# Vaccination and religion

The relationship between vaccination and religion is complex and multifaceted. While no major religion explicitly prohibits vaccinations, some individuals cite religious adherence as a basis for opting not to vaccinate themselves or their children. Historically, both pro- and anti-vaccination groups have used religious arguments to support their positions. For instance, in Australia, anti-vaccinationists founded the Church of Conscious Living, a "fake church", in an attempt to claim religious exemptions, which ultimately led to the removal of such exemptions in the country. Similarly, a United States pastor has been reported to offer vaccine exemptions in exchange for church membership. This article will explore the historical and contemporary trends surrounding vaccination and religion, including the influence of anti-vaccination movements globally, current debates in the U.S., the significant interplay of politics and religion on vaccination rates, and the use of religious exemptions by parents.

## Historical
### Early religious influences on vaccination

One of the earliest documented cases of variolation involved a Buddhist nun (bhikkhuni) between 1022 and 1063 CE. She ground smallpox scabs into a fine powder and administered it through the nostrils of an uninfected person to promote immunity. Centuries later, the 14th Dalai Lama continued the tradition of disease prevention by personally supporting polio vaccination campaigns.

### Religious figures and advocacy for vaccination

In 1721, the influential Massachusetts preacher Cotton Mather was the first known person to attempt smallpox inoculation on a large scale, inoculating himself and more than two hundred members of his congregation with the help of a local doctor. While his view later became standard, there was a strong negative reaction against him at the time.
Rowland Hill (1744–1833) was a popular English preacher acquainted with Edward Jenner, the pioneer of smallpox vaccination, and he encouraged the vaccination of the congregations he visited or preached to. He published a tract on the subject in 1806, at a time when many medical men refused to sanction it. Later he became a member of the Royal Jennererian Society, which was established when vaccination was accepted in Britain, India, the US, and elsewhere. John C. Lettsom, an eminent Quaker physician of the day wrote to Rowland Hill commenting:
   You have done more good than you imagine; and for everyone you may have saved by your actual operation, you have saved ten by your example; and perhaps, next to Jenner, have been the means of saving more lives than any other individual.
In 1804 during an outbreak of smallpox in New Spain Fr. Manuel Abad y Queipo personally paid for and brought the smallpox vaccine from the Capital to Valladolid.
In 1816 Iceland made the clergy responsible for smallpox vaccination and gave them the responsibility of keeping vaccination records for their parishes; Sweden also had similar practices.
Catholic and Anglican missionaries vaccinated Northwest Coast Native Americans during an 1862 smallpox epidemic.

### Religious opposition to vaccination

In 1798, several Boston clergymen and devout physicians formed a society that opposed vaccination. Others complained that the practice was dangerous, going so far as to demand that doctors who carried out these procedures be tried for attempted murder.
When vaccination was introduced into UK public policy, and adoption followed overseas, there was opposition from trade unionists and others, including sectarian ministers and those interested in self-help and alternative medicines like homeopathy.
Anti-vaccinationists were most common in Protestant countries. Those who were religious often came from minority religious movements outside of mainstream Protestantism, including Quakers in England and Baptists in Sweden.
Jehovah's Witnesses condemned the practice of vaccination in 1931 as "a direct violation of the everlasting covenant that God made with Noah after the flood", but reversed that policy in 1952. The decision of whether to vaccinate themselves or their family is left to individuals. Some more recent Jehovah's Witness publications have mentioned the success of vaccination programs.

### Legislation and religious exemptions

In the UK, a number of Vaccination Acts were introduced to control vaccination and inoculation, starting in 1840, when smallpox inoculation was banned. The 1853 Act introduced compulsory free infant vaccination enforced by local authorities. By 1871, infant vaccination was compulsory and parents refusing to have their child vaccinated were fined and imprisoned if the fines were not paid. Resistance to compulsion grew, and in 1889, after riots in Leicester, a Royal Commission was appointed and issued six reports between 1892 and 1896. It recommended the abolition of cumulative penalties. This was done in an 1898 Act, which also introduced a conscience clause that exempted parents who did not believe vaccination was efficacious or safe. This extended the concept of the "conscientious objector" in English law. A further Act in 1907 made it easier to obtain exemption.

