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Opting Out: The Moral Right To Religious And Conscientious-Belief Exemptions To Vaccination

By Barbara Loe Fisher

The issue of “forced vaccination” is becoming one of the most widely discussed public health and civil liberty issues in America today. At the forefront of this public conversation stands the nonprofit charity known today as the National Vaccine Information Center (, which represents more than 50,000 parents, healthcare professionals and informed citizens in every state. NVIC was founded by parents of DPT vaccine–injured children, who launched the organized vaccine-safety and informed-consent movement in America in 1982. 1

While NVIC continues to serve as a voice for families of children and adults who have suffered vaccine reactions, injuries or deaths, today a great many of our active supporters are healthcare consumers and providers who want to make informed healthcare choices, including vaccination choices, for themselves and their children. Many of those who support our work are not opposed to the concept of vaccination and do not object to every vaccine. However, they are opposed to doctors and government health officials having the power to intimidate, threaten and coerce them into violating their conscience or deeply held religious beliefs in the event they conclude that either vaccination in general or, more commonly, a particular vaccine is not appropriate for themselves or their children.

The vaccine choice advocates at the National Vaccine Information Center do not advise for or against the use of vaccines. However, we defend, without compromise, the individual’s human right to exercise informed consent to medical risk-taking as an overarching ethical principle in the practice of modern medicine for which voluntary use of vaccines should be no exception. NVIC advocates for the inclusion and protection of flexible medical, religious and conscientious-belief exemptions to vaccination in all public health policies and laws. 2

An Increase in Vaccinations and Chronic Illness

U.S. obstetricians are now giving women four vaccines during pregnancy 3 and pediatricians are giving infants and children three times as many vaccinations as they were given in 1982, when federal recommendations were 23 doses of 7 vaccines between two months and 6 years old, 4 versus today’s child vaccine schedule of 69 doses of 16 vaccines between the day of birth and age 18, with 49 doses given before age 6. 5 Parents and grandparents, along with a growing number of healthcare professionals, are asking legitimate questions about why so many highly vaccinated children in America are so sick. They are wondering why:

  • 1 child in 6 is learning disabled or developmentally delayed; 6

  • 1 in 10 is struggling with ADHD; 7

  • 1 in 9 is suffering with asthma; 8

  • 1 in 50 develops autism 9 and

  • 1 in 400 becomes diabetic. 10

Today, everybody knows somebody who was healthy, got vaccinated and was never healthy again.

The Debate Over Vaccine Risks Vaccines are pharmaceutical products that carry two risks: a risk the vaccine will cause a serious health problem, 11, 12 and a risk the vaccine will fail to provide protection from the infection it is supposed to prevent. 13, 14 Although most Americans today voluntarily accept all government-recommended vaccines for their children despite voicing more concerns about vaccine safety, 15, 16 others are choosing to decline one or more vaccines for health reasons or for religious or conscientiously held beliefs. 17, 18

The debate about vaccination during the past decade has focused on how, and how often, vaccines cause harm, with public health agencies and medical trade groups defending vaccine-safety science and parents of children who regressed into poor health after vaccination criticizing the quality and quantity of the science. Increased public awareness that we are not all the same and do not all respond the same way to vaccines—just as we do not all respond the same way to prescription drugs—has made us less willing to tolerate inflexible implementation of one-size-fits-all vaccine policies that fail to protect those individuals at greater risk for suffering harm from vaccination. 19

Today, almost no vaccine-related adverse event or existing health problem qualifies as an “official” medical reason for doctors to exercise caution and not vaccinate a child or adult. 20, 21, 22, 23 Adults and parents of children who have suffered reactions and serious health problems following vaccination are being pressured to receive more vaccines by doctors who deny an association between vaccination and chronic disease and disability. 24, 25

It’s About Choice

At the heart of this contentious debate about vaccine safety is a larger ethical issue: Do individuals have the moral right—and should they have the legal right—to make voluntary choices about whether to use all government-recommended and -mandated vaccines? 26, 27, 28

Even though the majority of Americans continue to voluntarily use vaccines recommended and mandated by the government, there is rising opposition to doctors and public health officials using intimidation, threats and sanctions against citizens if they adopt alternative vaccination schedules, refuse to accept all recommended vaccines or exercise religious and conscientiousbelief exemptions to vaccination. 29, 30, 31

No Guarantees

There are compelling reasons to defend the ethical principle of informed consent and flexible vaccine exemptions in public health policies and laws. Vaccination is a medical intervention performed on a healthy person using a pharmaceutical product which has the inherent ability to result in the injury or death of that person. There is no guarantee that the introduction of labaltered killed or live microorganisms and other vaccine ingredients 32 into the body of a healthy person will not compromise the health or cause the death of that person either immediately or in the future.

