America is dying: Brooklyn ft. the Measles

In 2017, two cases of measles were reported in New York City. Within the last year, 285 cases of measles were identified in New York City. Think about that.  This 142-fold increase has a point source — one unvaccinated individual.This highly contagious disease is fatal, particularly for children and pregnant women who are immunocompromised. Measles’ resurgence has proven to be one of the most frustrating public health crises because the disease shouldn’t even exist. It is highly vaccine-preventable. The measles-mumps-rubella (MMR) vaccine is 93% effective at one dose, and 97% effective at two doses.

Mayor Bill de Blasio of New York declared this outbreak a public health emergency. It is important to emphasize the danger of measles. The virus can be infectious before the patient develops the characteristic red splotches, meaning that what seems like a simple cold could actually be a very serious disease. Additionally, even minimal or no contact with an infected person can cause disease transmission. It is an airborne virus, so if someone with measles coughed in a room, their droplets would stay infectious for two hours after said person left.

This crisis in New York is concentrated in an Orthodox Jewish religious community in Brooklyn, which is particularly concerning because New York City is such a densely populated area. For context, imagine walking even a block in the City. How many people would you breathe, cough or sneeze on? If you were infected, every single unvaccinated person you came in contact would have a 90% chance of getting measles.

NYC, in response, has mandated that all people in certain zip codes receive the vaccine, with the financial penalty for foregoing a vaccination set at a punitive $1,000. This entire scenario reveals a central question surrounding most public health issues of today: Do we prioritize personal freedoms like the liberty to abstain from a vaccine or the safety of everyone else? American values place such an emphasis on freedom that it seems obvious that movements like the anti-vax campaign would surface. While I believe that there are certainly medical situations where personal discretion should be of utmost concern, vaccination is not one of them.

I support Mayor de Blasio’s decision to contain the outbreak, moving to more drastic measures — such as shutting down and fining religious schools with unvaccinated children. These actions do not have bad intentions; they represent a more involved effort to contain this threat. There have been concerns that it is not within de Blasio’s jurisdiction to carry out such mandates, but the mayor seems confident about his actions. At the end of the day, vaccination is not only important for individuals, but it also promotes the notion of “herd immunity.” This idea refers to the vaccination of entire populations to prevent the transmission of disease to those who are not immune (i.e. allergic to vaccines, immunocompromised). Mayor de Blasio said it himself: “I don’t think it’s your unalienable right as a United States citizen to allow your child to catch and transmit a potentially fatal infection,” and he is absolutely right.