Question:

Recently there’s been is a lot of debate and discussion on the issue of vaccinations. As a parent, I’m curious what Jewish law has to say on the topic.

Informed Citizen

Answer:

Dear Informed Citizen,

Thank you for your question! Or perhaps I should say questions, because the topic of vaccinations has many sub-topics and issues that need to be addressed. What makes your question even more complex is the fact that the term vaccination is very broad—there are some vaccinations that are for life-threatening diseases, and others for non-life-threatening ailments. Also, different segments of the population might have different risks based on their age and location, and so on.

However, before we address the question of vaccination specifically, we first need to understand the Torah’s take on the importance of guarding your health in general.

The Halachic Mandate to Take Precautions

Guarding your own health doesn’t only make sense, it’s actually a mitzvah. That means that even if you don’t want to do it, for whatever reason, you are still obligated to do so. The Torah is teaching us that our body is a gift from G‑d, and we are therefore not the owners of it and we can’t cause it any damage.1

It is not enough to deal with health issues as they arise; we must take precautions to avoid danger. The final chapter of the Code of Jewish Law 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, as the verse states,2 ‘Only guard yourself and greatly guard your soul . . .’”3

As an example of this ruling, Rabbi Moshe Isserles (known as the Rema), one of Judaism’s outstanding halachic decisors, writes that when a plague breaks out in a city, the inhabitants of that city should not wait for the plague to spread. Rather, they (with some exceptions4) are obligated to try and flee the city at the onset of the outbreak.5

When there is an epidemic, not only is it your obligation to flee, but as a parent you have the obligation to secure the safety of your children. Rabbi Yeshayah ha-Levi Horowitz, known as the Shelah, writes that any parent who doesn’t move his children out of a city plagued by an epidemic is held responsible for their fate.6

We have established that one must do whatever is in their power to save oneself, one’s children, and others as well from possible life-threatening dangers. and it would seem that there is no difference between vaccinating and having to flee a city when there is an epidemic.

However, the question of general vaccinations when there is no current epidemic seems to be a bit more complex.

Vaccinations

The directives found in the Code of Jewish Law for avoiding danger don’t really carry any risks of their own (e.g., fleeing the city, not eating meat and fish together, or not putting coins into your mouth). Vaccinations, however, may have certain risks, however minuscule they may be. Thus presenting us with the question of whether one may take a small risk now in order to perhaps avoid a bigger risk later.

In grappling with this issue, one of the leading authorities at the time of the discovery of the smallpox vaccine during the 19th century, Rabbi Yisroel Lipschutz (famed for his commentary on the Mishnah entitled Tiferet Yisrael), ruled that despite the risk of death from the smallpox vaccine (at that time 1/1000), one should still get vaccinated.7

Yet some have postulated that since nowadays the risk of contracting many of these diseases has been largely eliminated—or at the very least, is significantly less than during the smallpox epidemics—therefore, even if the risk of damaging side effects is also very low, what we are left with is two opposing risks, and the Talmudic dictum of shev v’al taaseh adif8—“in some cases of doubt, better to sit and do nothing”—applies, and one shouldn’t vaccinate.9

When the polio vaccine was being implemented in Israel, there were those who turned to the Lubavitcher Rebbe, Rabbi Menachem M. Schneerson, of righteous memory, for his opinion. The following is a sampling of his replies.

In the winter of 1957 the Rebbe wrote a reply, pointing out that he was hurrying to do so because of the prime importance of the issue at hand:

. . Regarding your question about inoculations against disease:

I am surprised by your question, since so many individuals from the Land of Israel have asked me about this and I have answered them in the affirmative, since the overwhelming majority of individuals do so here [in the United States] successfully.

Understandably, if there are inoculations that are produced by multiple pharmaceutical companies, you should use the ones whose product has been safely tried and proven.10

In the spring of 1956 the Rebbe wrote:

. . In reply to your letter in which you ask my opinion about the injections that are commonly given to young children:

It is with regard to matters such as these that the axiom “Do not set yourself apart from the community” applies. You should act according to that which is done by [the parents of] the majority of children who are in your children’s classes . . .11

Even as the polio vaccine effectively eliminated the dreaded disease, there were instances where faulty shots actually brought about illness. In a letter from the winter of 1957, the Rebbe addressed this issue:

. . The event that occurred in the United States was at the beginning of the use of these vaccines, before the [exact] medical compound was definitively established. This is not the case at present, after months of experience with the vaccine.

