彼得·史密斯、劳拉·昂加尔 宾夕法尼亚州埃夫拉塔 —— 近期一个周五，身着保守服饰的阿米希派和门诺派教徒购物者，与来自更广泛公众的购物者，在当地一个巨大的露天市场上混杂在一起，摊贩们售卖着色彩斑斓的南瓜和菊花、油炸馅饼和南瓜瓜、运动球衣和芭比娃娃配件。
PETER SMITH, LAURA UNGAR EPHRATA, Pa. — Amish and Mennonite shoppers in conservative dress mingled with shoppers from the wider public on a recent Friday at a vast outdoor market here, where vendors sold colorful pumpkins and mums, fry pies and squash, sports jerseys and Barbie accessories.
这种互动在宾夕法尼亚州中部的兰开斯特县很常见，这里是美国阿米希派人口最多的聚居地 —— 也是全美35年来最严重麻疹疫情的中心。虽然阿米希派出于宗教原因避免许多类型的公民参与，但他们 —— 就像全美许多其他易感麻疹的群体一样 —— 并非真正与世隔绝。
Such interactions are common in Lancaster County in central Pennsylvania, home to the largest Amish population in the U.S. — and the epicenter of the nation’s worst measles outbreak in 35 years. While they avoid many types of civic engagement for religious reasons, the Amish — like many other groups vulnerable to measles across the nation — are not truly separate.
“我们都是相互关联的，”圣裘德儿童研究医院的迭戈·伊哈诺博士说。强劲的疫苗接种率曾让美国人的防护好得多。
“We are all interconnected,” said Dr. Diego Hijano of St. Jude Children’s Research Hospital. Robust vaccination rates once protected Americans much better.
但普通公众的接种率现在正在下降，而阿米希派的接种率长期以来一直很低，这为这种具有传染性的病毒 —— 自2000年以来在美国被官方认定为“已消除” —— 在这里乃至更远的地方传播创造了完美条件。
But rates among the general public are now falling , and rates have long been low among the Amish, creating the perfect conditions for the contagious virus — officially considered “eliminated” from the U.S. since 2000 — to spread here and beyond.
根据州政府数据，宾夕法尼亚州拥有全美最多的麻疹病例，今年已超过1350例，其中三分之一以上仅在兰开斯特县。社区领袖表示，这还是大幅少报，因为许多麻疹患者从未看过医生。
Pennsylvania has the most U.S. cases, with over 1,350 this year, more than a third in Lancaster County alone , according to state figures. That’s a big undercount, community leaders say, since many people with measles never see a doctor.
该州已记录3例兰开斯特县的麻疹相关死亡病例，以及其他县的2例。
The state has recorded three measles-associated deaths in Lancaster and two in other counties.
此次疫情尤其冲击了阿米希派和保守派门诺派教徒组成的“朴素社区” —— 因其朴素的着装和有限的技术使用而得名。疫苗接种率和对疫苗的态度差异很大。但总体而言，他们比普通人群更不可能接种疫苗，这更多是由于文化和习惯，而非教义。
The outbreak has especially hit the “Plain communities” of Amish and conservative Mennonites — so named for their modest dress and limited use of technology. Vaccination rates, and attitudes about vaccines, range widely. But overall, they are less likely to be vaccinated than the general population, due more to culture and habit than doctrine.
许多人现在表现出对疫苗的新开放态度，而普通公众成员也在采取额外预防措施。
Many are now showing a new openness to vaccines, while members of the general public are also taking extra precautions.
所有这些都凸显了“朴素社区”与更广泛的“英语”人群之间的相互关联性。
All of this has underscored the interconnectedness of Plain and wider “English” populations.
平民派人避免参与担任公职等公民活动。不过，他们仍经常在这个人口达五十万的不断增长的县里与邻居购物和做生意，该县的城市核心地带被环绕着的郊区住宅区与阿米什农场相邻。
The Plain People avoid such areas of civic participation as holding public office. Still, they regularly shop and do business with their neighbors in this growing county of half a million people, where an urban core is ringed by suburban subdivisions abutting Amish farms.
“很难想象这会是一个孤立的社区，”非营利机构联合社区护理机构的首席医疗官安妮-玛丽·德里科博士说。该机构在兰开斯特市及周边城镇设有诊所，并有一支流动医疗车开展面向阿米什人和门诺派信徒的“平民健康”外展项目。
“There’s no way to imagine that this is going to be an isolated community,” said Dr. Anne-Marie Derrico, chief medical officer at the nonprofit Union Community Care. It has clinics in the city of Lancaster and outlying towns, along with a mobile unit operating a “Plain Healthy” outreach to the Amish and to Mennonites.
