Vaccination and the Christian Worldview

February 9, 2015

The discussion of whether or not parents should vaccinate their children has been going on in some circles for years, but recent outbreaks of vaccine-preventable diseases in the United States have brought the conversation to a fever pitch. As Ross Douthat has recognized, vaccine skepticism occurs on a spectrum and has a wide range of motivating factors. When faced with the various questions that arise from so many different perspectives, the vaccine conversation sometimes sounds more like a cacophony. In the midst of the confusion, Christians should lead the way as those who wisely weigh the evidence and act accordingly for the good of those around them.

Vaccines Are Safe and Effective

When it comes to the complex milieu of questions surrounding vaccination, the least complicated issue is the science behind why they are recommended. The data overwhelmingly demonstrate that vaccines are safe and effective. Simply put, vaccines are the greatest public health achievement in human history. At the turn of the 20th Century, infectious diseases represented the greatest threat to life. Nearly one out of every six children died before the age of five due to an infectious disease and, of those who survived, many more experienced reduced quality of life due to long-term sequelae of infections. In the last century alone, it is estimated that vaccines saved 300 million lives—nearly double the number of lives lost in all wars combined during the same period of time.

To highlight the effect of vaccination in reducing the burden of specific infections, one has only to look at the dramatic decrease in the number of vaccine-preventable diseases after implementation of routine vaccination practices. Vaccination has resulted in the worldwide eradication of smallpox, the elimination of poliomyelitis in the Americas, and a 93-99% reduction in reported cases of chickenpox, measles, mumps, rubella, rotavirus, pneumococcus, Haemophilus influenzae type b, pertussis, tetanus, and diphtheria in the US. It is important to note that these infections are not inconsequential childhood diseases—reduction in the incidence of these diseases results in thousands of live saved per year in the US.

In addition to being extremely effective at preventing infectious diseases and saving lives, vaccines are also safe. No, that does not mean they are completely without risk, but no medication is. The fact remains, however, that after rigorous pre-licensure investigation and years of post-licensure usage in the general population, vaccines have been shown to be remarkably safe. The risk that any currently licensed vaccine would cause serious harm is extremely small and receiving the vaccine is much safer than getting the disease itself. Noting the infrequency of serious complications, their risk should be weighed against the protective benefit of receiving the vaccine. As such, the remote possibility of serious complications should not routinely be used as grounds for declining vaccination. As with any medication, however, a person’s medical history may indicate legitimate risk factors that would require that they not receive certain vaccines (e.g., a history of life-threatening allergic reaction to a vaccine component or to a previous vaccine dose).

The Perception of Risk

From both a global and national perspective, the overwhelmingly positive experience of the past 100 years makes a strong case for being confident in a decision to vaccinate. For the vast majority of people, an assessment of risk versus benefit weighs heavily in favor of following the recommended vaccination schedule in order to promote both individual and societal welfare. But if it’s so clear-cut, why do some choose to abstain from vaccinating themselves or their children? As you can probably tell from personal experience or from following the national conversation, the reasons behind vaccine hesitancy or refusal are myriad and varied. In most instances, however, it comes back to a basic risk/benefit assessment.

We all perform countless risk/benefit assessments on a daily basis. Every choice we make carries a risk with it. Common sense leads us to consider whether or not making a particular choice is worth taking the attendant risk, but these assessments are not one-size-fits-all. People differ in their perception of risk depending on many factors, including personality, educational background, life experience, and worldview. When it comes to considering vaccines, in order for a risk/benefit assessment to persuade a person to refuse a vaccine, they will have to either lessen the perceived benefit of receiving the vaccine, or increase the perceived risk of its side effects. At this point, it’s important to note an interesting paradox that plays into this risk assessment: because they work so well, vaccines are their own worst enemy.

