30 Years Ago, a Philly Church Refused to Vaccinate Its Kids Against Measles. The Results Were Deadly

A look back at the city’s last vaccine crisis — and what we can learn from it today.

philadelphia measles outbreak

These are lessons we can learn from the fatal Philadelphia measles outbreak. Illustration by Jon Krause

Bob Ross remembers the moment vividly.

The date was January 16, 1991, the same day that then-President George H.W. Bush launched Operation Desert Storm, the second stage of America’s war with Iraq. Little did Ross know that Philadelphia was about to embark on a war of its own.

Ross, then the 36-year-old deputy health commissioner for the City of Philadelphia, was sitting inside the Department of Public Health building on South Broad Street on that unseasonably warm winter day when his office phone rang. On the other end of the line was a woman who was reluctant to give her name. She wanted to convey an anonymous tip.

“We wound up nicknaming her ‘Deep Throat,’” recalls Ross — a reference to the Washington Post’s secret Watergate source — with a half-suppressed laugh.

The woman said her daughter was a member of Faith Tabernacle Congregation, a small Nicetown church attended by mostly white working-class families living in Northeast Philadelphia. It wasn’t a church that was on Ross’s radar. Hell, it wasn’t really on anybody’s radar. It was just one of hundreds of churches in the city. Except it wasn’t.

Faith Tabernacle congregants didn’t believe in doctors, the woman explained. They refused all medical treatment, instead trusting that God would heal according to His will. Some would live. Some would die. But it was God’s decision. Unsurprisingly for a group of people who won’t seek medical intervention even when they’re dying, the flock also forbade all preventative medicine, including vaccinations and immunizations.

The tipster told Ross she was concerned about her granddaughter, who was a student at the church school, which was presided over by the church’s fundamentalist pastor, Charles Reinert. The grandmother said an alarming number of children at the school had recently come down with what she suspected was measles, and she was worried that her granddaughter would be next. The sick students, she explained, had developed blotchy rashes all over their ­bodies — a telltale early symptom of measles, as Ross knew all too well.

“And before long, the first kid at the school dies,” says Ross. “The parents only called after the kid was already dead. I was astonished. It made me realize what a nightmare this was going to be. Either their faith was so strong or they were so deranged, depending on your point of view, that they wouldn’t call a doctor when their child was dying.”

Though the church would quickly become the focal point of a public-health crisis in early 1991, Faith Tabernacle wasn’t the beginning of the measles outbreak in Philadelphia.

Back on April 20, 1989, the Athens, Georgia, alt-rock band R.E.M. played the Spectrum in South Philly, closing their main set with “It’s the End of the World as We Know It (And I Feel Fine).” In the audience that night was a teenager who had just returned from a trip to Spain and had brought an unwelcome passenger: a case of measles.

According to Children’s Hospital of Philadelphia vaccine expert Paul A. Offit, who has closely followed and chronicled the spread of preventable diseases throughout his career, this R.E.M. fan appears to have been Philadelphia’s patient zero. A handful of others at the show soon came down with cases. “Measles had entered the city,” Offit wrote of this moment in his 2015 book Bad Faith: When Religious Belief Undermines Modern Medicine.

Measles cases continued to pop up here and there in the densely populated city in 1989 and 1990 — as is common with highly contagious infectious diseases. But measles never managed to get a firm grip on any particular neighborhood or community in that two-year period, in part because the vaccination rate among the overall population was reasonably good. That all changed once the illness made its way to the Faith Tabernacle school.

Enrollment at the grades-one-through-12 institution was reported at about 200 students, none of whom had been immunized against measles. The disease is easily transmitted through the air when an infected person coughs or sneezes. A mild case can pair flu-like symptoms with that blotchy rash. More serious cases can lead to pneumonia, dehydration, blindness, or inflammation of the brain. Before a vaccine became available in 1963, nearly every child in the United States caught measles, resulting in some 48,000 hospitalizations and 400 to 500 deaths a year.

While somebody in your neighborhood might have come down with measles back in 1991, there wouldn’t have been wildfire spread, provided enough of your neighbors had been immunized. But taking scores of unimmunized children and cramming them into the same building is the epidemiological equivalent of a tinderbox.

