What a Grand Rabbi’s request might teach us about combating vaccine hesitancy

first_img But there was a twist. The characteristics of ultra-Orthodox Jewish communities that might potentially make them vulnerable to the spread of vaccine hesitancy — being tight-knit, distrustful of outside authority — are the same ones that members have used to encourage other families to vaccinate.An ultra-Orthodox oncology nurse in Brooklyn heard, from her cousin in New Jersey, that some neighbors weren’t vaccinating their kids. So she started texting with parents, refuting misinformation, explaining the science and safety of immunization, and, eventually, lugging reams of research to meetings in homes around the tri-state area.Rabbis have stated that vaccines are kosher and urged their congregations to protect themselves and their children by getting immunized.The email that Brown received was a similar effort from within the community — but the interventions that ensued weren’t just meant for families. They were also designed to help doctors.The request started with none other than Grand Rabbi David Twersky, a spiritual leader — the rebbe — of the Skver Hasidic sect. Descended from a long line of revered religious teachers, Twersky guides his ultra-Orthodox community from New Square, a patch of former farmland 20 minutes west of the Hudson River.“There are thousands and thousands of people over the years who are going to the rebbe for blessings — or if they have a problem, to ask advice,” explained Victor Ostreicher, a businessman who’d grown up close to the rabbi.The questions that these visitors ask can be about almost anything. But in October, when the measles outbreak began, more and more of them had to do with vaccines. “Some people were scared,” Ostreicher went on: So-and-so had told them they shouldn’t vaccinate, somebody else told them they should, and some doctor had said something that raised questions in their minds. They wanted to know what the rebbe advised. Please enter a valid email address. The Refuah Health Center in Rockland County, N.Y. Erica Yoon for STAT Leave this field empty if you’re human: “Not that the rebbe had the question if vaccinations should be given,” Ostreicher said. “He was 100% sure.” But Rabbi Twersky thought it might be useful to have a document from some medical authority that he could show visitors, to help convince them that immunizations would not only protect their children, but also that the injections were safe.Over the years, when congregants came to him with serious health problems, he often recommended that they go to the Mayo Clinic, in Rochester, Minn. And Ostreicher — a founder of Rockland County’s Refuah Health Center, where many members of the community get health care — has often accompanied them as a patient advocate. In the last seven years, he estimates, he’s made the trip around 10 times.“Mr. Ostreicher is our founder and our board treasurer, he’s also in many businesses, and has an ability to interact with and navigate very difficult things,” explained Chanie Sternberg, president and CEO of Refuah. “Going to Mayo is two sides of one coin: It’s helping the patient understand the system, and helping the doctor understand the patient.” Eric Boodman By Eric Boodman May 10, 2019 Reprints About the Author Reprints Newsletters Sign up for STAT Health Tech Your weekly guide to how tech is transforming health care and life sciences. When the illness began to spread in the last seven months, it brought tension with it, as contagion often does. About two-thirds of the cases were occurring within outbreaks in New York: one in Brooklyn, the other in Rockland County, both places with substantial ultra-Orthodox Jewish communities. Apparently, measles took off when some travelers returned stateside from Israel, and its spread was aided by an anti-vaccine tract circulating among some religious families. But some in these communities felt that, because of a small minority within their ranks, attention was unfairly focused on the group as a whole.As Aron Wieder, a Rockland County legislator, put it, “The misrepresentation of the Orthodox community as not being vaccinated — it’s spreading like the measles disease.”advertisement HealthWhat a Grand Rabbi’s request might teach us about combating vaccine hesitancy [email protected] center_img Related: Can officials require vaccinations against measles? A century-old case may give them a foothold In a religious N.Y. community, an unprecedented response to measles puts trust in government to the test While volunteering in this way, Ostreicher had encountered a number of practitioners specializing in a bunch of organs, but he’d become especially friendly with Brown. That wasn’t entirely a coincidence. Brown makes a point of getting to know the friends and family who come to his patients’ appointments. He enjoys it, and it can be a useful diagnostic tool; the hangers-on are often best-equipped to tell him about what he calls “those transient symptoms that … may not come across in a 90-minute neurological observation.”So, when Grand Rabbi Twersky asked for a letter stressing the importance of vaccines, Ostreicher reached out to Brown, who in turn got in touch with his Mayo Clinic colleague, pediatrician and vaccine researcher Dr. Robert Jacobson, who sat down to write. He wrote about the hospitalizations that happen in a quarter of measles cases, about the brain swellings that can occur, about the chances of death. He wrote about how the measles-mumps-rubella shot prevents the disease.