthodox Jewish communities in Borough Park and Williamsburg, Brooklyn. To date, there have been 48 confirmed cases, including 28 in Borough Park and 20 in Williamsburg. Additional suspected cases are being investigated. In recent weeks, cases have begun occurring in younger children. During the past month, the median age of cases has declined to 2 years (age range 10 months – 17 years) with 19% aged less than 12 months, 52% aged 12 months to 4 years, and 29% aged 5 – 18 years. All cases were in persons who were unvaccinated at the time of exposure, because they were too young to have been vaccinated or because their parents delayed or refused vaccine for their children. Over 2,000 identified people have been exposed to measles in households (through relatives or friends), apartment buildings, and medical provider offices.

Measles transmission has been sustained by two factors: a large pool of susceptible children under 12 months of age and large family and communal gatherings. To interrupt the spread of measles in this community, the Health Department recommends that the first dose of measles-mumps-rubella-vaccine (MMR) now be given at 6 months of age to all Orthodox Jewish children living in Borough Park, Williamsburg, and Crown Heights. Although cases of measles have not yet been identified in Crown Heights, we are extending this recommendation to this community to prevent introduction of measles. Further, non-Orthodox children receiving medical care in practices that serve predominantly Orthodox Jewish patients, should also receive MMR vaccine beginning at 6 months of age because of the increased risk of exposure.

A dose of MMR vaccine given prior to the first birthday (there is a 4 day grace period) will not be considered a valid dose in the Citywide Immunization Registry (CIR) or for daycare or school entry. Infants who receive MMR vaccine before their first birthday should receive an additional dose at 12 months of age as long as 28 days have passed after the initial vaccine dose. These children will still require a ‘second valid’ dose prior to school entry at 4 – 6 years of age.

In the setting of this outbreak, Orthodox Jewish children aged 12 months and older living in Borough Park, Williamsburg, and Crown Heights who have received their first dose of MMR should receive their second MMR dose now, as long as 28 days has elapsed after the first dose. This second dose will be considered valid and will count toward the school immunization requirements.

Vaccination at an earlier age is recommended by the Centers for Disease Control and Prevention for outbreak control when many cases are occurring among infants <12 months of age. This will increase the proportion of infants who are protected against measles. Ninety five percent of infants who were 6 months old at the time of vaccination demonstrated a response to the vaccine as measured by cell mediated immunity and/or seroconversion (Gans et al. JID 2004;190:83-90). The same study documented that an infant’s ability to respond to a second dose of MMR is not compromised by early administration of vaccine. MMR vaccination of children 6 – 11 months of age who will be traveling overseas is already a routine Advisory Committee on Immunization Practices recommendation and is considered safe.

Providers who need additional MMR vaccine should place an order with the Vaccines for Children (VFC) Program through the Online Registry as per current procedures. Practices in the affected neighborhoods will be able to order the quantity of vaccine required to implement this recommendation. For questions or assistance with ordering VFC vaccine, please call 347-396-2400. Providers will need to purchase additional vaccine for their privately insured patients. The Health Department will communicate with the New York State Insurance Department to prevent problems with insurance claims. If you have trouble with reimbursement, please notify the Bureau at the number above or by e-mailing nycimmunize@health.nyc.gov.

Information about reporting suspect cases of measles, laboratory testing, isolation of suspected or confirmed cases, or post-exposure prophylaxis recommendations have been previously sent and are available at http://www.nyc.gov/html/doh/html/diseases/immmea.shtml

Please call DOHMH if you have questions at 347-396-2402 (weekdays 9-5pm) or 212-764-7667 (after hours and weekends). Your cooperation is appreciated.


Sincerely,

Jennifer Rosen, MD
Director, Epidemiology and Surveillance
Bureau of Immunization
NYC DOHMH

Jane Zucker, MD, MSc
Assistant Commissioner
Bureau of Immunization
NYC DOHMH

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Comments

[Yochanan Lavie]

There is a Polio spike in Muslim countries thanks to a nutty Nigerian Mullah's paranoia. Chareidim look down on other religions, yet do the same sorts of things.

[David]

Just as the frumma sorcerers now go against Jewish tradition and refuse to work or educate their children, they now fail to care for their children by refusing to vaccintate them.

