Measles? These days, why not?

Updated with new West Texas statistics, 3/1/2025

The recent outbreak in West Texas has sickened 146, mostly children and adolescents, hospitalized 20, and killed an unvaccinated school-age child, as of this writing. Lately, I’ve been looking at the recent outbreak through a wide lens.  The truth is, if our medical and public health institutions are going to be dismantled, along with the ethos of communal responsibility and social justice that sustained them, the result can only be an increase in suffering and death. Have we forgotten that these institutions have provided us here in the modern West with the longest life expectancies and best qualities of life known to human history? As a result, there is an urgent imperative to apply our Jewish values to the spheres of medicine and public health. This current outbreak is not yet on par with those of the past in the United States, but its cause is emblematic of the current state of our society, in which the needs of the many are disregarded in favor of the needs of the few, or the one.

Jewish ethics stand in contrast to the latest societal trends in America, especially where they relate to medicine and public health. It seems that we have confused the concept of personal liberty, based in a sense of shared societal good and destiny, with a self-preoccupation that glorifies individual perspective and need, no matter how irrational or harmful to others. Jeff Levin, PhD, MPH, a professor of epidemiology and religious studies at Baylor University, publishing in the Journal of Religion and Health in 2012, laid out a listing of ten ethical concepts derived from Jewish tradition pertaining to medicine and public health that serve to remind us of our personal responsibility during these times. These Jewish ethical values serve to combat the influences of a degraded, toxic political culture, and hopefully fill the gap with a positive paradigm promoting reconciliation, cooperation, and the renewal of a shared sense of community and societal obligation.

1. B’rit (covenant): The social obligations that define and govern responsible human conduct, what Rabbi Jonathan Sacks called “covenantal morality… an affirmation of mutual obligations.”
2. K’dushah (holiness): Respecting the needs of others honors their innate holiness.
3. Tzedek (justice): We are obligated to ensure that people who are not as advantaged as us do not suffer because of a lack of something essential to their wellbeing, exemplified in Torah as “Justice, justice shall you pursue, that you may live” (Deuteronomy 16:20).
4. Chesed (mercy): We must be merciful to the less fortunate, as we have been in their shoes, and we must also act compassionately toward others if we are to work together effectively to address the needs of the disadvantaged and oppressed.
5. Mip’nei darkhei shalom (for the sake of peace): For the sake of peace, we are to forego focusing solely on ourselves, on our immediate welfare or reputation, on “being right,” and instead attend to “doing right.”
6. Pikuach nefesh (to save a life): When a life is on the line, little else matters, certainly not one’s political ideology, financial well-being, or ritual piety.
7. K’lal (peoplehood): As Jews we see ourselves as a community, as a people, not as a conglomeration of separate, disconnected individuals. We have special obligations to fulfill, and a central task for us is to labor together to repair the world, to fix the broken, and to heal the sick.
8. Tikkun olam (repair of the world): A clarion call to the greater purpose of life, the repair and perfecting of the world through healing and restoration, which can only be fulfilled in a communal context. The ongoing presence of the poor or needy among us is a sign of the world’s brokenness and of our failure to take seriously the charge to “learn to do good, devote yourselves to justice” (Isaiah 1:17).
9. T’shuvah (repentance): The recognition of the pressing need to return to our highest values regarding medicine and public health.
10. Jovel (jubilee): The idea of restoration to an older perfect order, the concept that if essential healthcare needs are not being met, a bold voluntary redistributive justice is asked of us to accomplish this.

Let’s examine the ongoing measles outbreak in Texas from the perspective of this list. Often mistaken as a historically common and harmless childhood disease, in the pre-vaccine era measles virus caused upwards of 48,000 hospitalizations and 400-500 deaths per year in the United States. Even today in the era of the safe and effective MMR vaccine, especially in the worldwide context of malnutrition and HIV disease, measles accounted for 107,500 global deaths in 2023, mostly in unvaccinated or under-vaccinated children under the age of 5. One of the most contagious viruses known, measles virus can linger in the air of a room for up to 2 hours, infecting 9 of 10 nearby people exposed. The virus can also induce an “immune system amnesia,” rendering a person again vulnerable for years to infections that they had previously survived. measles is especially deadly to those with immunocompromised status such as cancer chemotherapy patients and those with advanced HIV disease, killing up to 70% of infected cancer patients in one study from 1992.

