Inside the public health campaign to stop polio in New York’s Jewish community

Spread the love

Imagine that you are an epidemiologist, tasked with convincing a dubious public about the spread of a dangerous disease that could have devastating consequences for those who contract it, but so far, only one person has become seriously ill. Meanwhile, he roams undetected, a silent stalker. People forget about the disease. They move on to topics that feel like more immediate concerns in their lives.

That’s the challenge facing public health experts and educators in New York’s Rockland County, where a young man contracted polio over the summer, leaving him paralyzed. It was the first case of paralytic polio in the United States in nearly a decade. Before polio vaccines were developed in the 1950s, the disease paralyzed about 16,000 people a year in the US.

“We’re asking people, please, pull a fire alarm in a large building, which will cause a massive response. But do it because they tell there’s a fire, but you don’t smell smoke, you don’t see flames, and no one says fire,” said Shoshana Bernstein, a writer and health educator who lives in Monsey, a majority-Jewish town in Rockland County. “That’s what polio is. There are no signs of polio anywhere.”

She wants to say that there are no visible signs of polio, but epidemiologists have been trawling sewage in the area for months and have found signs that the virus is still circulating in the area. (Traces of poliovirus come out in people’s feces.)

“We can detect it in the sewage, and in fact, in five counties over many, many months, we’ve been continuously detecting poliovirus up until this month,” said Eli Rosenberg, deputy director of science at the Department’s public health office. of Health of the State of New York. “We have ongoing evidence of circulation in the community, and that means it’s essentially a matter of time until we see more cases of paralysis.”

The patient was identified in local media reports as an unvaccinated Orthodox Jewish man in his 20s, prompting a mass vaccination campaign in the area, where vaccination rates are much lower than state and national averages. .

But at a time when mistrust of public health officials is high and people are tired of living through other public health emergencies, it’s hard to reach a skeptical public. Instead, public health officials are taking a bottom-up approach that engages local leaders and doctors, and is intended to avoid stereotyping the Orthodox community, which is in part a corrective to how the health apparatus public administration managed the recent measles outbreaks and the COVID-19 pandemic.

“Vaccine hesitancy is not a Jewish thing. It’s a national problem,” Bernstein said. Vaccine skepticism has increased across the board since the COVID-19 pandemic.

“I think we’re trying to take a bit of a softer approach, but we still benefit from all the lessons learned,” Rosenberg acknowledged. She noted that when New York ended religious exemptions for vaccines in 2019, it led to an increase in vaccination rates. But it also had negative consequences. “That was effective, but it has also sown some mistrust, or some resentment. Nobody likes to be told what to do,” added Rosenberg.

Bernstein, who has worked with public health authorities since the 2015 measles outbreak, agrees that the approach has changed. “There is definitely a focus on bringing health education to the community in a culturally sensitive way,” she said. “There is definitely an understanding of the need to change at the community level, because from the top down it is not working. We need to connect with people from all spectrums and from across the country at a level that resonates with every community.”

The New York State Department of Health estimates that between 5,000 and 10,000 people have been infected with the poliovirus, which is believed to have come to the United States from Jerusalem. Some countries, including Israel, use a version of the polio vaccine that exposes recipients to the live virus, which in rare cases can allow it to spread. Vaccinated people can still contribute to the spread of polio, although they will not get sick from it.

“If they’ve been vaccinated, they wouldn’t be paralyzed, but they could potentially be participating in transmission,” said Kimberly Thompson, a polio expert who founded a nonprofit called Kid Risk, which investigates global transmission of the virus. “We look at a place like Rockland County, Hasidic Jews there and Haredim in general, low vaccination coverage puts them at risk. And because there is such an intense potential for transmission in the population, anyone who is not vaccinated up to any age is at risk.” People can get the vaccine regardless of age, even if they didn’t get it as a child.

The most urgent need when it comes to stopping the spread of polio is to increase vaccination rates. The state held vaccination clinics throughout the summer in conjunction with local authorities and religious leaders, as well as health centers. “We’re not coming in visibly, loudly, you know, showing up with a truck that says CDC, or State of New York on the side, but we’re taking a slightly more nuanced approach,” Rosenberg said.

According to state data, 60% of Rockland County residents have received all three doses of polio vaccine by age 2, the recommended vaccination window. The state average is 79% and the national average is 92%.

New York state’s response to the virus has focused on the Jewish community because that’s where the virus appears to be spreading, Rosenberg said, and not out of any ill will toward Orthodox communities where vaccination rates are lower.

“For sure there are other groups that are being left behind,” Rosenberg said, noting that some immigrant communities also have relatively low vaccination rates. “Our biggest concern remains in these Jewish communities, particularly because that is where our data points. [to] the lowest coverage. We have these kinds of zip code breakdowns, so we know where the areas of least coverage are.”

But a vaccination campaign, even if it is effective, is not the only answer. There may be a fire right now, but the public health response to polio requires understanding that vaccine education is an ongoing and never-ending priority.

“There is no single action, post or disclosure that is going to seal the deal. It will have to be an emergency response when there is an emergency and a constant state of education. Constant. We can never let go of vaccine education,” said Bernstein, who is leading that work.

He worked with local, state, and national public health authorities to create a brochure called “Tzim Gezint”, Yiddish for “to your health” (a phrase commonly used after a person sneezes). Provides a comprehensive and easy-to-digest overview of vaccinations and why Orthodox families should vaccinate their children.

“It starts with the Torah perspective from a rabbinical source that would resonate with the Satmar sect, which is the type of Hasidic people that lives in Kiryas Joel,” Bernstein said. (The brochure was designed specifically for the Hasidic community in Orange County, 25 miles north of Monsey.) “He did not focus on a vaccine. It focused on the story, really educating the community about what a vaccine is. Why do we have it? Because is good? How are they made?

Although it is adults who make decisions for their children, it is the children’s health that is at risk if they do not get vaccinated. An animated video Bernstein produced, called “Dovi and Rochel Stay Healthy,” shows two young Orthodox children learning how vaccines keep us healthy.

“Thank you Hashem, for giving us vaccines”, a child in tzitzit sing while riding a scooter.

Over the summer, more than a dozen Rockland County rabbis published an open letter urging people to get vaccinated. But local public health educators are also investing to make sure pediatricians and primary care physicians are also well prepared to prepare the benefits of vaccination for their patients.

“What we have heard from members of the community, from many leaders, is really that people want to listen to their doctors, and in fact they will listen to what their pediatrician has to say about vaccination, often with more attention than they do. that religious leaders and rabbis might have to say,” Rosenberg said.

How to send it: “The health professional you trust to heal you when you’re sick,” Bernstein said, “should also be the person you trust to keep you healthy.”

Rosenberg said the state has seen a “modest increase” in vaccinations since clinics opened this summer, though not the level they had hoped for. In the period from July 21 to October 31, 21% more doses of polio vaccine were administered to children 18 and younger in Rockland, Orange, Sullivan and Nassau counties than in the previous year, according to data submitted to New York State Immunization Information. System.

“As a Jewish epidemiologist who helps lead the response efforts,” Rosenberg said, “we want to get ahead of this, make sure that the Jewish community is a model of good health and that we protect ourselves and our neighbors, and that those are things that are part of Jewish values.”

#public #health #campaign #stop #polio #Yorks #Jewish #community

Leave a Comment

Your email address will not be published. Required fields are marked *