“我们有平民派患者来到城市，也有城市里不接种疫苗、去上学、参加其他项目并与其他儿童一起活动的患者，”德里科说。
“We have Plain patients coming to the city, we have patients in the city who don’t vaccinate, who are going to school, going to other programs with other children,” Derrico said.
宾夕法尼亚州的麻疹病例数已从九月的高峰下降，但一些医生预计，随着冬季带来更多室内聚会，病例数将回升。
Pennsylvania’s measles rates have declined from their September peak, but some doctors expect them to rise as winter brings more indoor gatherings.
虽然大多数病例较轻，但麻疹可能导致严重甚至致命的并发症，例如肺炎和脑炎。
While most cases are mild, measles can cause serious and even fatal complications, such as pneumonia and encephalitis.
联合社区护理机构举办了小规模疫苗接种诊所，以接触平民派人群，共接种了约450剂麻疹疫苗。“这希望能产生重大影响，”德里科说。
Union has held small-scale vaccine clinics to reach Plain populations, resulting in about 450 measles shots. “That’s hopefully made a significant impact,” Derrico said.
联合社区护理机构的诊所还为婴儿提供比常规时间更早的疫苗接种，这是卫生专家在麻疹暴发地区建议的做法。
Union’s clinics are also offering vaccinations for infants earlier than normally scheduled, as health experts advise in areas experiencing measles outbreaks.
劳伦和梅森·斯彭斯最近带着他们10个月大的儿子鲍文去诊所接种了第一剂MMR疫苗，即麻疹、腮腺炎和风疹疫苗。这个“英语”家庭经常去公共场所，包括农贸市场。
Lauren and Mason Spence brought their 10-month-old son, Bowen, to a clinic recently to get his first dose of the MMR vaccine, short for measles, mumps and rubella. The “English” family frequently goes to public places, including farmers markets.
“很可怕，”劳伦·斯彭斯说。“传播得很快。”平民派社区对疫苗的态度随时间起伏不定——最近一次转冷是对严格的COVID-19公共卫生措施的反应，据社区领袖和学者称。麻疹暴发促使许多人接受疫苗接种，同时也加深了其他人的疫苗怀疑态度。
“It’s scary,” Lauren Spence said. “It’s spreading quick.”Attitudes toward vaccines in Plain communities have alternately warmed and cooled over time — most recently cooling in reaction to strict COVID-19 public health measures, according to community leaders and scholars. The measles outbreak is prompting many to accept the shots while reinforcing vaccine skepticism in others.
一名阿米什农民以法莲·祖克（Ephraim Zook）表示，即使在他和妻子照料年幼的双胞胎度过疾病后，他仍反对疫苗。“我们只是觉得麻疹是一件自然的事，”他说。
One Amish farmer, Ephraim Zook, still opposes vaccines even after he and his wife nursed their young twins through the illness. “We just felt that measles is a natural thing,” he said.
一位门诺派市场摊贩表示，他所在的社区大多已接种疫苗，没有出现感染。
A Mennonite market vendor said his largely vaccinated community has had no infections.
一位平原派农民表示，在他的成年兄弟姐妹开始染上麻疹后，他接种了疫苗。面对要收获的蔬菜和要采摘的烟叶，“我想，如果我染上，我就完了，”他说。
One Plain farmer said he got vaccinated after his adult siblings began getting measles. With vegetables to harvest and tobacco leaves to pick, “I thought, if I get it, I’m going to be done,” he said.
大多数接受美联社采访的人要求不使用他们的名字，以符合平原派不引人注目的传统。
Most interviewed by the AP asked not to use their names, in keeping with Plain traditions of not calling attention to themselves.
社区领袖和专家表示，那些避免接种疫苗的人通常并非出于意识形态驱动。
Those who avoid vaccines usually aren’t driven by ideology, community leaders and experts say.
