Orthodox, Amish among NY's lowest COVID vaccination rates. But 'there's more to the story'

David Robinson Nancy Cutler
New York State Team

New York state’s COVID-19 vaccination push is severely lagging in communities with large Orthodox Jewish and Amish populations, but the reasons fewer shots are reaching their arms extend far beyond religious beliefs.

From rural upstate New Yorkers' mistrust of government to large pockets of children under 12 being ineligible for COVID-19 vaccines, challenges abound in the dire effort to boost vaccination rates in parts of the Finger Lakes and Hudson Valley.

In fact, the lowest vaccination rates in New York ZIP codes include two Orthodox Jewish communities in Rockland and Orange counties, as well as a small Seneca County town that is home to dozens of Amish and Mennonite families.

The three communities — Monsey in Rockland County, Romulus in Seneca and Monroe in Orange — had partially vaccinated only about 17%, 22% and 28% of residents, respectively. In contrast, about 56% of New Yorkers overall received at least one COVID-19 vaccine dose.

Refuah Health Center in Spring Valley is offering walk-in COVID-19 vaccine shots in this tent set up in their parking lot April 20, 2021.

The low local vaccination rates, which need to be raised to limit the risk of future COVID-19 outbreaks, stood in stark contrast to celebrations last week after New York state overall reached the milestone of partially vaccinating 70% of adults.

Meanwhile, Gov. Andrew Cuomo recently warned local officials to brace for more vaccine-related accountability, pledging to display lists of ZIP codes with the lowest vaccination rates during his regular public broadcasts.

The Democratic governor also recalled using the same tactic to denounce hospital leaders for failing to vaccinate enough workers earlier this year.

“You want to increase the vaccination rate, go to the lowest performing areas in the state and get them up,” Cuomo said last week, urging local officials to deploy more vaccine resources to the locales.

Indeed, out of the roughly 1,700 ZIP codes statewide, the bottom 10% have partially vaccinated less than 38% of total population, leaving plenty of New Yorkers vulnerable to COVID-19 infections.

Local officials, residents push back against Cuomo

Romulus is said to have one of the lowest COVID vaccination rate on June 21, 2021.  Romulus Deputy Town Supervisor Michael Joslyn said one of the reasons may be that the zip code also includes the town of Varick and the population also includes people who are incarcerated who did not want the vaccine as well as the Amish community.  Joslyn himself has been vaccinated, he said "I wouldn't want to be the cause of someone else getting sick."

Local officials and residents in Seneca, Orange and Rockland counties, however, asserted the governor was using misleading data to steamroll what should be a more nuanced public health discussion.

“If you want someone to comply with something, you don’t want to shame them into it because that really causes them to dig in their heels,” said Romulus Deputy Town Supervisor Michael Joslyn, a Republican.

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Some Orthodox Jewish leaders suggested the vaccination percentages unfairly singled out religious communities with higher numbers of young children unable to get shots, which are approved for ages 12 and older.

Many Amish and Mennonite communities have also historically rejected vaccines in general, Romulus area officials said, adding they’ve already had numerous COVID-19 vaccine educational meetings with members of the religious sects that shun many aspects of modern society.

Further, Romulus-area officials suggested Cuomo’s comments could potentially deter people in the Republican-leaning town from getting vaccinated.  

“There’s already a lot of people here who think they don’t need the vaccine,” Joslyn said, noting a mix of governmental and scientific mistrust fuels much of the reluctance.

“Quite honestly, Governor Cuomo is not well thought of in this area,” he added.

Hudson Valley leaders also argued vaccine outreach has already been underway for months targeting skepticism about the shots – and vaccination hesitancy in general – in pockets of the Orthodox and Hasidic Jewish community.

"We’re actively going out and reassuring patients that the vaccine is safe and effective, and you should really go out and get it," said Alexandra Khorover, chief strategic officer at Refuah Health Centers based in New Square, Rockland County.

An upstate NY town’s COVID vaccine struggle

An Amish buggy heads to a home with an extra horse running. beside it on Yerkes Road in Romulus on June 21, 2021.  Romulus is said to have one of the lowest COVID vaccination rates.  Romulus Deputy Town Supervisor Michael Joslyn said one of the reasons may be that the zip code also includes the town of Varick and the population also includes people who are incarcerated who did not want the vaccine as well as the Amish community.  Joslyn himself has been vaccinated, he said "I wouldn't want to be the cause of someone else getting sick."

One of the people declining the vaccine is Lisa Heitmann, a 59-year-old office assistant and Romulus-area native, whose reluctance stems from her distrust of the federal government’s ability to properly approve the shots.

She attributed it in part to the history of the Seneca Army Depot, a controversial U.S. Army munitions storage site in Romulus that attracted antinuke and antiwar protests before closing about 20 years ago.

“That certainly plants the seed of distrust of government,” Hietmann said, adding she also has concerns about the depot’s potential impacts on local cancer rates.

