Making hay was more than a figure of speech last week at the New Holland auction house in Pennsylvania last week, where a ton of top quality hay bales were going for upwards of $400, up about 20% from last year.

For members of the Lancaster settlement, a term used to describe the Amish population that settled here in 1760, the price of hay was only part of the discussion: the price of horses, donkeys and milk were also topics of conversation and, as it has been for year or more, a potentially deadly outbreak of measles.

In the most recent count, 1,398 cases had been detected, according to the Pennsylvania department of health. Since 1 August, 150,000 doses of MMR vaccine had been administered, with more than 50,000 given in October alone.

The outbreak, and the politics surrounding it under Robert F Kennedy Jr, the health secretary, has focused on Lancaster county, placing the Amish under a spotlight. While there is no Amish religious opposition to vaccines broadly, a study found that that less that a third of Amish residents had been immunized against measles, mumps and rubella.

“It wasn’t that way 50 years ago in our community,” said Christ Stoltzfoos, standing outside a barn of horses, miniature ponies and donkeys that were also up for auction. But Stoltzfoos didn’t have a ready explanation for why vaccinations had lapsed in the community, which is descended from German-speaking religious conservatives and where the modern world is largely kept at bay.

All of his immediate family had been vaccinated, and had not got sick, but some cousins weren’t and did, Stoltzfoos said.

“I guess you don’t get to change anybody’s mind. The people that changed their mind are the people who got really sick from it. They say now they would have gotten vaccinated. But the people that didn’t really get sick, they still say: ‘Oh, it’s not really that bad.’”

The attention the Amish have received while experiencing the worst outbreak in the nation has not always been welcome. But the state, under Josh Shapiro, the Democratic governor, has mounted an intensive outreach of pop-up clinics and mailings to encourage the community to get protection.

The Lancaster settlement depends in large part on tourism, with coach loads of visitors stopping to by shoofly pie and other Amish delicacies. Vaccination is thus, in part, a business decision. Still, almost two-thirds of measles cases in Pennsylvania have been among adults, a mirror opposite of how measles is typically transmitted.

All five of the Pennsylvania mortalities involved people who were unvaccinated by choice or because they were too young to receive it, according to the Philadelphia Inquirer.

But within the Lancaster community, vaccines don’t necessarily carry the politicization of the “English” world. “A lot of people now get the shots,” Stoltzfoos said.

Nearby, John Kaufman, 81, was operating from a different playbook. He said the vaccine was hard on the immune system. “You get the measles and you get over it. People have it once, and it’s over. But if you hurt your immune system with the shots, something else will creep up on. The shot will take care of the measles, but it’ll stir something else up. Then what?”

He pointed to reports that Covid shots had been linked to heart attacks and, he said, cancer: “If you’re strong and healthy you might be able to work the Covid shot off. But if you had a weakness in yourself, it could take over.”

Anna, a young woman at the auction, also said she had had measles. “It was miserable,” she said. “My whole family had it, except my dad. He got the vaccine. I wouldn’t get the vaccine now because if you had measles, you’re stronger for it. Why change that?”

Thinking around the measles vaccine in the community is in some ways a reflection of thinking in the “English” world beyond, where health authorities are battling outbreaks in South Carolina and Texas for much of the last year. But those outbreaks primarily affect children.

Pennsylvania has recorded five measles-associated deaths (including two infants and three adults with underlying health conditions), but those numbers are not reflected in CDC data, which records three deaths nationwide of 4,588 confirmed cases in 2026.

This month Kennedy, who heads the vaccine-skeptic Maha movement, claimed that the “people of Pennsylvania suffered” because Shapiro’s administration politicized the state’s measles outbreak.

Kennedy said that a “global measles outbreak” had been caused by decline in the number of people receiving the measles vaccine during Covid. Pennsylvania, which has 27% of US cases, had only begun applying for CDC emergency assistance in September.

But Shapiro claimed that the CDC would not correctly acknowledge the measles-related deaths “because it doesn’t fit their phony narrative. I think RFK is doing great destruction in this country by stoking this vaccine skepticism.” The state has sent 300 health department staff to the area and administered nearly 6,000 vaccinations.

Vaccination politics has also reached the race for Pennsylvania’s 11th congressional district, where five-term Republican representative Lloyd Smucker is being challenged by Democrat Nancy Mannion. At a town hall-style debate last week, Smucker, who was raised Amish until he was five years old, said the Amish are making decisions they think are best for their families.

“The role of government should be to do research and development on vaccines and be open and transparent about what that means. It was disappointing to me to see the governor using the measles to score political points,” he said. “It turns out that the first two deaths really weren’t caused by measles at all.”

But Mannion, a former emergency nurse and international healthcare leader, told the Guardian: “The Amish aren’t anti-vaccination, but they don’t access the healthcare system in the same way. It’s not just the Amish that are part of this outbreak because of the skepticism has brought to vaccines I would tie directly back to Robert Kennedy Jr.”

Measles, Mannion said, “is completely preventable and had been eradicated, but now we’re living in a surge. I’d say there is a link between his anti-vaccine stance generally and what were seeing now.”

The Amish in Lancaster are not the only such community to experience larger political forces. In upstate New York, the state health department has been battling three small Amish schools over whether the children fall under immunization rules or should be granted an exemption on freedom of religious practice grounds.

Kathy Hochul, the New York governor, recently declared a statewide health emergency after more than 100 people contracted measles, an outbreak epidemiologists believe is connected to the outbreak in Pennsylvania and also one in Ohio. The schools now face fines of $2,000 per unvaccinated student.

Steven Nolt, professor of history and Anabaptist studies at Elizabethtown College, points out that is by family tradition and not religious instruction that the Amish accept or decline immunizations. At the same time, he said, there is some evidence that vaccine-skeptical groups had been doing outreach to the Amish since 2015.

But accurate information is hard to come by, he says. “We don’t have good data but it’s clear they are under-vaccinated, but by how much we don’t know. The Amish are a religious group, so governments are not allowed to track information. We don’t know any better how many Amish are immunized than how many Anglicans or Presbyterians are immunized.”

At the New Holland auction, the measles question was in fact less pressing than land values, interest rates, the costs of diesel, hay and livestock. The Amish were to some extent protected from the price of fuel because they use horses in the fields, but also exposed because of their use of diesel-powered generators, pickers and milking machines.

A shift in farming practices, from crops and livestock to milk and vegetables, also presented changes, and many had moved away from agriculture to furniture-making and construction. Dairy prices were way down but organic milk was a good business, Christ and his uncle Amos Stoltzfoos agreed, with 100lbs fetching $51.

“We’re at their mercy but I don’t feel that we’re wrongly used,” Christ said of the milk companies. But sales of raw milk, illegal to consumers in New York have also become an outside political issue.

“I think it’s good they regulate raw milk or it will be like the measles soon,” Christ Stoltzfoos said. Both agreed that the Amish don’t like to deal directly with the government. “Most of us don’t even know what’s going on,” the younger man said. “I read the paper but that don’t tell me much.”