Does Jewish law mandate vaccinations?

The Torah commands us not to stand idly over someone else’s blood, thereby imposing a responsibility to care for others.

polio vaccine illustrative 370 (photo credit: REUTERS/Oswaldo Rivas)
polio vaccine illustrative 370
(photo credit: REUTERS/Oswaldo Rivas)
Since February, health officials have found strains of the polio virus in many parts of Israel and identified a couple of dozen carriers of the virus. To prevent an outbreak, Israel launched a nationwide campaign to vaccinate all children under the age of nine, raising the question of whether Halacha mandates participation in this effort.
This question partly relates to the obligation to administer preventive medicine. The Torah promises that God will protect those who observe the commandments with complete fidelity.
Yet Jewish sources have long recognized that no one can remain assured that they are worthy of such providential protection, or rely on miracles to save them. The Torah commands, “Be careful and watch yourselves,” which was understood as a directive to avoid dangerous situations and activities. Jewish law requires us to remove dangerous objects from our environs, ranging from shoddy ladders to dangerous dogs to unprotected weapons.
The spirit of these norms derives from the biblical obligation to place a guard railing around one’s roof. Both Maimonides and Rabbi Yosef Karo list prohibited activities within their legal codes, with Rabbi Moshe Isserles further adding that “one should avoid all things which endanger oneself, as we treat physical dangers more stringently than ritual prohibitions.”
The question remains how proactive a person must be to avoid such scenarios. Generally speaking, Jewish law asserts that one may undertake certain risks that most humans accept with equanimity. We ski, drive cars and undergo elective surgery even as all those activities entail certain risks. Yet in the case of vaccinations, one must also note that the goal is to protect not only oneself but the entire community, the nation – and even the world. Anyone familiar with the history of smallpox or rubella knows the terrifying horrors that they cause.
The Torah commands us not to stand idly over someone else’s blood, thereby imposing a responsibility to care for others.
In the late 18th century, doctors attempted to prevent the continued onslaught from smallpox by inoculating healthy people with a low grade of fluid taken from stricken patients.
The hope was that a mild, controlled dose would allow the body to protect itself from a wild, spontaneous outbreak, even as this imposed a risky level of exposure. As David Ruderman has documented, Rabbi Abraham Nansich, himself mourning the death of two children, published a pamphlet in 1785 urging Jews to participate in this initiative. While one might not normally permit such risky inoculations, he argued that all humans are at greater danger from a deadly outbreak, and therefore everyone must accept the risks imposed by inoculation.
Edward Jenner’s invention of a safer smallpox vaccine at the turn of the 19th century was celebrated by scholars like rabbis Israel Lifshitz and Eliezer Fleckeles, who strongly advocated vaccination and noted that this was a far superior alternative to the solution mentioned in earlier halachic literature: to flee town. When vaccinations were only available for a limited time in one’s area, many scholars allowed people to desecrate Shabbat to receive the treatment.
Vaccinations are undoubtedly one of the greater inventions of the modern era and have saved countless lives. This blessing sometimes leads to complacency, as some individuals become immune to the phenomenon of mass outbreaks and plagues. Others fear immunizing their families because of the minimal risks associated with vaccines. In effect if not in intent, they rely upon the so-called “herd immunity” that occurs when most other people get vaccinated, thereby reducing the chance of contagion.
Public health officials have strongly countered that vaccines present minimal risks (especially relative to other health-care procedures) and that many of the sensationalistic claims linking vaccines to autism and other terrible side effects have been scientifically refuted. Furthermore, we must reserve the protections of herd immunity for those who cannot get vaccinated because of weaker immune systems. Nonetheless, certain people around the world continue to avoid vaccinations, including limited elements of ultra-Orthodox communities in America who have recently experienced tragic outbreaks of mumps and measles.
As Rabbi Asher Bush has noted, Rabbi Yosef Shalom Elyashiv argued that given the widespread contemporary medical consensus, parents are obligated to vaccinate their children, and schools or camps may exclude those who fail to take those preventive measures. Many Jewish decisors including Rabbi Yehoshua Neuwirth argued that in the absence of an outbreak or national legal mandate, schools should strongly encourage but cannot force the vaccination of children, even as their parents remain negligent, since Jewish law decidedly supports vaccination. This follows the health policies of many countries, which allow conscientious objectors to avoid vaccinations.
Be that as it may, all scholars agree that the effort to prevent the return of polio is a national mission. We must support the call of Israel’s chief rabbis who declared that Jewish law mandates all children to be vaccinated in accordance with Health Ministry regulations. ■
The writer teaches at Yeshivat Hakotel and directs the Tikvah Israel Seminars for Post-High School Students.