On February 7, 1991, the first child at Faith Tabernacle died of measles. Her name was Caryn Still. She was just nine years old. Three days later, Still’s classmate, Monica Johnson, was also pronounced dead. What started as a rash on Johnson’s body led to unconsciousness and, finally, cardiac arrest. True to church doctrine, Johnson’s parents never called a pediatrician to see if there was anything they could do — not even to make their daughter more comfortable, let alone save her life.

“For the strengthening of our belief,” Johnson’s father told the Philadelphia Daily News at the time in defense of his failure to seek medical treatment for his dying daughter. “That is why God has chosen her.” The father also said that immunizations amounted to “interference with God’s will,” echoing what his pastor had preached from the pulpit time and time again. (The Johnson family would eventually lose another daughter, Tina Louise, to measles.)

Realizing he needed a face-to-face meeting with the church’s pastor, Ross took a ride out to the rectory. His goal was to convince Reinert that he needed to tell his parishioners to get their children vaccinated and to seek medical treatment for any current rashes or fevers, stat. Reinert was relatively cordial, says Ross, which wasn’t at all the reception he expected. But he was completely unmoved by Ross’s pleas for compassion and common sense.

“I gave it the old college try,” says Ross. “But it was really a waste of time. At the end of the day, these parents were taught that God and Jesus heal all, and that’s that. It was an absolute. There was no room for interpretation.”

But the visit to the rectory wasn’t completely useless.

Ross managed to convince Reinert to turn over a list of names, addresses and phone numbers for all of the families with children in the church school. The two men also came to an agreement about how Ross would proceed next. They agreed that the health department wouldn’t examine or provide treatment to a child without a parent’s permission, in most cases. But — and this is a very important but — if the department came across a child with serious complications that required immediate hospitalization, Reinert understood that Ross would have no choice but to make a phone call and have the child taken to the nearest hospital. And if a parent refused to allow that to happen, as Ross suspected some would, he would go to a judge and get a court order. Reinert assured Ross the church wouldn’t fight any such court orders duly handed down by the bench.

“It was a bit of a negotiation,” says Ross. “There was a lot of back-and-forth, but eventually, I got that much out of him.”

Ross immediately started making calls, with minimal success. A few days into the effort, he learned of another death at the school and realized the mother of the child in question had been one of his first calls from the list.

“I said, ‘Holy shit!’” Ross recalls. “That kid had to be tremendously ill, if not near death, when I talked to the mother. She specifically told me that the kid was okay. And that’s when it came to me that these phone calls just weren’t enough. I told my colleagues that we had to get to these families in person. It was clear that we couldn’t rely on verbal reporting of the health status of a kid.”

Ross went to the chief residents at St. Christopher’s and at CHOP, where he had trained in pediatrics prior to joining the health department, and told them he needed pediatricians and nurses to volunteer to make house calls. The team, Ross included, fanned out across the city.

By the time Ross and the other doctors and nurses got to the families, they learned that many of the children they encountered had recently had measles and that most had already recovered without any kind of medical assistance. But not all.

Ross visited a home in Northeast Philadelphia with nine children, according to the church’s list. (Large households were the norm in the church, Ross says, because just as the church preached against immunizations, it preached against birth control.) When Ross arrived, he found the kids’ grandmother taking care of them. The parents were both at work. As he casually observed the children in the living room, Ross saw signs that they had recently had measles — the fiery red rash eventually starts to fade — and was glad they appeared to be on the road to a full recovery. “The kids actually looked pretty good,” remembers Ross.

Then he noticed something. The list Reinert had given him indicated that the family had a total of nine children. But as he looked around the room, he counted only eight. Ross asked about the discrepancy, and the grandmother reluctantly told him that one of the children was upstairs, watching TV. He went up the stairs and was alarmed by the young girl he saw.

“She’s lying on a couch in front of the TV, looking like death warmed over,” Ross says. “She was icy. Wasting away.”

Ross asked the grandmother how long the girl had been like that and says he got a lecture about the “power of God that heals all.” He asked to use the phone — “This was before the days of cell phones” — and called a judge to get a court order, figuring it was the only way he was going to get the girl to a hospital. The judge granted the order, and EMTs showed up within minutes to take the girl to the emergency room at St. Christopher’s.

