Rockland County is in the midst of a measles epidemic. As I write this, there are at least 155 cases of measles — a disease that was eliminated from the United States in 2000.
I write this article as a mother and grandmother, as a pediatrician, as a part of a team that developed new vaccines, and as a rabbi.
As a pediatrician, I took care of children who succumbed to diseases that we no longer worry about today. I remember sitting with a mother as she struggled to understand why her beautiful little boy — who was fine until a few days before — had died of Hib disease so quickly that antibiotics did not have time to act. A vaccine against Hib, which is recommended for all children today, was not available back then.
Many years later, I met another mother. She, too, had a child who died of Hib disease. But her story was different. There was a vaccine available, but she was overwhelmed with the responsibility of new motherhood. There was so much information on the internet, and it was scary. There was even talk of a government conspiracy. How could she know what to do to best protect her child? Her pediatrician assured her of the benefits of vaccination, but she thought she’d just wait, and decide later. When her toddler died, she learned, in a way that no parent ever should have to learn, that making no decision was also a decision, and it had consequences. Terrible consequences.
As a vaccine researcher, I conducted trials of new vaccines in thousands of children, to make sure that the vaccines were both safe and effective against the disease they were designed to protect. My team was testing a new vaccine against whooping cough. Because there already was a whooping cough vaccine in the United States, there was not enough disease here to test the new acellular vaccine to see if it worked. But to our surprise, we found that we could test this vaccine in the developed world. In what was then West Germany, the parental anti-vaccine movement was very strong, vaccine rates dropped, and a whooping cough epidemic was sweeping the country. Now, parents were willing to test a brand-new vaccine in their children, because they could see how devastating this forgotten disease was.
Both my children received all their vaccines on time. As a pediatrician, I knew how serious these diseases were. The day that my son received his routine measles vaccination, there was a pediatric resident on a ventilator, in the hospital in which I was working. She had contracted measles from a patient, and was very, very ill.
The Rockland County measles outbreak is centered in an Orthodox Jewish community. As a rabbi, I know that there is nothing in Judaism that would prohibit vaccination. On the contrary, the most important precept in Judaism is pikuach nefesh, saving a life. Even the laws of Shabbat may be suspended, if someone’s life is at risk. In Judaism, we also have an obligation to heal. As it says in the Talmud, “One who saves one life, it is as if he saves an entire world.” Prevention, too, is important. The Torah tells us “You shall make a parapet for your roof.” That is, we have an obligation to remove hazards to public health and safety from our domain.
The Talmud also tells us that dina malchuta dina. The law of the land is the law. Throughout Jewish history, we have understood the need to comply with the just laws of the society in which we live. The law requiring that our children be immunized is like other laws that govern how we live together. We stop at red traffic lights to make life safer for drivers and pedestrians. We wear seat belts because they protect lives in case of accident. Immunization protects us against deadly infectious diseases and has the added effect of providing herd immunity. By reducing the spread of disease, it can protect babies who are too young to be fully immunized, and it can protect people, both young and old, who have medical contra-indications to vaccination, or who have fragile immune systems. When enough people say, “Let someone else vaccinate their child — mine will be safe,” the herd immunity breaks down, and none of us is safe from these deadly diseases.
It is good public health policy to enforce immunization laws, to make sure that susceptible children stay out of school, and, if necessary, other public spaces, for the safety of all.
I am now savta — grandma — to four beautiful grandchildren, and I am proud and relieved that they are all up-to-date on their immunizations.
Jill Hackell is the rabbi at West Clarkstown Jewish Center. She’s also a physician, who earned her medical degree from Johns Hopkins School of Medicine, where she also did her pediatric residency. She practiced general pediatrics for several years and then moved to the pharmaceutical industry, where she did clinical research on new vaccines for more than 20 years, including vaccines against pertussis (whooping cough), Hib (Haemophilus influenza b), and pneumococcal disease. She has combined these two paths with an interest in bioethical issues, teaching Jewish bioethics at the Academy for Jewish Religion, and graduate-level secular bioethics at Dominican College.