## Current
### Christianity
#### Conservative Christian groups:

Some conservative Christian groups in the United States oppose mandatory vaccination for diseases typically spread via sexual contact, arguing that the possibility of disease deters risky sexual contact. For example, the Family Research Council opposes mandatory vaccination against HPV, a virus that causes various cancers: "Our primary concern is with the message that would be delivered to nine- to twelve-year-olds with the administration of the vaccines. Care must be taken not to communicate that such an intervention makes all sex 'safe'." Studies have shown that HPV vaccination does not result in increased sexual activity.

#### Support for vaccination:

Other Christians have supported vaccinations and mask wearing in the wake of COVID-19 to stop the spread of the disease, even using scripture to support the position.

#### The church of Jesus Christ of Latter-Day Saints:

The Church of Jesus Christ of Latter-day Saints has made vaccination an official initiative in its humanitarian relief program. The Church has also called on its members to see that their own children are properly vaccinated. In March 2021, the Church added encouragement to vaccinate to its General Handbook of Instructions, noting that "Vaccinations administered by competent medical professionals protect health and preserve life. ... Members of the Church are encouraged to safeguard themselves, their children, and their communities through vaccination." In August 2021, the Church again encouraged vaccination, specifically against COVID-19, in a public statement from the First Presidency: "We know that protection from [Covid and its variants] can only be achieved by immunizing a very high percentage of the population.... To provide personal protection from such severe infections, we urge individuals to be vaccinated."

#### Christian science:

Although the Church of Christ, Scientist encourages reliance on prayer, it does not forbid vaccination or any other medical practice, and in 2015 it did not renew its application for religious exemption for vaccinations in Australia because it deemed the exemption "no longer current or necessary".

### Islam and Judaism
#### Dietary concerns and medical exceptions:

Islam and Judaism, religions with dietary prohibitions that regard particular animals as unclean, make exceptions for medical treatments derived from those animals. However, this may not be universally accepted due to a lack of central authority in these religions. For example, in Aceh Province, an autonomous province of Indonesia with its own Islamic Sharia Law, eighty percent of people refuse all vaccinations due to concerns about pig, or its derivatives, being used to make some vaccines (eating pig is considered haram).

### Hinduism

Hinduism consists of various denominations that share core beliefs but differ in philosophies and practices. With no single founder, it is known as Sanatan Dharma (the Eternal Tradition) and traces its origins to the Vedic texts of ancient India, dating back to between 1500 BCE and 500 BCE.
In Hinduism, the ethical and symbolic meanings of scriptures, as interpreted by spiritually enlightened gurus, are often prioritized over literal interpretations. Vaccination is generally accepted in countries with a predominantly Hindu population.
Hindus uphold the principle of non-violence (ahimsa) and value all forms of life, believing that divinity exists in every being, including plants and animals.
Many Hindus follow a vegetarian diet to honor higher forms of life, while others consume meat only on specific days. Dietary practices differ across regions and communities. This review did not find any current concerns among Hindus regarding the presence of bovine-derived ingredients in some vaccines.

### Buddhism

Buddhism is a religion with a variety of traditions, beliefs, and practices based on the teachings of Siddhartha Gautama, known as the Buddha, which means "the awakened one." The Buddha shared his insights to help people overcome ignorance, desire, and suffering, ultimately leading to Nirvana—a state of liberation from suffering. He taught in the eastern region of what is now India between the 6th and 4th centuries BCE, possibly around 563–483 BCE.
Buddhism includes several major branches, such as Theravada, Mahayana, Vajrayana, and Zen, but lacks a single central text or authority to define its doctrines or ethics. In predominantly Buddhist countries, vaccination is generally accepted.
Buddhism does not oppose using non-animal-derived medicines to treat illnesses, viewing treatment as an act of compassion. For example, while antibiotics destroy microorganisms, they are accepted because they help people stay healthy and maintain the harmony of body and mind, which supports progress toward Enlightenment. Preventing disease is seen as a way to preserve this harmony.

