The Disease We Forgot

Measles, Memory, and the Jewish Obligation to Protect Life

Last Shabbat after services, increasingly concerned by reports of measles outbreaks around the country, I asked a retired pediatrician in my congregation how we had arrived here. His answer was immediate. “This didn’t begin now,” he told me. “This has been building for decades.” He had practiced medicine long enough to remember a world in which childhood diseases were not abstractions. Parents feared them because they had seen what they could do. Physicians did not need to persuade families that measles, polio, or whooping cough were worth preventing. The evidence was sometimes living next door.

Then medicine became extraordinarily successful. Before the measles vaccine became widely available, millions of Americans contracted the disease each year. Tens of thousands were hospitalized. Hundreds died. Others suffered pneumonia, encephalitis, and permanent complications. Vaccination changed that landscape so dramatically that in 2000 measles was declared eliminated in the United States. And therein lies one of the great paradoxes of prevention: Success erased its own evidence.

A generation of parents grew up never seeing a child seriously ill with measles. Another generation followed. The vaccine remained visible, with its needle, its possible side effects, and the controversies surrounding vaccination. The disease it prevented largely disappeared from view. Eventually, some began asking why the vaccine was necessary at all.

This week, as I thought about that conversation, I found myself returning to one of the Torah’s most troubling commandments: Zachor et asher asah lecha Amalek. “Remember what Amalek did to you.” The Torah recalls that Amalek attacked the Israelites when they were exhausted and vulnerable, striking those who lagged behind. And then comes an unusual double command: Zachor. Remember. Lo tishkach. Do not forget. Why both?

Because not forgetting and remembering are not quite the same thing. We can retain information without allowing it to affect how we live. Jewish memory demands more. Zachor turns the past into responsibility. We remember slavery in Egypt not simply to preserve an ancient historical fact, but so that the stranger will matter to us. We remember Amalek not merely to recall an enemy, but to remember what happens when the vulnerable are left unprotected. And we may need to remember measles for much the same reason.

The people most dependent upon widespread vaccination are not always the people making the decision. They include infants too young to be fully immunized, people undergoing cancer treatment, those with compromised immune systems, and others for whom vaccination may not provide adequate protection. Their safety depends, in part, upon the choices made by people around them. That makes vaccination more than a question of individual preference. It becomes a question of responsibility.

Jewish law has very strong language for that responsibility. The principle of pikuach nefesh, the preservation of human life, overrides virtually every other commandment. The Talmud derives this from the Torah’s words v’chai bahem, “you shall live by them.” The commandments were given so that human beings may live through them, not die because of them.

There is also another biblical command that speaks powerfully here: Lo ta’amod al dam re’echa. “Do not stand idly by the blood of your neighbor.” Jewish responsibility does not end with the question, “Am I safe?” It asks, “What responsibility do my choices create for the safety of someone else?”

This question has been addressed directly in modern Jewish law. Rabbi David Golinkin, with whom I had the privilege of studying and who has visited our congregation on several occasions, wrote a responsum specifically addressing vaccination against dangerous diseases including measles, rubella, polio, and COVID-19. His conclusion was unequivocal: except when there is a genuine medical contraindication, Jews have an obligation to vaccinate themselves and their children, and Jewish institutions may require vaccination when necessary to protect the community.

But I do not believe our response to the present measles resurgence should begin with condemnation. Calling frightened or skeptical parents ignorant may satisfy those of us who are convinced by the science, but it will not rebuild trust. There are legitimate reasons why confidence in institutions has deteriorated. Public-health authorities have sometimes communicated poorly. The experience of the pandemic intensified suspicion and hardened divisions. Misinformation has filled the resulting vacuum. The answer cannot simply be, “Trust us.” Trust must be earned.

But neither should distrust cause us to forget what earlier generations knew firsthand. Measles did not become dangerous again because medicine forgot how to prevent it. It became dangerous again because we began forgetting what prevention had saved us from. And this is where remembering must become action.

Parents who have delayed or declined vaccination should revisit that decision with a trusted pediatrician. Adults who are uncertain about their own immunity should speak with their physicians. Those entrusted with the care of children, schools, congregations, camps, and other communities should recognize that protecting the vulnerable is not somebody else’s responsibility.

The goal is not blind obedience to authority. Questions deserve answers. Concerns deserve to be heard. Medical decisions should be made with competent medical guidance. Once we know that a safe and effective means exists to prevent a dangerous disease, and once we understand that our own decisions can leave another human being exposed, Jewish tradition does not permit us the luxury of indifference.

Previous generations did the difficult work of bringing measles under control. They left us an inheritance of protection created through science, vaccination, and communal responsibility. We should not require another generation of children to become seriously ill before we rediscover why that inheritance mattered.

That may be the distinctly Jewish lesson of this moment. Memory is not nostalgia. Memory is responsibility. We remember suffering so that it does not have to be rediscovered by those who come after us. We remember vulnerability so that those at the edges are not abandoned. And we preserve life not only because our own lives are precious, but because the life of the person beside us is precious as well.

Zachor. Remember. And then act upon what we remember. Not so that we remain frightened by the diseases of the past. So that our children do not have to meet them again.