“Here at Mayo Clinic we not only make sure all of our children get this vaccine on a timely basis,” he wrote, “but we make sure all of our medical staff get the vaccine as well.”Then he pressed send.The Grand Rabbi wasn’t the only authority in Rockland County who wanted some backup.The doctors and nurses at Refuah had already been doing everything they could to stop the outbreak. “We’ve been working in lockstep with the Department of Health to offer vaccinations to anyone willing to receive them. We did robocalls, banners, town hall meetings. Word of mouth is a big one,” said Dr. Corinna Manini, the center’s chief medical officer. “We have automated ways for people to call in 24/7 and determine their measles vaccination status.”But they still had questions about how best to deal with patients hesitant to get vaccines.They’re hardly the only ones. “Physicians sometimes feel overwhelmed about these vaccine-hesitant parents,” said Eve Dubé, a medical anthropologist who studies vaccine hesitancy at the Québec National Institute of Public Health, in Canada. “They feel their own expertise is being criticized. For physicians to be told, ‘I don’t trust what you’re saying’ — that can be very emotional.”So, as the Grand Rabbi began circulating Jacobson’s letter, and as the measles outbreak continued, the leaders at Refuah decided to fly the doctor in from Minnesota. “It was important for our providers to hear from someone who had done the research — what works and what doesn’t work,” said Sternberg, the president and CEO.The training was planned for March 25 — one day before the Rockland County executive declared a month-long state of emergency, in which all unvaccinated children were banned from indoor public spaces such as houses of worship, malls, and schools. So many Refuah practitioners wanted to listen to Jacobson they couldn’t all fit in the conference room, and he had to give his talk twice.He began the way he would in his own practice: with the presumption that parents will vaccinate their children. “Say, ‘Your child’s due for the MMR vaccine, I’ll have the nurse come in and do it,’ … with the assumption, you came to see me, this is what we do as part of the visit,” he explained in an interview this month. It’s the same thing he does for other routine procedures. “I don’t get into a long discussion about the benefits and risks of a stethoscope exam. I just say, ‘Now I’m going to take a listen to your heart.’”It was a technique that had worked in a 2013 study, when researchers filmed 111 discussions in which physicians brought up vaccines and found that those who asked parents about vaccines were more likely to face hesitancy than those who assumed the shots would take place.But there will be some parents who continue to express worry. As tempting as it might be to simply hand them some pamphlets to read, Jacobson explained, this is the moment for the physician to start asking questions. “You step back, and you say, ‘So I understand you don’t want to do the MMR vaccine. Can you tell me why?” he said. “This is really important because clinicians who might just jump into it and start giving advice on the vaccine without knowing what the parent’s concern is may completely miss the boat and have really failed to connect with the parent.”After all, he said, the parent and the pediatrician are after the same thing: To protect the child. Only once that sense of trust and shared purpose is established — one built on hearing out the parent’s questions and concerns — only then might the practitioner have a chance at changing someone’s mind with evidence and advice. “The clinician’s effectiveness will be in that room and in that relationship of caring one on one,” he said.It’s hard to say, once Jacobson flew back to Minnesota and the Refuah practitioners dispersed back to their exam rooms, whether his words had a direct effect on the local measles numbers themselves. After all, the training coincided with other public health measures. Last week, the Rockland County executive announced that “19,661 safe and effective MMR vaccinations have been given since the outbreak began; clearly illustrating that the combined outreach and education efforts have had a significant effect.”Yet there’s long been a fraught relationship between the county administration and the area’s ultra-Orthodox communities.  Though the reasons might be different from place to place, similar sentiments are felt in various communities across the U.S. and abroad. As Dubé put it, “We’re in an era of lower trust — in elites, in medical authorities, in experts. … It’s larger than just vaccines.”In her work as an anthropologist, interviewing mothers of new babies, Dubé has heard it again and again, how beliefs are rooted in relationships, with concerns about vaccines spreading from friend to friend, family member to family member, beloved leader to congregant.We listen to the people we know. Often, they have more power than statistics in a flyer or advisories on a website. So this long chain in defense of immunization — from rebbe to community leader, community leader to trusted doctor, trusted doctor to expert colleague, expert colleague to practitioners in the rebbe’s own backyard — might be less circuitous than it sounds. As a neurologist whose patients return to see him year after year, Dr. Robert Brown Jr., of Mayo Clinic, hears about plenty besides strokes and aneurysms. His older patients pull up smartphone photos of grandkids and great-grandkids; his farmer patients talk of rough winters, rainy spells, fluctuations in the price of corn. While investigating memory loss and personality change, he hears about dogs, football games, vacations, and funerals.But in November, someone he’d met in the clinic sent him a question he wasn’t expecting. The man was in Rockland County, N.Y., a leader in the ultra-Orthodox Jewish community. He was concerned about a measles outbreak there, and was wondering how to address parents’ hesitations about vaccines.The question is an important one, puzzled over by pediatricians and psychologists alike, and it’s taken on a new urgency in 2019, when the number of confirmed measles cases in the United States — 764, as of last week — is the highest it’s been in 25 years. How that question arrived in Brown’s inbox, it turns out, might just help inform the answer.advertisement @ericboodman Related: General Assignment Reporter Eric focuses on narrative features, exploring the startling ways that science and medicine affect people’s lives. Tags infectious diseasepublic healthVaccineslast_img read more

