Should Catholics be pro or anti vaccination?

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It was recently asked on a Facebook forum:

“Is it morally possible for a Catholic to be anti-vaccine? Or does our faith teach us to accept such science?”

Pope Francis gives a vaccine to a boy held by Mexico's first lady Angelica Rivera during a visit to the Federico Gomez Children's Hospital (CNS)

Pope Francis gives a vaccine to a boy held by Mexico’s first lady Angelica Rivera during a visit to the Federico Gomez Children’s Hospital (CNS)

So this is my answer, as a scientist, as a doctor, as a medical virologist, as a Catholic.

My position is that the anti-vaccine (aka anti-vax) position is indeed immoral.

Vaccines and the huge benefits they have brought are a matter of science and history and fact, and there is plenty of evidence for those who are willing to look at it. I’ll briefly comment on some aspects of vaccine success and discuss some legitimate instances where vaccines are inappropriate, and I’ll give useful links below; my purpose here is to make a statement and not to provide several years worth of studying science on one page. I’ll also touch on the valid problem of vaccines tainted with a history of abortion.

I’ll start with a really harsh heading. Harsh, but true.

Anti-vax is a medical equivalent of anti-life flat earthism

The anti-vaccination belief is the modern day medical equivalent of flat earthism or geocentrism (which has its own growing Catholic support) or the idea that the moon landings were faked.

Unlike geocentrism, however, which is a belief that doesn’t cause death and disability and suffering, the anti-vax position is the moral equivalent of:

  • preventing communities from having clean running water
  • preventing people from washing their hands after going to the toilet
  • banning antibiotic use. Antibiotics do more harm than vaccines, and have more side effects – they can make you deaf, damage your kidneys, suppress your bone marrow, etc … yet they have done far more good than harm. The risk from vaccines is far less.

In fact, I would go so far as to say that the anti-vax movement is not even pro-life, because the damage it causes in terms of unborn and childhood and adult death and disability is significant, completely preventable, and therefore lies squarely on their shoulders.

Simply put, anti-vaccinationism is an ideology, a pseudoscience, or a “theology” as one anti-vaxxer on the Facebook forum called it, and certainly not science. And given the damage this ideology does, it has a worse effect on the communities most anti-vaxxers live in (the USA and western Europe) than school shootings and suicide bombers.

The facts

1977 Star Wars vaccine poster

1977 Star Wars vaccine poster

  • Vaccines do not cause autism.
  • Vaccines have eradicated smallpox. In the 20th century smallpox killed nearly half a billion people. Today it kills nobody, thanks to vaccines.
  • Vaccines have almost eradicated polio. Wildtype poliovirus type 2 has been eradicated; wildtype poliovirus type 3 hasn’t been seen since 2012. Before the polio vaccine, polio killed nearly half a million people each year. Today? 22 reported cases in 2017. 27 cases thus far in 2018. Millions of lives saved, even more millions of people spared temporary or permanent paralysis.
  • Vaccines will, in the next decade or two, eradicate measles. We’re down to 100000 deaths per year from 2.6 million deaths per year in 1980, thanks to vaccination. If the anti-vax movement had its way completely, between 1 million and 2.5 million additional children would die each year from measles. As it is, several thousand children die each year thanks to the efforts of anti-vaxxers.
  • Vaccines are well tested for efficacy and safety in clinical trials. (Anti-vaxxers don’t read those studies because they prefer their own “research“, i.e. reading anti-vaxxer websites.)
  • Vaccines are safer by far than the diseases they prevent.
  • Vaccines are safer than driving a car, being a passenger in a car, or getting drunk.
  • Vaccines are cheaper by far than treating the diseases they prevent.
  • Vaccines form a very small part of the global pharmaceutical industry. Pharmaceutical companies would benefit more from not making vaccines, because then there would be more infections to treat, and more chronic illness to treat, even with the smaller surviving population. Yet responsible scientists and doctors have made sure that vaccine production and development continues, and that vaccines are available as cheaply as possible especially to those who need them the most in the developing world.

Don’t like those facts? Feel free to make up your own – it’s allowed these days. Just please don’t say you “researched” vaccines. Be honest and say “I read something on the internet and believed it.