Therefore, once a vaccine’s reliability is firmly established, there is no worry. To the contrary . . .12

In a similar vein, Rabbi Shlomo Zalman Auerbach, one of the preeminent rabbis of the past century, rules that if one has reasonable concern of the dangers of not being vaccinated, and the only chance to be immunized is on Shabbat (or the person would have to wait 4 or 5 years for the next chance to be immunized), then immunization would be permitted on Shabbat.13

Mandating Vaccinations

Assuming that vaccinating when there is a high risk of catching a disease is similar to fleeing from an epidemic, then it’s mandatory for you to do it, and others can be compelled to do so as well. The question that still needs to be addressed is whether, from a purely halachic perspective, we can mandate it even when there is no current epidemic.

Some hold that since vaccinations have become the accepted and standard practice, it is incumbent upon all parents to provide them for their children. Thus, it would be right to mandate vaccination.14 Others, however, are of the opinion that while we can at times force someone to receive medical treatment, we cannot, from a purely halachic perspective, compel a healthy person or a parent to vaccinate, even if his or her refusal is based on an “irrational fear.”15

Obviously, as in all cases, especially in regard to the health of children, one should consult one’s personal physician, a licensed medical doctor. If your personal physician advises you not to vaccinate due to specific concerns, then you should not vaccinate.

Food for Thought

Having discussed the Torah’s approach to vaccines in a general, it should be noted that not all vaccines are necessarily equal, and some pose unique questions of their own. For example, chickenpox (varicella), while inconvenient, is relatively benign and very rarely fatal in children. On the other hand, while adults are less susceptible to varicella infection, they are more likely to die of chickenpox. Perhaps, some argue, it would be better for the child to actually get chickenpox than be vaccinated?16

Another potential question rises with the polio vaccine. Strains of polio have been found in parts of Israel which can affect unvaccinated people. To remedy this, there is a campaign to introduce a weakened live strain of the virus into children who have already been inoculated but can still transmit the virus to others. Having received the live virus, the child will not get sick, but will fight the virus and not be a carrier, thus helping to eradicate the virus completely. However, at the same time, this child cannot come into close contact with immune-deficient people, who will contract the disease even from a weakened live virus. The question then is: do we compromise the health of some immuno-deficient people with whom one may come in contact, for the greater good?

In summary, as with many other issues in Jewish law, open and educated debate based on Torah principles and the opinions of our sages is vital to reaching a consensus. As the Rebbe writes, it is with regards to matters such as these that the axiom “Do not set yourself apart from the community” applies.

Vaccination as a Life Lesson

Let’s conclude with the following incident related by the Lubavitcher Rebbe, Rabbi Menachem M. Schneerson, of righteous memory.

A Jew visited me recently, and we discussed education. He told me that statistics have shown that a bad education harms only 5 percent of children.

I asked him if he vaccinated his children for measles, polio, etc. He replied: “Of course! We are parents!”

“Do you know what percentage of children who do not receive the vaccine actually contract the disease?” I asked. He happened to know the statistic—less than 3 or 4 percent. In other words, even for a possibility of 4 percent, and especially in these countries where these diseases are even more rare, it is still worthwhile to vaccinate, with all of the pain, etc., that it causes. Why?

“Who cares about those minor inconveniences, as compared to what possibly could happen without vaccinating?” he responded.

I said to him: “If for a doubt of 4 percent it is worth causing the child pain, enduring the child’s screaming and all the other effects of the vaccination, just to avoid the disease—even though for the most part there is not even a possibility of any life danger, but rather just severe discomfort for some time—how much more so is it worthwhile to ensure the health of the child’s soul, where the doubt is 5 percent, and where the vaccine does not cause any pain. All that is required is to sign the child up for studies in a Torah-true educational facility! This action will affect his entire life!”