“压倒性的原因与反对疫苗无关，”艾伦·胡佛（Allen Hoover）说，他是一位老秩序门诺派教徒，曾任新荷兰镇教区医疗中心的管理人员。“仅仅是，‘嗯，我们以前从没做过，而且我们都挺过来了。’”胡佛表示，对医务人员来说，最有效的策略是鼓励接种疫苗，而不是强力推动。他说，外部专业人士需要时间才能在平原派社区中建立信任。需要多久？“二十年，”他说。
“The overwhelming reason had nothing to do with being against vaccinations,” said Allen Hoover, an Old Order Mennonite and former administrator of the Parochial Medical Center in the town of New Holland. “It was simply, ‘Well, we never did before, and we came through all right.’”Hoover said the most effective strategy for medical workers is to encourage vaccination — not to push it aggressively. It takes time for outside professionals to build trust in Plain communities, he said. About how long? “Twenty years,” he said.
纽约州有一个阿米什学校和个人的集团，正要求美国最高法院要求该州允许以宗教理由豁免学校疫苗接种要求，如同宾夕法尼亚州和大多数州所做的那样。
One cluster of Amish schools and individuals in New York is asking the U.S. Supreme Court to require their state to allow exemptions to school vaccine requirements on religious grounds, as Pennsylvania and most states do.
但根据伊丽莎白敦学院杨中心（Young Center for Anabaptist and Pietist Studies）主任史蒂夫·诺尔特（Steve Nolt）的说法，更广泛的阿米什领导层并未将此视为一个宗教问题。
But the wider Amish leadership hasn’t presented this as a religious issue, according to Steve Nolt, director of the Young Center for Anabaptist and Pietist Studies at Elizabethtown College in Lancaster County.
“在阿米什神学或历史文件中，你找不到任何专门涉及或反对免疫接种的内容，”他说。
“There’s nothing in Amish theology or historic documents that you can find that specifically addresses or is opposed to immunization,” he said.
根据杨氏中心的数据，约有4.5万名阿米什人和6000名旧秩序门诺派教徒居住在兰开斯特县及周边地区。诺尔特说，他们中的许多人依赖传统疗法，很少看医生。
About 45,000 Amish and 6,000 Old Order Mennonites live in and around Lancaster County, according to the Young Center. Many rely on traditional remedies and visit doctors infrequently, Nolt said.
今年的疫情继2025年德克萨斯州及北美其他地区门诺派社区的疫情之后发生。
This year’s outbreak follows ones in 2025 in Mennonite communities in Texas and elsewhere across North America.
当患者呼吸、咳嗽或打喷嚏，或通过受污染的表面，麻疹极易传播。
Measles spreads easily when people who have it breathe, cough or sneeze, or through contaminated surfaces.
“就传播性而言，麻疹真的是传染病中的‘狮子王’，”明尼苏达大学传染病研究与政策中心主任迈克尔·奥斯特霍尔姆说。“在美国，没有任何对麻疹病毒易感的人——无论是未接种疫苗者，还是未患过麻疹者——应该对麻疹感到安全。没有任何人。”随着疫苗接种率下降，风险也在增加。
“Measles is really the lion king of infectious diseases when it comes to transmission,” said Michael Osterholm, who directs the University of Minnesota’s Center for Infectious Disease Research and Policy. “No one in the United States of America who is susceptible to the measles virus, either having not been vaccinated or not having previously had it, should feel safe from measles. No one.”The risk grows as vaccination rates decline.
根据美国疾病控制与预防中心的数据，2025-26学年，92.4%的美国幼儿园儿童接种了规定的麻疹、腮腺炎和风疹（MMR）疫苗。这低于2019-20学年的95.2%。
According to the Centers for Disease Control and Prevention, 92.4% of U.S. kindergarteners in 2025-26 received the required MMR shots. That’s down from 95.2% in 2019-20.
兰开斯特富兰克林与马歇尔学院民意研究中心主任贝伍德·约斯特在近期的一篇评论文章中写道：“虽然‘朴素教派’群体是一个容易识别的攻击目标，但我们县儿童疫苗接种率的下降并不局限于阿米什人。自2020年以来，宾夕法尼亚州中部每个县的幼儿园疫苗接种率都在下降。”该中心2022年的一项调查发现，绝大多数门诺派家庭表示给孩子接种了疫苗，而阿米什家庭这一比例约为30%。
“Though Plain communities are an easy and recognizable target, declining childhood vaccination rates in our county are not limited to the Amish,” wrote Berwood Yost, director of the Center for Opinion Research at Franklin & Marshall College in Lancaster, in a recent commentary. “Kindergarten vaccination rates have declined in every central Pennsylvania county since 2020.”A 2022 survey by the center found the vast majority of Mennonite families reported having their children vaccinated, compared to about 3 in 10 Amish families.
