In December 2014, “The Happiest Place on Earth,” Disneyland, was plagued by a measles outbreak. In all, 131 people were infected — the majority of whom were unvaccinated. Shortly after, the University of California announced that beginning in 2017, students will need to provide proof of four additional vaccinations, plus a tuberculosis screening, to the current Hepatitis B requirement — or else face a hold on their registration until they do so. Around the same time, Senators Richard Pan and Ben Allen introduced legislation to end California’s vaccine exemption loophole within the state’s public education system. It deemed parental personal reasons (“I don’t believe in vaccinations”) as illegitimate bases for exemption from vaccinating their children, and also would release a list of unvaccinated students (based on religious or medical exemptions) so as to better pinpoint sources of future outbreaks. (The legislation stalled last week.)
The uncanny timing of these events has reignited debates regarding immunizations and the bioethics governing them, particularly in terms of enforcements and consequences in failing to comply.
The University of California has adopted a policy similar to that proposed in the aforementioned legislation: According to Dr. Gina Fleming, medical director of the UC Student Health Insurance Plan, the UC will only honor medical and religious exemptions; UC spokesperson Shelly Meron added that the UC will maintain an inventory, so to speak, of all exempted students in case of future outbreaks.
Because of vaccines’ proven effectiveness in case of outbreaks, their mandatory enforcement in academic settings — in which large and diverse groups gather ― makes sense. Personal or philosophical oppositions are merely not strong enough convictions to endanger populations with detrimental but preventable diseases. However, what happens when the lines between personal convictions and religious beliefs become blurred?
Jewish bioethics boil down to Deuteronomy (Devarim) 4:15, which translates along the lines of “And you shall watch yourselves very well” ― a statement that implies a personal duty to protect ourselves from disease. Moreover, Maimonides teaches us that we have an obligation to take care of out bodies physically so we can maximize integrating G-d’s teachings into our lives (Mishneh Torah, Hilchot Deot 4:1).
In Judaism, life on Earth is precious. To forgo life-saving medical advancements is to undermine life. Rabbi Nachman of Breslov, who died of tuberculosis in 1810, wrote in Kuntres Hanhagot Yesharot [Compilation of Upright Behaviors], “One must be very, very careful about the health of children…One must inoculate every baby against smallpox before one-fourth [3 months] of the year, because if not, it is like spilling blood [murder].” Preventative medicine is thus taken very seriously, and actively refusing it is akin to purposely endangering one’s life.
The Shulchan Aruch, the Code of Jewish Law, heavily favors preventative medicine, stipulating, “It is a positive commandment to remove anything that could endanger life, and to safeguard against any of these things, and to be very careful, to guard yourself and guard your soul. Someone who does not remove that which is potentially dangerous will have set aside this positive mitzvah” (Choshen Mishpat 427: 8-10).
Vaccinations affect more than just the individual being injected; vaccinations guard entire communities from potential outbreaks. Thus, Jewish bioethics prescribe vaccinations as more than just a personal duty — they are community obligations. The final chapter of the Shulchan Aruch emphasizes that “just as there is a positive commandment to build a guardrail around the perimeter of a rooftop lest someone fall, so too are we obligated to guard ourselves from anything that would endanger our lives.”
Hence, Judaism stipulates vaccinations as not only permissible, but obligatory. Minority reluctance to vaccination because of non-kosher ingredients in certain vaccines (such as rat blood in the smallpox vaccine) has also been refuted, since there is no prohibition to these ingredients as long as they are administrated by non-oral means, such as injection. Moreover, in cases of life and health dependency, oral kosher laws can also be suspended; thus, Jews who use the religious exemption clause from forgoing vaccination requirements are treading a fine line, for they are endangering both themselves and the greater community.