Knowing this, Jewish ethics (and common humanity) would dictate a response in which the individuals of a community band together to protect the most vulnerable. Who would argue that young children and cancer patients are not worthy of some extra bit of societal consideration? Despite this, 125,000 kindergartners in the United States, a record number, had an exemption for at least one required vaccination, and nearly 20% in Gaines County, Texas, the epicenter of the ongoing measles outbreak, had not received the MMR vaccine prior to the 2023-24 school year. And, amid all of this, our Senate confirmed a known peddler of vaccine and public health disinformation as our Secretary of Health and Human Services, in charge of the very agencies tasked to promote vaccine acceptance and its accompanying sense of communal obligation and healing.

As we saw with COVID-19, the laws of science and nature prevail, despite any amount of wishful thinking or political magic tricks. Once you go below a certain threshold of vaccination in the community, measles will reappear. It’s that simple. It just doesn’t seem that anyone, on either side of the political spectrum, is expressing any amount of sufficient outrage. Need every generation experience the scourge of infectious disease to realize the value of the treatments and preventions that countless scientists and physicians have labored on for over the past century? Or much like our Jewish tradition teaches, should we trust in the basic wisdom and approach of our forebears, questioning when needed, but standing on the shoulders of giants rather than trying to reinvent the wheel ourselves?

When vaccine refusal is applied to even more serious infectious disease such as polio, what prevents the actual horror show from going forward, allowing antivaxxers to continue to refuse immunizations, is the belief in science and sense of communal responsibility that the still majority of American feel in terms of public health. Those who continue to vaccinate themselves and their children create the modern world in which one can have the privilege of indulging their antisocial and irrational beliefs against vaccine science. Imagine if rampant polio once again paralyzed tens of thousands of American children; I wonder how quickly many vaccine-refusers would clammer for their life saving shot?

This is not an argument for blind adherence to the dictates of a faceless bureaucratic monolith, or against a meaningful reform of the federal government.

It is an appeal to all, that in making personal, well-reasoned decisions for us and our families, we also consider our neighbors and communities.

In a democracy, self-reliance, personal responsibility, and autonomy are key values that we should all seek to practice to a reasonable degree. But the argument that to exercise autonomy, a person must solely focus on the needs of the self, or a select group of like-minded friends and family, is morally indefensible, and actually self-defeating.

In the end, the health of the greater community and society often dictates the health of the individual, and a society rife with conflict and disease will invariably bring harm to most, if not all of its members. Our Jewish tradition recognized this long ago and can help us bring about a healthy and just society once again.

In the case of the current outbreak in Texas, given the essential safety of the measles vaccine, those refusing it are entirely unjustified from the standpoint of either modern bioethics or ancient Jewish values.

But here we are, in an era when the endangerment of one’s neighbor is often met with nothing more than a shrug.

The result of all of this, the conclusion that we can draw, is that we can and must do better.

Long after this particular strain of American history has burned across the sky, our descendants will be left with the consequences of this era’s choices.

Our generational chain, l’dor v’dor, must be left strengthened by a renewed commitment to the Jewish ethical values that can help to heal our country, and even our world.

Adam Skrzynski

Adam King Skrzynski, a Detroit native, is an infectious disease physician specializing in HIV medicine, a husband, and father of three daughters living in South Jersey outside of Philadelphia. He is a member of Congregation Kol Ami in Cherry Hill, NJ, where he serves on the Board of Trustees, a member of the Board of Directors of the Society for Humanistic Judaism, and a Madrikh candidate with the International Institute for Secular Humanistic Judaism. He is fascinated by the intersection of Judaism and medicine, and the potential for ancient Jewish principles of healing to be applied to modern medical practice. Adam can be reached at adam.king.skrzynski@gmail.com