New York City declared a public health emergency and ordered mandatory measles vaccinations amid an outbreak in Brooklyn, which has become the latest national flash point over refusals to inoculate against dangerous diseases.
Outbreaks nationwide have forced state and city health officials to pursue tougher stances, such as mandatory vaccines or banning unvaccinated children from public places, prompting legal challenges and judicial intervention.
New York's mandate comes as health officials have scrambled to blunt the spread of measles. At least 285 people have contracted the disease in the city since September, mostly in Brooklyn's Williamsburg neighbourhood.
"This is the epicentre of a measles outbreak that is very, very troubling and must be dealt with immediately," Mayor Bill de Blasio (D) said. "The measles vaccine works. It is safe, it is effective, it is time-tested. … The faster everyone heeds the order, the faster we can lift it."
The mandate orders all unvaccinated people in four Zip codes, including a concentration of Orthodox Jews, to receive inoculations, including for children as young as 6 months old. Anyone who resists could be fined up to US$1000.
"We cannot allow this dangerous disease to make a comeback here in New York City," de Blasio added. "We have to stop it now."
Some Orthodox Jews have resisted vaccines. City health officials said yesterday that yeshivas in Williamsburg that do not comply will face fines and possible closure.
Government pushes for inoculations and public space bans of unvaccinated children have prompted a backlash among anti-vaccination activists, whose misinformation campaigns have led to declines for vaccinations against one of the world's most contagious diseases.
In New York City late last year, the health department ordered yeshivas and childcare centres in the Orthodox Jewish community to keep out unvaccinated students. One school that violated the mandate has been linked to more than 40 cases, the health department said.
"We're making clear that unvaccinated students will not be allowed in schools or day cares," de Blasio said.
Insured adults and children will be covered. Those who are uninsured will pay what they can afford, de Blasio said, and those who cannot afford the vaccination will receive it free.
The outbreak in the area has been tied to a child who had not received the measles, mumps and rubella (MMR) vaccine and contracted the disease during a trip to Israel.
"Since then, there have been additional people from Brooklyn and Queens who were unvaccinated and acquired measles while in Israel," according to the city's health department.
New York has contended with measles outbreaks and the legal challenges that have arisen in efforts to contain them.
An outbreak in Rockland County outside New York City led officials to ban unvaccinated children from public places in mid-March. A state judge overturned that decision 10 days later.