Polio in NY: Are we out of the woods for recurrence of paralytic virus?

It's been more than a year since a young Rockland County man was left permanently paralyzed by polio. No trace of the virus has been found in local wastewater for more than eight months. Vaccination rates for babies have held steady, for the most part.

How long is long enough for the absence of polio detection to equal eradication?

"There’s no guidebook for the U.S. because it doesn’t usually happen in the U.S," said Dr. Eli Rosenberg, deputy director of science for the New York State Department of Health's Office of Public Health. Rockland's polio case was the first in decades to be transmitted within the U.S.

Dr. Chitra Punjabi, director of TB and communicable disease control for the Rockland County Department of Health, agreed. "The lack of further cases is definitely reassuring," she said, however, "we don’t take a complacent stand."

For good reason.

"Polio or other vaccination-prevented diseases are just an airplane ride away," Punjabi said. "Unless it’s eradicated in the rest of the world, anytime it could show up here."

Areas with low vaccination rates are particularly vulnerable to viruses and other vaccine-preventable illnesses taking hold.

Focus on vulnerable communities

The state recently updated its polio vaccination dashboard for babies age 2 and under. While rates generally held the same as last year, Spring Valley's 10977 ZIP code dropped from 57.1% in 2022 to 55.9% in 2023.

That's significantly lower than the statewide vaccination rate for that age group, which was recently measured at 79.75%.

Spring Valley has a growing population, especially among new immigrants. While politicians have shared concerns about recent immigrants lacking vaccinations, state and local officials say it's too complex a situation to assume a pattern.

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Many people are coming from countries with robust immunization programs but also political and economic upheaval, Rosenberg said.

"People are showing up without their papers in hand," Rosenberg said. Even if they recall being vaccinated but can't prove it, health officials offer new rounds of vaccination "just in case."

There's plenty of home-grown vaccination hesitancy too. Skepticism about vaccines grew during COVID among some. Local health officials have worked hard to provide education and vaccine access to people skeptical of vaccines, including a small subset of families in Hasidic and Orthodox Jewish communities.

For example, a recent spike in pertussis wasn't found in the immigrant community, Rockland health officials say. And the 2018-2019 measles outbreak that hit Rockland hard, racking up 312 documented cases, was focused in the Hasidic community.

Local and state officials have worked with local health providers to increase vaccination rates in these enclaves of vaccine resistance. Data show some success: In 2022, Monsey's 10952 ZIP had the lowest polio vaccination rate for babies in the county, at 37.3%. The 2023 data show babies' polio vaccination rate in 10952 at 41.4%.

As for new immigrant families, Julie Krauchuk, Rockland Health Department director of patient services, said they are coming to the county's Spring Valley clinic eager to participate in preventative medicine, including childhood vaccines.

Visit to vaccine clinic

The county Health Department has long offered family planning and other healthcare at the Main Street site in the village. But amid a push to increase childhood vaccinations, the site started offering immunizations this year. The site already accounts for more than a quarter of immunizations given by the Health Department.

"The cooperation we're getting is 100%," said Krauchuk, a family nurse practitioner.

On a recent morning, Anabel Cajamarca visited the clinic with her 7-year-old son, Maykel. They arrived in Spring Valley from Ecuador two months ago. Maykel needed paperwork for school, so even if the family said the shots had been given before, they were given again.

Anyelyn Lorenzo Maldonado, 8, stopped by the clinic for vaccine updates. She had just come from Guatemala two months ago to join her mom, Mirna Maldonado, who had been in Spring Valley for five years. Her mother said Anyelyn was just happy to be back with her. Anyelyn looked the other way as she got two shots, one in each arm, and then smiled after and waved goodbye.

"Families are wanting to make sure their children are protected and healthy and go to school," Krauchuk said.

By the numbers

The newly released data by the New York State Department of Health solely focuses on polio vaccination rates for babies 24 months and under. It only counts a baby as vaccinated if they have received all three recommended doses of the polio vaccine by age 2; a fourth booster is given around age 4.

Punjabi said that means a child who gets the third shot in the polio series a week after the second birthday won't be counted.

In Rockland and Orange counties, the places where New York's polio vaccination rates are among the lowest, the rates are relatively stable: Rockland County's 2022 overall rate was 60% in 2022 and 61% in 2023; Orange County's 2022 polio vaccination rate for babies was 59% and 59.8% in 2023.

State data: Find the polio vaccination rates for babies in your county, ZIP code

While vaccination rates among babies remain concerning, state data show that by school age, public- and private-school students catch up.

The credit for that: A 2019 New York law that limits religious exemptions from school vaccination mandates, which was pushed through on the heels of Rockland's measles outbreak.

'Mom of a toddler'

Punjabi said in the face of vaccine hesitancy, it's important people get accurate information about the value of vaccines.

"I get it. I just had a baby in 2022." Punjabi said. "I’m a scientist, but there’s always still that moment of hesitation when I’m bringing this little fragile thing to the doctor’s office for 3, 4 shots."

But it’s quickly overcome, Punjabi said, because she's seen the damage these vaccine-preventable diseases can do.

"I'm an infectious disease doctor who believes vaccines are the biggest public health advances," she said, "and I’m a mom of a toddler who is focused on her safety as well as other children in the community."

Nancy Cutler writes about People & Policy for lohud.com and the USA Today Network New York. Reach her at ncutler@lohud.com; follow her at @nancyrockland on X (formerly Twitter), Instagram and Threads.

This article originally appeared on Rockland/Westchester Journal News: Polio in NY: What vaccine rates, wastewater tests show