Balancing Public Health and Religious Freedom: The Debate on Vaccinations

In July, the Brooklyn-based U.S. District Court for the Eastern District of New York rejected the claims of a Long Island couple who, beginning in 2007, asserted a religious basis for their refusal to immunize their daughter who was then almost 4 and an applicant to pre-kindergarten” The court’s decision was based on the fact that the church that the woman belonged to did not instruct her that she could not get her children vaccinated and that the woman was generally concerned about the vaccinations due to their possible link to autism.

Vaccinations are among some of the most powerful illness-prevention tools available to clinicians. There is a general consensus in the United States that children should be immunized, where possible, against infectious diseases. While the federal government has no laws mandating vaccination, all 50 states require certain vaccinations for children entering public schools. Each state has different regulations regarding valid exemptions but many of these laws relate to religious beliefs. 
 
 
A recent article published by Gotham Gazette discusses the recent increase in parental refusal to vaccinate children: “In the last decade, the number of parents who refuse to vaccinate their children or who delay their vaccinations has risen. An increasing number of parents who object to inoculating their children are relying on the religious exemption in refusing immunization” Those parents citing religious objections to vaccination have been criticized for using religion as an excuse when there are other underlying reasons for refusal.  For example, some parents object to vaccinations due to the risk of autism, diabetes, asthma and other ailments. The links between vaccinations and these conditions have either been disproven or proven to be extremely rare and almost always occurring in people with already compromised immune systems.
 
Unsurprisingly, the increase in refusal of vaccinations in a country where they are made readily available has provided food for debate. Proponents of immunization argue that religion is not a valid reason to refuse immunization, pointing out that doing so jeopardizes public health overall: "People who can't get vaccinated because of a medical reason really rely on everyone else to protect them".  What is the right balance between freedom of religion and the public good? Should parents have the right to refuse vaccination for their children on religious grounds or otherwise? As the refusal rate for vaccinations rises, these questions are increasingly important ones for health care practitioners to be asking themselves across the U.S.
 
Clinicians can play a key role in decision-making regarding vaccination: “In focus-group discussions, several parents who were not certain about vaccinating their child were willing to discuss their immunization concerns with a health care provider and wanted the provider to offer information relevant to their specific concerns”. By remaining sensitive to religious beliefs, listening to parents fears or concerns, and correcting any misconceptions about vaccinations, physicians can help parents make an informed decision. Practitioners do need to address these often challenging and sensitive topics, and with the right tools made available to staff, it may be a great deal less difficult to do so.
 
Rachel Maryles
Assistant Program Director
Religious Diversity in Health Care