In late December 2014, the “happiest place on earth” became ground-zero for an outbreak of measles, a highly contagious respiratory illness which was declared eliminated in the U.S. in 2000. All told, the CDC reported approximately 200 cases of measles stemming from Disneyland.
As Jewish schools begin thinking about the next school year, it is time for us all to prepare for the next outbreak. Indeed, it is time for a conversation with our schools about vaccines.
Day schools — like all other pre-schools, primary, and secondary schools – have publicly available data on immunization rates. We were shocked that vaccination rates are so low in many Jewish day schools. A quick survey of the day schools in Los Angeles, for example, reveals that many kids who cannot medically get vaccinations cannot rely on herd immunity for protection.
While there is a great deal of data on vaccination rates for full-time schools, there is a gap in the research regarding Jewish supplementary religious schools. To begin closing this gap, we conducted a survey; our primary research question was simple: Do supplementary religious schools think about vaccination?
Our Data – A Survey of Religious Schools Vaccination Policies
After posting in a variety of social media venues, we received 82 responses, mostly representing Reform and Conservative schools, from 20 states. Based on the schools’ demographic alignment with Avi Chai Foundation’s Census of Jewish Supplementary Schools, these data should be representative of national trends.
Only 4 percent of supplementary religious schools surveyed have a vaccination policy. About one-third of schools have begun a conversation about having a vaccination policy. The responses indicate that recent events have moved these conversations along, and we assume that if we did a follow-up survey in a year, these numbers would be considerably higher. Some administrators lean on the state law for full-time schools’ vaccination policies. One director noted, “In our state, all students at public and private schools must be vaccinated. We state that all students must have their updated health records on file at their secular school.” This is not the case for most states. Supplementary schools in all but two states need to have a policy to close the holes left by state law.
For the schools that have started a conversation about vaccination policies, most started the conversation because of outbreaks like the one at Disneyland. When asked to describe the conversations, most schools are pushing for policies that only allow for medical exemptions. One Rabbi decided not to even have a conversation: “Vaccination is required. Period.”
The Science is Clear – The MMR Vaccine is Safe and Effective
The focus of our research is on the vaccine for measles, mumps, and rubella (MMR). Measles is a highly contagious virus that is spread through coughing and sneezing, close personal contact, or direct contact with an infected person. The measles virus can remain active and contagious in the air or on infected surfaces for up to 2 hours, and can be transmitted by an infected person 4 days prior to the onset of symptoms. The measles virus is so contagious that if one person has it, 90% of people close to that person who are not immune will also become infected.
The MMR vaccine is so effective that as of the year 2000, measles was considered eliminated in the United States. However, because of the increased prevalence of the anti-vaccination movement, more children are not being vaccinated and this once-eliminated disease has returned. So far in 2015, there have been 159 cases of measles from 18 states and the District of Columbia (as of April 10, 2015), following a record 644 cases of measles in 2014.
Vaccines are for Everyone’s Protection
There are, however, individuals in the population who cannot receive the MMR vaccine. Since MMR is a modified live vaccine, individuals with a compromised immune system, such as those with different kinds of cancers or autoimmune diseases, cannot be vaccinated. Additionally, infants cannot be vaccinated until they are 12 months old, and do not receive the second dose until they are 4-6 years old. These people who for medical reasons cannot be vaccinated rely on “herd immunity,” or the collective protection provided by being surrounded by vaccinated individuals, to protect them.
The Jewish Imperative is Clear and Institutions are Establishing Policies
There are a number of articles online and in print from the last year alone that discuss the Jewish imperative to vaccinate. The Reform and Conservative Movements, in 1999 and 2005 respectively, published responsa that argue in favor of vaccination, providing exemptions only for medical reasons. (CCAR 1, http://ccarnet.org/responsa/rr21-no-5759-10/, Rabbinic Assembly) Many Orthodox authorities follow the same guidelines: the safety of the community is paramount and, therefore, kids should receive vaccines. Roger Price wrote a piece for the Jewish Journal in July 2014, which details the cross-denominational arguments for vaccination. He concludes: “Vaccinations are not contrary to Torah principles. Indeed, vaccinations are mandated because Jewish tradition places the highest value on preventing foreseeable damage to individuals and the community.”
The Union for Reform Judaism recently instituted a policy that applies to campers, staff, faculty, and their families attending URJ Camps and Israel programs. Their policy requires “that all children, staff, faculty, and their families planning to attend our URJ camps and Israel programs must be immunized.”
What Can Be Done?
*Parents: Talk to your school about vaccines. Be proactive about starting a conversation, but be careful about the language used in this discussion. Even though the research is clear, we should be sensitive not to demonize other families in our communities. This is about the health of our families, not setting up an “us vs. them” dichotomy.
*Clergy: Make sure your community understands the Jewish values behind establishing a vaccination policy. The responsa and policies above cite numerous texts and Jewish values that you can draw upon to ensure your community understands the message.
*School Administrators: Help your school establish a vaccine policy. Here is our suggestion: “Because we care about the health of all members of our community, proof of immunization is required in order to attend our school, except for medically-necessary exemptions.”
We would hope the number of schools with vaccine policies will climb as awareness grows. It is up to each of us to make this change happen. The science is clear. The Jewish imperative is clear. Together, let’s protect ourselves and those in our community who need it most.
This piece was co-written by Jeremy Gimbel & Sarah Gimbel, PhD, a post-doctoral fellow at the Brain and Creativity Institute at University of Southern California.