Editor’s note: The Personal Belief Exception percentages provided by the KQED search tool, which are quoted below, are for the school’s kindergarten class in the 2014-2015 school year. For context, we’ve added the total number of each school’s kindergarten students that year and the number who filed PBEs, data provided by the California Department of Public Health. The original percentage for Contra Costa Jewish Day School was listed incorrectly.
As you surely know by now, measles—once essentially eliminated in America—is again becoming an epidemic. According to the Centers for Disease Control and Prevention, the number of cases in the U.S. is at a 20-year high. In the recent outbreak at Disneyland, the vast majority of the victims were unvaccinated.
California in general is chock full of crunchy clusters of people who refuse to vaccinate. A study published earlier this month found five areas in the Golden State with stratospheric rates of unvaccinated or under-immunized kids: Northeastern Sacramento County and Roseville (5.5 percent); Marin and Southwest Sonoma (6.6 percent); Northeast San Francisco (7.4 percent); an area from Alameda to El Cerrito (10.2 percent) an area south of Sacramento (13.5 percent). The statewide average vaccine refusal rate, outside these areas, is 2.6 percent. To achieve herd immunity, in which the percentage of people who are vaccinated is high enough to protect the unvaccinated, 94 percent of the population has to be immunized against the measles.
Measles is no harmless little illness. Around the world it causes 400 deaths a day, 16 deaths an hour. It’s one of the leading causes of death among children. Among those who survive, it can cause pneumonia, brain damage and hearing loss. As health writer Dan Diamond pointed out in Forbes yesterday, you’re 35,000 times more likely to die from measles than to win at Powerball. An unvaccinated baby in a room with someone who has measles, however, has way more impressive odds: he has a 90 percent chance of developing the virus. (Crowded places like Disney and or a classroom mean a fabulous chance of transmission. And if you have measles, you have four glorious days in which you’re contagious before you even develop symptoms.)
Pertussis is a terrible disease too. Before the availability of a vaccine in the 1940s, it was a major cause of child mortality in the U.S.; in developing countries it still causes 195,000 deaths a year. And it’s miserable: The disease makes children cough so hard they may break ribs. And yet in 2014 there were 8,000 pertussis cases in California. Two babies died.
You would think that Jews, with our values of tzedek, tzedek tirdof (“righteousness, righteousness shall you pursue”) and al tifrosh min hatzibur (“don’t view yourself as separate from your community”), as well as our general proficiency in the areas of health and medicine, would be all over vaccination. You would think that since our sage Reb Nachman of Breslov (who died in 1810 of tuberculosis, back in pre-TB-vaccine times) wrote, “One must be very, very careful about the health of children… One must inoculate every baby against smallpox before one-fourth of the year, because if not, it is like spilling blood,” we’d be vaccinating fiends all up in this joint.
There’s no halakhic (Jewish law-based) reason for this. In 2005, the Conservative Movement’s governing body, the Rabbinical Assembly, ruled that Jewish Day Schools can, in accordance with halakha, make immunization compulsory. And Orthodox Jews who believe Judaism encourages opting out should heed the full-throated call to vaccinate from David Shabtai of Boca Raton Synagogue: “Jewish law cannot serve as a basis for a religious exemption for vaccination. Claiming that it does is a perversion of both logic and religious law.”
And yet. Jewish actresses, from Big Bang Theory co-star Mayim Bialik (who has a Ph.D. in neuroscience!) to Lloyd-Dobler-pen-bringer Ione Skye (author of a children’s book about Yiddish, and married to Jewish musician Ben Lee), have turned up their noses at evidence-based medicine. (Skye has stated that skipping some vaccines makes “instinctive sense”: “As a mother, it just felt better to me—and my kids never had any reaction.”) Thank heaven for Amanda Peet! Author of a forthcoming children’s book about being Jewish at Christmastime, wife of novelist and Game of Thrones showrunner David Benioff, activist with the United Nations [email protected] campaign, and star of the new HBO series Togetherness, she’s also the parent of a child who contracted pertussis between her second and third doses of the vaccine. “I know a lot of parents who stagger their kids’ vaccines,” she told The Hollywood Reporter last year. “Their position is, ‘Hey, why are you so gung ho on tanking your kids with all those vaccines?’ They act almost concerned for me, and I want to say, ‘Wait a minute, your children are actually benefiting from the barrier I’m putting in place for them, and now you’re questioning my soundness of mind for doing that?’”
Alas, Peet often seems to be a voice in the wilderness. The California Department of Public Health recently created a public database of immunization levels in all California kindergartens (public, private and parochial), and KQED’s California Report turned it into an easily searchable tool (methodology here). I plugged in the names of the 68 schools in Private School Review’s list of Jewish elementary schools in the state and found 14 with nosebleed-inducing levels of vaccine refusal. Here is the list of schools (only elementary schools that have kindergartens are in the database) and their Personal Belief Exemption (PBE) rates for kindergartners. Remember, six percent is the threshold for herd immunity.
Abraham Joshua Heschel Day School, Northridge: 18 percent (22 students, 4 PBEs)
Adat Ari Day School, Valley Village: 13 percent (16 students, 2 PBEs)
Bais Chaya Mushka Chabad, Los Angeles: 11 percent (28 students, 3 PBEs)
Brandeis Hillel, San Rafael: 8 percent (12 students, 1 PBEs)
Cheder of Los Angeles, Los Angeles: 12 percent (32 students, 4 PBEs)
Cheder Menachem, Los Angeles: 9 percent (23 students, 2 PBEs)
Contra Costa Jewish Day School, Lafayette: 14 percent (14 students, 2 PBEs)
Emek Hebrew Academy Teichman Family Torah Center, Sherman Oaks: 8 percent (51 students, 4 PBEs)
Hebrew Academy Huntington Beach: 18 percent (33 students, 6 PBEs)
Harkham Hillel Hebrew Academy: 10 percent (63 students, 6 PBEs)
Ilan Ramon Day School Agoura: 13 percent (16 students, 2 PBEs)
Kabbalah Jewish Academy, Los Angeles: 75 percent (12 students, 9 PBEs)
Tehiyah Day School in El Cerrito: 13 percent (30 students, 4 PBEs)
Valley Beth Shalom Day School, Encino: 18 percent (40 students, 7 PBEs)
Three more schools had no data available: Oakland Hebrew Day School, Torat Hayim Academy and Yeshiva Rav Isacsohn Torath Emeth.
As Diamond points out in Forbes, the work of Dartmouth political scientist Brendan Nyhan has shown that presenting credible scientific evidence to anti-vaccine parents only makes them dig in their heels. American Journal of Public Health editors Dr. Kenneth Camargo Jr and Roy Grant have proposed a different approach: using pro-vaccine experts and activists who are not scientists as educators. People who get PBEs are people who tend to distrust public health experts, so using people with “interactional expertise” as communicators, instead of relying on doctors and scientists to spread public health messages, might be effective.
If the carrot doesn’t work, perhaps the stick will. Lawmakers are discussing tightening the rules for receiving PBEs. Ethicist Arthur Caplan has explored the idea of suing or criminally prosecuting non-vaccinators for causing illnesses. Me, I’m open to suggestions.
Come on, Jewish parents. Let’s be a light unto the nations.
Marjorie Ingall is a former columnist for Tablet, the author of Mamaleh Knows Best, and a frequent contributor to the New York Times Book Review.