Explainer: Measles, vaccines, religious exemptions

The slogan for this year’s World Immunization Week (April 24 to April 30) was “Protected Together: Vaccines Work!” The message is particularly relevant as “vaccine hesitancy” is listed by the World Health Organization as one of the top 10 threats to global health. Even countries like the United States, where vaccines are readily available, are experiencing avoidable disease outbreaks.

In 2000, the United States “eliminated” measles, which means there was an absence of continuous disease transmission for greater than 12 months, but the disease is back with more cases reported in the first four months of 2019 (704 as of April 26) than were diagnosed in any full year since 2000; and the list of impacted communities is growing.


Measles Facts

Measles is a highly contagious disease that causes skin rash, spots in the mouth, fever, cough, runny nose and red watery eyes. Complications include ear infections, diarrhea, pneumonia, encephalitis, hearing loss, brain damage and death. According to the Centers for Disease Control, one out of every four people who contract measles will be hospitalized, and [f]or every 1,000 children who get measles, one or two will die from it.” By comparison, only 5 to 15 percent of vaccinated children will develop minor symptoms from the M.M.R. vaccine, which is 97 percent effective at preventing measles. More serious complications, including encephalitis, are possible, but the risk is far less than that resulting from the disease itself.


A very small percentage of people are allergic to the egg and gelatin proteins used to produce M.M.R. vaccines, and there have been only “33 confirmed vaccine-triggered anaphylaxis cases among 25,173,965 vaccine doses, which corresponds to a rate of 1.3 cases of anaphylaxis per million vaccine doses.” Anaphylaxis in an otherwise healthy person is serious, but not fatal, when properly treated with epinephrine. The federal government maintains an adverse reaction reporting system and provides “no fault” compensation to individuals who develop serious complications from vaccines.

Contrary to the fears of some parents, the current M.M.R. vaccine contains neither mercury, thimerosal (a mercury compound) nor aluminum, and there is absolutely no scientific study indicating that autism is caused by the M.M.R. vaccine. Even the 1998 report by British gastroenterologist Andrew Wakefield that is heralded by some, but repudiated by the medical community, merely noted a reported coincidence, in a very small sample of children, between bowel inflammation, autism symptoms and the administration of the M.M.R. vaccine. The report itself succinctly states: “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described.”

A 2017 review of medical research conducted by the National Vaccine Information Center, a nonprofit that supports voluntary vaccination choices, found no study that proved a causal relationship. While noting that “privately funded research continues to investigate the potential association,” the report recognized that “the majority of doctors and health officials reject the suggestion that M.M.R. vaccine is associated with the development of autism in children.”

Vaccines are developed by medical researchers and recommended for immunization by various public and private organizations, such as W.H.O. the Centers for Disease Control and Prevention and the American Academy of Pediatricians, using the most accurate scientifically verified information available. While a healthy dose of skepticism is appropriate when dealing with Big Pharma, medical professionals review reported data on vaccine efficacy and adverse reactions and make adjustments to doses, schedules and vaccine ingredients as more is learned. For example, concerns related to thimerosal led to its removal from the M.M.R. vaccine used in the United States; and an increased rate of febrile seizures found in patients given M.M.R.V., a combined varicella (chicken pox) and M.M.R. vaccine, led to improved parental notification regarding the risks and benefits of available vaccines.

Immunization Laws and Exemptions

The United States government does not enforce vaccine protocols except with regard to visa applicants and certain federal employees. As in many countries, immunization standards are enforced primarily through state and local public and private school registration requirements. This ensures near universal coverage and, by eliminating infected disease carriers, creates a herd immunity for the very young who have not yet been vaccinated, pregnant women who should not be vaccinated and those with compromised immune systems or severe allergies who cannot withstand vaccination. Every suitable person who is not vaccinated increases the risk of infection for others and leaves communities vulnerable to disease outbreaks.

As in many countries, immunization standards are enforced primarily through state and local public and private school registration requirements.

In Jacobson v. Massachusetts (1905), the Supreme Court upheld the power of the states to require vaccination to protect the public health, and in Prince v. Massachusetts (1944) it opined that “[t]he right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death.” Simply put, the First Amendment does not bestow the right to refuse vaccination against contagious diseases.

Nevertheless, all but three states, California, Mississippi and West Virginia, currently permit religious or personal exemptions from vaccination requirements. None of the major religions practiced in the United States, including Christian Science, prohibit vaccinations. But individual adherents may object based on dietary restrictions (the gelatin used in some vaccines is pork- or bovine-based), pro-life disapproval (some vaccines use “descendent cells” from abortions), or the belief that “God made me perfect” or will heal the faithful.

