Guarding Ourselves

On the good news that a coronavirus vaccine might soon see emergency approval here in the United States, we are going to enter a new phase of the pandemic. For months we have been confined to using non-medical mitigation methods of stopping the spread. In other words we have tried to stay home as much as possible and use masks and social distancing when we have to go out. We can now see the light at the end of the tunnel where most of the population has immunity to the illness following a mass vaccination regimen.

Herd immunity, which would allow a return to normal, is still months away. In the meantime we will enter a phase of the pandemic where some people will get the limited number of vaccines while others wait. This raises a number of practical and ethical questions. It behooves us to look at what Jewish sources can teach about vaccines.

The Jewish approach is actually one that has received a lot of attention in recent years as many in the ultra-Orthodox community have avoided getting their children vaccinated, leading to outbreaks of measles in some places. The vast majority of Orthodox rabbis decreed that vaccination was necessary and important, yet still some resisted.

The discussion comes down to a prohibition in Jewish tradition against taking unnecessary risks. We are obligated to guard ourselves and protect our bodies as gifts from God. When vaccinations were first introduced, rabbinical authorities wholeheartedly endorsed them because they curbed major outbreaks.

Ironically, the success of modern vaccines has led to resistance to them by some. The logic goes like this: If it is unlikely that my child will get a disease, but the vaccine to prevent that disease has the risk of a side effect (however miniscule) then the principle of not taking risks should allow me to refuse the shot. In this person’s mind they might believe that either way there is a risk so the best course of action is to “sit and do nothing” (known as shev v’al taaseh adif in Jewish thought).

The first problem with this thinking is that it may not be correct since most people are probably unaware of the risks of measles in their community vs. the risks of vaccine side effects. The second problem is that it represents a selfish attitude that will ultimately do harm to oneself or ones children. If enough people refuse a vaccine, then herd immunity diminishes and the disease can be transmitted and it becomes more likely that you or your unvaccinated child gets sick.

It will be interesting to see the response to the coronavirus vaccine in the ultra-Orthodox community. Will it be treated like the measles vaccine in the last few years or the smallpox vaccine in the 19th century? I hope that it will be compared to the latter, which wiped out a terrible disease almost from the face of the earth.

The coronavirus vaccine will also present difficult questions of scarcity and rationing. Not everyone will be able to receive it right away so who gets it first? Some have argued that superspreaders, many of whom are young adults who go to parties and other events, should get it first, but there are moral and practical problems with such a plan.

Obviously, it would seem unjust to “reward” those who have not followed the rules of social distancing and mask wearing with the “gift” of immunity. Vaccinating young adults first could also be counterproductive since right now, the first two vaccines have only proven effective at preventing onset of symptoms, not transmission of the disease. Taking the vaccine will mean that you are not likely to get sick, but you could still give COVID to someone else, which means that giving it to superspreaders could have disastrous results if they interact with vulnerable populations.

It is possible that the COVID vaccines also prevent transmission, but this hasn’t been tested yet. Therefore, the CDC recommendations of first giving the vaccine to frontline workers and nursing home residents makes the most sense, ethically and practically. The vaccines were designed and tested to prevent people from getting sick so the most vulnerable of our populations should get it first.

During this next phase of the pandemic we are likely to have more reassurance that if we are infected we won’t develop severe symptoms, but the virus may still spread at an alarming rate. If that’s the case, we may still need to wear masks and keep apart for months to come. We aren’t quite ready to let our guard down, but maybe we can start to envision a bit of a return to normal.

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