ALBANY — As New York has emerged as the epicenter of a national outbreak of measles, local lawmakers and health officials have struggled to compel some ultra-Orthodox Jewish communities, where most of the cases have been found, to drop their resistance to vaccinations.
Public health emergencies have been declared in New York City and Rockland County; summonses have been issued to those not abiding by vaccination requirements; and schools have been closed.
But state lawmakers have thus far resisted passing a bill that would eliminate religious exemptions for vaccinations.
The exact reason for the lawmakers’ reluctance is unclear, but could stem from a number of factors, including opposition from groups like the Robert F. Kennedy Jr.-led Children’s Health Defense, an anti-vaccination group, as well as sensitivity about religious constituents, particularly ultra-Orthodox groups, who have often wielded political influence.
Despite an all-Democratic monopoly in Albany, the bill, first introduced in 2015, has not moved past the Assembly Health Committee.
Most states allow religious or personal-belief exemptions, but four states do not: California, West Virginia, Mississippi and Arizona. In California, the state’s move to revoke such exemptions during a measles outbreak in 2015 led to vaccination rates increasing.
But in New York, a similar bill has languished.
The bill would eliminate an exemption from vaccination requirements for schools for any parent or guardian who holds “genuine and sincere religious beliefs” in opposition to immunization.
“They just don’t want their kids vaccinated because they bought into the nonsense on the internet,” Mr. Dinowitz said. “And you can’t convince them that they’re wrong.”
Orthodox Jewish leaders have said there is nothing in Jewish law that forbids vaccinations.
Aron B. Wieder, a county legislator in Rockland County, one of the hot spots in the current outbreak, said that while some Orthodox Jews may be “anti-vaxxers,” their opinions are not in line with Judaic teaching.
“There have been many rulings by rabbis and rabbinical boards that have said the opposite,” said Mr. Wieder, who is Orthodox, adding that some have even called getting vaccinated “a religious obligation.”
With more than 700 cases in more than 20 states, the current outbreak is the worst since the disease — which can be fatal in rare cases — was declared eliminated in 2000. It has even crept into the nascent presidential race: President Trump, long a vaccine skeptic, reversed course last week, saying that citizens “have to get their shots.”
In New York, Gov. Andrew M. Cuomo had initially expressed reservations about the bill, saying in an interview earlier last month that the proposal raised a “serious First Amendment issue, and it is going to be a constitutional, legal question.”
But this week, Mr. Cuomo, a Democrat, seemed to shift his position. In a radio interview on Tuesday, he said that he respected the religious exemption, but did not think it applied in the face of the outbreak. “You have a public health crisis,” he said.
And on Wednesday, Rich Azzopardi, a senior adviser to the governor, said the administration was “exploring other potential legislative and executive actions” in response to the outbreak.
The Assembly Health Committee is led by Richard N. Gottfried, the Assembly’s longest serving member and usually a reliably liberal voice on all things related to health. (Mr. Gottfried, a Democrat from Manhattan, is the sponsor, for example, of the New York Health Act, which would establish a universal single-payer health plan in the state.)
But on the issue of eliminating religious exemptions, Mr. Gottfried has withheld his support, saying he has First Amendment concerns about Mr. Dinowitz’s bill. “I’m thinking about it,” he said.
Some legislators in Albany privately question whether one of Mr. Gottfried’s top aides — his chief of staff, Wendi Paster, who has recently expressed opinions online which seem to offer qualified support for not vaccinating children — may be influencing his decision.
In a recent posting on the website Quora, Ms. Paster wrote in response to a question about whether vaccines are safe if there’s a family history of negative reactions to vaccines: “Your child, your choice.” She also noted a Centers for Disease Control and Prevention post about various vaccines. “You are right to be concerned.”
Ms. Paster also linked to a website for the National Vaccine Information Center, whose president, Barbara Loe Fisher, has been outspoken in her opposition to mandatory vaccination. The group’s motto is: “Your Health. Your Family. Your Choice.”
In an interview on Tuesday, Mr. Gottfried said he is aware of Ms. Paster’s views, but that they do not influence his views on vaccination.
“There are members of my staff who have divergent views on various issues relating to vaccines,” he said. “And I personally have always been a very adamant believer in the importance of getting as close to 100 percent vaccination as possible.”
Ms. Paster echoed that, saying that she supported vaccination for children “while supporting religious and medical exemptions.” Asked if she personally believed in the safety of vaccination, she replied: “What matters is that Assembly member Gottfried very strongly believes in the safety and importance of vaccination.”
Simcha Eichenstein, a Democratic Assemblyman from Brooklyn who is one of the few Orthodox members of the Legislature, said that the lack of vaccination in Orthodox communities is overstated. “Just like every other community throughout the state we have a small fraction of anti-vaxxers,” he said, adding that he was concerned with the government “legislating when religious beliefs apply.”
Mr. Gottfried said on Tuesday that he would take up the religious exemption bill in committee as soon as Mr. Dinowitz could confirm that it would have enough votes to pass, something the assemblyman said he’s close to doing.
In the State Senate, officials said they expected to move their version of the religious-exemption bill as soon as next week, along with a second bill — introduced in March — that would allow any child 14 years or older to ask for and receive vaccinations, regardless of their parents’ beliefs. “We have a public health crisis on our hands,” said Senator Gustavo Rivera, the chairman of the Senate health committee.
State Senator Brad Hoylman, the sponsor of the religious exemption bill in Albany’s upper chamber, echoed that sentiment, saying “we need to act before the crisis gets any worse and God forbid, a child dies.”
State health officials have now recommended that vaccinations for children begin as early as six months old in areas where the measles outbreak has occurred, accelerating the usual timetable for such immunizations.
For his part, Mr. Dinowitz said he’s been surprised by the slow pace to adopt the bill, but said it’s not too late to stem the crisis.
“Evolution is a reality, the earth is round, climate change is people-made and vaccinations save lives,” he said. “And they are safe.”