约斯特呼吁公众不要将疫情归咎于阿米什人或任何群体。他写道：“我们每个人都容易受到错误信息和令人困惑的信息的影响。”疫情期间在各人群中上升的疫苗犹豫现象至今仍然存在。
Yost urged the public not to blame the Amish, or any group, for the outbreak. “Every one of us is susceptible to misinformation and confusing messages,” he wrote. Vaccine hesitancy that rose across populations during the pandemic still lingers.
这就削弱了“群体免疫”——即一个地区有足够多的人对麻疹具有免疫力，使病毒不再容易传播。尽管只有100%的免疫才能保证病毒不传播，但通常认为，如果一个社区的MMR（麻疹、腮腺炎、风疹）疫苗接种率达到95%，疫情就不太可能暴发。宾夕法尼亚州幼儿园的MMR疫苗接种率去年降至93.2%。
That’s eroded “herd immunity,” which occurs when enough people in an area have immunity to measles that it no longer spreads easily. Although nothing short of 100% immunity guarantees the virus won’t spread, an outbreak is considered unlikely if a community has a 95% MMR rate. Pennsylvania’s kindergarten MMR vaccination rate fell to 93.2% last year.
据美联社对该州数据的审查，兰开斯特县的接种率为88%，该县宗教学校和其他私立学校的接种率低于公立学校。
Lancaster County’s rate is 88%, with rates lower in the county’s religious and other private schools than in public schools, according to an AP review of state data.
在整个县和整个州，因宗教或哲学原因获得至少一种强制疫苗接种豁免的学生比例已大幅上升。诺尔特说，一些反疫苗团体在宣传中把阿米什人作为目标。
Across the county and state, the percentage of students receiving religious or philosophical exemptions from at least one required vaccination has risen significantly. Nolt said some anti-vaccine groups targeted the Amish with their messaging.
2021年，多年来协助领导反疫苗运动的小罗伯特·F·肯尼迪在兰开斯特县的一个集市上发表讲话，声称政府正试图强迫阿米什人接种疫苗。
In 2021, Robert F. Kennedy Jr., who helped lead the anti-vaccine movement for years, spoke at a Lancaster County fair, alleging the government was trying to force the Amish to vaccinate.
肯尼迪现任美国卫生部长，他最近与宾夕法尼亚州民主党州长乔什·夏皮罗就疫情的严重程度发生争执。随后又引发了更多争议，因为该县验尸官将一名感染麻疹婴儿的死亡归因于脾脏破裂，而非麻疹本身。
Now U.S. health secretary, Kennedy recently sparred with Pennsylvania’s Democratic governor, Josh Shapiro, over the extent of the outbreak. Further controversy ensued when the county coroner attributed the death of a measles-infected infant to a ruptured spleen, not the disease itself.
兰开斯特县委员爱丽丝·约德说，公职人员应团结一致，传递疫苗安全有效的信息，并鼓励人们接种。
Lancaster County Commissioner Alice Yoder said public officials should unite behind the message that the vaccine is safe and effective and should encourage people to get it.
这一策略在宾夕法尼亚州1991年上一次麻疹疫情暴发期间取得了成功。“朴素社区的人们排着队来接种疫苗，”她说。
That approach succeeded during Pennsylvania’s last measles outbreak in 1991. “There were lines of people in the Plain community that would come and get vaccinated,” she said.
D·霍姆斯·莫顿医生在米夫林县创立了宾夕法尼亚中部诊所，该诊所为患有遗传疾病的朴素社区患者提供治疗。他说，现在也在发生同样的情况。“我们在设立疫苗接种日方面取得了更多成功，”他说。
Dr. D. Holmes Morton, who founded the Central Pennsylvania Clinic in Mifflin County — which treats Plain patients with genetic diseases — said the same is happening now. “We are having more success at having vaccine days,” he said.
圣犹达儿童研究医院的希哈诺说，归根结底，这将让每个人都更安全。
Ultimately, this will keep everyone safer, said Hijano of St. Jude.
接种疫苗“对你的社区来说是一种爱的行为，”他说。“你自己会得到保护。但事实上，你实际上是在保护你周围的每一个人。”美联社的宗教报道通过美联社与The Conversation US的合作获得支持，资金来自Lilly Endowment Inc.。美联社对该内容承担全部责任。
Getting the shot is “an act of love to your community,” he said. “You will get protected yourself. But in truth, you are actually protecting everyone around you.”Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.