### New religious movements and alternative beliefs
#### Congregation of Universal Wisdom:

The Congregation of Universal Wisdom, a religion based on belief in chiropractic spinal adjustments and Universal Intelligence, forbids vaccinations. The New York Times covered the Congregation of Universal Wisdom and noted that many families have used these religious memberships to avoid vaccination requirements. In a court case citing the Congregation of Universal Wisdom, Turner v. Liverpool Cent. School, the United States District Court in New York affirmed the permissibility of claiming religious exemption from vaccination on the basis of such membership.

### Ethical and moral concerns
#### Use of fetal tissue in vaccines:

The use of fetal tissue in vaccine development has also provoked some controversy among religions opposed to abortion. The cell culture media of vaccines for varicella, rubella (in the MMR vaccine), hepatitis A, rabies (Imovax) and the Johnson & Johnson COVID-19 vaccine (no longer used in the U.S.) are produced using fetal cells to grow viruses. Since viruses require specific cells to reproduce, human cells are ideal for this purpose. Fetal cells, originally isolated from elective terminations in the 1960s, were chosen for their sterility, minimizing the risk of contamination. Fibroblast cells are used for all these vaccines except the J&J COVID-19 vaccine, which uses fetal retinal cells. Fetal cells obtained in the early 1960s have been continuously grown in laboratories and are still used for vaccine production today, with no need for additional sources. This method has led to moral controversy and considerations based on the principle of double effect by Thomas Aquinas. For example, the principle of double effect, originated by Thomas Aquinas, holds that actions with both good and bad consequences are morally acceptable in specific circumstances, and the question is how this principle applies to vaccination.

#### Catholic church's position:

The Vatican Curia has expressed concern about the rubella vaccine's embryonic cell origin, saying Catholics have "... a grave responsibility to use alternative vaccines and to make a conscientious objection with regard to those which have moral problems". The Vatican concluded that until an alternative becomes available it is acceptable for Catholics to use the existing vaccine, writing, "This is an unjust alternative choice, which must be eliminated as soon as possible." The Catholic Church advises its members to choose vaccines that are developed without the use of human cell lines whenever feasible. Nonetheless, the Vatican has stated that "all vaccinations recognized as clinically safe and effective can be used in good conscience, with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion."

### Political opposition to vaccination by religious groups
#### Opposition to vaccination among Jewish communities

Opposition to vaccination by Orthodox Jews is not a widespread phenomenon. The majority of Orthodox Rabbis view vaccination as a religious obligation. A magazine called P.E.A.C.H. that presented an anti-immunization message to Orthodox Jews was distributed in Brooklyn, New York in early 2014. 96% of students at Yeshivas (who are essentially all Orthodox Jewish) in New York City were immunized according to information obtained in 2014, although this is a lower than average rate.

#### Opposition to vaccination in Muslim communities
##### Nigeria

In 2003 imams in northern Nigeria advised their followers not to have their children vaccinated with oral polio vaccine, perceived to be a plot by Westerners to decrease Muslim fertility. The boycott caused the number of polio cases to rise not only in Nigeria but also in neighboring countries. The followers were also wary of other vaccinations, and Nigeria reported more than twenty thousand measles cases and nearly six hundred deaths from measles from January through March 2005. In 2006 Nigeria accounted for more than half of all new polio cases worldwide. Outbreaks continued thereafter; for example, at least 200 children died in a late-2007 measles outbreak in Borno State. In 2013, nine health workers administering polio vaccine were targeted and killed by gunmen on motorcycles in Kano, but this was an isolated incident. Local traditional and religious leaders and polio survivors worked to support the vaccination campaign, and Nigeria has not had a polio case since July 24, 2014; in 2016, Nigeria was declared polio-free.

