A small number of today’s parents, most of whom are too young to remember a time when vaccines did not exist, are convinced that polio, measles and other illnesses are so completely under control as to eliminate the need for vaccinations.
But Sharon Freundel, school nurse at the Jewish Primary Day School of the Nation’s Capital, remembers the days, back when she was a pediatric nurse in a doctor’s office, when children did die from Pertussis, also known as a whooping cough, a bacterial disease that causes violent fits of coughing. Pertussis has rebounded lately, resulting in a record number of cases this year (9,964), according to the U.S. Centers for Disease Control and Prevention in Atlanta.
This number represents a 24 percent increase from the previous year. Freundel strongly advocates for vaccinating children, and reports that no parents in her school this year have questioned the need to do so. Last year, two JPDS-NC students were not vaccinated, Freundel said, noting that one of the students had such severe allergies that vaccination was not recommended in that case. Another family opted out for what the parents said were religious convictions.
According to the Montgomery County Schools, children who have not been vaccinated are permitted to attend school so long as their parents provide proper documentation of a medical conflict or religious exemption. Exemptions from immunizations “are permitted if they are contrary to a student’s or a family’s religious beliefs.” But Freundel questions why a Jewish person would choose not to vaccinate a child when it is a mitzvah “to guard your soul.”
People must do everything to try and keep themselves healthy, she says. Mary Goldstein, the school nurse at the lower school at the Charles E. Smith Jewish Day School, also believes Judaism’s teachings should lead parents to vaccinate their children.
Jewish people are called on to care for the whole community, she says. “Immunization is one way to do that.” Vaccinations “are not an issue. Our parents are on top of this.” Dr. Ariel Dubelman, a doctor at Children’s Pediatricians and Associates in Gaithersburg, believes “as a general rule,” all children should be vaccinated. “We don’t consider it controversial. I think it’s pretty straight forward.” When a parent visiting his practice does question the need for vaccinations, Dubelman says, he and his medical colleagues attempt to educate them on the benefits of doing so.
Some parents opt to wait until their child is ready for school, but Dubelman believes the best time to immunize a child is during infancy. Still, some parents do refuse, Dubelman says, noting, “I would say it’s a very small handful, but yes, refusal happens.”
“I think we have lost the fear of these diseases,” says Baltimore pediatrician Rona Stein. “It’s wonderful that we’ve forgotten them, because they are now so rare [in the United States], but the downside of that is that we don’t remember how serious they are.”
“If you go to an underdeveloped country you will see them and realize they are not just minor illnesses,” she continues. “Anyone who’s been through a polio epidemic would gladly stand in line for the vaccine to get their children protected.”
M.D., a 29-year-old nonpracticing nurse and mother of three who would not allow her name to be published for fear of being exposed as a nonvaccinator, believes that the epidemics of yesteryear – the American Academy of Pediatrics points out that polio killed 6,000 people in 1916 and left another 27,000 paralyzed – had more to do with lack of hygiene.
“The world today is completely different than it was during the polio epidemic,” says M.D. “It was dirty. An average healthy person couldn’t get a disease like polio today. Polio in a healthy person today is usually asymptomatic or it has minor symptoms and comes and goes. Then the person develops immunity forever.”
Views like that have many doctors and health policymakers concerned about the risk of diseases reappearing. Although there have been parents who chose not to vaccinate their children as far back as the late 18th century when the smallpox vaccine was developed, in the past 15 years, the numbers of parents in the United States refusing, delaying or selectively vaccinating their children has increased.
According to the CDC, parental refusal or deferral of childhood vaccinations has led to an increase in diseases such as measles, which was “officially eliminated” here in 2000.
The federal agency reports that between Jan. 1 and Aug. 8 of this year, 18 outbreaks and 593 confirmed measles cases occurred in the United States. Mumps and chicken pox, as well, have also made comebacks in recent years and for the most part, the CDC attributes the increase in all of these formerly “eliminated” diseases to low vaccination coverage in certain communities. When relatively high numbers of people in a community are not vaccinated, that protection is diminished.
That may explain, say scientists, why close-knit communities such as the Amish and others who refuse vaccination because of their religious beliefs have been among the hardest hit by these outbreaks.
In recent years, there have been several outbreaks in haredi Jewish communities as well, most notably in the spring of 2013 when at least 58 people in Orthodox Jewish enclaves in the Borough Park and Williamsburg sections of Brooklyn, N.Y., developed measles.
This was reportedly the largest outbreak in the United States since the endemic spread of measles was eliminated. “I just assumed vaccinating was something you did, because vaccines saved humanity,” M.D. said with a chuckle.
“But then when my oldest was born, she had a traumatic birth; she was small and bruised and weak, and we didn’t want to give the hepatitis B vaccine right away.” Her pediatrician offered to inoculate her daughter at the first visit, but by the one-month checkup, M.D. was still apprehensive.
After pressure from her baby’s doctor, M.D. relented to having her daughter vaccinated at 6 weeks old. “She kept having weird symptoms: bloody diapers and hysterical crying,” M.D. says. “I cut out all the stuff [that might have been causing the symptoms] from her diet and was basically living off rice cakes and tuna, but nothing helped.
At about 10 months, we went to our regular doctor’s visit and the doctor said she was due for all these shots. I told him, ‘She has not been herself lately, and we are about to travel [to Israel]. Can we wait until we get back?’ ” Ultimately, M.D. and her husband decided not to continue vaccinating. In retrospect, the mother has no regrets.
She is unfazed by the possibility that her children might contract any of the diseases vaccines are meant to prevent, and she does not believe they are endangering others. Dr. Neal Halsey, director of the Institute for Vaccine Safety at Johns Hopkins University, notes that “vaccines work extremely well, but they are not perfect.”
But Rabbi Shmuel Kamenetzky, founder and dean of the Talmudical Academy of Philadelphia, and his wife Temi, have spoken out against vaccinating children. When reached by telephone, both Kamenetzkys confirm their belief that vaccinations, not the diseases they prevent, are harmful. “I see vaccinations as the problem. It’s a hoax. … It is just big business,” says Kamenetzky, who says he follows the lead of Israeli Rabbi Shmaryahu Yosef Chaim Kanievsky, who rules that schools “have no right to prevent unvaccinated kids from coming to school.”
But Sharon Billing, a Baltimore nurse and mother, once challenged Temi Kamenetzky at a lecture. “How can you advise young mothers to do this?” she recalls asking the rebbetzin. “You’re old enough to remember whooping cough and diphtheria. As Jews, we are required to guard our health.” To Billing, “it’s a public health issue, and there is no credible research to show that vaccines lead to developmental disabilities.”
Beginning this fall, two additional vaccines are being phased in statewide. Kindergarteners will now be required to receive an additional dose of the chicken-pox vaccine, and seventh-grade students must receive the vaccine against diphtheria, tetanus, and pertussis, as well as one dose of a vaccine against meningitis.
Simone Ellin is senior features reporter at Baltimore Jewish Times, WJW’s sister publication.
Suzanne Pollak is senior writer at Washington Jewish Week.