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Against Religious Exemptions in the United States

Vaccines exist for many diseases and are generally efficacious. There is a complex ethical interaction within the multifaceted issue of objection. There is no doubt that vaccines create net positive benefit for the overall population, however, some individuals believe that vaccines are inappropriate for themselves or their children. Each vaccine carries its own risk and benefit, and people may prioritize the potential harms over population health. States have accommodated these sentiments in legislation that allows for exemptions to vaccine mandates. Exemptions fall under two categories: religious and philosophical. Religious exemptions allow parents to deny vaccination for their children if vaccination violates their “sincere religious beliefs,” and philosophical exemption expands this privilege to those with beliefs that are not considered religious. This discussion omits medically appropriate exemptions; all states have laws allowing individuals to forego vaccination for reasons that generally include permanent or temporary immune insufficiency, serious allergy to a component of the vaccine, or history of adverse reactions to vaccination. There is almost no ethical debate on whether or not medical exemptions are appropriate.

All states require proof of immunization for children to enroll in schools; while there are varying sets of required vaccines, most often in particular are the diphtheria, measles, rubella, and polio vaccines. States that do have exemptions vary widely in what they allow, what vaccines are involved, and the reasoning behind their laws. Some exemptions allow for specific vaccines only, such as Virginia where personal exemptions are only specified for the HPV vaccine, and some exemptions are allowed only for specific places, such as Missouri where the personal belief exemption applies to child care facilities but not public schools.

Ethically, there is little difference between religious and philosophical beliefs, as they are both considered important individual values; regardless, states retain the distinction in legislation. I argue that, based on the separation of church and state, the government should not allow religious exemptions from vaccine mandates due to the widespread implications of possible outbreaks as well as the apparent lack of religious foundation to vaccine hesitancy and objection. The interaction of religious beliefs and refusal is complex. Religious exemptions seem to carry more political weight than philosophical ones, perhaps because there is perceived power in the religious organization and legal precedent that religion is a protected area of life. Interestingly though, almost no religions have explicit opposition to vaccination. In a 2011 study that examined Hinduism, Buddhism, Jainism, Judaism, Christianity, and Islam and found that, at least in scripture and explicit official sentiments, vaccination itself is not prohibited in any of them. The only explicit exception was the Christian Science Church. The article concludes that vaccine objection under the guise of religious objection tends to be philosophical or traditional rather than religious.

In practice, I recognize that it is difficult to tell families that their religious beliefs are falsely interpreted or merely social, rather than grounded in their faith. Varying interpretation of religious texts likely allow for certain aspects of vaccination to violate religious doctrine. Regardless, this should not invite the opportunity for medically vulnerable populations such as the sick, elderly, or infants to be exposed to potentially fatal diseases based on another person’s belief that vaccines violate their religion. Radical individualism in this case is irresponsible as vaccination prevents serious diseases, are the most cost effective public health intervention available, and have proven safety and efficacy through rigorous scientific testing. One person or one group’s beliefs should never endanger the health of other individuals.

JME Digest | June 2018

JME Digest | May 2018