Measles concerns highlight vaccination gaps among 2-year-olds in greater Riverdale

In ZIP code 10471, which encompasses Fieldston, North Riverdale and parts of Riverdale, just 45% of 2-year-olds have completed the seven-vaccine series recommended by healthcare professionals — the lowest rate in the borough, according to the New York City Department of Health and Mental Hygiene.

As of June 30, the department reported that only 104 of an estimated 232 children in that age group in the area had completed the series, compared with 64% across the borough and 61% citywide. In neighboring ZIP code 10463, which includes Kingsbridge, Marble Hill, Spuyten Duyvil and other parts of Riverdale, the rate was 65%.

For Dr. Gerard Igel, medical director of Montefiore Medical Group Riverdale Pediatric, the figures were unexpected.

“I’m actually surprised that this immediate area has such low rates,” he said, although he said he has encountered considerably more vaccine hesitancy among parents in recent years.

The seven-vaccine series comprises the recommended doses of vaccines protecting against diphtheria, tetanus, whooping cough, polio, measles, mumps, rubella, hepatitis B, chickenpox and certain serious bacterial infections, for children before their second birthday.

Children who have not completed the series may still have received some vaccinations, meaning the city’s figures do not necessarily indicate how many children remain entirely unvaccinated.

The vaccination disparity extends to individual vaccines as well, with just 62% of 2-year-olds in 10471 receiving at least one dose of the measles, mumps and rubella vaccine, compared with 88% across the Bronx. Coverage for the vaccine protecting against diphtheria, tetanus and pertussis, commonly known as whooping cough, stood at 54%, compared with 74% throughout the entire borough.

Sheila Hankin, an assistant professor and co-director of the family nurse practitioner program at Lehman College, said the city findings were particularly striking because low vaccination rates are often associated with communities facing substantial barriers to medical care.

“Where we see health disparities, where we see vaccine hesitancy or nonconfidence is in areas where those social determinants of health are prominent, and 10471 is just not one of those areas,” she said.

Hankin suggested that cultural attitudes, social influences and misinformation could contribute to the disparity, although she could not identify a specific explanation for the area’s rates.

A city health department spokesperson also cited access to medical services, insurance, community attitudes and trust in health care institutions as possible explanations for differences between neighborhoods. The department cautioned that 10471 has a relatively small population of 2-year-olds, meaning even modest changes in the number of vaccinated children or the estimated population can noticeably affect its reported percentages.

Igel said vaccine hesitancy is hardly new, but the growing influence of public figures questioning vaccines has changed conversations between doctors and families.

“I think the fact that there are public figures who are now endorsing vaccine hesitancy has sort of empowered these people to actually refuse vaccines,” he said. “Now there are far, far more people who are refusing the vaccine.”

The consequences extend beyond individual children. Low vaccination coverage can weaken herd immunity, the protection that develops when enough people are immune to a disease to limit its spread. For measles, which is exceptionally contagious, roughly 95% of a community must be immune to prevent sustained transmission, Hankin said.

The concern has become increasingly urgent as Gov. Kathy Hochul declared a statewide disaster emergency on Oct. 5 in response to rising measles cases in rural New York and neighboring states. The executive order expanded the number of healthcare professionals authorized to administer vaccines, including paramedics, midwives and pharmacists, and gave nurses greater flexibility to order testing.

Igel warned that younger children are especially vulnerable to serious complications from infectious diseases, including measles, which can cause pneumonia, brain inflammation and, in rare cases, death.

“I think people have forgotten how dangerous many of these illnesses that we’re immunizing against are,” he said.

Both medical professionals emphasized that improving vaccination rates requires conversations with parents rather than confrontation.

Igel said he tries to approach hesitant families without judgment, explaining scientific evidence supporting vaccine safety while acknowledging concerns about immunization schedules. For parents uncomfortable with multiple vaccines during one appointment, he sometimes arranges additional visits, provided they follow through.

Hankin similarly emphasized the importance of trust between patients and medical professionals, particularly when misinformation or previous negative experiences with healthcare institutions influence vaccination decisions.

“The approach really requires a person-centered, community-centered approach that really builds trust, that improves access, that provides accurate information,” she said.

The city health department said it uses neighborhood vaccination data to identify communities with low coverage and guide educational outreach to families and medical providers. Through the Vaccines for Children program, the department also supplies free vaccines to providers serving uninsured and Medicaid-eligible children.

Despite the low local vaccination rates among 2-year-olds, the department noted that more than 95% of New York City children have received most recommended vaccines by kindergarten, reflecting the state’s school immunization requirements. But waiting until school enrollment can leave other, younger children, who are not yet old enough for vaccines, vulnerable to preventable illnesses, according to Igel.

Igel urged families to consider the evidence supporting vaccine safety and remember the dangers of diseases that routine immunizations have made increasingly uncommon.