Curated! A successful and well-written investigation into the causes of a recent and somewhat concerning event, gathering the information to figure out what's really happening behind a popular news story & easy narrative. I love having this example, and will hopefully remember to link to it when people ask me why I don't believe popular narratives about why things happened.
Comment half in jest, half serious: if the problem is lack of fluency in Obscure Language, then might this be a case where people today would be better-served by LLM nurses and doctors, rather than human ones?
One of the problems with low german as I understand it (I have mennonite grandparents that speak it), is that there's no formal spelling system, and an abundance dialects. There's also not a ton of low german content online to train off of, though there are a decent number of books written in low german.
I'd be curious to know how good LLM translation is despite that.
Seems like even pretty bad automated translation would get you most of the way to functional communication - and the critical enabler is more translated text, which could be gathered and trained on given the current importance - I bet there are plenty of NLP / AIxHealth folks who could help if Canadian health folks asked.
A nurse or doctor having gone through the trouble of learning an obscure language to provide healthcare for Mennonites, is a costly signal that suggests that the doctor cares about Mennonites.
A costly signal like that is good to establish trust. Most of vaccine hesitancy is likely about lack of trust in mainstream medicine and an LLM nurse or doctor is unlikely very trustworthy for Mennonites who are skeptical of a lot of technology.
If the costly signal hypothesis is true, it is really a self-sabotaging memeplex for those religious nuts, since the larger society should probably consider cost-benefit ratios and funding medical practitioners training in an obscure language meant to be costly[1] is probably not the way to buy the most QALYs. You don't even have to be anti-religious, you just have to be EA to see that helping people who make themselves cheaper to help is more effective if you're egalitarian.
- ^
So if it ever becomes cheap, like with the LLM suggestion, then it no longer works
I think it's quite easy to see communities as the Mennonites or Amish als self-sabotaging memeplexes. They way they operate is quite costly. At the same time, they might argue that they have healthy birth rates and it's mainstream society with birth rates that aren't enough to long-term sustain the society as "self-sabotaging memeplex".
Your comment runs counter to the OP's claim in the bottom section called Mennonites Are Susceptible To Facts and Logic, When Presented In Low German. E.g. the anecdote about the woman who thought the hospital turned her away, sounds like it's not about vaccine hesitancy but about total inability to communicate.
And sure, human doctors and nurses who know Obscure Language are a much better solution than LLM doctors and nurses, but realistically the former basically don't exist, so...
ChristianKl's point in their second paragraph still stands though. Most people still aren't trusting of LLMs giving them medical solutions, and Mennonites are unlikely to be any more trusting
Again, I feel like both you and ChristianKI are pattern matching on a different type of low-vaccination community, one with vaccine hesitancy out of conviction etc. The claim in the OP is that the main problem for this particular community isn't that they distrust mainstream medicine; their main problem is that they outright can't communicate.
We are talking about a community that has community evaluation of technology and only uses technology when the community evaluates the tech to be good for the social fabric of the community.
I'm not sure whether "out of conviction" is a very good category. https://globalnews.ca/news/11214661/ont-measles-mennonite/ does suggest that historic distrust in authorities is a key factor.
It's not that they distrust mainstream medicine in particular but that general distrust of authorities leads to distrust of vaccination as well.
While it that case it's more historical distrust, it's probably similar to the distrust you get prevent churches from gathering during lockdowns because of bad public health policy and afterwards discover that the congregation doesn't trust you anymore on vaccines.
Even if they are receptive to vaccinations, what makes you think they will be receptive to a newfangled communication medium such as LLM?
"It is to train up and hire health care workers who can speak Low German."
Could you please write a bit about how many potential health care workers who speak Low German are there in Canada? How easy is it to do that?
As extremist religious sects, Mennonites and other Anabaptists have proven particularly susceptible to the Evangelical extremism currently blazing through Christianism in North America.
It’s true to say that Mennonites love their children and don’t want them to die of measles, but the reality is more complicated. The Pre-tribulation Rapture theology associated with vaccine hesitancy has become increasingly common among Anabaptists. So much so that Anabaptist Conference and leaders in the US and Canada have issued multiple statements denying the validity of the theology, but also saying they do not prohibit it.