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As for the science, Heitmann said she received polio and measles vaccines but is leery of the fact COVID-19 vaccines took months to reach the public, as opposed to the years of research and trials involved in prior vaccines.

“There’d have to be a lot more years of studies,” she said, explaining what could convince her to take a COVID-19 vaccine.

Romulus schools Superintendent Marty Rotz expanded on the local pushback against Cuomo’s comments on the community’s vaccination efforts.

“It’s implying that since all these incentives are out there, that people from this ZIP code must somehow be unsupportive of the efforts to end the pandemic, and that’s certainly not true,” Rotz said.

School officials in Romulus, for example, have regularly contacted parents to provide vaccine safety information and encourage them to get themselves and their children vaccinated, she said.

Some of the struggles to sway parents, however, evoked memories of prior challenges to convincing Amish and Mennonite families to get vaccinated against measles.

“There’s always going to be resistance from certain groups to not get vaccinated, unless it’s required,” Rotz said.

A state law in 2019 that repealed the religious exemption to school vaccinations in New York, for example, marked a turning point in starting to slowly boost measles vaccination rates among the Amish and Mennonites in the Romulus area, she said.

The shift included a judge rejecting an Amish family’s high-profile lawsuit seeking to restore the religious exemption for school vaccination. The case attracted anti-vaccine protests to Seneca County and involved unvaccinated children attending Cranberry Marsh School, a private Amish-run school in Romulus.

A Mennonite church official in Romulus declined to comment on the COVID-19 vaccination and a phone number listed for the Cranberry Marsh School was not answered last week.

What local officials are doing about COVID vaccines

Romulus is said to have one of the lowest COVID vaccination rates on June 21, 2021.  Romulus Deputy Town Supervisor Michael Joslyn said one of the reasons may be that the zip code also includes the town of Varick and the population also includes people who are incarcerated who did not want the vaccine as well as the Amish community.  Joslyn himself has been vaccinated, he said "I wouldn't want to be the cause of someone else getting sick."

Seneca County’s Health Director Vickie Swinehart also bristled at the governor’s portrayal of local officials’ vaccination efforts.

She noted county officials, including herself, have reached out to Amish community leaders and families about COVID vaccines.

“There is a distrust in the vaccine in some of the population and some of them just feel God will take care of it,” she said, adding there “is a fine line between being pushy and being informative.”

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“We’re respecting their belief and their needs just like any other member of the community that does not want to get the vaccine,” she said, noting vaccine outreach will continue to focus on the Amish and other people yet to get vaccinated.  

County and local officials also described a variety of targeted vaccination efforts, including vaccine clinics at area schools, hotels and the Del Lago Resort and Casino in Tyre, which included incentives such as $20 in free gambling credit.

Plans are also in the works for vaccine clinics at local employers, farmers’ markets and the Sampson State Park in Romulus, Swinehart said, conceding some of the locals may still refuse the shots.

“There is just a percentage of the population that is just not going to get it, regardless of what we tell them … and we’ve kind of hit that brick wall in some places,” she said.

Still, Swinehart welcomed the state government’s recent commitment to focusing efforts on the communities missed by the vaccination push thus far.

“There’s more to the story than just a low (vaccination) number, and if people don’t know why the numbers are so low they won’t be able to address them,” Swinehart said.

The governor’s comments last week came after state health officials last month began releasing ZIP code-level vaccination data, in response to requests by USA TODAY Network and county officials.

For example, many Romulus officials and residents last week questioned if the state-run Five Points Correctional Facility skewed the local vaccination rate.

Informed by USA TODAY Network that about 41% of the 983 inmates at the facility have received the COVID-19 vaccines, Swinehart said the information allowed local officials to better understand the depth of vaccine reluctance outside the prison walls.

Why COVID vaccinations lag among Orthodox Jewish

Shoshana Bernstein has "Proud to Vaccinate" magnet on her car to illustrate that not all Orthodox Jews are against vaccinations in Monsey April 12, 2019.

In the close-knit and insulated Hasidic and Orthodox Jewish communities in Rockland and Orange counties, many leaders slammed the governor for publicly decrying their neighborhoods’ vaccine efforts without proper context.

They noted many of the ZIP codes on Cuomo’s lists consist of large families with very young children that skew COVID-19 vaccination comparisons to other communities.

For example, the Rockland County hamlet of Monsey’s median age is 15.5 years old and more than 56% of the population is below 18. In the village of Kiryas Joel in Orange County, 61% of residents are under 18.

Meanwhile, only the Pfizer-BioNTech COVID-19 vaccine is approved for ages 12 to 17.

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Shoshana Bernstein, a pro-vaccine activist in Monsey, likened the over-simplified notion that Hasidic and Orthodox Jewish communities are more apt to decline vaccinations to starting up a car and saying it runs great without ever checking under the hood.

“How about we scrutinize the tens of thousands of plasma donations that have saved hundreds of thousands of lives,” said Bernstein, referring to Orthodox Jews participating in efforts that used blood from recovered COVID-19 patients to treat others battling the respiratory disease.

