Of measles and Jewish law

From the moment our ancestors set foot out of Egypt, two of the fundamental directives they were taught in so many ways were to “stay healthy” and to “protect the health of everyone else.”

As Pesach neared, however, those two directives seem to have vanished from certain charedi-dominated communities in New York — in Willliamsburg, Brooklyn, and in Rockland County — and in Ocean County, New Jersey. The result is the worst outbreak of measles in our area in at least 30 years, with 298 cases reported as of this writing and undoubtedly many more by the time you read this.

Not only are the people who live in these communities at risk, but they are spreading it outside their enclaves. Westchester County, for example, began to see measles cases more than a week ago among people who recently visited either Williamsburg or Rockland County. A measles outbreak in one home in Monmouth County is directly related to the Ocean County cases, according to New Jersey health officials.

To be sure, measles is not restricted to charedi communities. Between January 1 and April 4, according to the Centers for Disease Control, there were 465 cases reported nationwide, compared to a total of 349 cases in all of 2018. Hardest hit (outside our area) are states in the Pacific Northwest, notably Washington and Oregon. Others states reporting outbreaks include Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, Oregon, and Texas.

Europe, too, is experiencing a measles epidemic. In 2018, according to the World Health Organization, 82,596 people there contracted measles — three times the number in 2017 and 15 times higher than 2016 — resulting in the deaths of 72 children and adults.

The main reason for the measles outbreak here and overseas is a virulent misinformation campaign by the so-called anti-vax movement. The MMR vaccine successfully protects against measles, mumps, and rubella (hence MMR). Before it came along in 1963, according to the CDC, “as many as 4 million people [in the United States] became infected every year. Nearly 50,000 were hospitalized and up to 500 people died annually.” By 2000, the MMR vaccine had virtually eliminated measles in the United States.

The anti-vax movement is not swayed by that fact. It uses made-up “science” concocted by a British physician — since discredited — who fraudulently claimed that MMR, among other things, is a leading cause of autism. Ten of his colleagues who attached their names to his “study” subsequently disavowed its findings. The physician himself lost his license to practice. In Washington state, the anti-vaxers who rely on the study are found among many liberal communities. In Texas and parts of the Bible Belt, the anti-vaxers are found in conservative communities, spurred on especially by a number of evangelical Christian churches.

Charedi communities, however, do not often follow the goings-on in Christian communities. The anti-vax crowd, therefore, decided to appeal to them in terms that would catch their attention. Anti-MMR literature designed just for those communities began to appear. One charedi anti-vaxer, for example, was quoted by the New York Times as saying, “Vaccines contain monkey, rat and pig DNA, as well as cow-serum blood, all of which are forbidden for consumption according to kosher dietary law.”

The person making that statement, either ignoring halacha on the subject of a vaccine’s kosher status or deliberately misstating it, is a contributing editor to a charedi-targeted anti-vax publication. For the record, the medical use of substances forbidden for eating undergo many changes in their nature before becoming part of a vaccine, and so lose their original identity in the eyes of Jewish law. In any case, being injected with a substance is not considered ingesting that substance. For that reason, IV nutrition drips on Yom Kippur are permitted by many authorities for seriously ill patients, while caffeine addicts in Williamsburg and elsewhere have relied on caffeine-laden suppositories to get them through their fasts.

There also is this claim now circulating in the charedi communities: “Childhood diseases, like measles and chickenpox … are not a legitimate public health menace….” The 72 deaths in Europe in 2018, and the up to 500 deaths in the United States annually before MMR came along in 1963, testify to the absurdity of that claim.

To be clear, Orthodox authorities of all stripes are horrified at what is going on in the charedi communities. They are working overtime to dispel the anti-vax propaganda, especially on religious grounds. “[I]nfecting other people is totally unacceptable,” said Rabbi David Niederman, a Satmar chasid who is president and executive director of the United Jewish Organizations of Williamsburg and North Brooklyn.