The theology puts great value on bodily purity, leading adherents to believe not vaccinating their children is an expression of love for them. Dying before Parousia is sad, but it’s better in the long run (eternity) to be pure. There are varying degrees of belief. The more grounded end of the spectrum believes that the End Times are inevitable, but do not make day to day life decisions based on the imminent arrival of The End. The other end of the spectrum believes the End Times are coming sometime between lunch and dinner and their day to day lives are governed by that belief. In the balance of risk, they reckon the chances of getting measles are lower than Jesus’s return and they will be rewarded for their purity in the Judgment without all that science in their bodies. Imminent Parousia remains a fringe belief, but one that has seen significant growth over the last decade in nearly every sect of Evangelical and Fundamentalist Christianism and particularly among fringe groups.
There’s no doubt that medical care and participation in preventative medicine are improved when the caregivers are proficient in the language of the patient. But the effect of occultism on the return of measles cannot be overstated. Language carries logic and reason, both of which are tertiary concerns for True Believers. Extreme religious beliefs topped off with extra Biblical occultism* is a public health threat.
*Occult driven disease isn’t limited to Christianism. Polio is a recurring problem among Hasidic Jews. It’s cholera and hepatitis C for Wahhabis, Syphilis was historically a problem in some paths of Buddhism. Parasitic infection and bacterial infections from geophagia remain a problem in certain paths of Buddhism.
1Thank you for this comment! I think it clarifies some important things about what's actually going on on the ground level, and I genuinely appreciate the additional context.
However, I disagree that "the effect of occultism on the return of measles cannot be overstated". I feel like it is being overstated right now! People believe a lot of deranged things, but I believe that you are wrong about the extent that people are willing to choose those beliefs over the health and lives of their children and others in the community. I am not saying that this never happens, but I think it genuinely does not happen that often, and when it does it is genuinely contentious.
You can also reduce the amount it happens when you have nurses and support workers who understand the culture and can work with it. From the CBC interview:
TD: Can you give us a sense of why there's vaccine hesitancy in some Mennonite communities?
CF: The biggest thing is that they don't want to not trust God. So their faith has a lot to do with it. Once I was able to help a lot of them understand that God has created doctors for the purpose of helping them, they would listen a little bit more.
TD: What lessons do you think you've learned working with Mennonite communities during this measles outbreak?
CF: The biggest thing for us, my coworker and I, is to just get them to trust us. If they don't want to vaccinate, we respect that. Because they see that we respect their values, they start to really trust and understand that we're here to help them, not to hurt them.
From another interview she did earlier in 2025 for a Canadian magazine, Macleans:
When it comes to measles in particular, most families just don’t understand the seriousness of the condition. They think that, like chicken pox, contracting it will create immunity. They don’t know that measles could lead to other illnesses and be particularly harmful for children, whose developing bodies are more vulnerable to the infection and its complications.
and
This work has gone a long way. Clients come to us asking about measles and vaccinations after hearing about the severity of cases from their friends and family. We’ve had many productive conversations about immunization and how it intersects with religious beliefs and community health.
Many of my clients are trying to do what’s best for their families, and they respect authority as long as they feel respected in turn. They do, however, have internal struggles about whether getting vaccinated is a betrayal of their faith or whether it could cause harm. But once they’ve considered how immunization can help vulnerable people, some of them even feel a little embarrassed over how strongly they opposed it. All in all, we’ve managed to give at least half of our patients vaccines since I started working at the clinic—and the rate of vaccination has increased since the outbreak started.
Lastly, here is a passage from an article covering the outbreak in Alberta:
Proudly, she recalls seeing a lightbulb go off for one woman who described an epiphany in one of her recent groups.
“She said, ‘I can make decisions for my family, and it doesn’t have to be public knowledge. I can make these decisions and not share it with my family members if they ask and I can just say that’s my business,'” Meggison said, and described other women nodded in response to this passionate declaration.
This does not sound to me like a community that is lost to conspiracist thinking. It sounds like a community that is wrestling with live issues.