Qualcomm China shipments slashed on US sanctions

first_img Related Tags Author Previous ArticleDeutsche Telekom, Cellnex ink Dutch tower tie-upNext ArticleEricsson North America CTO exits Qualcomm completes $1.4B Nuvia buy Devices HomeDevicesNews Qualcomm China shipments slashed on US sanctions Chris joined the Mobile World Live team in November 2016 having previously worked at a number of UK media outlets including Trinity Mirror, The Press Association and UK telecoms publication Mobile News. After spending 10 years in journalism, he moved… Read more center_img Qualcomm pulls trigger on latest processor AddThis Sharing ButtonsShare to LinkedInLinkedInLinkedInShare to TwitterTwitterTwitterShare to FacebookFacebookFacebookShare to MoreAddThisMore 21 JAN 2021 Apple faces 5G modem wait MediaTek overtook Qualcomm as the largest supplier of smartphone system-on-chips (SoCs) to China during 2020, an analyst report revealed, with the latter recording a 48 per cent fall in shipments year-on-year partly due to US restrictions on Huawei.A report released by Shanghai-based CINNO Research estimated total shipments for the Chinese market at 307 million units in 2020, down almost 21 per cent year-on-year.Although not breaking down numbers for each manufacturer, it highlighted the decline in Qualcomm’s shipments along with a 17.5 per cent drop in HiSilicon’s figures, also attributed to the US restrictions.In contrast, Taiwan-based MediaTek’s shipments showed “explosive growth”, elevating it top spot for the first time.CINNO Research attributed MediaTek’s rise to support from China’s largest domestic manufacturers, especially for its mid-tier processors.However, it added: “At the same time, it is undeniable that the series of sanctions imposed by the US on Huawei and HiSilicon also force major manufacturers to seek more diversified, stable and reliable supply sources.”At the end of 2019 the research company estimated Qualcomm held a 37.9 per cent share of the market, followed by HiSilicon (35 per cent) and MediaTek (17.4 per cent). By end 2020, MediaTek’s share had increased to 31.7 per cent followed by HiSilicon (27.2 per cent) and Qualcomm (25.4 per cent). Subscribe to our daily newsletter Back Chris Donkin MediaTekQualcommlast_img read more

New Prototype Trigger Pro Specialized Gravel Tire May Indicate Launch of New Gravel Grinder…

first_imgImage Credit: Cyclocross MagazineAfter the bevy of images flooded social media last week of a  new prototype Specialized Road Bike, the internet has been quiet regarding the speculated launch of a new gravel grinder. While we wait for an official announcement, the eagle eyed team at Cyclocross Magazine has spotted a new semi-slick prototype at the 2014 Lost and Found gravel race.Image Credit: Cyclocross MagazineThe folding tire was originally developed for Rebecca Rusch to race the Dirty Kanza,  but it may soon be available to the masses. Head over to Cyclocross Magazine for more information.last_img read more

