Hackney is battling a measles outbreak. Why aren’t Charedi families vaccinating their children?

The underlying cause is no mystery. Hackney has the lowest childhood MMR vaccination rate in the UK. Just 60.8 per cent of five-year-olds have had both doses – well below the national average of 84 per cent, and far from the 95 per cent needed for herd immunity.

Less obvious, however, are the stories that sit beneath these statistics.

There are familiar patterns to vaccine hesitancy. Deprivation plays a role. So does ethnicity. In Bristol, outreach has focused on the Somali community, which has lower-than-average uptake.

Hackney is more complex. It’s home to a mix of groups with longstanding scepticism toward official medicine: homeopathic home-schoolers close to Shoreditch; Caribbean and West African families around Dalston; and, in the north, the Charedi Jewish community – one of the most vaccine-hesitant in Europe.

The dynamics differ, but the result is the same: a borough of neighbourhoods exposed to a virus many thought had been extinguished.

In Hackney, just two GP surgeries offer walk-in vaccination clinics. Both are open only on Sundays – and both are in Stamford Hill.

Home to the largest Charedi Jewish population in Europe, the area has seen viral surges before. It was hit hard by Covid 19, and in 2018, after a child died during a measles outbreak in Israel, more than 300 children in the community caught the virus. In recent years, the World Health Organisation has held talks with local rabbis about “persistent outbreaks of vaccine-preventable diseases”.

At the Spring Hill Practice near Stoke Newington station, I had hoped to speak to parents bringing their children to be vaccinated. But the clinic is quiet. “We did have some people come in earlier,” the receptionist offers, almost apologetically. “It’s been quiet lately.”

Which is surprising. Dr Tehseen Khan, a clinical director coordinating the local immunisation response, has confirmed that the current outbreak is concentrated in Stamford Hill. So why, on the only day the clinic is open, is no one here?

I try the other walk-in centre up the road, Stamford Hill Group Practice. It too is empty. “It’s been really quiet lately,” says the receptionist. “A few months ago, we had loads of people coming in.”

After a short wait, a woman arrives pushing a buggy, flanked by two children on scooters. She hands over three red vaccination books. “Nobody I know has measles,” she says. “But one of my sister’s friend’s babies got it. Nobody knows where from.” With school out for summer, she explains, many families are away or busy with weekend plans.

Another woman arrives soon after, wearing a pink and green patterned headscarf and cradling a baby with strawberry blonde hair. “People are busy,” she says. “People around here have busy lives – they have a lot of children.” The average Charedi household size is six, and the birth rate is such that the community doubles in size every 15 years.

“The only day you can come in is on a Sunday,” she adds. “Otherwise, you have to spend over an hour on the phone just to get through to the doctors.”

Access certainly may be part of the problem – the wait to book an appointment, or to be seen – can take hours. But is it the only reason?

Herschel Gluck, an avuncular rabbi in his late sixties, sits in his Stamford Hill home, his white beard flowing, his eyes sharp and bright. A few weeks earlier, he tells me, he’d dropped in on a family who were involved in some charity work. He expected a routine chat about supporting poor Charedis in the area. But something was wrong. Their young son had been hospitalised with measles.

The parents weren’t sceptics, at least not exactly. They simply hadn’t seen vaccination as urgent. But after several days of high fever, their son had weakened. By the time Gluck arrived, the parents had left for the hospital. The rest of the family had gathered around the kitchen table in despair. The child survived, but only just.

“People don’t understand how serious measles is,” says Gluck. One person with measles can infect up to nine out of ten people around them if they’re not protected.

When I mention similar stories to doctors in the borough, many stress the need for patience and sensitivity when speaking to hesitant parents, especially when religion plays a role. Gluck, who received an OBE in 2013 for services to interfaith relations, recommends a more direct approach.

“The council and the NHS can tend to think that the Charedi community are a load of backwards people who aren’t vaccinating because they don’t understand the importance,” he says. “The reality is that you’re dealing with a sophisticated community, a community which reads up on these matters and which needs to be convinced before they allow material to be injected into their children’s bodies.”

This, he says, goes some way to explaining why Stamford Hill’s Charedi community was initially reluctant to take up the Covid vaccine. In recent years, he notes, many in the Charedi community have followed the rise of US Secretary of Health Robert F Kennedy Jr, an avowed vaccine sceptic who invoked the Holocaust when criticising Covid vaccine mandates in 2022.

“The things he says are presented in the manner that seems credible to many people,” Gluck says, shaking his head. “It’s okay to have alternative medicine, but one mustn't forget about the basics – about protecting one’s children with proven medicine.”

How, then, to communicate this to people?

Gluck is keen on the idea of medical pamphlets on the importance of vaccination posted through people’s doors. “I’m not saying everyone should be given a thick book with all the medical background", he says, “but people should be educated. They should know what vaccines are, why they’re important. They have a right to understand.”

Such old-school methods can reach people with limited internet access. Social media has had a profound impact on disinformation about vaccines, says Gluck, but in terms of effective counter-messaging, “I’ve always said one needs both. One needs a dual approach.”

But when I ask one of the mothers in the vaccination centre in Stamford Hill whether she’d received any leaflets, she laughs. “What information?”, she says, throwing her hands back. “We haven’t received any of that!”

The Interlink Foundation, which promotes Orthodox charities and causes, does provide physical publications in the Stamford Hill area, in Hebrew and English. But government funding for targeted communications is tight, and none focus on measles specifically. When physical disinformation still circulates – a 44-page anti-vaccination booklet was distributed during Covid – and doubts about vaccines linger on, it can be challenging for any generalised messages to cut through.

In Stamford Hill, life seems to be carrying on as normal. Children tear happily along the wide, puddle-lined pavements, their mothers in waxy black raincoats hurrying to keep up.

“I’m not worried,” one Charedi woman tells me when I ask about the recent surge in cases. “They’re vaccinated.”

I look around at the hundreds of kids buzzing around us and wonder how many have not been inoculated. Half? A quarter?

But before I can ask her thoughts, her three young children dart off, each in a different direction. “I’m sorry!” she calls out, turning in pursuit. “I’m just so busy today!”

A version of this piece originally appeared in Dispatch.