In recent years, the United States has experienced significant measles outbreaks, particularly in Orthodox Jewish communities in New York, challenging the country’s ability to maintain its measles elimination status. These outbreaks, fueled by anti-vaccine disinformation, necessitated a comprehensive public health response to contain the spread of the highly contagious disease.
The measles outbreaks in New York, which began in late 2018 and continued through much of 2019, were primarily observed in Orthodox Jewish communities. These communities had been subjected to anti-vaccine misinformation for several years, making them particularly susceptible to the disease. Public health experts emphasized the crucial role of building trust within these communities to leverage the most effective tool for preventing measles: the vaccine.
Dr. Neil Vora, an expert in pandemic prevention, underscored the importance of vaccination in preventing measles, noting that two doses of the measles vaccine are 97% effective in preventing the disease, with long-lasting immunity. Federal health agencies recommend a 95% vaccination rate to prevent outbreaks, a target that New York communities struggled to achieve initially due to widespread misinformation.
During the New York outbreaks, over 200,000 vaccine doses were administered in New York City and approximately 30,000 in Rockland County, significantly exceeding the usual annual numbers. These efforts increased vaccination rates among young children in affected Brooklyn neighborhoods from below 80% to about 91%. However, the process faced considerable resistance, reflecting the deep-rooted disinformation within the community.
Dr. Oxiris Barbot, then the city’s health commissioner, highlighted the challenges in rapidly vaccinating the population, stressing the need for trusted messengers to promote the importance of vaccination. The outbreak response required individualized approaches, with health workers visiting homes and engaging in one-on-one conversations to address concerns about vaccination.
The measles vaccine quickly builds immunity, taking only a few weeks to reach full effectiveness. Retrospective studies suggest that the vaccination campaigns in New York City during the outbreak prevented a much larger crisis, potentially reducing cases by tenfold. However, other dynamics, such as “measles parties,” where children were intentionally exposed, also influenced the outbreak’s spread, particularly among infants and young children.
During the peak of the outbreak, local authorities declared a state of emergency to access necessary resources for managing the crisis. This declaration supported ongoing community efforts to counteract misinformation about vaccines and measles. Community leaders like Dr. Blima Marcus played a pivotal role in these efforts, using their positions within the community to dispel myths and provide accurate information on vaccination.
Dr. Marcus and her team developed pamphlets on the measles-mumps-rubella (MMR) vaccine distributed to approximately 10,000 homes. These pamphlets were part of a strategic initiative to counter anti-vaccination messaging and provide reliable information to those less likely to seek out digital resources. Community-led efforts were crucial in this context, as they allowed for a more culturally sensitive and responsive approach to combating misinformation.
The measles outbreaks in New York highlighted the critical need for culturally sensitive public health strategies when tackling vaccine-preventable diseases. Building trust with community leaders and directly addressing misinformation were pivotal in controlling the outbreak. These lessons underscore the importance of preparedness and adaptability in public health responses, especially as similar outbreaks continue to pose challenges in other areas of the United States.