I'll also note that the degree of suspicion and hesitation in the community seem actually sort of justified, in that there's been a string of broken promises between the mennonites and the Canadian government. From Macleans:
Our ancestors came from Europe, and when they settled in Canada, they negotiated a number of promises with the Canadian government—including educational independence. When some provinces later passed laws requiring Mennonite children to attend public schools, many families, wanting to hold tight to their religious and cultural identity, emigrated to South America.
Over the course of doing my reserach, I also found a significant number of stories of under-communicated or coerced vaccinations like this, set in the mid 20th century in Canada and up to the modern day in Mexico:
She remembers a public health nurse rolling into her Mexican hometown of Durango on horse-and-buggy with a cooler of vaccines. The nurse told Meggison’s mother to line up her 12 children in the yard, asked for their ages, and immunized them, without explanation.
“She didn’t know what had been given to her kids. She didn’t have the language skills to ask the questions,” Meggison said about her mother, whose primary language was Low German.
This seems like a terrifying thing to have gone through, and I understand how it could foster mistrust and give cover to more conspiratorial thinking.
2Do you have a reference for the geophagia in Buddhism? I can't seem to turn up anything on the internet, but maybe it's not well documented in English?
thank you for the diligent and open reporting. i learned more about Canada and crosscutting issues like vaccination and the power of language. it seems reoccurring to me that at the heart of most of human misunderstandings is language. you point this out clearly in your investigation. i hope someone picks this up and finds these communities the language support they need
3Full offense to Health Canada: this is a terrible graphic, because if you don't look at it carefully you will think that the provinces in dark blue have approximately the same number of cases, and this is very false.
Yeah, who even does that?
When people say "measles" they think "OMG Black Death! We're all gonna die!" It's important to note that, despite the huge rise in cases, virtually everyone infected has recovered. The two exceptions I could find are two infants with congenital measles -- a terrible tragedy of course, and (most likely?) preventable with widespread vaccination. But let's keep this in context, please.
1Measles causes immune amnesia, which sets your immune system back 2-5 years. You'd need to follow people for years to know what the true cost was.
This post was originally published on November 11th, 2025. I've been spending some time reworking and cleaning up the Inkhaven posts I'm most proud of, and completed the process for this one today.
Today, Canada officially lost its measles elimination status. Measles was previously declared eliminated in Canada in 1998, but countries lose that status after 12 months of continuous transmission.
Here are some articles about the the fact that we have lost our measles elimination status: CBC, BBC, New York Times, Toronto Life. You can see some chatter on Reddit about it if you're interested here.
None of the above texts seemed to me to be focused on the actual thing that caused Canada to lose its measles elimination status, which is the rampant spread of measles among old-order religious communities, particularly the Mennonites. (Mennonites are basically, like, Amish-lite. Amish people can marry into Mennonite communities if they want a more laid-back lifestyle, but the reverse is not allowed. Similarly, old-order Mennonites can marry into less traditionally-minded Mennonite communities, but the reverse is not allowed.)
The Reddit comments that made this point are generally not highly upvoted[1], and this was certainly not a central point in any of the articles. It is a periphery point in all of the articles above at best. Toronto Life is particularly egregious, framing it like so:
This is, ironically, misinformation: true information framed in such a way to precisely give you the incorrect view of things.
In this post I will make two arguments: first, yes, it is the Mennonites that began (and are the biggest victims of) the biggest measles outbreak of the current century, and second, thinking of them as resistant to vaccination is actively harmful to the work of eliminating measles from Canada once again.
I've been following the measles outbreak closely for basically its entire duration, because I have a subscription to my local newspaper, the Waterloo Record. The writers there do frequent updates on the outbreak, often with higher quality and more detail than you get in the national papers. This is because Waterloo Region has a significant Mennonite population, so shit sometimes got real scuffed.
Like, over last spring, there were fairly regular advisories about local stores we shouldn't go into or quarantine if we did because someone with measles went in. One of them was the pharmacy across the street from the university campus, so that was fun.
