Poliomyelitis worries parents. Doctors say vaccination is the answer.

The news that the polio virus was found in New York’s sewage on Monday caused mixed reactions among parents in the city. Some are no longer afraid. Others were frightened.

Public health officials, however, had a simple message for them: vaccinate their children. If they are vaccinated, they are safe.

In South Williamsburg, a predominantly Hasidic enclave in Brooklyn where polio vaccination rates for 5-year-olds are among the lowest in the city, mothers on playgrounds pushed swings and watched their children play. With only one case found so far, a paralyzed Rockland County resident, several mothers thought the situation warranted caution, but was not alarming.

“It’s a concern,” said Esther Klein, 24, of South Williamsburg, Hasidic and the mother of a 1-year-old son. “I want to make sure his vaccines are up to date,” she added. He said what worries him is if more people start getting sick.

In nearby Domino Park, several mothers were reassured by their pediatricians that their children would be fine because they had been vaccinated. But Elsa de Berker, 32, said she fears for her daughter, who will soon turn 2, even though her polio vaccines are up-to-date: “It’s scary.”

As some sought help from pediatricians’ offices Monday to schedule vaccination appointments, they were largely reassured: As long as they kept their children on the standard vaccination schedule, their children should be protected.

The polio vaccine is very effective. The first dose is usually given when children are 2 months old; the second one will be given after two months. After these two doses, protection against paralysis is at least 90 percent.

The third dose is usually given when the child is 6 months old. This dose provides about 99 percent protection against paralysis. The fourth dose, given after the child turns 4, is intended to ensure lifelong protection.

“My advice is to stick to the vaccine schedule and you’ll be fine,” said Dr. Peter Silver, pediatrician and assistant chief medical officer at Northwell Health. “I don’t think you’re at serious risk if you get vaccinated. The population at risk is the unvaccinated.

Babies younger than 4 months are usually protected by their mother’s antibodies because their mother has been vaccinated.

The steady circulation of polio in sewage in London since February has recently led to a recommendation that children between the ages of 1 and 9 receive an extra booster dose. But public health officials say the outbreak in New York has not yet reached a level of concern. In addition to the case identified in Rockland County, officials found 20 positive sewage samples in Rockland and Orange counties and six positive samples from city sewage in June and July.

“There is currently no recommendation that those who are fully vaccinated against polio should receive booster doses or that children should receive the vaccine series earlier or earlier on Monday,” Cornell Medicine’s doctors wrote in an email to patients.

Anyone with no history of polio vaccination is eligible to be vaccinated, including adults. However, as a rule, everyone born after 1955 is vaccinated to go to school. A lifetime booster dose is available for those at particular risk.

Although only one case of paralysis has been reported in the New York area so far, health officials believe they are only seeing the “tip of the iceberg” in terms of the prevalence of polio because paralysis is so rare.

The region’s only positive case was found in an unvaccinated 20-year-old man in Rockland County. Doctors suspected acute mild myelitis as the cause of his leg paralysis, but he tested positive for polio in July. Rockland County health officials said the infection was not travel-related because he had not traveled at the time of the infection.

Authorities have not released further biographical information about the man, but local authorities say he is part of the Hasidic community there. Vaccine skepticism is widespread among some of that community, and it has intensified during the Covid-19 pandemic.

While the majority of Hasidic children are vaccinated, a significant minority are not, community members said, because of concerns about vaccines and because the pandemic has necessitated adherence to vaccination schedules, especially for those with large families. The public is not monolithic, and tensions persist between those who oppose vaccines and those who believe such reluctance puts the public at risk.

“From my perspective, it has a lot to do with anti-vaxxers,” said Yosef Rapaport, a pro-vaccination Hasidic media consultant and podcaster. “With the delay in vaccination, coupled with the rise of the anti-vaxxer movement, we’re just waiting for a catastrophe,” he said.

A pediatrician in Williamsburg, who spoke anonymously to protect the confidentiality of her patients, said many mothers she sees are concerned about the safety of vaccines because of misinformation. They often prefer to delay dosing until childhood, when a child’s immune system is stronger. He said he saw similar trends in 2019 when measles spread in the community.

In Rockland County, health officials regularly hold free clinic vaccinations in an effort to increase rates. Refuah Health, one of the main health providers in the region, administered 450 polio vaccines between July 21 and August 21. 11, – said the press secretary. More than half of them were children under 2 years old.

Some providers are reporting an increase in vaccinations in recent weeks, as of August. Only 60 percent of children 1, 2 and younger received the three recommended polio vaccines in Rockland and Orange counties. According to Orange County Health Commissioner Irina Gelman, the low rates are not limited to Hasidic areas.

In New York, 86 percent of children under 5 have received three doses of the polio vaccine. However, vaccination by postal code shows much lower rates in a number of districts representing different population groups.

Behind Williamsburg is Battery Park City, an affluent Manhattan neighborhood with childhood vaccination rates ranging from 5 to 56 percent. Other areas with low childhood vaccination rates include parts of Bedford-Stuyvesant and Brownsville, where the majority of residents are black, and the southern tip of Staten Island, a politically conservative, predominantly white area.

City Health Department spokesman Patrick Gallahue said: “Sampling of wastewater is not specific to areas where people are infected with polio.”

New York is not planning a polio vaccination campaign, but the city is asking health workers in areas with low vaccination rates to immediately reach out to families whose vaccinations are overdue. About 93 percent of urban children under the age of 5 received at least one dose.

Poliomyelitis is a human-to-human virus that enters the body through the mouth, mainly through infected feces. About 75 percent of people with polio have no symptoms, but they can still spread the virus. About 25 percent have mild symptoms such as fever, muscle weakness, headache, and nausea. In about 1 in 200 cases, polio can infect a person’s brain and spinal cord, causing permanent paralysis or death.

Thanks to the success of the vaccine and the national immunization program, the incidence of polio declined dramatically in the late 1950s and early 1960s. The last case of poliomyelitis in the United States was recorded in 2013.

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