To vaccinate or not to vaccinate

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Seeking wisdom from experience, medical expertise, and church leaders

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Editor’s note: Thanks to our readers for their many comments. We particularly appreciate links to medical journal articles. WORLD, starting on Friday, March 6, will publish additional material concerning this vital issue.

We don’t know precisely from the Bible whether to use vaccines or not, but we do know that we are to care for our families, our neighbors, and ourselves. We do well to pay attention to experience, medical expertise, and church leaders. —Marvin Olasky

Experience

When I was 4 years old I had the chicken pox and, according to my parents, the flu at the same time. I remember feeling awful, and I still have a few pox marks to remind me.

When I was in the first grade I had what we called “the two-weeks” measles. I spent most of two weeks in my dark room with only a night-light. Blankets were over the windows, because it was thought that exposure to bright light while having the measles could damage the eyes. The only thing good about the experience was that, as the illness neared the end of its course, my dad brought me a baseball glove and bat.

When I was in second grade, the Salk polio vaccine became available for all children. Class-by-class we went to the school office (this was a small Christian school) and got our shots. In addition to the stress of getting the shot, there was the pressure to take it like a man and not to embarrass oneself. Twice during the school year we got the shot and once we came back to school during the summer to get a third. I remember two things pre-vaccine:

Parents lived in fear, especially through the summer months, that their kids might contract polio and so watched for symptoms. There were pictures on television and in magazines of children in leg braces to help them walk and others in iron lungs to help them breathe.

I think it was in the fifth grade I noticed swelling along my jaw during school. That night at supper (for some reason I recall we had coleslaw) my parents confirmed I had the mumps. One of the concerns that parents had for their sons in those days was that the mumps would cause sterility. (Not to worry, my wife and I had five sons.)

Somewhere along the way I got the “three-day measles” (rubella). It didn’t make me very sick, but I had to be kept away from pregnant women because, if she lacked immunity (hadn’t had rubella as child) and contracted the disease, it could harm her baby.

I did not get the smallpox vaccination till the summer before I went off to Belhaven College. I got it because the college required it. The reason many of my contemporaries and I had not got it earlier was because smallpox had been eradicated in the United States because of the near universal vaccination of previous generations of Americans.

I have had the flu quite a few times. The most vivid memory I have of it comes from a time when our family of seven was living in two-bedroom house in a small town in Mississippi, and my wife and I got it at the same time. We had arranged for a carpenter to come and build a closet in the “master bedroom” to house the washer and dryer. And that week we both came down with the flu. Our bedroom not being available, we pulled out the bed in the sleeper sofa and lay there during the day. The people in the church were very kind and checked on us and brought us food, but whenever someone came to the door, we would say to each other, “Whose turn is it to get up?” Such was the extremity of the malaise.

I tell these stories, not because they are unique, but because they are the common experience of people of my generation. We got fewer childhood illnesses than our parents, but we still got a lot of them.

I was spared whopping cough (pertussis) and polio. Why? Vaccinations. My kids were spared all but the flu and chicken pox. Why? Vaccinations. Their kids might be spared them all, except the flu, and even it, depending on how accurately the scientists predict which strains of flu are most likely each season. Why? Vaccinations.

I like vaccines a whole lot more than I like the diseases they prevent. When I have gone on mission trips, I have got whatever vaccines were recommended for the countries I visited. When I hit 65 I got the pneumonia shot. When I went to the doctor last, I got the flu shot and some kind of booster. If it’s recommended, I get it. I only wish there were cancer and heart disease vaccines. Any disease I can avoid through vaccination I intend to avoid.

