Dr. Eliana Aaron contributed to the international epidemiological reporting system for proMed -,mail. ProMED-mail is a program of the
International Society for Infectious Diseases http://www.isid.org.

An Israeli expert panel sub-committee recommended vaccinating children with
MMR at age 1 and age 2 years to provide an additional booster to this
vulnerable age-group. Children ages 1 to 4 years remain the most affected by
the measles epidemic.

Routine vaccinations of 6-year-olds will continue in school-based clinics.
This is in light of an ongoing epidemic in Israel affecting primarily
ultra-orthodox Jewish populations and sporadic communities of anti-vaxxers.
This epidemic has spread to other ultra-orthodox communities
internationally.

The recommendation is that the Ministry of Health has no
budget or staff to implement any additional vaccination programs, and the
current public health vaccine clinics are working at maximum capacity. It is
estimated that more than 2 million Israelis are unvaccinated or partially
vaccinated. The current epidemic has infected 4292 people between 2018 and
11 Jul 2019.

The ultra-orthodox education system is not a public school system, and
outsiders, such as government-contracted vaccine clinic nurses, are not
admitted. Also, the high number of children per family, lack of easily
accessible clinics or mobile vaccine clinics, logistical problems traveling
to well-child vaccine clinics (that is, getting on a public bus with 4 or
more small children) are all contributing factors towards the low
vaccination rates in this population.

Several years ago, during a passive polio scare, the community rabbinical
leaders encouraged over one million ultra-orthodox people to get
polio boosters. This leaves us to hope that further cooperation and education
efforts among community leaders can lead to successful vaccine campaigns.

--
Dr Eliana M Aaron, DNP, APN-BC
Director, EMA Care LLC