The COVID plasma effort, she said, underscored that the Hasidic and Orthodox Jewish community understood what was at stake from COVID and take the science seriously.

Further, COVID-19 vaccine outreach has faced similar challenges that hindered a measles inoculation push in Rockland and Orange counties in 2019, following a high-profile outbreak of the disease among unvaccinated Hasidic and Orthodox Jewish enclaves.

That includes COVID-19 vaccine misinformation campaigns that tap into the community newsletters, social media groups and Whatsapp messaging platforms used by Orthodox Jewish, including one effort to mislead women about unproven fertility risks from the vaccines.

Avigayil Rosenblum, however, is an Orthodox Jewish woman who received the COVID-19 vaccine, despite encountering the online chatter. The 38-year-old mother of three said she would like to have more children and is not worried that the vaccine would be a determining factor.

“The OU (Orthodox Union and Rabbinical Council of America) have supported it,” said Rosenblum, adding getting vaccinated is “a Torah obligation.”

Besides, she said, “the alternative, which is getting COVID, is scarier.”

Rosenblum noted she is unaware of any community members or rabbis speaking out against vaccination.

“I think it’s a small but very loud percentage,” she said.

Shoshana Bernstein has "Proud to Vaccinate" magnet on her car to illustrate that not all Orthodox Jews are against vaccinations in Monsey April 12, 2019.

Rosenblum said she also has plenty of friends who live in Israel, which had higher vaccination rates than the U.S. earlier this year. Calling them her own “little focus group,” Rosenblum said that she knows couples who were vaccinated and are now expecting.

Meanwhile, Rockland County Health Commissioner Dr. Patricia Schnabel Ruppert said county officials worked with local health providers, the town of Ramapo, which has a significant Orthodox and Hasidic Jewish population, on finding ways to more effectively discuss patients’ concerns about COVID-19 vaccinations.

That includes, she said, addressing the research around the vaccine and fertility.

Ruppert said the outreach to Orthodox Jews focused on the fact both the U.S. Centers for Disease Control and Prevention and Food and Drug Administration continue to monitor the use of the COVID-19 vaccination during pregnancy.

“These data did not identify any safety concerns for pregnant people who were vaccinated or for their babies,” Ruppert said. 

“However, pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people, and I strongly urge those who are pregnant to receive a COVID-19 vaccine,” she added.

Similarly, Bernstein noted educational efforts within the Orthodox Jewish community proved key during the measles outbreak that hit the Hasidic community hard.

Just like during the measles outbreak, Bernstein added, education and information remain key for COVID-19 vaccines.

The dialogue needs to be nonjudgmental, Bernstein said, citing the example of parents concerned about limited cases of myocarditis, a heart condition, among young people tied to the COVID-19 vaccine.

“There are fears and those fears deserve to be addressed,” Bernstein said.

Now that health-care workers are less overwhelmed as COVID-19 cases plummet, she added, those important patient-provider conversations can more easily take place.

Groups like the Jewish Orthodox Women’s Medical Association have also continued educational efforts in the Hudson Valley communities. The group of doctors, nurses and other medical providers has held Zoom sessions and published articles encouraging vaccination.

A tale of two town officials' different COVID vaccine views

Romulus Town Supervisor David Hayes, a Republican, also criticized Cuomo for trying to put pressure on people to get vaccinated.

“It’s a form of coercion. It’s like a school yard bully,” Hayes said, adding a better approach is vaccine education and outreach.

Hayes, however, said he will not take the COVID-19 vaccine himself until further evidence of its safety and efficacy is gathered.

“It’s too experimental for me. I have to see a long-term study,” he said.

But when neighbors and constituents seek vaccine advice from Hayes, he says his response is simple: “If it makes you feel safe and you want it, you should get it.”

“I’m not a medical doctor by any stretch of the imagination,” he added. “If they’re saying get it, do your own research. Don’t rely on just me.”

Josyln, the deputy supervisor, said his conversations with townsfolk and relatives spanned the myriad reasons some Americans in general are reluctant, or outright refusing, to get vaccinated.

“I’ve heard opinions ranging from, ‘I hardly ever get sick and don’t need the vaccine’ to ‘I’m concerned it was rushed through approval,” he said.

Joslyn’s responses to his neighbors draws from his choice to get vaccinated.

“I’ve got a lot of friends and relatives that are at higher risk,” he said, “I wasn’t quite as concerned about myself. I just didn’t want to pass it on to someone, even inadvertently.”

His vaccination sales pitch also relies on the fact hundreds of millions of Americans have been vaccinated and coronavirus cases are plummeting, as severe vaccine breakthrough infections and side effects remain extremely rare.

“I’m not an anti-vaxxer by any stretch of the imagination, and if you can show me a benefit and a safety factor, I’m in," he said.

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David Robinson is the state health care reporter for the USA TODAY Network New York. He can be reached atdrobinson@gannett.com and followed on Twitter:@DrobinsonLoHud