ReviewWhat the World's religions teach, applied to vaccines and immune globulins
Highlights
► Religion-based objections to vaccination date to circa 1796. ► Over 60 vaccine-preventable outbreaks in religious settings have been described. ► Ostensibly religious reasons to decline vaccination may mask safety questions. ► Acceptability may hinge on transformation, dilution, purpose, and alternatives. ► Important reasons to vaccinate include preserving health and duty to community.
Section snippets
Background
People conducting immunization programs may encounter individuals who hesitate, question, or decline some or all vaccines or immune globulins based on religious beliefs or related cultural reasons. Such matters are intensely personal and may be disconcerting for health professionals not comfortable discussing religious issues or who usually make immunization decisions based on matters more closely aligned to quantitative sciences.
The word religion derives from the Latin religio or religionem,
Methods
To identify professional and lay documents related to the acceptability or unacceptability of vaccines and immune globulins based on religious beliefs, PubMed and Google databases were searched using the search terms [outbreak and religion], [vaccine and religion], and [vaccine and “name of specific religious group”], specifying each of the world's religions estimated to have at least 5 million adherents: Bahá’í Faith, Buddhism, Christianity, Confucianism, Daoism, Hinduism, Islam, Jainism,
Populous religious groups
Discussion of the major religious groups appears below, sequenced by the founding dates of these traditions. The Christian denominations are listed alphabetically. This review did not identify any canonical doctrine that has led to religious objection to vaccines or immune globulins for Bahá’í Faith, Confucianism, Daoism, Shinto, or Sikhism.
Most ostensible objections to immunization attributable to religious belief fell into three categories: (a) violation of prohibitions against taking life,
Discussion
This review is intended to explain pivotal aspects of religious teaching that have been applied for and against the acceptability of vaccines and immune globulins. As various examples described above show, the scriptural, canonical passages cited here are not interpreted uniformly by each believer within a faith tradition. The multiple sects, denominations, and branches within each of the major religions demonstrates the multiple ways various passages have been applied [4], [83], [86].
This
Personal note
The coming together of public health and religion is not a collision; rather it involves repeated intersections. We can advance both healthcare and our own condition by discussing them openly more often. I remain open to finding and reading doctrinal teachings not identified in my searches to date.
Acknowledgements
The assistance of numerous religious scholars, believers, and vaccine experts who critiqued drafts of this review is greatly appreciated, including: Ibrahim AbuAmmar, Brant Biehn, Joye L. Bramble, Shehla Hussain, Chester J. Kitchen, Barbara J. Kuter, Mark Loeb, Manal Morsy, Paul A. Offit, Diane C. Peterson, Samir Shaikh, Neel Sheth, Benoît Soubeyrand, Walter L. Straus, Rita Swan, Deborah L. Wexler, Charles (Skip) Wolfe, Robert M. Wolfe, and Karie Youngdahl; from the Associated Jehovah's
References (223)
The Leicester anti-vaccination movement
Lancet
(1992)Anti-vaccination movements and their interpretations
Soc Sci Med
(2006)- et al.
Clustering of exemptions’ as a collective action threat to herd immunity
Vaccine
(2003) - et al.
Impact of addition of philosophical exemptions on childhood immunization rates
Am J Prev Med
(2007) - et al.
Measles in a highly vaccinated society: the 2007–08 outbreak in Israel
J Infect
(2009) - et al.
Seroprevalence of mumps antibodies in subpopulations subsequently affected by a large scale mumps epidemic in Israel
Vaccine
(2011) - et al.
Poliomyelitis outbreak in an unvaccinated community in The Netherlands, 1992–93
Lancet
(1994) The World's Religions (Plus)
(2009)- et al.
History of the World's Religions
(2008) Angel of death: the story of smallpox
(2010)
Ethics and immunization policy: promoting dialogue to sustain consensus
Pediatrics
The American anti-vaccinationists and their arguments
Bull Hist Med
Individual rights versus the public's health—100 years after Jacobson v. Massachusetts
N Engl J Med
Smallpox and its eradication
Being immunized for the sake of others
Hosp Pharm
Refusals and delay of immunization within southwest Alberta. Understanding alternative beliefs and religious perspectives
Can J Public Health
No more kidding around: restructuring non-medical childhood immunization exemptions to ensure public health protection
Ann Health Law
How orthodox protestant parents decide on the vaccination of their children: a qualitative study
BMC Public Health
Fatal diphtheria—Wisconsin
MMWR
Childhood vaccine-preventable diseases—United States
MMWR
Haemophilus influenzae type b disease among Amish children in Pennsylvania: reasons for persistent disease
Pediatrics
A community-wide outbreak of hepatitis A in a religious community: impact of mass administration of immune globulin
Am J Epidemiol
Hepatitis A outbreak in a socially-contained religious community in rural southern Ontario
Can Commun Dis Rep
Measles among children with religious exemptions to vaccination—Massachusetts, Ohio
MMWR
Multiple measles outbreaks on college campuses—Ohio, Massachusetts, Illinois
MMWR
Measles in a population with religious exemptions to vaccination–Colorado
MMWR
Measles outbreaks in religious groups exempt from immunization laws
Public Health Rep
Measles among the Amish: comparative study of measles severity in primary and secondary cases in households
J Infect Dis
High attack rates and case fatality during a measles outbreak in groups with religious exemption to vaccination
Pediatr Infect Dis J
Outbreak of measles among Christian Science students—Missouri and Illinois
MMWR
Outbreak of measles in a religious group—Montreal, Quebec
Can Commun Dis Rep
Outbreak of measles in a religious group, Montreal, Quebec
Wkly Epidemiol Rec
Measles outbreak—southwestern Utah, 1996
MMWR
Health consequences of religious and philosophical exemptions from immunization laws: individual and societal risk of measles
JAMA
Individual and community risks of measles and pertussis associated with personal exemptions to immunization
JAMA
Measles outbreak—the Netherlands, 1999 April—2000 January
MMWR
Outbreaks of measles in communication with low vaccine coverage
Commun Dis Rep Wkly
Outbreak of measles in an Orthodox Jewish community
Euro Surveill
Postexposure prophylaxis, isolation, and quarantine to control an import-associated measles outbreak—Iowa, 2004
MMWR
An outbreak of measles among unvaccinated young adults and measles seroprevalence study: implications for measles outbreak control in adult populations
J Infect Dis
Import-associated measles outbreak—Indiana, May–June 2005
MMWR
Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States
N Engl J Med
An ongoing outbreak of measles linked to the United Kingdom in an ultra-orthodox Jewish community in Israel
Euro Surveill
Measles outbreak associated with a church congregation: a study of immunization attitudes of congregation members
Public Health Rep
Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem
Epidemiol Infect
Outbreak of measles in two private religious schools in Bourgogne and Nord-Pas-de-Calais regions of France, May–July 2008 (preliminary results)
Euro Surveill
Objections against vaccination: the perspective of those who refuse
An outbreak of measles in Orthodox Jewish communities in Antwerp, Belgium, 2007–2008: different reasons for accumulation of susceptibles
Euro Surveill
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JDG is an employee of Merck & Co., Inc., Whitehouse Station, NJ. This work represents the author's opinions and not those of Merck & Co. The author has been a practicing Roman Catholic his entire life, and has explored religious aspects of immunization since the 1990s.