Pastors and religious leaders have always had an influence on public health. They are the shepherds of their congregations, and as such they would be remiss to fail in upholding basic efforts to fortify God’s people from the spread of infectious disease.
The first well-known pastor to act on the subject of innoculation was Cotton Mather. Yes, the Cotton Mather, who also directed the horrors that were the Salem Witch Trials. While his legacy in the witch trials remains fairly common knowledge, the part he played in introducing variolation into the US is lesser known. Arthur Allen has carefully documented this history in his book Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver. During the 1721 smallpox epidemic, Mather began writing fervently to doctors in Boston to find one who would perform a procedure known as variolation. He was convinced that this procedure, uncommon in Europe and thus far unused in the US, would be the only way to stop smallpox from spreading wildly through the population. Variolation, which involved taking the fluid from the pustules of an infected person and scratching it into the skin of the person to be innoculated, was much more dangerous than modern vaccines and the science was virtually untested except in a few published cases. Mather learned of the practice from an African slave, who claimed to have been innoculated against smallpox as a boy.
As people today are prone to argue that vaccination causes harm and poisoning of the body, and undermines faith in God as Divine Healer, so did Mather’s counterparts argue in protest of his urgings. Indeed, this is where the first claims were made by people opposed to innoculation, and some of these same arguments still persist today in discussions about vaccines. Nevertheless, through Cotton Mather’s persistence, his smallpox legacy is a truly victorious one. Smallpox was eradicated from the globe in 1976 through mass innoculation programs, particularly after the practice was improved and made much safer. Smallpox itself was a highly infectious disease that killed at least 1/3 of the people who fell ill. Thanks to the fiery insistence of a puritan preacher, we no longer have to worry about waves of smallpox sweeping through our communities.
The vast majority of parents in the US vaccinate their children for most illnesses. This includes parents representing most faith groups. Amish people are one group that has made news in recent decades for disease outbreaks due to low levels of vaccination in their communities. While the Amish lifestyle is strict, the shunning of some technology is a community restriction meant to maintain a focus on God, and does not preclude vaccination. A 2009 study of community member’s attitudes revealed that most Amish do vaccinate to some extent, and among those who do not, they cite the same fears and concerns as those that persist in mainstream society. It is not necessarily unique cultural or religious beliefs that lead to unvaccinated Amish children.
In 1979, a polio outbreak occurred that included Amish persons from 4 different states. This was the last outbreak of wild poliovirus in the US. The CDC concluded:
The 1979 outbreak demonstrated both the tremendous progress to date in achieving protection of the U.S. population but also the fact that polio could find a way to reach the remaining pockets of susceptible persons in the country. In addition, the outbreak made clear the necessity of taking a global approach to polio…
At the heart of this issue is the fact that, if not for those pockets who resist vaccination, illnesses that spread only through human populations could potentially be eradicated by strong vaccine efforts. That would be the end of the disease, and of the need to vaccinate. Smallpox is gone. Polio and measles could be gone.
The polio-free status the United States has enjoyed since 1979 comes at a cost… [vaccine-associated polio] should be reduced substantially as a result of the recently adopted sequential IPV-OPV schedule. An estimated $230 million also is spent each year to maintain the high levels of polio vaccine coverage. Once polio is eradicated from the planet, polio vaccination can be discontinued…
The fact that vaccination carries a small risk only serves to underscore the benefit of eradicating the disease. It does not make sense to avoid a very small risk of vaccination by allowing the return of very devastating illness and disease. It does make sense to work to have these diseases eliminated in this generation– not to allow pockets to emerge for outbreaks to erupt– so that the next generation will have no need for the vaccine.
Many Amish were convinced after the 1979 polio outbreak that vaccination was worth it. It was a small outbreak but it led to 15 cases of paralytic polio. Many of the Amish who chose to be vaccinated during that outbreak did so after seeing these results, and knowing that what might be a mild illness for them could be spread to someone for whom the illness would be deadly. In his book Amish Society, John Hostetler documents (p. 324):
In the case of the polio outbreak, after a series of visits by health officials, the Amish arranged for mass immunization in their homes and schools. The objection to polio immunization was finally overcome when a lay member argued that the Amish would not want to be the cause of other persons getting the disease.
Much more recently, in 2014, several unvaccinated members of an Amish community returned from mission work in the Philippines carrying the highly contagious measles virus. In June of 2014, NPR reported that many Amish families who had not vaccinated their children for a number of reasons were choosing to be vaccinated because of the great burden of the measles outbreak. It started in April, when a nurse identified measles in one Amish family.
“The rash. They had the conjunctivitis in the eyes, their eyes were red,” she says. “They don’t want the light, they sit in the darkened room, wear dark glasses. I mean they were just miserable. High temperatures, 103, 104 temps. So this was the measles.”
When one family was asked why they had not vaccinated, the father responded
“I guess there was no scare to us before… I guess we were too relaxed.”
All of the community’s activities, including their worship, were interrupted for months as the disease spread wildly. As of September of this year, 377 cases of measles were reported in Ohio despite more than 8,000 unvaccinated people choosing to be vaccinated in response to the outbreak.
This year has seen a total of 594 cases, mostly in unvaccinated people, resulting from 18 separate outbreaks caused by unvaccinated people bringing the disease into the country.
The recurring themes here are that concerns about vaccination are valid, and in religious communities they can be especially troubling as we sort through our views of obligation to God and to our neighbors. These diseases, though, are far from benign and evidence shows that we can hold some hope of eradicating serious, debilitating, life-altering and even life-ending illnesses by preventive measures– by vaccination. Vaccines work best before an outbreak, and as the Ohio measles case shows, mass vaccination after an outbreak has limited benefits. People who are exposed before vaccination will still fall ill. People who are exposed between the time of vaccination and the time that it takes the body to produce antibodies may still fall ill and spread the disease to others.
It is not wise for Christians to grow complacent, following the example of Hollywood’s elite. Let’s heed these examples that God has given us, the wisdom of those who have suffered this before us, and take measures to prevent the next outbreak.