Vaccine timeline, 2015

Vaccine timeline, 2015

A note on anti-vax individuals and moral complicity

Anti-vaxxers, as individuals, can certainly hold their opinion without personal moral guilt if they are sincerely taken in by the anti-vax mythology. People believe strange things. I don’t think they can help that. Whether it’s a fear of moths, the belief that the earth is flat, or that vaccines are evil, they can’t help that. Some experience or website spurred an irrational thought or fear that they haven’t managed to get rid of. The Catholic Church is fully aware of that phenomenon when it teaches that one of the criteria for an individual’s act to be a mortal sin, the sinner needs to know that what they are doing is wrong. Anti-vaxxers do not understand the disastrous errors of anti-vaccinationism, and so on a moral level, they are excused. That, however, doesn’t make the damage they do okay.

Side effects of vaccines

Me getting a rabies vaccine

Me getting a rabies vaccine

Vaccines have side effects. Of course they do.

0.1-0.2% of children who get measles die from measles. Fewer than 0.00001% of those who get the measles vaccine die from vaccine-related complications.

Any loss of life is terrible, and there are few medical interventions without that risk. It is terrible that any child has to die from a vaccine, or suffer damage from a vaccine.

However, vaccine side effects need to be put in the context of the disease they prevent, and in the context of the risk they present. Every single available vaccine, individually and overall, is safer than penicillin. Sometimes penicillin kills. That doesn’t mean we stop using it. Vaccines need to be put in the same category as any other legitimate potentially life-saving medical intervention.

People who should not get vaccinated

There are certain groups of people who should not be vaccinated with live attenuated vaccines. Every clinician and scientist knows that. Immunocompromised people (HIV, cancer, organ transplants, others) and pregnant women need to be cautious about live attenuated vaccines such as the chickenpox vaccine at critical times during their condition. If a severely immunocompromised person lives with family, those family members may need to be treated differently too. On the one hand, they should be vaccinated with killed/subunit vaccines to protect their immunocompromised family member. On the other hand, sending the children off on a long holiday the moment they are vaccinated with some live attenuated vaccines may be a fun idea … or they could be exempted – but rather vaccinated to protect their endangered family member.  Even this travel/exemption is over-cautious, because most of the live attenuated vaccines do not shed from the vaccinated person, and even then risks are extremely low.  It all depends on the cause and degree of compromise of the person’s immune system, and the vaccine involved.  SCID – extra cautious, avoid giving live vaccines to the affected child.  HIV – depends, but contacts can be vaccinated.  Vaccines may also not be very effective in immunocompromised people.

Similarly, patients with allergy to vaccine components such as eggs should be managed carefully.  There are other legitimate contraindications for various vaccines.  Legitimate ones.

These are not anti-vax situations, although they are certainly exploited by the anti-vax movement. They are legitimate medical circumstances which make some vaccines less safe at certain times. Such circumstances are rare, and should be discussed with your doctor. As a medical virologist, I advise on these cases in a professional capacity, so I know all about them, but do not email me or comment asking for advice – go to your doctor.

Abortion-related vaccines

Picture of a random baby off WikiMedia Commons

A baby

In the past, aborted fetuses were used to create cell lines. Some of those cell lines exist today, such as the MRC-5 line, and are used to grow viral vaccine strains in them. That is morally problematic. We’re benefiting today from the immoral deaths of unborn children. I fully support the push to create newer moral versions of the vaccines that currently use these cell lines, and the Catholic Church does too.

That said, the Catholic Church, while noting the problems with these vaccines and encouraging people to push for more moral alternatives, clearly permits their use by Catholics.

I will attempt an analogy.

  • A man gets shot in the head*. He is a registered organ donor. Is it morally permissible to transplant his organs into others?
    • The doctors doing the transplant did not kill him, arrange his death, or wish for him to be killed.
    • The patients receiving his organs did not kill him, arrange his death, or wish for him to be killed.
    • The organs have a morally tainted history, but the doctors and patients involved are not morally responsible.
      *Such a man will likely not have his organs transplanted as his body would likely wait for an autopsy.
  • An unborn child gets aborted deliberately, but not for the deliberate procurement of fetal organs or cells, but cells eventually lead to vaccines.
    • The doctors giving the vaccines did not perform, arrange, or wish for the abortion.
    • The patients receiving the vaccines did not perform, arrange, or wish for the abortion.
    • The vaccines have a morally tainted history, but the doctors and patients involved are not morally responsible.

