This is part of The Vaccine Divide, a data investigation into America’s potential loss of its measles-free status as the deadly virus roars back and childhood vaccine defenses continue to crack and crumble.
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defenses → roar → status
When Roberta Devers, a midwife in Lancaster County, Pennsylvania, did a prenatal check on an expectant mom this week, the woman — a member of the Amish community in her third trimester — had been sick with measles.
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woman → do → measles
Devers said she has cared for dozens of pregnant women infected with the virus since measles began spreading rapidly in the county in April.
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measles → say → April
Lancaster County is largely rural, with sprawling family farms.
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County → sprawl → farms
“Every single day,” she said, “someone’s calling to ask what they do.
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they → say → what
They’re pregnant and they’ve gotten it, or their babies have gotten it.”
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babies → ’re → it
Devers, 63, estimates she has delivered nearly 2,000 babies in her 38-year career.
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she → estimate → career
She has a degree in maternal and fetal health, but she is working as an unlicensed, traditional midwife in Pennsylvania, independent of the hospital systems and without physician oversight.
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she → have → oversight
State law bars traditional midwives from practicing medicine.
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law → bar → medicine
Devers said she questioned immunizations as a young mother and never vaccinated her son.
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she → say → son
“There was as much information against vaccines as there was about the efficacy of vaccines,” she said.
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she → be → vaccines
“It was difficult to know who to trust and who to believe.”
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It → know → who
Her experiences in Lancaster County’s outbreak have changed her mindset.
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experiences → change → mindset
“Numbers and books became people,” she said.
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she → become → ?
“It was humanized by watching what was happening to the mothers I was serving.”
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I → humanize → mothers
In mid-October, the Pennsylvania Health Department alerted doctors about a rise in measles infections in pregnant women and newborns.
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Department → alert → women
As of Wednesday, state health officials had confirmed measles in 97 pregnant women.
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officials → confirm → women
There’s no data, however, on how many miscarriages have occurred because of measles.
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miscarriages → ’ → measles
Devers said one of her young mothers went into labor at 17 weeks, losing her baby.
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one → say → baby
“There was no doubt in my mind that it was the measles,” she said.
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she → be → mind
“Two weeks earlier, she had gotten the measles and then miscarried.”
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she → get → measles
Midwives like Devers are the closest many pregnant women in the community come to mainstream medicine.
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women → come → medicine
Medical or vaccination clinics aren’t always easy to reach in rural areas, especially for Amish families who rely on horses and buggies for transportation.
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who → reach → transportation
The families tend to rely heavily on health advice from midwives because they work with generations of women in the same families.
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they → tend → families
Devers even offers a discount to her longtime clients: After nine babies have been delivered, the 10th is free.
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10th → offer → clients
“We’re involved in the most intimate experience of their lives.
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We → involve → lives
We’re in their bedrooms.
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We → ’re → bedrooms
We have long conversations at the kitchen table about health,” Devers said.
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Devers → have → health
“We are their trusted practitioners.”
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We → trust → ?
Devers can give advice to isolate, minimizing spread of the highly contagious virus.
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Devers → give → virus
She can explain the risks of measles infections during pregnancy, such as preterm birth and miscarriage.
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She → explain → birth
She can’t do the thing experts say is critical in curbing the outbreak: administer measles vaccines.
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experts → do → vaccines
“People ask me, ‘Do you have that vaccine in the car?’” she said.
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she → ask → car
Many inquiries are from unvaccinated husbands, she said, wary of being exposed to measles at work and then bringing the virus home to their wives and children.
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she → say → wives
“I have to say no.
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I → have → ?
Midwives requested directly to the Health Department that we be allowed to carry this vaccine, and we were told no.”
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we → request → vaccine
The Pennsylvania Health Department said in a statement that it “does not have the authority under current state law to allow traditional midwives to administer vaccines, nor does DOH regulate the practice of medicine in the Commonwealth.”
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DOH → say → Commonwealth
Any change would need to come from the Legislature.
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change → need → Legislature
There are opportunities for people to get the measles vaccine in Pennsylvania, and those shots can come from certified, licensed nurse midwives under state law.
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shots → be → law
The Health Department said it has given nearly 11,000 measles-mumps-rubella vaccinations this year.
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it → say → vaccinations
…and 47 more, not listed.
The Aporia
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