[Peanut Cavalry]

**There is a Polio spike in Muslim countries thanks to a nutty Nigerian Mullah's paranoia. Chareidim look down on other religions, yet do the same sorts of things.**
Posted by: Yochanan Lavie

Ignorance is neither limited by religion nor ethnicity (or anything for that matter). Ignorance is a general condition, if you don't believe me look at the rise of the far right in Europe for a current comparison. Nobody has dibs on the amazing power of ignorance.

Power? Yes, power. Keeping people ignorant is a wonderful control mechanism for a large group of people. As long as ideas and thinking are contained then so are emotional reactions and hence any actions that result from frustrations brought about by terrible living situations are predictable.

The ignorant blame the dark-skinned immigrants and not their own flesh-and-blood politicians who sell them out. The ignorant blame demons and curses rather than understand disease and research. The ignorant kill and maim (including circumcision) rather than learn and understand about health. Women who don't 'knuckle under' are strung up, beaten down, and murdered by the ignorant. The Roma people are accused of every evil under the sun without any evidence by the ignorant. Ignorance destroys and kills. Ignorance causes genocides.

The Charedei, the chosen ignorants of the world, blame women and goyim and everybody but themselves for their own bombastic behaviour and actions that create the very problems that afflict them whether in short or long-term fashion.

Isaac Asimov wrote an excellent piece regarding the Cult of Igorance and I invite all and sundry to get this bit of verbage and read how chillingly true became his predictions of the future only a mere 33 years ago!

http://media.aphelis.net/wp-content/uploads/2012/04/ASIMOV_1980_Cult_of_Ignorance.pdf

Yochanan, ignorance is all over the place and ignorant Muslims only get a super tiny slice of that pie.

[Yochanan Lavie]

PC: Thanks for the Asimov link. Yes, Muslims have only a tiny slice, but my rhetorical point is that black hats are the pot that call other kettles black.

[anuran]

Your freedom of religion ends when you become a menace to public health and to little children.

[S M L]

Another reason to keep away from Haredim.

[Peanut Cavalry]

Yochanan, you make an excellent point! I see what you mean, now.

Thank you for reading Asimov's article. I was a bit young at the time of its writing but I'm sure I would have whole heartedly agreed with what he was saying as I had already noticed a systematic dumbing down in the school system literally a year after it was published.

[Yochanan Lavie]

PC: The whole culture has been dumbed down. I teach, and stemming the tide of ignorance is like King Canute trying to command the literal tide. Teachers are being told what to teach and how to teach by politicians and billionaires, who are only concerned with raising a docile workforce.

[Yoel Mechanic]

YL: re: education, if it was only to make docile workers (who presumably would be competent)I wouldn't think things would be as bad as what is going on now(and not everyone fully appreciates just how bad things have gotten). Docile in what way? I don;t think some of the big city high schools are even graduating "docile workers" or any sort of workers at all.

And why are kids not capable of sitting still? (as you mentioned in an earlier post). That doesn't sound so docile.

[Yochanan Lavie]

Docility is the goal, not the reality. The educrats want to minimize creativity by debasing the humanities in favor of STEM. It is easy to blame schools. If your pants still has a spot on them after sending them to the dry cleaners, you can blame the cleaners because spot cleaning is an activity that only takes place in their shop. But education involves the entire (largely nonexistent nowadays) community. Why do I constantly see school aged children on the streets at 9, 10, 11 pm on a school night? Why do parents buy their kids iphones but not tutoring? You say high schools "fail" but how can we magically transform a barely literate middle school graduate who doesn't come to class, and is disruptive and unprepared when he does? Outreach to parents is often futile; they are either overwhelmed or apathetic if you can even reach them. Often no 2 people in a given household have the same last name. Not to mention inadequate housing, medical issues, and inadequate employment as additional factors. But maybe those are the teachers' fault, too. After all, we are all-powerful. (Sarcasm!)

[Hal]

It's not so simple folks. There's lots of evidence, including kids with severe issues that started immediately after vaccinations, for opposing vaccines. At the least we need to cut back on the quantity and not consider them safe without question. You are pumping chemicals in people, aluminum, mercury. You don't think there will be problems with that?