Israel's Ministry of Health has taken the unusual step of authorizing the exclusion of unvaccinated children from kindergartens and other educational settings if they have been exposed to measles. This decision marks a significant escalation in efforts to curb a major ongoing measles outbreak in the country.
The policy was implemented following a confirmed measles exposure incident on February 4 at a kindergarten in the Samaria settlement of Emanuel. A child diagnosed with measles attended while contagious, putting classmates and staff at risk. Initially, two unvaccinated children were barred from attending; this was later expanded to six children across two kindergartens in the same complex.
The directive relies on Section 19 of the Public Health Ordinance. It applies specifically to unvaccinated children who were in close contact with a confirmed case and did not receive post-exposure prophylaxis (such as vaccination within 72 hours of exposure).
Health officials stress that measles is one of the most contagious viruses known, with an infection risk exceeding 90% for unvaccinated individuals in close proximity to a case. The disease has a long incubation period of up to 21 days, and infected people can spread it before symptoms appear. Complications can be severe, including encephalitis (brain inflammation), with a fatality rate of about 1 in 1,000 cases and a similar rate for serious long-term issues. In rare instances, a fatal chronic brain condition can emerge years later, particularly if infection occurs before age 2.
The current outbreak, which began around April of last year, has resulted in approximately 2,900 confirmed cases (with estimates suggesting the true number exceeds 10,000). Tragically, it has claimed the lives of 14 children to date, with 20 patients currently hospitalized, including 10 in intensive care. Affected areas include Jerusalem, Beitar Illit, Bnei Brak, Modi'in Illit, Kiryat Gat, Petah Tikva, and Netivot.
The Public Health Division at the Ministry of Health emphasized the urgency of vaccination. "After an exposure event, the risk of developing the disease is very high. We recommend preventive vaccination within 72 hours, which prevents illness very effectively." The Ministry added that while parents have the right to make choices for their own children, "parents cannot decide for other children." Allowing unvaccinated, exposed children into group settings puts others, especially vulnerable groups like immunocompromised individuals or pregnant women, at risk.
Routine measles vaccination is provided free in Israel at age 1 and again before first grade, and is considered safe and highly effective based on extensive scientific evidence. The Ministry urges parents to vaccinate promptly, noting that a simple vaccination can prevent severe illness or death.
The exclusion orders are temporary and subject to weekly review or updates based on new medical information (such as if a child develops symptoms). Violating the restrictions by sending an exposed, unvaccinated child to school could constitute a criminal offense.
This represents a precautionary measure amid an extreme public health situation, aimed at protecting the broader community during one of Israel's most serious measles outbreaks in recent years.