There are very few predictors that have been identified by medical science to give advance warning that an individual will suffer an injury or death after vaccination. 33, 34

The U.S. recommended child vaccine schedule has not been fully scientifically evaluated. 35

Most vaccine injuries are not compensated and vaccine reactions are not reported in the U.S. 36, 37, 38, 39, 40

There is no guarantee that a vaccine will protect a person from contracting or transmitting an infectious disease. 41, 42

The FDA and CDC openly state that the numbers of human subjects tested in clinical trials are too small to detect all serious vaccine-adverse events before licensure and widespread use. 43, 44

The significant gaps in scientific knowledge about vaccine risks and failures and who is more vulnerable to suffering harm from vaccine use makes vaccination a medical procedure that could be viewed as experimental each time it is performed on an individual or released for widespread use in a population after licensure. This makes the legal right to informed consent to vaccination an even more important human right.

Medical Paternalism vs. Individual Autonomy

Since World War II, informed consent has been increasingly adopted as the ethical principle governing rules for conducting medical experiments on humans, as well as for guiding the ethical practice of medicine. 45 The informed consent principle is reforming the authoritarian, paternalistic medical model, which allows the physician—and the physician alone—to determine what kind of medical treatment a patient will receive.

Healthcare consumers today are more interested in engaging in critical thinking and empowering themselves with information about the benefits and risks of medical interventions and pharmaceutical products. They are demanding a new relationship with doctors based on mutual respect, truth-telling and a more equal decision-making partnership.

Along with a challenge to medical paternalism is also a historic challenge to the dominance of the medical model, which relies almost exclusively on prescription drugs, vaccines and surgery as the primary way to prevent and cure illness. The holistic health movement that took root in America in the late 20th century is moving toward more a diversified, multi-dimensional health and wellness model in the 21st century as significant numbers of people in the U.S. and other developed countries choose to eat organic, exercise, meditate, limit their pharmaceutical intake, and seek out doctors practicing chiropractic, naturopathy, homeopathy and acupuncture. 46, 47, 48

This paradigm shift and historic public discussion about science, values, beliefs and how to heal and stay well involves ethical and political issues related to autonomy and the power of the state. The outcome will determine whether the ethical principle of informed consent will survive as the single most important ethic shaping the practice of medicine.

Ethics in Philosophy and Religion

In the centuries before World War II, religious scriptures, as well as some of the greatest philosophers in history, from Aristole to Thomas Aquinas and Immanuel Kant, 49 have acknowledged that the very meaning of life itself in great part hinges on the ability of the individual to choose his own fate. But British legal reformer Jeremy Bentham, a contemporary of smallpox vaccine creator Edward Jenner, disagreed and developed a political doctrine in the 19th century known as utilitarianism, which judges the rightness or wrongness of an action by its consequences.

Jacobsen v. Massachusetts (1905): A Utilitarian U.S. Supreme Court Ruling

Utilitarianism, which adopted a mathematical model for creating public policy and law based on the “greater good” argument, influenced reform of both British and U.S. law in the 19th century, as well as modern cost benefit analyses. 50, 51 In 1905, attorneys representing medical doctors and government health officials in the historic Jacobsen v. Massachusetts case 52 convinced the U.S. Supreme Court that states should be allowed to legally require all citizens to use the smallpox vaccine. Using a utilitarian rationale, the Court declared that states could force the use of smallpox vaccine because it is:

“…the duty of the constituted authorities to keep in view the welfare, comfort and safety of the many, and not permit the interests of the many to be subordinated to the wishes and convenience of the few.”

Attorneys representing state public health officials argued that doctors could predict ahead of time who will be injured or die from vaccination, and so the 1905 Supreme Court stated in its majority opinion:

“The matured opinions of medical men everywhere, and the experience of mankind, as all must know, negative the suggestion that it is not possible in any case to determine whether vaccination is safe.”

However, the Supreme Court justices also warned that smallpox vaccination must not be forced on a person whose physical condition would make vaccination “cruel and inhuman to the last degree.” In a prophetic and largely ignored caveat, the Court warned:

“All laws should receive a sensible construction. General terms should be so limited in their application as not to lead to injustice, oppression or absurd consequence. It will always, therefore, be presumed that the legislature intended exceptions to its language, which would avoid results of that character. The reason of the law in such cases should prevail over its letter.”

One of the most tragic legacies of Jacobsen v. Massachusetts, which has served as the legal foundation for state vaccine mandates for more than a century in the U.S., is how the Supreme Court used it in 1927 to justify state-enforced sterilization.