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An executive order pulled close to 6,000 unvaccinated children out of schools. Nearly 17,000 doses of the measles-mumps-rubella (M.M.R.) vaccine were given in 26 weeks. There was a public health campaign in which community officials, doctors and rabbis testified to the importance of immunizations. None of those efforts stemmed the severe measles outbreak that has been plaguing Rockland County in New York since October. (Gold and Pager, 3/26)

"It's an attention grab, there's no question about it," Rockland County Executive Ed Day said at a news conference, noting that he didn't believe such a drastic step has ever been tried in the U.S. before. Day said he was taking the action in hopes of reversing a recent uptick in cases amid disturbing reports that health workers were encountering resistance when investigating cases. Rockland's outbreak has most heavily affected Orthodox Jewish communities, in which vaccination rates tend to be lower. (3/26)

As health inspectors have tried to vaccinate children, Mr. Day said, they’ve faced “increasing resistance” from unvaccinated families. Some parents have hung up their phones on inspectors calling to ask about vaccinations, and unvaccinated children have been seen in public places. “It endangers the health and well-being of others, and displays a shocking lack of responsibility and concern for others in our community,” he said. (Honan, 3/27)

Caught in the grips of a persistent and long-running measles outbreak, a New York county on Tuesday took the extraordinary step of announcing it would ban children who have not been vaccinated against the disease from enclosed public places as part of a 30-day state of emergency. Schools, houses of worship, shopping malls in Rockland County — anywhere that people who are not related to one another congregate indoors — will be off limits for unvaccinated children, officials said. (Branswell, 3/26)

Citing pockets of resistance that are impeding the county's efforts to stem a measles outbreak that has risen to 153 cases since October, Rockland officials today declared a state of emergency. Starting at midnight, anyone who is under 18 and not vaccinated against measles will be banned from public places. This ban will last until the declaration expires in 30 days or until people are vaccinated. (Spillane, Goldblatt and Cutler, 3/26)

Michigan's most severe measles outbreak in years continues to grow and has sickened 22 people in metro Detroit, health officials announced Tuesday. The confirmed cases — 21 in Oakland County, where the outbreak began, and one in Wayne County —  are all believed to be linked to a sickened traveler who visited the area earlier this month. Two other suspected cases are under investigation. (Zaniewski, 3/26)

California’s vaccination laws could become among the strictest in the nation if a bill introduced Tuesday to stop bogus medical exemptions becomes law. State Sen. Richard Pan (D-Sacramento), a pediatrician and author of California’s 2015 law to eliminate personal and religious exemptions from childhood immunizations, introduced CA SB276 (19R), which would require state public health officials to approve medical exemptions requested by physicians. (Colliver, 3/26)

“Some schools are reporting that more than 20 percent of their students have a medical exemption,” Sen. Richard Pan, D-Sacramento, said in a statement introducing the bill. “It is clear that a small number of physicians are monetizing their exemption-granting authority and profiting from the sale of medical exemptions.” Pan, a doctor, has been one of the most vocal proponents of vaccination in the Legislature. He sponsored the 2015 law that required children to receive vaccines if they attend school, day care or development centers. (Sheeler, 3/26)

The bill would also mandate the creation of a statewide database of medical exemptions, including those that doctors have already approved. State and local public health officers would have access to the database and could revoke exemptions that do not meet the new guidelines. Pan, a pediatrician, said the change is necessary to combat doctors who sell fraudulent medical exemptions to parents. (Koseff, 3/26)

Calaveras County Health Officer Dean Kelaita said he believes the public “dodged a bullet” on measles transmission, but in Placer County, public health officials are still investigating potential exposures to a family fighting three cases of measles. Michael Romero, a public health official with Placer County, said the family is at home fighting off the deadly virus. (Anderson, 3/26)

An international traveler infected with measles visited 20 places across the South Bay — including the Apple Park Visitor Center in Cupertino, Hoover Tower at Stanford and the Great Mall in Milpitas — over an eight-day period, triggering a Santa Clara County warning of possible public health exposure. People who were at the same stores, restaurants or other visitor attractions as the infected person was between March 16 and 23 and who haven’t been vaccinated or had measles before should watch for symptoms of the highly contagious respiratory disease, including a high fever, runny nose, cough, and red eyes, followed by a rash that spreads all over the body. (Vo, 3/26)