Getting Religion about Vaccines

Herd Immunity?
As the current measles epidemic continues unabated, many are looking for explanations. One obvious target are the religious and personal belief exemptions that have allowed for increasing pediatric undervaccination. Yet the fact that many states and other entities allow religious exemptions might suggest that most religions object to vaccines. Miriam Krule writing in Slate explodes the myth of religious exemptions and describes how despite few true exemptions, it is very easy to claim one.

Her conclusions:

"The only two religions that have any possible negative stance (though it’s not even clear that they do) on vaccination are Christian Scientists and the Dutch Reformed Church."

"In order to apply for a religious exemption, you don’t even need to be religious. If you live in Connecticut, for example, all you have to do is fill out this incredibly simple form... In Florida, all that is needed is the child’s name, date of birth, and social security number—no proof of religion, or even name of a religion, is needed."

Irrespective of the lack of formal religious exemptions, when we speak with parents as physicians or public health officials, we need to be aware that three existing vaccines (hepatitis A, rubella, chicken pox) were developed from cell lines derived from aborted fetuses. For this reason, some Catholic and other parents might refuse to vaccinate their children. However, this issue has been well studied by the National Catholic Bioethics Center and the Pontifical Academy for Life who "have determined that it is morally licit, and even morally responsible, for Catholics to use even those vaccines developed from aborted fetus cells."

Dr. Paul Cieslak in the Catholic EWTN news states "While the new measles cases are cause for concern, the outbreak isn’t nearly as bad as it could be, and that is thanks to vaccinations. The fact that it doesn’t spread to everybody is a testimony to the fact that most of them [who were exposed] are immune, and most of them got that way through vaccinations. And when we have seen transmission of multiple cases, it has been largely among unvaccinated people. As a Catholic, I would argue that it [vaccination] is a socially conscious thing to do. It’s not only good for you, it’s good for your fellow man."


  1. Good stuff, thanks. This is a particularly interesting and relevant discussion for me as well, as the medical director of our employee clinic. Just this past week we had a meeting with our legal representative to discuss a particularly difficult case of someone who had requested a religious exemption to the influenza vaccine for reasons that seemed quite suspect to us.

    The discussion we had was enlightening. Although I agree with the arguments made here and in the Slate article, where we seem to stumble is with the definition of a "religious belief" or, as some put it, a "deeply held personal belief."

    I'm not sure if you've referenced it before, but I was directed to an informal 2012 letter from the US EEOC Office of Legal Counsel that was in response to an inquiry from a member of the public. It's available at

    In it is an interesting discussion of what constitutes a "religious belief":

    [Religious beliefs include theistic well as non-theistic "moral or ethical beliefs as to what is right and wrong which are sincerely held with the strength of traditional religious views"...beliefs are not protected merely because they are strongly held. Rather, religion typically concerns "ultimate ideas" about "life, purpose, and death." Social, political, or economic philosophies, as well as mere personal preferences, are not "religious" beliefs protected by Title VII. Therefore, whether a practice is religious depends on the employee's motivation.]

    This certainly creates a fuzzy but ultimately permissive standard, and while we have struggled with its interpretation at times, we typically end up allowing most religious exemption requests even if it is clear that they are not tied to a particular organized religion.

    One issue we come up against quite frequently is the case where an employee makes a request for religious exemption from the influenza vaccine even though that person willingly took all of the necessary vaccines in the past in order to comply with the hiring requirements -- in other words, the request is interpreted as insincere. The response, per the letter and the EEOC's Compliance Manual, falls back on a person's beliefs possibly changing over time:

    [...although prior inconsistent conduct is relevant to the question of sincerity, an individual's beliefs - or degree of adherence - may change over time, and therefore an employee's newly adopted or inconsistently observed religious practice may nevertheless be sincerely held. An employer also should not assume that an employee is insincere simply because some of his or her practices deviate from the commonly followed tenets of his or her religion.]

    This is getting a little bit away from the discussion here, since this is referencing the management of health care workers, who we hold to different standards and practices than the general public. But it did help shed some light on the complex issue of "religious beliefs" and why exemptions are made even when those beliefs don't jive with the explicit tenets of most organized religions.


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