Polio has reemerged in New York. The virus was identified in late July in an unvaccinated Rockland County man and has since been detected in wastewater samples in at least two counties. It is too early to tell whether a limited outbreak — or worse, a full-blown epidemic — is brewing, but experts have been concerned about the virus spreading in communities with low vaccination rates. The man who tested positive is part of an Orthodox Jewish community in which vaccine hesitancy tends to run high. Only 60% of Rockland County 2-year-olds have been fully vaccinated against polio, compared with 80% in most of the rest of the state.

Unless health officials get those percentages up quickly, a virus that has been all but eradicated may become entrenched. That would be heartbreaking, but it would not come as a surprise. Measles descended on the same communities in 2019, COVID-19 ravaged them disproportionately in 2020, and before either of those, mumps and whooping cough were known to pop up at regular intervals. The increasing regularity of these crises has begun to make them feel inevitable: The vaccines are there. The people don’t want them. What are officials supposed to do?

A large, rigorous vaccination campaign feels like an especially tall order now, with public health agencies tapped from the COVID pandemic and even the most receptive groups weary of public health messaging. But in the long shadow of frustration and neglect, an unsung collective has been gathering strength: advocates and health workers from Orthodox Jewish communities. “The last few years have been very intense,” said Nesha Abramson, outreach director at Community Counter, a nonprofit focused on public health advocacy in Orthodox communities. (Abramson is Haredi and lives in Crown Heights in Brooklyn.) “But we’ve learned a ton about what works and what doesn’t.” Here’s what she and others like her want health officials to know.