A new study in the New England Journal of Medicine
has found that ultra-Orthodox
boys who sit in hevrutot
– face-to-face groups studying the Talmud in close
quarters – were more likely to contract the mumps – even though they had
received the requisite vaccinations – than counterparts who study in an ordinary
classroom with all students facing the front.
Higher rates of infectious
diseases have also been reported among Israeli haredim, mostly boys but also
members of their family of both sexes and all ages – partly because they have
considerably lower vaccination rates than their American counterparts but also
due to the crowding and close proximity in which they live and
Among the complications of mumps, which has almost been wiped out
in the US because of vaccination, is orchitis [inflammation of one or both of
the testicles], while meningitis, pancreatitis, deafness, mastitis and facial
Bell‚s palsy were much less frequent. According to the NEJM article.
method of learning, practiced at all levels of Talmud study in yeshivot,
involved lively conversation and arguments over the Talmud, and partners are
often switched, thus helping to spread infections.
In the mumps outbreak,
according to Dr. Albert Barskey of the US Centers for Disease Control and
Prevention and colleagues, over 3,500 cases were reported in haredi teens aged
13 to 17 in New Jersey, New York City and Rockland and Orange countries in New
York. The mumps apparently came from an 11-year-old boy in a haredi boys summer
camp in New York’s Catskill Mountains. The boy had been vaccinated as
Over 400 of the cases resulted in orchitis.
people are in close proximity over a long period, as in yeshivot, viruses like
the mumps are more likely to overwhelm them even if they had received the
requisite doses of vaccine, the NEJM study said.
Some cases have spread
to girls, who do not learn in hevrutot
, but are exposed in crowded homes and at
religious family gatherings. A few years ago, a major measles outbreak in Israel
developed when an infected hassid came with his family to Israel to attend a
huge wedding and post-nuptial celebration [Sheva Brachot] during the week after
Asked to comment, chief of the Health Ministry’s epidemiology
Paul Slater, himself a haredi, told The Jerusalem Post
that the ministry has not changed its policy on vaccinations of haredim as a
result of the outbreaks. “We do not give a third vaccination against the mumps.
We have an outbreak once in a long while. We are busy catching up and
vaccinating those who have not received the two vaccinations,” he said. “It is a
huge investment in manpower.”
Yeshiva students should go to their family
health centers [tipat halav] for vaccinations, but when there is a major
outbreak, public health nurses come to yeshivot. The problem is that most of the
students will refuse because most public health nurses are women, whom they
don’t want to touch them, Slater added.
The average vaccination rate
among haredi children is only 70 percent, compared to more than 95% among Arabs
and a bit lower among the general Jewish population.
“We haven’t changed
our policy on haredi vaccination; nobody in the world has either. The mumps
outbreak died out on its own,” said Slater. “I have been in this field for 25
years, and I have developed a sense of modesty about possible
We don’t know what infectious disease will be coming next. It
is very hard to anticipate. I don’t wish the mumps on anybody, but we can’t
vaccinate everybody every year. Yet we are trying our best to increase
vaccination coverage to the level recommended by the Health Ministry. One can
measure antibody levels and find they are OK, but due to the close proximity,
they can still get sick.”
Asked whether changing the tradition of hevruta
in small spaces would reduce the infection level, Slater said that nothing would
induce the yeshivot to change their study habits.”
But when asked whether
better ventilation would “dilute” the viruses in the air, Slater said, “Yes,
keeping the windows open and better ventilation would improve things, but this
is something we can’t control.”
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