Yemen’s cholera epidemic called ‘worst ever’ by Oxfam

first_imgIn just over 3 months, Yemen has reported more than 368,000 cholera cases, the most recorded in a single year, according to the nongovernmental organization Oxfam.”It is quite frankly staggering that in just 3 months, more people in Yemen have contracted cholera than any country has suffered in a single year since modern records began,” Nigel Timmins, Oxfam’s humanitarian director, said in a statement.The crisis, which began in October of 2016, picked up speed in April. Since then, there have been approximately 5,000 new cases suspected every day. The World Health Organization (WHO) said there were 368,207 suspected cases reported from Apr 27 to Jul 19, and 1,828 deaths, resulting in a case-fatality rate of 0.5%.Almost all (21 out of 23) of Yemen’s governorates have reported cholera cases. The Al Hali district (Al Hudaydah governorate) has the most cases, with 14,229 suspected cases and 23 deaths in the last 3 months.Yemen’s cholera outbreak is worsened by a collapsing public health infrastructure, where healthcare workers haven’t been paid by the government in more than 10 months, and clinics, water treatment centers, and plumbing have suffered because of conflict and internal displacement of thousands of people.The WHO estimates that more than half of all Yemeni health facilities are closed, and 14.8 million people don’t have access to healthcare in that country.New totals surpass Haiti’sOxfam said Yemen could report as many as 600,000 cases by the end of the year, making it the largest outbreak since records started in 1949. The previous annual record was in Haiti in 2011, when 340,311 cases were recorded, the group said.Speaking today at a press briefing in Geneva, WHO officials said that malnutrition among Yemen’s displaced people creates a vicious cycle for cholera.”We need to break the vicious cycle of malnutrition and diarrhea,” Fadela Chaib, a spokesperson with the WHO, said, according to notes from the briefing. “17 million people in Yemen are currently food insecure. Malnutrition exacerbates diarrhea, and diarrhea leads to malnutrition.”Children under the age of 15 account for 41% of suspected cases, and people over 60 account for one third of all deaths. The WHO had planned for a one-dose vaccination campaign this month, but has now tabled that plan in favor of a two-dose campaign slated for next year. Officials said the situation has moved so quickly, vaccines are not a priority tool. Instead, diarrhea treatment centers, oral rehydration corners, and healthcare workers are the main focus of WHO’s efforts to stop the outbreak. The WHO said $64 million, in addition to the $10.2 million already spent, is needed in Yemen.Kenya outbreak growsIn other cholera news, Kenya is reporting growing numbers in its cholera outbreak, which is active in Garissa and Nairobi. As of Jul 17, a total of 1,216 suspected cases including 14 deaths (case-fatality rate of 1.2%) have been reported since the first of the year.Kenya has been battling cholera since January, and like Yemen, has seen an uptick in cases since April. Outbreaks are occurring in the general population and in refugee camps.The country has also reported two point-source outbreaks in Nairobi County, one involving conference participants at a hotel and the other in people who attended a trade fair.See also:Jul 20 WHO update Jul 19 WHO report Jul 21 Oxfam statementJul 21 WHO Kenya updatelast_img read more

Lea Michele releases gorgeous music video for Christmas in New York

first_imgLea Michele has unveiled a gorgeous music video for her original festive track Christmas in New York.Taken from her recently released holiday album Christmas in the City, Christmas in New York was written by Michele with Adam Anders, Nikki Anders and Peer Astrom. Take a look at the video below:The magical video captures the spirit of the season with Michele performing inside a snow globe and in the back of an iconic NYC yellow taxi as it rolls through the brightly-lit city. There are also scenes shot at the Rockefeller Center with Christmas revellers skating on the ice rink.Christmas in the City is Michele’s first festive collection and her first studio album since 2017’s Places. Christmas in New York follows the album’s lead single It’s the Most Wonderful Time of the Year, which was released to tease the album in September.Michele has been busy promoting the record and recently performed White Christmas with Kelly Clarkson on The Kelly Clarkson Show. You can grab a copy of Christmas in the City now to get in the festive spirit!last_img read more