Religious exemption statutes are not uniform. Some states, such as New York, put the burden on parents to convince school officials that their objections to specific vaccinations are based on “genuine and sincere religious beliefs.” Parents who appeal the denial of exemption requests have the burden of proving to a court that their beliefs are sincere and religiously based. This risks unconstitutional judicial “entanglement” with religion, but this law has been upheld by the U.S. Court of Appeals. Other states, such as Indiana, simply require parents to submit a written statement indicating they have a religious objection to vaccination.

Non-religious objections to vaccination include a distrust of pharmaceutical companies and politicians, opposition to animal testing and simple libertarianism. State personal conscience statutes vary, but generally they do not require parents to justify their objections. At most, parents may need to indicate they understand the consequences of non-vaccination. Washington State, for example, which currently is experiencing a measles outbreak, provides an exemption form that requires objectors to indicate a medical professional has informed them of the benefits and risks of immunization.

Although the First Amendment does not require states to grant religious exemptions to vaccination requirements, state Religious Freedom Restoration Acts provide additional rights to religious adherents and require state laws that substantially burden religious rights to be narrowly tailored to support a compelling government interest. If the 21 states with R.F.R.A.s tighten their exemption laws to better protect their residents from contagious diseases, their courts might be required to second-guess public health officials and consider whether vaccination is the least restrictive method to achieving public safety.

Public Health Emergencies

Even states that permit religious or personal exemptions may take emergency action to protect public health during crises. The current measles outbreak in New York precipitated two emergency health orders in Rockland County and one in New York City. The first Rockland County order, which excluded unimmunized students from schools and public places, was enjoined because the judge determined the outbreak of 166 cases in a population of 330,000 did not qualify as an “epidemic” warranting emergency measures. By April 25, the number of confirmed cases rose to 200 and the county issued a second emergency order enforcing a less restrictive exclusion of anyone with an active case of measles or who recently has been exposed to the measles virus. Time will tell whether this order also is enjoined.

Every parent wants happy and healthy children, but unless we literally live on a deserted island, we are “a part of the main” and owe an obligation to our neighbors to protect them as well as ourselves.

New York City’s emergency declaration excludes unimmunized children from schools and requires every adult and child who lives, works or resides in specified ZIP codes to be vaccinated. Violators are subject to a $1,000 fine. The judge deciding a challenge to this order determined the measles outbreak in Brooklyn—which at the time included 285 measles diagnoses and has since jumped to 390 confirmed cases in a borough of 2.5 million peopleis an epidemic and refused to enjoin the emergency decree. (“A fireman need not obtain the informed consent of the owner before extinguishing a house fire,” the judge wrote. “Vaccination is known to extinguish the fire of contagion.”) An appeal has been filed.

Every parent wants happy and healthy children, but unless we literally live on a deserted island, we owe an obligation to our neighbors to protect them as well as ourselves. As the Supreme Court held in Jacobson v. Massachusetts (1905), when it upheld mandatory smallpox vaccination:

[T]he liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good. On any other basis, organized society could not exist with safety to its members. Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy. Real liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own, whether in respect of his person or his property, regardless of the injury that may be done to others.

When it comes to vaccinations for polio, measles and other dangerous diseases, that may mean accepting the risk that our child might be one of the very few who has a serious reaction and suffers harm. The alternative is to knowingly leave the most vulnerable among us—infants, pregnant women and their unborn children, the immunocompromised, and the highly allergic—completely exposed. Understandably, this is not something our government wants to allow.

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Tatiana Durbak
1 year 1 month ago

I find that the refusal to vaccinate one's children is a profoundly selfish position, since it endangers the children of other people.

1 year ago

Good Catholics object to MMR because it is made from aborted fetuses.

1 year ago

Good Catholics object to MMR because it is made from aborted fetuses. While there are those scientists at the Vatican who say this doesn't matter and vaccinate your children anyway, the overarching issue is not scientific, but religious--doing the morally good action. For many good Catholic parents, this means no vaccines from aborted fetuses. Listening to what God is personally saying , and not what a medically trained and medically mined scientist is saying.

Sharon Lindenburger
1 year ago

You're kidding, right? The morally good action is to have your kids vaccinated. Period. Otherwise you and your kids are endangering public health, and in my view that is a crime against humanity. I'm a Catholic. My children were vaccinated as are my grandchildren. That's what good parents do. They take care of their children and keep them safe. If your children are not vaccinated, I would not consider you to be a good parent, despite your dogmatic form of Catholicism. This is the 21st century. Vaccines save lives.

1 year ago

The morally good action is not have your "kids" vaccinated in all cases. Period.
Tetanus and Polio vaccinations do not use aborted fetuses.
How many people die from measles, mumps and rubella?
When we force the american medical association model as the morally good action, in all cases, we have begun to argue the other side of the abortion issue--we also impede on religious freedom.

The morally good action is to not have your children vaccinated.