Which makes me wonder, why the intensity of the anti-vaccine movement? A few guesses:

Because of the success of the vaccines, parents now do not have the experiences of childhood illnesses older people have had, hence less appreciation of the risks of the diseases, less understanding of the necessity of the vaccines (until like smallpox they are no longer needed because they are wiped out worldwide), and the luxury of objecting. Some have an undue suspicion of science in general and medical science in particular. They do not appreciate how much practical science has improved our lives or how much medical science has increased the length and quality of our lives. Medical science can get things wrong, but it gets a lot right. Since the discovery of penicillin and the development of other antibiotics, a great many lives have been saved, but doctors no longer routinely prescribe them because they have found that overuse has led to the development of antibiotic-resistant strains of bacteria. It’s possible for science to proceed on mistaken assumptions and jump to wrong conclusions and otherwise get it wrong, but good science is humble, honest, and objective. Most medicine today is evidence-based. The questions for doctors are: What works? What works best most often? What poses the fewest risks? There are those who focus on the risks they believe are posed by the vaccines. It wasn’t long ago that candidate Obama spoke about vaccines and the risk of autism. Though some continue to assert this risk, every study done so far has indicated there is no link between vaccinations and autism. Others point to the risks of adverse reactions. Adverse reactions are rare, and serious ones are extremely rare. Yes, there is risk, but there is no such thing as living a risk-free life. We take calculated risks all the time not just for ourselves but also for our kids. Let him run around the yard and he might fall and break his arm. Give her peanut butter and she might go into anaphylactic shock. The risks associated with the vaccines are far less likely and severe than the risks if one contracts the illnesses they prevent. Others are wrongly confident in what is “natural.” They do not understand that nature is out to kill you and to make your life more difficult, until it does. It is particularly baffling that Christians who know the history, effects, and doctrine of the Fall are so pro-natural. A good bit of our energy as humans has to be devoted to beating back the thorns and thistles and delaying returning to the dust. Polio, whopping cough, measles, mumps, influenza, chicken pox are natural. Vaccines are “unnatural.” Thank God they are.

I’ll make some sacrifices. Send me the high fructose corn syrup, especially if it has been made into a pecan pie. I’ll take the genetically modified, pesticide-spayed, fertilzed grains and vegetables. I’ll eat the corn-fed beef and let you have the grass-fed. But get those kids vaccinated. It will be good for them—and the rest of us, too.

—William H. Smith is a long-time pastor.

Medical expertise

What is a vaccine?

Our immune system is constantly protecting us against bacteria, viruses, parasites, and fungi. That’s why people receiving treatments that suppress their immune systems are very susceptible to infections.

The idea of vaccinations is to give a person a component of an infectious organism to stimulate his or her immune system to act against it before it causes harm. It’s training your immune system to be on guard against particular invaders.

The history of vaccines

Edward Jenner was a country doctor living in England who in 1796 performed the world’s first vaccination. He took pus from a cowpox lesion on a milkmaid’s hand and injected it into an 8-year-old boy named James Phipps. Six weeks later, Jenner injected two sites on Phipps’s arm with smallpox, yet the boy was unaffected by this as well as subsequent exposures. Based on 12 such experiments and 16 additional case histories he had collected since the 1770s, Jenner published a volume called Inquiry into the Causes and Effects of the Variolae Vaccine.

Jenner came up with his idea by the observation that milkmaids infected with cowpox, visible as pustules on the hand or forearm, were immune to subsequent outbreaks of smallpox that periodically swept through the area.

Since Jenner’s discovery, governments have invested in vaccines. Initially, vaccines were considered a matter of national pride and prestige. In the 20th century, a standard battery of childhood vaccinations were developed and eventually required for public school attendance.

Some diseases vaccines prevent

Polio: In this disease, people develop muscle weakness and the inability to move. The weakness can extend to the diaphragm, the muscle that moves our lungs, resulting in people having to be placed on a ventilator to support breathing. Historically, a ventilator called on iron lung was used to artificially maintain respiration until a person recovered sufficiently to breath independently.

Rubella: When pregnant women become infected with this virus, it can cause serious birth defects such as heart problems, hearing and vision loss, and intellectual disability.

Diphtheria: This bacteria causes a membrane to develop in the oral cavity that can block the airway, causing people to suffocate to death.

Measles: This virus can cause a cough, inflamed eyes, a sore throat, a fever, and red, blotchy skin. In about 30 percent of cases, complications such as blindness, inflammation of the brain, and pneumonia occur.

The impact of vaccines

A little more than a century ago, before vaccines, the U.S. infant mortality rate was 20 percent, and the childhood mortality rate before age 5 was 20 percent.

Are vaccines safe?

