Tuesday, February 16, 2010

Orthodox Jews, Vaccination, and Mumps

I've discussed anti-science attitudes among Orthodox Jews in previous blog posts. I've also discussed how this has resulted in low vaccination rates among Orthodox, especially charedi, Jews. Now we are seeing the consequences. Over the last three weeks, a mini-epidemic of mumps has broken out in New York among the Orthodox population. The first cases started appearing this summer in Williamsburg, but there are now over 1500 cases and the epidemic has made inroads into the general non-Orthodox population. Apparently while a majority of the Orthodox Jews are vaccinated, the level of vaccination was reduced enough that herd immunity no longer applied. Quoting from the LA Times:

Mumps is marked by a swelling of the salivary glands, giving the victim a characteristic chipmunk-like appearance. Most victims have fever and headache, and a few suffer from hearing loss, meningitis and swollen testicles that can lead to infertility. It was once a common disease in the U.S., with an average of 186,000 cases per year before the mumps vaccine, now included in the mumps-measles-rubella, or MMR, vaccine was introduced in 1967. The mumps part of MMR is thought to be the least effective of the three vaccines, with 73% to 91% of those vaccinated obtaining proteciton after one dose and 79% to 95% after two doses.

Patient zero in the current outbreak was an 11-year-old boy who returned from England on June 17. Mumps has become more common in that country recently because of the substantial number of parents who refuse to let their children receive the MMR under the misguided belief that the vaccine can cause autism. About 7,400 cases of mumps were reported in Britain last year.

Orthodox Jews have accounted for more than 97% of cases, and the majority -- 61% - -are among 7- to 18-years-old. More than three-quarters of the patients are male. Among those for whom vaccination status is known, 88% had received one dose of MMR and 75% had received two doses.


The threat of sterility needs to be especially emphasized. In Orthodox Judaism, there are few things more important than having children. Mumps can induce infertility in both males and females. It is not at all unlikely that children who have gone through this epidemic will have trouble finding marriage prospects. Thus, the failure to vaccinate has produced what may become terrible, long-term problems for many children for the rest of their lives. The Orthodox unwillingness to vaccinate has become a self-inflicted wound. In this case, anti-science attitudes were far from harmless and the results may yet grow to more seriously threaten both the Orthodox population and other people as well. Failure to vaccinate children creates serious risk to your children and the people around your children. Vaccinate. For some of these children, it is already too late. They will bear the physical and social scars of their parents' decisions.

10 comments:

Shalmo said...

Kool! Perhaps karma is at work here. Perhaps this is Hashem letting them know that the million baby strategy; making lots of babies to cover up whatever they lose to OTDs is not how God wants his "chosen" to survive.

Of course that is a cruel thing to say, because its their rabbis who are to blame for this.

However poverty, housing and all the expenses of the frum lifestyle in today's economy are far more pressing matters for the Orthodox. Infertility is by all means a blessing in disguise, as many of those mothers have little choice when they become baby factories.

This brings another topic I have been wondering for a while, how long can OJ really last?

There is the growing poverty. There is the growing rate of OTDs. There is growing disatisfaction with the community in general.

One expects a shifting down of the ultra-orthodox to modern orthodox to conservative. Time will tell!

Joshua said...

Shalmo,

I'm not aware of any hard evidence that the rate of OTDs is growing. The poverty rate among Orthodox Jews has been constant about for the last decade or so.

From a strictly demographic perspective, the number of Orthodox Jews is growing (indeed they are the only form of Jews whose population seems to be actually increasing substantially at this time).

Shalmo said...

