In Pennsylvania, nurse Dale Weiser has spent the past few months making unexpected home visits, driving 30 miles (48.3km), sometimes daily, to a rural corner of the state where many Amish people live, to vaccinate dozens of family members against measles. This was reported by Qazaqyia.kz citing BBC News.
Weiser, who works for the Chester County Health Department, said many people she encounters do not have health insurance and have little interaction with the health system. "When you start talking and you answer their questions, and build that trust, a lot of times they will make a different decision," she said.
The state health department told the BBC it has administered nearly 4,300 measles, mumps and rubella (MMR) vaccines at pop-up clinics near the epicentre of the outbreak since it began in late April. But the state has reported four deaths from measles complications, marking the most deadly outbreak the US has seen since 1992.
In the Amish community, people are growing fearful of more deaths as they watch their friends and family fall sick. Weiser said the community is not easy to reach because they do not use social media. "They are suffering at the moment, and we're trying to reach out and make connections," she said.
Amish people began coming to the US in the early 1700s, with the first community settling in Lancaster, Pennsylvania. Known as the "Plain People" for the simple clothes they wear, the Amish do not use many forms of technology, relying on horse and buggies instead of cars. About 90,000 Amish people live in Pennsylvania, with estimates suggesting around only a quarter of Amish people in the Lancaster area have had the MMR vaccine.
According to Braxton Mitchell, a genetic epidemiologist with the University of Maryland School of Medicine, there is no particular religious text advising against vaccines, but Amish people do not have regular contact with the western medical system or a way to easily travel to appointments. "A lot of people who haven't gotten vaccinated, it's not because they have a strong stance against getting vaccinated for measles. It's just that they haven't gotten around to it. It's not convenient," he said.
Mitchell said Amish people are extremely social, so when the virus hits one church group, it affects everyone who is unvaccinated. "Measles is rampant in the Amish community. People are concerned about it," he said. He added the community has been especially concerned about the dangers to babies; so far two newborns have died of measles complications, as well as an 18-year-old and a 40-year-old woman, according to state officials.
Chester County public health officials did not wait long to launch a response to the growing measles outbreak in their community, which shares a border with Lancaster County, the epicentre of the outbreak. Jeanne Franklin, the director of the health department, said officials have been using some of the strategies they employed during the Covid pandemic — knocking on doors to let people know about the outbreak and offering private settings, like people's homes, for immunisations. Since the outbreak started, the county has given 538 MMR vaccines, 340 of which they administered in private settings.
"People have called up and said, 'I can't get to your clinic, or, I don't want people to know I've changed my mind. If you can come to us, that's a lot easier,'" Franklin said. Local health officials said the boots-on-the-ground approach has helped the health department dispel misinformation and build trust with the community.
In recent years, childhood vaccination rates have fallen across the country as false theories about the safety of the measles vaccine have proliferated on social media. Weiser said those theories have found roots even in an insulated community with limited access to computers. She has heard people ask if there are heavy metals in the vaccine that could make them magnetic, or if the shot has a computer chip in it. "You're clearly getting information from that hard-core group that is promoting that misinformation and disinformation," she said.