The measles outbreak in Israel in 2018-19: lessons for COVID-19 pandemic

Abstract

During 2018-2019 Israel saw some 4300 measles cases in a country-wide epidemic. Increased measles incidence rates and considerable disease burden have been observed in under-vaccinated communities, predominantly Jewish ultraorthodox. The measles epidemic, despite proper public health handling, revealed susceptible population subgroups as well as gaps and lacking resources in the Israeli public health systems. In the COVID-19 pandemic in Israel, as of December 2020, the number of COVID-19 cases reported nationally was over 300,000 with approximately 3000 fatalities. Notably, minority groups such as the ultraorthodox Jewish community and the Arab community in Israel has been profoundly affected by the COVID-19 pandemic. We believe it is still possible to implement the key lessons from the measles outbreak in Israel that could aid in the COVID-19 response in Israel and elsewhere. These conceptions should include a social-based approach, investment in public health human resources and infrastructure, tackling root causes of inequalities, emphasis on trust and solidarity, proactive communication, need for political will, and proper use of epidemiological data as a basis for decision-making. In parallel to proper use of COVID-19 vaccines, when available, a 'social vaccine' is crucial as well as preparedness and response according to public health principles.

Trust in COVID-19 policy among public health professionals in Israel during the first wave of the pandemic: a cross-sectional study

“…The literature emphasizes the critical role of trust in government policy and transparency in decision making in order to obtain an effective crisis response [ 39 , 40 ] The decision-making process and the internal discourse in the committees should be transparent [ 41 , 42 ], and based on scientific and epidemiological data [ 43 ]. Transparency during the decision-making process allows professionals and other stakeholders who may not be involved in the decision-making process to access the evidence being used to inform management, policy, and decisions [ 44 ].…”

“…With the research showing a very high level of trust in the Association of Public Health Physicians and in hospitals, increased involvement of these leaders (assisting with decision making and vaccine recommendations) could have been used as leverage to increase the level of trust among professionals towards the policy [ 23 ]. Moreover, particularly in countries with a diverse population such as Israel, it is extremely important that the health policy information system includes relevant representatives who are highly trusted by the populations they represent, in order to increase the level of trust in policy [ 43 ]. Indeed, corrective action was taken during management of the crisis to include public health professionals at a higher level of management, following the establishment of Magen Israel, which included leaders of the Israeli Association of Public Health Physicians and managers of leading hospitals [ 39 ].…”

Is stronger religious faith associated with a greater willingness to take the COVID-19 vaccine? Evidence from Israel and Japan

“…For example, ultra-Orthodox Jews in Israel and several other countries including Belgium, the US, and Canada have experienced outbreaks of mumps and measles because they have not vaccinated their children [9,24,34,35]. Moreover, ultra-Orthodox Jews in London, New York and Jerusalem have experienced disproportionately higher rates of coronavirus [14,20,33,40,41].…”

Should COVID-19 vaccination be made mandatory?

“…Authors have emphasized the need for a social-based approach and the use of epidemiological data as a basis for decision-making about assigning vaccination policies. [ 3 ]…”