##### Pakistan and Afghanistan

In the 2000s, in Pakistan and Afghanistan, some Taliban issued fatwas opposing vaccination as an American plot to sterilize Muslims, and kidnapped, beat, and assassinated vaccination officials; the head of Pakistan's vaccination campaign in Bajaur Agency was assassinated in 2007, on his way back from a meeting with a religious leader. In 2011, a CIA spy ran a fake hepatitis vaccination campaign to search for Osama bin Laden; such actions were strongly condemned by US and international health NGOs, the doctor involved was jailed and the CIA promised not to use vaccination as a cover again. A genuine polio vaccinator had previously vaccinated Osama bin Laden's children and grandchildren in his compound in Abbottabad. Both major sides of the Afghan civil war now support polio vaccination, and polio rates are declining rapidly in Afghanistan, with only five cases in January–July 2015. In Pakistan there were 28 cases in the same period.

#### Opposition to vaccination among African American religious groups

In 2015, leaders of the Nation of Islam spoke out against a California Bill that removed philosophical exemptions to school vaccination requirements, alleging a link between MMR vaccine and autism. They also said that government mandated vaccines were another Tuskegee Syphilis Study.

##### Opposition to vaccination among Evangelical Christians

According to a March 2021 poll conducted by The Associated Press/NORC, vaccine skepticism is more widespread among white evangelicals than most other blocs of Americans. 40% of white evangelical Protestants stated they weren't likely to get vaccinated against COVID-19.

## Impact of COVID-19 on religious perspectives and vaccination rates

The spread of COVID-19 has brought vaccine hesitancy into the global spotlight, but what influences the significant differences in vaccination rates across regions? Research spanning 195 regions worldwide suggests that religiosity (an institutionalized belief) and spirituality (more personal and intuition-based) play a key role in shaping vaccination trends.
In the first study, data from 23 global regions revealed a negative correlation between both spirituality and religiosity and COVID-19 vaccination rates. These findings remained consistent even after adjusting for vaccine supply limitations. The second study, which analyzed data from 144 regions, reinforced this trend—religiosity continued to be a strong negative predictor of vaccination rates, even when accounting for factors such as GDP, population age, collectivism, vaccine skepticism, and past vaccination history. The third study focused on all U.S. states and the District of Columbia, once again showing that higher levels of spirituality and religiosity were linked to lower vaccination rates, even after controlling for other variables. Overall, these studies highlight a strong relationship between spirituality, religiosity, and vaccine uptake, suggesting that regional differences in these factors may significantly influence real-world vaccination behaviors.
Additionally, in another study, Cross-National Comparison of Religion as a Predictor of COVID-19 Vaccination Rates, researchers explored the impact of religiosity on COVID-19 vaccination rates across nations while accounting for socio-economic and cultural factors. Analyzing data from 90 countries, covering 86% of the global population, they found a negative correlation between Christianity and vaccination rates, whereas no such relationship was observed for Islam, Buddhism, Hinduism, or non-belief. Factors such as the importance of religion, freedom of expression, sex ratio, median age, and most cultural variables showed no significant connection to vaccination rates, while the Human Development Index did. The study also highlighted how different religions influence vaccine uptake.

## Exemptions

In the U.S., all 50 states and Washington D.C. require certain vaccines for students to attend school, aligning with recommendations from the CDC's Advisory Committee on Immunization Practices. While medical exemptions are permitted in every state, laws regarding non-medical exemptions for religious or personal reasons differ. Thirty states and D.C. permit religious exemptions, while thirteen allow either religious or personal exemptions. Louisiana and Minnesota do not specify whether non-medical exemptions must be religious or personal. Five states (Mississippi, California, West Virginia, Maine, and New York) are the only states that do not allow any non-medical exemptions, meaning all other states permit religious exemptions for parents who choose not to vaccinate their children for religious reasons.
The number of religious exemptions rose greatly in the late 1990s and early 2000s; for example, in Massachusetts, the rate of those seeking exemptions rose from 0.24% in 1996 to 0.60% in 2006. Some parents falsely claim religious beliefs to get exemptions. The American Medical Association opposes such exemptions, saying that they endanger health not only for the unvaccinated individual but also for neighbors and the community at large.
On January 1, 2016, Australia introduced legislation that removed eligibility for childcare and welfare benefits if parents refuse to vaccinate their children, removing religious exemptions at the same time as the only religion to apply for an exemption (Church of Christ, Scientist) deemed their exemption to no longer be relevant.