The Mennonite Outbreak
Here is what the outbreak looks like, Canada-wide:
Full offense to Health Canada: this is a terrible graphic, because if you don't look at it carefully you will think that the provinces in dark blue have approximately the same number of cases, and this is very false. Sasksatchewan has barely over a hundred, Alberta has almost 2000, and Ontario has almost 2400 cases.
What's the deal with Ontario, and Alberta? Some of it comes down to the numbers game; those are two of our most populous provinces. But Quebec has twice the population of Alberta, and it's trucking on with only 36 cases in the entire province.
The answer is that it's the Mennonites, who are overwhelmingly settled in those two provinces.[2]
I'll be focusing on the outbreak in Ontario, because that's the part of the story I'm more familiar with. If you dig into older news pieces, the Mennonite connection is corroborated by government officials:
Mennonites have a social structure where, once the community reaches a certain number of families, they undergo mitosis, and half the families split off to form a new community far away. Based on reddit scuttlebutt, it seems like there has recently been a daughter community that moved from southern Ontario to New Brunswick, which makes it doubly unsurprising that there were many southern Ontario attendees to the original superspreader event.
Additionally, Moore, remarked in a memo he sent out to local health bodies:
And Global News reports:
Some smaller publications have found connections in their own investigation. The London [Ontario] Free Press in March 2025 (the beginning of the outbreak) linked the outbreak in West Texas to their Mennonite population, and identified that several measles exposure sites in counties that have been heavily afflicted by measles are Mennonite in nature:
A recent Washington Post article also corroborates the link, but buries it under several paragraphs of preamble about general vaccine skepticism.
Mennonite Geography
Public Health Ontario has infection numbers for you, broken down by geographic area ("public health units"). Here's what that looks like when I plot them on a graph. Notice that there are five units that are responsible for basically all of the cases, and you will have heard of none of them because they include zero major population centres.
I admit that I do not have the temerity required to separate out Mennonites from like, generic rural dwellers, but something wonky is going on here! The measles outbreaks are all in sparsely populated regions while the big cities (with their big suburbs, presumably where all the anti-vaxxers would be) carry on basically unscathed.
To better visualize this, I am going to combine a bunch of charts together jankily: the geographic distribution of measles (blue), population density (red, adapted from Wikipedia, and, in lime green, the settlements of Amish and Mennonite communities I found online.[3]
Okay, sorry, you will need to stare at it for a bit. The key takeaway is that the blue areas (which represents measles cases) almost perfectly avoids the most populated areas (red), and are full of green dots (where the Mennonite and Amish settlements are).
Let's look at this another way. Here's a Public Health Ontario COVID report from April 2022 (i.e. after vaccinations have been available for a while). Pages 8-10 include comparable charts on cases per 100,000 people broken down by Public Health Unit. It's relatively stable between PHUs, and larger in city centres compared to rural settlements. This makes sense, because urban settlements are by definition denser, which means it's easier for viruses to spread.
Here are the outbreaks plotted against each other, if you're curious.[4] Notice that the same five public health units no one has heard of are outliers again, which is what you would expect.
Also note the different degrees of variance in cases per 100,000 people in a health unit. COVID cases per 100k ranged from about 4,000 to 11,600 across health units, which is roughly a 3x difference. The Measles cases were actually incredibly discontinuous across units: many units had literally zero cases, some had under 30 cases per 100,000 people, then there's a huge gap, and then there's five regions that had over 100 cases per 100,000 people.
For the statistically inclined, the coefficient of variation (standard deviation divided by mean, expressed as a percentage) was about 25% for COVID and 193% for measles, which is almost eight times higher.[5] (If these numbers mean nothing to you, don't worry about it. The point is just that COVID spread relatively evenly and measles did not.)
Lastly, here is some incidental info from some July 2025 coverage on the outbreak in St. Thomas (a smaller city, in that vertical belt of green dots across central southern Ontario, in the PHU Southwestern Public Health which is the one with the most cases):
As of October 28, there has been 771 cases of measles in the Southwestern PHU. If 150-200 of them were Low German-speaking mennonites as of July, and most of their clients had symptoms at that time, this indicates that the Mennonites would have made up for a substantial amount of all cases in that PHU.