“They saved her life!” Ross says. “But when I went to check on her in the hospital the next day, when she looked 80 times better, her grandmother and parents greeted me with nothing but hostility. If looks could kill, I would have died that day.”

The girl was soon back home. Meanwhile, the health department visited more families. In all, four court orders were obtained to hospitalize children. More lives were saved.

But the court orders covered emergency treatment only, not immunizations for families at the church. And Ross didn’t want to wind up back where he’d started. So he came up with a drastic idea: forced immunizations for the children of religious objectors. He went to then-Mayor Wilson Goode to talk him into getting the city’s lawyers to make it happen and found it an easy sell. “I think he was looking back on the MOVE bombing, recognizing that he had to do something about all these horrible headlines about yet another tragic situation in Philadelphia,” Ross reflects. The years from 1989 to 1991 saw a spike in measles cases across the country, and the outbreak in Philadelphia was among the worst. And headlines in national newspapers reflected that, in part because of the involvement of the church, which many consider a cult.

The pastor, Reinert, thought he could get the American Civil Liberties Union to intervene on the church’s behalf, but even the ACLU wouldn’t take the case. “There is certainly a free-exercise-of-religion claim by the parents,” the head of the Philadelphia ACLU told the Inquirer. “But there is also a competing claim that parents don’t have the right to martyr their children.”

The health department eventually got its way. Nurses inoculated any Faith Tabernacle child who hadn’t yet been exposed. By June of 1991, the measles outbreak here had run its course.

Between Faith Tabernacle and one other Philadelphia church with similar beliefs, six children died from measles, out of 486 people infected. Outside the churches, three children died out of 938 people infected, meaning the risk inside the churches was about 1,000 times greater, as Offit points out in his 2015 book. If only they had been vaccinated.

“That vaccine is 97 percent effective,” Offit says today. “The math isn’t hard.”

The measles outbreak in Philadelphia was 30 years ago, long before the anti-vaxxer movement took hold in America based on fake news and false “science.” The movement thrived in the early 2000s and still lingers today, pushed on social media by celebs like Robert Kennedy Jr. and Jenny McCarthy, and by activist mommy bloggers and influencers pushing “parental choice.” It was yet another hurdle for public-health officials.

Now, we’re struggling through a pandemic that shut the city down for the first time one year ago this month. The 1991 measles outbreak claimed nine lives in Philadelphia. As of press time, COVID-19 had killed 2,945 city residents and infected nearly 112,000.

It’s too early to say how many Philadelphians will get the COVID-19 vaccine and how many will refuse. As we reported this story, the biggest problem was getting the vaccine into the arms of the people who did want it. But we know that some of the communities most disproportionately affected by the virus are among the most resistant — perhaps not because they care what Jenny McCarthy posts on social media, but because of a general distrust of the government and the for-profit health-care industry that’s rooted in specific historical betrayals.

One national survey recently showed that more than a quarter of health-care workers — health-care workers! — didn’t want to get the vaccine. Then you have anti-vaxxers, plus people who still refuse to wear a mask, plus religious sects like Faith Tabernacle, which, by the way, has 10 churches in Pennsylvania. And the church is still preaching against medicine and science. Reinert died 20 years ago, but the new pastor assured Philly Mag that the teachings of the church remain the same with regard to vaccinations and medical treatment. (He declined to answer any further questions and promptly hung up.)

“I would divide the vaccine-skeptical sentiment into two groups,” says Offit. “There are people who are just that: skeptical. And it’s reasonable to be skeptical. And then there’s the anti-vaccine movement. They don’t believe in science. What was it that Neil deGrasse Tyson said? ‘You can’t use reason to convince anyone out of an argument that they didn’t use reason to get into.’”

Ross, who went on to become the city’s health commissioner before moving to California, where he heads a health-care foundation, says he’s not sure how the COVID vaccine will play out in the end.

“But it’s disturbing and disappointing that there continues to be so much distrust and mistrust of the public-health system and the health-care industry,” he says. “There are many causes. But we need to find the solution. We have a lot of work to do.”

Published as “Sticking Point” in the March 2021 issue of Philadelphia magazine.