In this March 2019 photo, a sign at the Rockland County Health Department in Pomona, N.Y., explains the local state of emergency regarding a measles outbreak.

A few weeks later, polio was detected in wastewater supplies in New York City and on Long Island — prompting local, state and federal health officials to race to avoid a repeat of the measles surge while Covid-19 and monkeypox continues to spread in New York.

But with a statewide polio vaccination rate among 2-year-olds of less than 80 percent — not including New York City (where that rate for kids under age 5 is 86 percent) — and an even lower rate in Rockland County, officials are faced with a familiar task: convincing vaccine-hesitant people to get the shots.

Signs about measles and the measles vaccine are displayed at the Rockland County Health Department in Pomona, N.Y., on March 27, 2019.

In Rockland County, which has a population of 339,000, local health officials have been working with the state Department of Health and the U.S.

The county had a polio vaccination rate among 2-year-olds of just 60 percent as of August — one of the lowest in the state, according to data from the New York State Immunization Information System.

State health officials said vaccination rates are generally higher by the time children enter school, with nearly all adults vaccinated against polio.

Rockland County Health Commissioner Patricia Schnabel Ruppert said officials have informed physicians in at-risk ZIP codes of the patients in need of polio shots and, in some cases, worked with providers to send letters to individuals encouraging them to get themselves or their children vaccinated, or up to date on polio vaccinations.

Ruppert acknowledged that Rockland County health officials “probably lost some of that headway [they] had made” on vaccination rates following the measles outbreak as response to Covid-19 forced health departments to refocus efforts on the pandemic|

With Covid finally on the decline in New York, the county had planned to work with the state on vaccination audits at schools and day cares this past spring, as part of a larger campaign to increase vaccination rates, Ruppert said.

Rockland County Executive Ed Day said the county is working with the state Department of Health this fall to ensure schools are complying with vaccination requirements — an issue which he and others argued takes on new significance as polio spreads in New York.

The CDC said the polio virus was detected in wastewater samples collected in June 2022 from Rockland County outside New York City.

Although the coronavirus pandemic has presented challenges for public health officials beyond the immediate Covid response — including lagging childhood vaccination rates, medical workforce shortages and a rise in anti-vaccine rhetoric — it has also offered some benefits.

“Our focus began where the individual case of paralytic polio was identified (Rockland County) and the surrounding areas because of what we know about how polio spreads, and these efforts will continue and expand,” Jeffrey Hammond, a spokesperson for the state Department of Health, said in an email.

Kimberly Thompson, a polio expert and president of Kid Risk, a nonprofit that works on public health issues, told POLITICO that the value of wastewater monitoring may be greatest in communities with low polio vaccination rates, including the Hasidic Jewish community in New York, Amish communities, minority populations without access to care and communities with significant pockets of people who oppose vaccines.

23, the state Department of Health reported 69 positive wastewater samples of concern, 62 of which were genetically linked to the individual case of paralytic polio in Rockland County.

Sarah Ravenhall, executive director of the New York State Association of County Health Officials.

Sarah Ravenhall, executive director of the New York State Association of County Health Officials, said the limited polio surveillance is due, in part, to a lack of testing capacity for wastewater samples

County health officials are working with the state on a plan to expand surveillance to other counties

The county health officials association had also pressed Bassett to declare polio an “imminent threat to public health” — as it has for Covid and monkeypox

9, also offers some support to local health officials, such as allowing certified emergency medical technicians, midwives and pharmacists to administer polio vaccines