I rest my case! Which is not to say that it is a perfect one but here is where I put it down because I am not going to put more effort into it. I encourage others to pick it up and put more work into it if they are so inclined.
Mennonites Are Susceptible To Facts and Logic, When Presented In Low German
The general sentiment both in the reddit comments and in most of the news coverage seems to be something like "oh, they're weird religious people, and therefore immune to logic about vaccines", and also something something religious tolerance meaning that we can't criticize their choices at all.[6]
But in reality, Mennonite parents love their children and do not want them to die of measles, and they do not want to contract measles themselves. Having looked into it, it seems to me like the largest barrier for them getting medical care and vaccination is that they are not fluent in English, they speak Low German.
In Ontario, three quarters(!!!!!!) of the 700 Mennonite community clients helped by a Low German-speaking personal support worker have agreed to be vaccinated.
In Alberta (the other large Mennonite population centre, and not coincidentally the other large site of the outbreak), there has been a 25% increase in demand for medical care in Low-German, and service has expanded from five to seven days a week.
And, like, yes, to be clear, there are loads of Mennonites who are actually anti-vaccine. I am not disputing the obvious fact that, in religious communities, many people are against vaccinations. Further, 75% still falls very short of the 92-94% vaccination rate needed for herd immunity. But a 75% vaccination rate is much, much higher than I'd have hoped for?
Here is an example of the miscommunication that can happen when one is not fluent in English:
If your measles outbreak comes from this sort of community, the solution isn't to fearmonger about anti-vaxxers. It is to train up and hire health care workers who can speak Low German. And to be clear, I think the PHUs that are affected are doing this, or at least the Ontario ones are, because our public health bodies are generally not disconnected from reality.
And that's what I found most frustrating about the media coverage. It obscures something that's genuinely very hopeful and turns it into another random culture war shitfest. But actually, it turns out that when you remove the actual language and access barriers, people make reasonable healthcare decisions for their families at pretty high rates!
So yes, Canada lost its measles elimination status today. But we can get it back in a year and a bit, if we're serious. And if we're serious about eliminating measles again, we need to focus more on investing in healthcare workers who speak the language of and can build relationships in communities, and less on implying that certain populations are fundamentally unreachable.
This was more true in November, a few comments who made this claim have now been highly upvoted.
There is a trend in the media to avoid naming specific demographics when they are disproportionately involved in bad things. I don't know enough about the soundness of the philosophy behind it to feel like I can comfortably decree "and this is bad", but just for my information diet purposes, it is extremely annoying.
These online sources are sparse for the obvious reason, and are likely somewhat outdated.
There was a health unit merger between 2022 and 2025 so I merged the data in the following ways for cross-comparison:
Claude ran the numbers for me:
Measles outbreak case rate per 100,000 measles = [127.8, 164.3, 0.2, 0, 2.7, 101.4, 28.7, 0.6, 0.3, 190.2, 14.8, 9.9, 2.5, 28.5, 17, 0, 0.3, 0.1, 20.9, 16.4, 2.7, 0.2, 13.6, 325.3, 0, 0.1, 21.1, 33.3, 0.2]
COVID cumulative rate per 100,000 covid = [6707.4, 7747.1, 9581, 8451.9, 7134.7, 6943.7, 4747.7, 4669, 7767.3, 4783.8, 8589.8, 7198.7, 8199.9, 4256.5, 6678, 9671.7, 6840.5, 11594.5, 6979.1, 7440.3, 4056.3, 7218.1, 6000.87, 6056, 7068.2, 10361.8, 6874.5, 9856, 8971]
Measles (n=29): Mean: 38.73 Std Dev: 74.84 CV: 193.2%
COVID (n=29): Mean: 7325.70 Std Dev: 1855.83 CV: 25.3%
Ratio of CVs: 7.6x
We love the Mennonites here the way Americans love the Amish. It's fun, in a way, to dunk on suburban moms, but if you bring up the fact that Mennonites beat their wives and abuse their children it really kills the vibe of the party. I have a huge axe to grind about this, but despite that I do not think it is good for them to die of measles.