"Fear is easy. Education takes time."

Shoshana Bernstein said these words as part of a campaign to educate the public about the importance of vaccines amidst an historic measles outbreak.

Bernstein, a vaccine advocate, is one of many within the Orthodox Jewish community trying to fight the public perception that the Orthodox Jewish community is responsible for the measles outbreak.

"For the most part, it's only in New York state where that perception is being played out," she said Tuesday. "It's unfortunate. I believe that what makes us such a wonderful community here in Rockland County is our diversity, but diversity can get complicated, and there are pre-existing tensions that are being kind of played on."

Bernstein has teamed up with others to educate people within the Orthodox community about the importance of vaccinations. She co-organized "An Evening of Vaccination Education for Women" on Monday night in Monsey, at the same location where anti-vaccine advocates conducted their own symposium exactly three weeks earlier.

Monsey has been the epicenter of the outbreak, with 255 cases overall in Rockland County since the outbreak began in October. Most of the cases have been within the Orthodox community.

Not anti-vaccine

But Bernstein and other Orthodox Jewish leaders say the measles outbreak is not because the Orthodox Jewish community is anti-vaccine or has low vaccination rates.

"Our vaccination rates are in fact, equal to and for large part, greater than average," she said.

Awi Federgruen, a professor of management and chair of decision, risk and operations at Columbia Business School, who coauthored an opinion piece for the New York Daily News about measles and the Orthodox Jewish community, said Tuesday that the data for school-aged children provided by the state Health Department showed a 96% vaccination rate at Jewish private schools.

This rate counters the myth that Orthodox Jews don't vaccinate, which Federgruen acknowledged is pervasive.

"It is higher than the average among other private schools in New York state by some six full points," he said. "So this completely, of course, defies any any claims to the contrary."

So why is this outbreak largely centered in the Orthodox Jewish community?

Benrstein and Federgruen said it is linked to the dynamic of the community itself. They cited density, how close-knit the community is, and travel as the three major reasons the outbreak has been so pervasive despite high vaccination rates.

"We have a very large population of under school-aged children," Bernstein said. "Ultra-Orthodox families are large."

That coupled with the close-knit nature of the community — thrice daily synagogue visits for prayers, large gatherings for celebratory occasions, and families living within a short distance of each other — make it difficult to contain an outbreak.

"Every elementary model in epidemiology will indeed consider the level of interaction and the intensity of interactions as one of the prime factors to explain whether or not a outbreak is going to sustain itself, or whether it's going to peter out," Federgruen said.

Since measles was officially eliminated in the United States in 2000, outbreaks have been linked to international travel, which is popular within Orthodox Jewish communities. Pilgrimages to Israel and the Ukraine are common, especially around the holidays, and both places are also experiencing large outbreaks.

The outbreaks in Rockland County and Brooklyn began during the Jewish high holidays last fall when travelers coming from Israel brought the highly contagious virus into the region.

Information and misinformation

"You have questions. We have answers."

That's how the flier announced the educational vaccine forum for Monday. Bernstein said the goal was to be open, honest and respectful. The flyer clearly stated the agencies involved, who would be speaking and their credentials, and gave an overview of what people could expect.

The women-only event had informational booths staffed by medical professionals to answers questions one-on-one and offered a question-and-answer session with the panel of speakers, who work at major hospitals and institutions.

Three weeks early, the anti-vaccine event was publicized with a vague flyer and robocalls inviting people to a "vaccines symposium" and a "highly informative night of science and discussion addressing your concerns, fears and doubts." The anti-vaccine bent of the event was not made clear.

A similar anti-vaccine symposium was held Tuesday night in Brooklyn at an Orthodox catering hall. A promotion on Facebook made the case that no one is allowed to argue with the science of vaccines and asked "Are they hiding information that they don't want you to know ... Have you been told everything???"

These anti-vaccine events are hosted by a group calling itself the United Jewish Community Council, but no information or website is available for it. The flier never say the events are anti-vaccine, but instead offer door prizes and busing from Monroe in Orange County, Lakewood in New Jersey and Borough Park and Williamsburg in Brooklyn. Separate seating is provided for men and women, and parents are asked to leave babies at home.

Bernstein said that without knowing who are the speakers at a "vaccine symposium," it's very easy to confuse people and draw them out to the events. The speakers are listed on the flier, but many within the Orthodox Jewish community would not have the resources to research their anti-vaccine activities.

"Conspiracy theorists target the innocent, the uninformed, the susceptible," she said. "We do live in a community where there is a certain demographic, not across the board, that do not access media or internet or even written information. And that makes them especially susceptible to misinformation."

That's why Bernstein has made it her mission to educate. Bernstein said it’s critical to create culturally sensitive education to reach different communities. Several years ago, she partnered with the Orange County Department of Health and authored a booklet on vaccine education specifically geared to the Orthodox Jewish community. That booklet was reprinted and distributed to the Rockland Jewish community.

The booklet, Tzim Gezint, was given out Monday as well as a booklet called "A Slice of PIE: Parents Informed and Educated." PIE was created as a response to an anti-vaccine magazine called PEACH, which stands for Parents Educating and Advocating for Children's Health.

About 125 women attended the event Bernstein helped organize. It was a smaller event than the "vaccine symposium" on May 13, but Bernstein said that was not problematic.

"It's not about the numbers, it's about the method," she said. "And it's about the long term results. People came and stood and listened and dialogued and talked and were listened to and respected. That's un-quantifiable."

She said they reached out to the community in a multitude of ways.

"We pursued every angle," she said. "Some with more success than others. We were finding that it's much easier to attract misinformation and sensationalism than it is to attract an open and honest dialogue. But often what's right is what's hard."

Twitter: @ReporterRox