There are many religious grounds to choose from. Above all others is Genesis  1:26-27, which says that humankind was created in God’s image, thus putting on us the obligation to protect that image. The midrash tells us of the sage Hillel the Elder. When he “finished with his students {for the day], he would walk with them. They asked him, ‘Our teacher, where are you going?’ ‘To fulfill a mitzvah,’ he said to them. ‘And what is this mitzvah?’ they asked. Said he to them, ‘To bathe in the bathhouse.’ ‘But is this really a mitzvah?’ they asked. ‘Yes,’ he said to them: ‘It is just like the icons [images] of kings that are found in theaters and circuses. The person responsible for [caring for] them must [constantly] wash them thoroughly…. How much more so must I [bathe], who was created in God’s image?’” (See Leviticus Rabbah 34:3.)

Rabbinic authorities from the Talmud on also have focused on a statement in Deuteronomy 4:15: “For your own sake, therefore, be most careful.” Based on that, Maimonides, the Rambam, ruled in his Mishneh Torah, the Laws of Personal Development (4:1), that “maintaining a healthy and sound body is among the ways of God.”

The rest of the verse has nothing to do with health, but that is irrelevant, the authorities say. “The implication of these verses,” wrote the 16th century halachist Rabbi Mordechai Jaffee (the Levush) “is that a person needs to guard himself, that he does not bring himself to any type of danger. Even though the simple reading of the text may not mean this, nevertheless our sages used these verses as a support to forbid a person anything that brings him to any danger.” (See his Levush Malchut, Yoreh Deah 116.)

The late 19th-century authority Rabbi Samson Raphael Hirsch was more expansive. “God’s word calls to us: ‘Do not commit suicide!’ ‘Do not injure yourself…!’ ‘Preserve yourself…!’ Therefore you should avoid everything which might possibly impair your health… And the law asks you to be even more circumspect in avoiding danger to life and limb than in the avoidance of other transgressions.

(See Chapters 62:427-428 in his voluminous commentary Horeb.)

There are other verses the authorities rely on, as well. Deuteronomy 7:15, for example, states, “The Lord will ward off from you all sickness.” A midrash quotes the sage Rabbi Acha as saying that it “depends on man himself that diseases should not come upon him.” He based that on the words “from you.” Said he, “What is the proof? [The verse] means it is from you [meaning it is dependent on you] that disease should not come upon you.” In the ensuing discussion, we are told that “Rabbi Sh’muel bar Nachman said in the name of Rabbi Natan: ‘Ninety-nine die of heat to one by the hand of heaven.’ The Sages said: ‘Ninety-nine die through [their own] neglect to one [who dies] by the hand of heaven.” (See Leviticus Rabbah 16:8.)

Beginning with the Torah, as well, it is clear that we have just as much responsibility to protect the health of others, which also means we cannot subject others to possible contagion. We saw this explicitly in the Torah portions we read over the last two weeks, Tazria and M’tzora. A person with a potentially infectious ailment must be separated from the community — not for that person’s sake, but for the community’s. (See Leviticus 13:2-4 and succeeding texts.) It follows that a person may not knowingly risk getting a potentially infectious disease which would then spread to others. It also follows that a person may not mislead others into avoiding being protected from those infectious diseases. For that, we also have Leviticus 19:14’s admonition not to put “a stumbling block before the blind.”

God Himself made clear that He gave permission to physicians to heal, based on Exodus 21:19, which states that if a person injures another “he must pay for his…cure.” (See the Babylonian Talmud tractate B’rachot 60a.) Standing in the way of physicians doing that is thus another violation of Jewish law.

Beginning tonight, we mark the Exodus from Egypt. As the Torah makes clear over and again, because “I, the Lord, am your God who brought you out of the land of Egypt,” the Exodus is meaningless without the ethical and moral laws that are based on it.

A chag kasher v’sameach to all.

About the Author
Shammai Engelmayer is rabbi of Temple Israel Community Center, in Cliffside Park, and Temple Beth El of North Bergen, both in New Jersey. A former president of the North Jersey Board of Rabbis, he chose to work as a journalist after being ordained. That career helped him hone the skills that serve him so well on the pulpit, and helped him become a popular adult Jewish education teacher in Northern New Jersey.
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