LAKEWOOD — The article in the local Jewish publication began ominously.

“Imagine, Heaven forbid, the following headlines,” Rabbi Yair Hoffman wrote in an essay assailing anti-vaccination members of the community. “’Measles Outbreak in Lakewood, New Jersey.’”

About six months later, the warning would prove prophetic.

As of this weekend, state health officials have confirmed 15 cases of measles in Ocean County in an outbreak that began in Lakewood last month when a traveler returned from Israel. Meanwhile, a new case has been reported in Passaic County while across the Hudson, outbreaks continue to spread in Brooklyn, with at least 29 cases, and Rockland County, with at least 76.

All the outbreaks are connected to Orthodox Jewish neighborhoods. The 2013 outbreak in the Brooklyn enclaves was tied to parents who boycotted vaccines, health officials said.

Jewish organizations in New York and New Jersey — including the influential religious community council in Lakewood, the Vaad — have issued statements of support for vaccinations and condemned campaigns peddling dubious claims about the hazards of vaccines and scientifically unsupported ties to autism.

But the anti-vaccine movement is hardly peculiar to these insular communities. It has grown exponentially in New Jersey, a state with the highest rate of autism.

The World Health Organization says that to stamp out measles, a community's immunization rate needs to be at least 93 to 95 percent. The statewide average for schoolchildren is 95 percent.

According to the state Department of Health, the immunization rate for Lakewood children in public and private schools is less than that, at 91.1 percent, with 4.1 of students claiming religious exemptions.

But Lakewood is not the worst.

Just half of Ogdensburg's students were vaccinated last year. Bradley Beach had a rate of 66 percent while Milltown Borough had a rate of 68 percent.

The rates in Bound Brook and Peapack-Gladstone were 72 percent, with more than a quarter of Peapack-Gladstone's 74 elementary and pre-K students claiming religious exemptions, the highest such exemption rate in the state.

About 200 municipalities in the state have vaccination rates of less than 95 percent. Scroll down to see the full map.

"Some people do choose not to get vaccinated ... and that becomes a problem," Dr. Ted Louie, an infectious disease expert with the Medical Society of New Jersey, told New Jersey 101.5 last month. "We all believe that if we had close to 100 percent vaccination rates, these outbreaks would probably go away."

Exemptions skyrocket

Measles, a viral infection that produces a fever, rash and serious complications, was declared eradicated in the United States in 2000. But the disease appears to making a comeback in a few corners as a result of parents choosing not to vaccinate their children, experts say.

"Children of parents who refuse vaccine doses have an increased risk for acquiring and transmitting measles and pertussis, and in small geographic areas with a preponderance of children whose parents have refused vaccine doses, an increased risk for pertussis and measles exists among members in the community," according to 2011 report from the U.S. Centers for Disease Control and Prevention.

The report said that three of the four measles outbreaks in 2008 happened in areas where parents had refused vaccines. If enough parents opt out of vaccinations, even the surrounding community's high vaccination rate may be enough to prevent the spread of the illness, the report said.

While a small number of children may suffer an injury after getting a vaccination, there is no known link between the measles, mumps, rubella vaccine and autism. The first study that ever made such claim was retracted. A subsequent study furthering that claim is considered by the scientific community to be flawed. Other studies have disproved the link.

Still, the number of children claiming religious exemptions from vaccines has nearly tripled in recent years in New Jersey — from 3,865 in the 2009-10 school year to 11,428 last year.

Earlier this year a crowd of about 300 people angrily shouted down a divided Assembly panel that approved a bill to require parents to submit a notarized document explaining how getting a vaccine conflicts with their bona fide religious tenets or practices. The bill has not been brought to a vote by the whole Assembly and the Senate version remains in committee.

Immunization rates by municipality

Scroll and click on the map to see the immunization rates for the public and private schools in your district and the percentage of students who claimed religious exemptions. The enrollment is of pre-K through Grade 6 and transfers. The 2017-18 data is from the state Department of Health.

Municipalities in green scored 93 percent or better. Municipalities in red had rates below 93 percent. Municipalities in black have schools that did not provide sufficient data.

Children in private and public schools and childcare facilities are required to be vaccinated unless they declare medical or religious exceptions. Schools and facilities are required to submit to the state an Annual Immunization Status Report declaring immunization coverage among students in childcare/preschool, kindergarten/Grade 1, Grade 6, and transfer students in any grade.