Mandatory school immunization laws have been key to improving vaccination rates in the United States and have contributed to a significant decline in vaccine preventable diseases. But, as with many public health campaigns, there is a tension between the need to protect the common good and individual liberty. And so, for as long as mandatory school immunization laws have been around, there been parents demanding an exemption to the rules. (See Viemester v. White, 179 N.Y. 235 (1904)).
Currently, 48 states, as well as the District of Columbia, permit religious exemptions to mandatory immunization requirements. While states approach the exemption requirements differently, for the most part parents simply need to provide a written statement that immunizations violate their religion. At the same time, there are 18 states that allow a “personal belief” exemption. In those states where personal belief exemptions are not allowed, there are, not surprisingly, a lot more parents relying on religion to avoid vaccination. (Shaw 2014).
This got me thinking. Which religions, if any at all, actually prohibit or discourage immunization as part of religious doctrine? That is, if a “religious belief” exemption means something different than a personal belief exemption — and it would seem to since they are separate exemptions — doesn’t the religious belief have to stem from something religion-based? But do any religions actually oppose immunization?
It turns out, no. Not really. The only organized religious group that has had an official doctrine opposing immunization are Christian Scientists. (Shaw 2014). All other mainstream organized religions of the world permit, even encourage, immunization. Here’s a brief run-down of some of the major religions, based on an excellent paper by John D. Grabenstein.
1. Hinduism: Hindus advocate non-violence and respect for life. Observant Hindus avoid beef. However, Grabenstein could find no doctrinal opposition to Hindu use of immunization despite bovine components of some vaccines.
2. Buddhism: Buddhists have had a long appreciation for the power of vaccination. The first written account of an act of immunization tells of a Buddhist nun who ground scabs from a smallpox victim into dust and then blew the dust into a non-immune person to produce immunity. Although Buddhists generally oppose the killing of animals and humans, there is no apparent objection to the bovine components in some vaccines.
3. Judiasm: A primary commandment of Judiasm is to act to save one’s own or another’s life and Judaic principles “emphasize the community benefits of disease prevention.” This has been interpreted by scholars to include encouraging immunization — even allowing the Sabbath to be set aside in times where vaccination services were irregularly available. As Rabbi Abraham Nanzig in 1785 wrote of vaccinating children against smallpox, “One who undergoes this treatment while still healthy, God will not consider it a sin. Rather, it is an act of eager religious devotion, and reflects the Commandment to ‘be particularly careful of your well-being.”(Deuteronomy 4:15).
4. Christianity: There are no scriptural or cannonical objections to immunization. Some Christian groups (particularly Roman Catholics) have raised concerns about the use of aborted fetal origins in some vaccine development. Two fetal cell lines have been used to produce vaccines and both lines come from purposely aborted fetuses in 1961 and 1966. It should be noted, however, that neither fetus was aborted for the purpose of obtaining the cell lines.
A team of ethicists at the National Catholic Bioethic Center and the Vatican’s Pontifical Academy for Life have concluded that the association between vaccines and abortion was “noncomplicit” and that using these vaccines is “not contrary to a principled opposition to abortion.” Being immunized does not share “in immoral intention or action of others.” Furthermore, these ethicisits concluded that parents have a moral obligation to protect their children’s life and health through immunization. If alternative options are available, these are preferred, but the lack of availability should not prevent or preclude immunization.
5. Amish: This is of particular interest given that the Amish community in Ohio has just recently experienced an outbreak of measles brought back to the U.S. from unvaccinated travelers to the Philippines. There is nothing in Amish or Hutterite religious doctrine that prohibits immunization. Most of the low immunization rates among the Amish can be attributed to objections to modernity, lack of access to care, and worries of safety as opposed to any true theological objection.
6. Church of Christ, Scientist: The central tenet of this religion is the spiritual healing of disease. For this reason, many followers refuse all medical help for disease as well as immunization. Sickness can be healed by prayer and recognition of its unreality. However, the churches founder, Mary Baker Eddy, stated in 1901: “Rather than quarrel over vaccination, I recommend, if the law demand, that an individual submit to this process, that he obey the law, and then appeal to the gospel to save him from bad physical results.” Thus, vaccination could be allowed, though reluctantly and with a perception that it may cause some form of harm. Indeed, during significant outbreaks of disease, followers of this religion have been more willing to accept immunization.
7. Dutch Reformed Congregations: Members of this religion have long opposed immunization, dating back to smallpox vaccination in the 1800s. Believers often choose to forgo immunization so as to avoid making a person less dependent upon God or to avoid interfering with what may be viewed interfering in divine providence. Communities of followers have seen repeated disease outbreaks and some believers have argued that immunization is akin to building a dam to prevent a flood, which is allowed but could also be seen interfering in divine providence (if God wants your land to flood, it should flood).
8. Jehovah’s Witnesses: Jehovah’s Witnesses is a Christian denomination known for its central tenet that followers must refuse transfusions of blood and certain blood components (some groups of followers don’t agree with this tenet). Throughout the 1920s-1940s the church denounced vaccination and banned members from vaccinating under penalty of excommunication. In 1952, the Church changed its stance, asserting that vaccination was an individual choice, “one for the individual that has to face it to decide for himself…” (Watchtower1952 Dec 15 p.764). Recent Jehovah’s Witneses publications seem to recognize the value of vaccination: “Vaccination can help to prevent some infections, but a wise person must still take necessary precautions when with someone who has an infectious disease.” (Awake! Mar. 2011).
9. Islam. The greatest obstacle to vaccination in the Islamic tradition is the religion’s prohibition of consuming certain animal products. Select groups of Muslims worldwide have opposed vaccination, but on socio-political grounds rather than theological ones. Multiple Islamic leaders have confirmed that immunization is compatible with Islamic principles, including the principle of preventing harm (izalat aldharar), and the principle of the public interest (maslahat al-ummah).
Thus, few (if any) religions actually prohibit followers from being immunized. Indeed, most recognize the goodness of immunization. Which begs the question: just what are these “religious exemptions” about? Not much, it would seem.