A public health emergency has been declared in New York City as it grapples with one of the largest measles outbreaks in decades, which is centered in the ultra-Orthodox Jewish community in Brooklyn.
Unvaccinated people living in certain ZIP codes in Williamsburg, Brooklyn, will have to get the measles vaccine, and those who do not comply will be issued violations and possibly fines, Mayor Bill de Blasio said, The New York Times reported.
"This is the epicenter of a measles outbreak that is very, very troubling and must be dealt with immediately," he said at a news conference in Williamsburg.
"The measles vaccine works. It is safe, it is effective, it is time-tested," de Blasio added.
The nation's largest metropolis is just one of many cities grappling with the return of measles, often fostered by "anti-vaxxer" sentiment that causes parents to forgo the measles-mumps-rubella (MMR) vaccine.
Across the United States, there have been 465 measles cases since the start of 2019, the US Centers for Disease Control and Prevention reported on Monday. The number of measles cases this year "is the second greatest number of cases reported in the US since measles was declared eliminated in 2000", according to the CDC.
Last year's total was 372 cases. The largest outbreak occurred in 2014, with 667 cases, CNN reported.
There have already been 285 confirmed measles cases in New York City since the outbreak began last fall, city health officials said. Most have been in Hasidic Jewish communities in Williamsburg and Borough Park, Brooklyn.
Last December, New York City ordered students who were not vaccinated against measles to be prohibited from attending classes in ultra-Orthodox schools in selected ZIP codes, but city officials have admitted the order was not effective.
On Tuesday, de Blasio said the city would fine or even temporarily shut down yeshivas that did not abide by the order, The Times reported.
Nearby Rockland County, New York, is also struggling with a measles outbreak. As of late last week, there had been at least 166 confirmed cases there.
On March 26, county officials issued a 30-day emergency order banning unvaccinated children under 18 from being in public places such as shopping centers, businesses, restaurants, schools, and places of worship.
However, that ban was overturned by a judge last Friday.
Dr Robert Glatter is an emergency medicine physician working at New York City's Lenox Hill Hospital.
He stressed that measles can be very serious, even deadly in rare cases. And when parents choose not to vaccinate their kids against this highly contagious disease, it can make all kids more vulnerable, due to an overall decline in what's known as "herd immunity."
"Achieving herd immunity is the most effective way to reduce the risk to the population at large when some people in the population choose not to vaccinate," Glatter said. "This includes the elevated risk to young infants as well as those who are immunosuppressed. Evidence suggests that herd immunity against measles is only achieved when 90-95% of the whole population is immune."
Glatter also believes that deliberate misinformation about the "dangers" of vaccines, often spread via social media, is fueling the anti-vaxxer movement. Because of this, "the president of the American Academy of Pediatrics [AAP] recently sent letters to the CEOs of Google, Facebook to highlight the increasing threat that online misinformation about vaccination poses to children's health," Glatter noted.
In the meantime, outbreaks like those in New York City continue to spread.
"Measles is a highly contagious disease," Glatter said. "People who are immunocompromised, as well as young children and non-immune pregnant women are at highest risk for severe complications.
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