Ole Miss hoping it found Moody’s replacement in Burnett

first_imgDeandre BurnettDeandre BurnettOXFORD— Ole Miss knows who its scorer is next season. His name is Stefan Moody, perhaps you’ve heard of him. It also believes it just found its man for the following season. His name is Deandre Burnett, a Miami transfer who announced his plans to be a Rebel on Monday afternoon. The 6-foot-2 shooter made his decision just a day after he wrapped up his visit to Oxford, where he was sold on the chance to be the Rebels’ guy – to run the show, to be their offensive focal point. In other words, to take over for Moody. Burnett will have to sit out the 2015-16 season because of transfer rules, but the timing works out very well for the Rebels. When Burnett is finally able to gets his chance on the hardwood, Ole Miss will be rolling out a new-look back-court. Guards Moody and Martavious Newby will be graduated by then, leaving a large offensive void. It’s Burnett’s job to fill it, and his strength is his scoring.“We are pleased to announce that Dre has chosen to join our program,” Ole Miss coach Andy Kennedy said. “He is a natural scorer who has always shown the ability to make plays.”The former four-star recruit was third in the nation in scoring as a senior at Coral City High School in Miami, averaging 37 points per game to earn 2012 Parade All-American honors. He piled up more than 45 points in a game three times. He sat out his first season in Miami after having wrist surgery, but he got off to a strong start last year. Burnett, who has two years of eligibility left, scored 19 points against Illinois in December and a career-high 21 against Green Bay. He scored double-digits seven times as a redshirt freshman. His minutes took a hit when conference play began, partly because the Hurricanes were so deep at the guard spot. He got a chance again later in the year, helping Miami to the NIT Championship game by scoring 12 points in the second round against Alabama and eight in a semifinal win against Temple. Burnett — who was also considering South Florida, La Salle and Marquette — is certainly a much-needed get for the Rebels, and he certainly has big shoes to fill. After singing from junior college, Moody ended his first season in Oxford as the only player in the Southeastern Conference to finish in the top 10 in scoring, 3-pointers, free throws and steals. “The experience he gained at the University of Miami battling in the ultra-competitive ACC has prepared (Burnett) to be in a position to make an immediate impact in our program,” Kennedy said.last_img read more

Filipina Alex Eala makes US Open juniors debut vs tough Aussie

first_imgMOST READ Malasakit Center bill awaits Duterte signature Manila’s hidden reservoir to re-emerge as tourist draw Women’s football teams served just egg, kikiam and rice for breakfast Australia slays Canada in Fiba World Cup ‘group of death’ LATEST STORIES Poulos, who hails from Canberra, made it to the main draw of the Australian Open thrice and French Open once. But she didn’t get past first round in all of previous stints.On Saturday, Eala disposed of qualifying top seed Romana Cisovska of Slovakia, 6-3, 6-0, at Cary Leeds Stadium Court 1 to formally enter the main draw of girls singles competition.AdChoices广告inRead invented by TeadsFEATURED STORIESSPORTSPH women’s football team not spared from SEA Games hotel woesSPORTSSingapore latest to raise issue on SEA Games food, logisticsSPORTSThailand claims not enough Thai food, drinks for players at hotelEala became the first Filipino to make the main draw of the US Open, or any Grand Slam event, since Jeson Patrombon in 1991.Eala, a scholar at Rafael Nadal Academy in Mallorca, Spain, converted six of 13 break-point chances, and had 74 winning percentage on her first serve. NorthPort forces rubber match, blasts No. 1 NLEX The 16-year-old Cisovska got 66 percent of her first serves in, against 50 percent by Eala, but she could only score on one of three break-point opportunities.AdChoices广告inRead invented by TeadsSports Related Videospowered by AdSparcRead Next Singapore latest to raise issue on SEA Games food, logistics Foot fetish: Nibbles a specialty at Indonesian restaurant Trending Articles PLAY LIST 00:50Trending Articles00:50Trending Articles00:50Trending Articles02:42PH underwater hockey team aims to make waves in SEA Games01:44Philippines marks anniversary of massacre with calls for justice01:19Fire erupts in Barangay Tatalon in Quezon City01:07Trump talks impeachment while meeting NCAA athletes02:49World-class track facilities installed at NCC for SEA Games02:11Trump awards medals to Jon Voight, Alison Krauss ‘City-killer’: Asteroid the size of the Great Pyramid may hit Earth in 2022, says NASA Kim Chiu rushed to ER after getting bitten by dog in BGC Filipina tennis hotshot Alex Eala is upbeat about her chances when she starts her first-ever US Open juniors stint on Sunday (Monday in Manila) against a tough 16-year-old from Australia.The 14-year-old said that while she’s facing Annerly Poulos, who has seen action in several Grand Slam events already, she’s on high morale playing the first round considering her impressive showing in the qualifying.ADVERTISEMENT Don’t miss out on the latest news and information. View commentslast_img read more