Sharon Lindenburger
1 year ago

You're kidding, right? The morally good action is to have your kids vaccinated. Period. Otherwise you and your kids are endangering public health, and in my view that is a crime against humanity. I'm a Cathlolic. My children were vaccinated as are my grandchildren. That's what good parents do. They take care of their children and keep them safe. If your children are not vaccinated, I would not consider you to be a good parent, despite your dogmatic form of Catholicism. This is the 21st century. Vaccines save lives.

1 year ago

I support a parent's right to choose based on moral conviction in this case. I also underscore our free will in these choices. Right to Life issue

Ellen Boegel
1 year ago

It might help you to read this article, https://www.historyofvaccines.org/content/articles/human-cell-strains-vaccine-development, from the College of Physicians of Philadelphia, that carefully describes the development of modern vaccines and quotes from the National Catholic Bioethics Center: "Descendant cells are the medium in which these vaccines are prepared. The cell lines under consideration were begun using cells taken from one or more fetuses aborted almost 40 years ago. Since that time the cell lines have grown independently. It is important to note that descendant cells are not the cells of the aborted child. They never, themselves, formed a part of the victim's body."

1 year ago

The Lab in Pennsylvania created the Rubella Vaccine. When you say "descendant cells" that means that the scientist took the cells from an aborted fetus and treated them with a caner causing drug. Once the cells become cancerous, they grow indefinitely in a petri dish.
The biomedical ethicists who said Catholic parents must provide vaccinations are also from Pennsylvania.
I think the biomedical ethicists judgment was short sided and based on emotion and fear. How much great it would have been for the ethicists you quote to leave the decision up to the parents. And leave the specter of death hanging over the community.

1 year ago

The elimination of smallpox was a wonderful thing, based on awesome discovery about humans and how we are created. A fullblown case of smallpox is deadly to the individual and deadly to large numbers of humans, but a small controlled dose gives humans immunity: Homeopathic medicine and prayer of petition for a cure, in action. The subsequent discovery by Salk and Sabin of two ways to polio immunities, one from fruit mold and the subsequent near elimination of polio were based on another discovery. When smallpox and polio were infecting the population, we also had measles, mumps, rubella and chickenpox infecting the population. The difference is that people don't die from MMR and chickenpox or even become disabled except in rare cases. Predictably, however, inventors and investors and those with agendas other than healing in conjunction with God; who decided to save humanity from measles, mumps, rubella, and most recently chickenpox. The specter of saving the world from every known contagen by the medical model raises important religious questions about health education and limit setting on the disciples of the medical model.

This issue of people dying or becoming disabled from illness has turned a corner and people are also dying and becoming disabled from the vaccines. There are people who are allergic to the ingredients in vacines. People die from the vaccines. There is a rise in autism and mothers correlate the autism in their child to the innoculation, but the medical industry says that is correlation, even coincidence, but not causation. The medical model vilifies MMR and chickenpox when humans contract them and they run their normal course, but not when they are in their vaccines. This is reminescent in a small way of the medical industry's approach to breastfeeding. The medical model told women to wean their babies, or supplement with iron drops because babies need iron and mother's milk doesn't have any. Finite knowledge masked as all knowing, and all good, always. Years later they found the iron in the water portion of the milk. They had only looked in the milk because that is where it is in other mammals. Is it possible medical industry cannot find a link between autism and certain vaccines because they don't know where or how to look? What the medical model knows of creation is miniscule in comparison to the fullness and wonder of God's creations. We have clay brains, and our knowledge is finite. Is there an arrogance to the medical model that contradicts the model of God? Which brings up the issue of those who monitor the medical model: Bio medical ethicists.

One of the standards for bio medical ethicists is to look at the big picture. What is the big picture? In the God Model, time has a beginning and an end. And no matter how difficult; we want to do His Will. At it's beginning there was a tree that was forbidden. To make an analogy, in this case, abortion is forbidden. No matter the consequences, even death, we are not supposed to eat of the fruit of the forbidden tree. In this case the aborted fetuses. Even when the clever serpent waltzes through the front gate, all educated and walking on two feet, and dazzling us with his insights and knowledge, especially seemingly of God, we are supposed to say, “No.” We are not supposed to engage. Then eons later, God became man and through divinity did miraculous healings. Did those bio medical ethicists see only their generation and maybe the next? Did they loose sight of the big picture?

Furthermore, did they have selective hearing and tune out the individual women voices of wisdom who are saying, “No”? And wait for God's time? What about the medical mask as an awesome preventive medical device? What about the fact that once this medical model was given the blessing of these ethicists, there is no chance that motivation or scarce resources would really be available to find something else. Could this evolve into a scenario where big business, and the state make it illegal fro the individaul to follow their conscience and to say, “No”


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