Problematic aspects with the second scenario:

Homo neanderthalensis at the Natural History Museum of Vienna

Homo neanderthalensis skeleton

  • Researchers got hold of the body after the abortion and harvested the cells, cultured them for several generations, and got the MRC-5 and WI-38 cell lines.
  • The problem lies with the initial researchers and how they obtained the body. They could have tried other moral ways of developing cell lines. They could have used non-human animals (where we get the Vero cell line from, which is used for vaccine production, e.g. polio, rabies). If they absolutely needed a human fetus, a morally untainted option would have been a natural miscarriage, although potentially disrespectful of a human body (many people legitimately donate their bodies to science, as well as the bodies of their miscarried children).
  • It should also be noted it is unlikely that the researchers were thinking along the lines of Christian moral theology, and unlikely they were gleefully aware of the moral implications of what they did. As unfortunate as such activities were, they were likely done with good intent (much like anti-vax propaganda), within a moral framework of substandard quality.
  • Vaccine manufacturers, and others, have likewise likely had good intentions, not evil ones. (And, by the way, “The road to hell is paved with good intentions” means that good intentions without action are worthless; it isn’t talking of good intentions that happen to have moral problems when examined in a perfect light.)

The Vatican, the National (USA) Catholic Bioethics Center, and I all agree – those moral problems do not mean that the use of these vaccines is morally prohibited. These are valid moral concerns, but not valid anti-vax arguments.

The National (USA) Catholic Bioethics Center’s FAQ on the Use of Vaccines has the following strong statement:

Am I free to refuse to vaccinate myself or my children on the grounds of conscience?

One must follow a certain conscience even if it errs, but there is a responsibility to inform one’s conscience properly. There would seem to be no proper grounds for refusing immunization against dangerous contagious disease, for example, rubella, especially in light of the concern that we should all have for the health of our children, public health, and the common good.

Points to be made here:

  • Following one’s conscience even if it errs – this principle applied to anti-vaxxers means, as I said above, that they are not morally culpable for their error.
  • A properly informed conscience – unfortunately that is very hard to develop in the anti-vax community because they have chosen to look to pseudoscience instead of fact, but the NCBC applies it here to indicate that a properly informed conscience will permit use of these vaccines.
  • the health of our children, public health, and the common good.” This is what vaccines work to produce.

A 2005 statement from the Pontifical Academy for Life is a worthwhile read.

Pope Francis gives a child a POLIO VACCINE! (CNS)

Pope Francis gives a child a POLIO VACCINE! (CNS)

It says (italic text that of Rome):

Moreover, we find, in such a case, a proportional reason, in order to accept the use of these vaccines in the presence of the danger of favouring the spread of the pathological agent, due to the lack of vaccination of children. This is particularly true in the case of vaccination against German measles. [Footnote 15]

Footnote 15 (emphasis mine):

This is particularly true in the case of vaccination against German measles, because of the danger of Congenital Rubella Syndrome. This could occur, causing grave congenital malformations in the foetus, when a pregnant woman enters into contact, even if it is brief, with children who have not been immunized and are carriers of the virus. In this case, the parents who did not accept the vaccination of their own children become responsible for the malformations in question, and for the subsequent abortion of foetuses, when they have been discovered to be malformed.

So. Anti-vax “theology” leads people to “become responsible for the malformations in question, and for the subsequent abortion of foetuses, when they have been discovered to be malformed.

Boy, am I glad I am not anti-vax. I wouldn’t want to be responsible for the deaths of born and unborn children on the scale that the anti-vax lobby produces, never mind on the scale they would produce if they got their way.

Now go and read about the Dunning-Kruger effect.  And then the informative and educational links below.

Comparison between pseudosciences

Comparison between pseudosciences

Sites worth reading:

Further information:

Catholicism

General

Anti-vax

Morality of Anti-vax

Measles

Chickenpox

Polio

Money

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