In the vast majority of cases, vaccines are effective and cause no side effects or only mild reactions, such as a fever or swelling and pain at the injection site. In 1998, the medical journal Lancet published a study linking the measles vaccine to autism. The study was subsequently found to be fraudulent. The journal retracted the paper and the study’s author, Andrew Wakefield, lost his medical license.

Why get vaccinated?

Vaccines prevent outbreaks of infectious diseases and save lives. When a certain portion of a community is vaccinated against a contagious disease, most members of the community are protected. Even those who aren’t eligible for certain vaccines, such as infants, pregnant women, or immunocompromised individuals, are protected. This is called herd immunity. So when you get vaccinated, you are not only keeping yourself healthy, you are also preventing the most vulnerable among us from getting sick.

—James Marroquin is a physician based in Austin, Texas, and a World Journalism Institute mid-career course graduate.

Church leaders

Recommendations of the Elders of First Presbyterian Church (PCA), Augusta, Ga., 2014:

(Editor’s note: One-third of the elders are doctors.)

God has blessed our church with a burgeoning number of children. All of us, and the Elders in particular, have a responsibility to protect our children at every level (spiritually, emotionally, and physically). Because of a combination of (1) increased world travel, (2) increased immigration, and (3) a growing number who choose not to receive immunizations for themselves or their children, we in the U.S. are at significant risk for diseases that were once thought to have been almost eradicated from our country. These diseases are not minor illnesses; they can kill and they can maim, especially infants and small children, the elderly, and those who are immunocompromised. Ironically, the very success of immunizations has led some to believe that vaccines are not necessary. These serious and vaccine-preventable diseases are making a comeback. (For instance, there have been over 500 cases of measles in the U.S. in the first half of 2014—a 20-year high.) Immunizations are extremely safe and effective. Immunizations are a gift from God, mediated through the common grace of medical science, and to be received with gratitude. Routine immunizations for adults and children protect not only the ones receiving the vaccines but also others surrounding them. Not being immunized as recommended may therefore be harmful to others, especially the youngest and weakest in our church. Christian liberty allows wide latitude in our daily decisions for ourselves and our families. Christian love requires that we use our liberty for the glory of Christ and with regard to the welfare of others. Freedom in Christ is to be used humbly and gently in love to build up and to help others. If one’s liberty harms another or infringes on the liberty of another, then it is the believer’s responsibility to limit his own liberty out of love for the other. We affirm the centrality of Jesus Christ and his gospel of grace. We must allow no secondary issues to divide our church. Maintaining the peace, purity, and unity of the church is the responsibility of all FPC members, and, most particularly, the responsibility of the Session.

Session recommendations:

The Session strongly recommends and urges that all children and adults in our church be immunized as medically indicated. The Session strongly urges all members to consider others in the matter of immunization for oneself and one’s children. Not being adequately immunized places others at risk, often the weakest and youngest of our church; this is especially true in our nurseries and Sunday School classes. The Session strongly recommends that any adult teaching or assisting in FPC nurseries or children’s classes be immunized according to current medical standards. The Session strongly recommends that any child utilizing FPC nurseries or attending children’s classes be immunized according to current medical standards. The Session authorizes the education of our congregation in issues regarding immunizations.

Update, Feb. 13, 2015:

Measles continues to spread. You have likely heard of the Disneyland outbreak. There is now a case of measles in Atlanta. The outbreaks seem to be occurring from the combination of international travel and lack of immunizations. Herd immunity is a concept in which the individual is protected not only by the immunization of the individual but also by the immunization rate of the community. In measles, for instance, a 92–94 percent immunization rate is needed for optimal protection. We have a responsibility to our church, local, and international communities. A question was raised about the issue of a few vaccines (chicken pox, shingles, hepatitis A, rubella, one brand of rabies vaccine) having been made in aborted fetal cell lines. The church’s immunization committee carefully considered this issue as we made our recommendations for universal immunization; we still stand by our recommendations. Here are some links to assist in thinking through this issue: a. Christian Medical & Dental Associations: “Immunization Ethics Statement” b. Christian Medical & Dental Associations: “Is Vaccination Complicit with Abortion?” c. Christian Medical & Dental Associations: “Vaccination Information and Recommendations” d. National Catholic Bioethics Center: “FAQ on the Use of Vaccines”