For academic research on how low birth-rates, intermarriage and assimilation are destroying Jewry, here are some articles to read:

-Low fertility and high intermarriage are pushing American Jewry toward extinction (http://www.aish.com/jw/s/48899452.html)

-European Jewry is slowly but surely disappearing before our eyes, melting away through a combination of ignorance, assimilation and intermarriage. (http://www.aish.com/jw/s/48892732.html)

-Will Your Grandchildren Be Jews? (http://www.aish.com/jw/s/48910307.html)

Now its important to bear in mind that the above articles all have a bias, in that they promote a fable common among Orthodox Jews, which is that Reform/Liberal and the Conservative Jewish denominations are headed to an end and that only Orthodox Judaism will survive.

However this is not true. A good critique for that thought has been provided in the following post: http://www.threejews.net/2008/09/will-your-grandchildren-be-reform.html

Quote:

"Of all children raised Orthodox, only 42% have remained Orthodox as adults. 29% become Conservative adults, 17% become Reform adults, and 12% become "Just Jewish". Thus, the basic demographic facts are clear. Orthodox Jews have a lower intermarriage rate and a higher birthrate than more liberal or moderate Jews, but a much higher denominational-switching rate. Of all Jewish adults who were raised Orthodox, fewer than half are now Orthodox. No other Jewish denomination has such a high switching rate. Thus Orthodox Jews cannot save Jewry from extinction."

Anonymous said...

I did not see any quote that Orthodox refuse to immunize. This a figment of your imagination.

I am a journalist who works for Orthodox media. I interviewed a pediatrician about this issue and he clearly told me that there is no problem with lack of immunization as such in the ultra Orthodox community, it is rather a result of a certain percent -larger than with other vaccines- of the MMR being ineffective.

In addition Orthodox Jewish yeshiva boys live in close proximity with each other, and families and communities are tightly interconnected. Then there is the fact of the easy transmission of the virus which is extremely virulent, causes the virus to infect even those those who were immunized.

No Yeshiva that I know of, permits any child without proper immunization papers into class, as is required by the law. No allegation whatsoever has been put forth to even suspect that the Yeshivas are not following these strict laws as required.

Joshua said...

Anonymous,

That's interesting because I've talked to at least one pediatrician from whom I got the impression that the vaccination rate is part of the problem. At least one source, the LA Times article here

http://www.latimes.com/sns-ap-us-med-mumps-outbreak,0,4824526.story

to agree with you that the rates are about the same and are pointing to the classroom setup and other social factors as the main causes of the transmission. I'm looking into this now and will update this thread when I get more data.


One incidental issue- relying on Yeshivot reported rates would strike me as a very bad idea. Given how many Yeshivot forge documents or simply lie outright to the federal government all the time, the notion that you'd have the Yeshivot doing a good job at all is frankly something where my default assumption would be in the other direction especially with Yeshivot among the charedim.

Joshua said...

Also, note that there's a fair bit of data that shows that charedim in Israel have a lower vaccination rate than the general population see http://alturl.com/tg6k .

Part of the issue may also be related to what we mean by "Orthodox" since the LA Times and others seem to be talking about a broad population whereas most of this outbreak has been among charedim. I'm not at aware of any data trying to distinguish vaccination rates for those in New York (although I can't actually find any source other than secondary sources like the above making the claim even for Orthodox Jews in general having the same rate). If the charedim vaccination rate is lower that could easily be lost in the general Orthodox rate if one had that data. It would also be enough due to the set-up of the community that you could plausibly have serious transmission problems with herd immunity if you just had a centralized population with lower vaccination rates that had other aspects making transmission easy (such as the issue of how students face each other).

Vashty said...

Joshua,

How timely! Despite the recent retraction by the Lancet of Wakefield's bogus autism study, untold numbers of persons (from what I've seen, the type that is quite literate but ignorant of science) continue to believe that the MMR vaccine is dangerous. They, too, are causing little outbreaks of disease among children who are too young or too sick to be vaccinated. Like many OJs, these people cannot be convinced by evidence, in part because they do not know how to interpret it.

Jeff Eyges said...

Joshua,

I've been told - although I don't have figures to substantiate it - that Reform is actually the fastest-growing denomination, primarily b/c they recognize patrilineal descent.

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