Every vaccine finds itself progressing in a cycle of public perception. Prior to the introduction of a vaccine, an infectious disease—measles, for instance—is prevalent in a population and all easily recognize its harmful effects. When a safe and effective vaccine becomes available, vaccine uptake is high because the public is aware of the risk of infection. As the population becomes increasingly immunized, the incidence of measles infections decreases to the point of near elimination. As routine vaccination continues over a period of time, the reduced disease burden fosters an “out of sight/out of mind” sentiment among the public, which leads to a decreased awareness of the risks associated with disease. During this phase, in comparison to the underappreciated risk of disease, the relative prominence of previously known adverse events associated with the vaccine grows. Whereas these rare events were previously considered worth the risk compared to a common and potentially serious disease, their significance is now magnified and the public loses confidence in the vaccine. Predictably, immunization rates begin to decline until they reach the point where outbreaks of disease begin to reemerge. The serious nature of the disease is once again brought into public view and advocacy efforts arise to help people become aware of the substantial public health benefits of vaccination. As the disease is seen with fresh eyes, the demand for vaccination rises again and the cycle continues. Based on this, the key to maintaining effective long-term vaccination rates is to remind people that the threat of disease is real, even if the perception of it is not.

A Call to Discernment

So far, we have considered a good deal about vaccinations but have said nothing in particular about how a Christian worldview informs this discussion. While the mass of information above is not distinctly Christian, followers of Christ will undoubtedly be able to see the hand of God at work through the common grace of life-saving medical advancements. That alone is reason to be thankful for vaccines and to glorify God for extending compassion to a fallen world.

Furthermore, as we who have the mind of Christ (1 Corinthians 2:16) consider the questions surrounding vaccination, we should strive to honor him with how we use that mind. Neither I nor any vaccine advocate I know would claim to have the market cornered on godly wisdom, but it does appear that when considering the common objections against vaccination, many Christians defer to a presuppositional feeling or fear rather than evaluating the evidence with God-given reason and discernment. With the amount of misinformation out there, Christians must be diligent to recognize and reject faulty arguments, especially when they directly impact the health of vulnerable populations. The litany of misleading objections to vaccination varies widely and has been thoroughly discussed elsewhere (here and here, for example) so we will not go through them again in this article.

When evaluating any pro- or anti-vaccination evidence, Christians would do well to remember that we do not operate out of a baseline disposition of unwavering skepticism and mistrust. I began this article with a long overview of how repeated scientific investigations and active surveillance have verified the safety and efficacy of vaccines. An additional point to make in conjunction with this is that vaccines are the most highly scrutinized medical intervention in history. Studies are perpetually ongoing as investigators seek any new data that would allow us to adjust our recommended vaccine practices in an effort to further reduce unnecessary risks and improve health outcomes. This process is not infallible, but it is largely reassuring.

Yet, as physicians seek to reassure hesitant parents by communicating that the data overwhelmingly support vaccination, some parents choose to summarily dismiss all of these studies as mere propaganda. Deviant motives are assumed, unscrupulous Pharma influences and government meddling are cited, and the expert opinion of men and women who have devoted their entire professional careers to improving the health of children is cast aside. Of course, we should not thoughtlessly believe everything we hear, but this type of deep-seated mistrust of institutions and authorities is not reflective of who we are in Christ. It betrays our trust in God’s sovereign design to appoint rulers and authorities for the common good of people and societies (Romans 13:1-5). We are not obligated to trust all government institutions unconditionally or uncritically, but when a Christian chooses to flatly dismiss the credibility of government institutions such as the National Institutes of Health and the Center for Disease Control and Prevention, he has run afoul of the ethos of Romans 13. Scientists in academia and pharmaceutical companies do not constitute the same type of God-given authority as government, but it still seems unwise to so easily spurn the efforts of those whom God has placed in a position to do good.

What About Vaccines Made with Aborted Fetal Tissue?

Another consideration pertaining to a Christian’s approach to vaccination is the moral objection to vaccines that utilize cell lines derived from voluntarily aborted human fetuses. There are two cell lines in question, MRC-5 and WI-38, each of which is derived from the tissue of two different fetuses aborted about 50 years ago. The abortions were elective, but they were not “exploitative” with respect to these cell lines, meaning that the abortions occurred for reasons other than the collection of tissue. Each tissue specimen was collected for research purposes post-mortem and used as the seed for a cell line that has been commonly used in medical and research laboratories since that time (along with cell lines from many other different types of human or animal tissue). MRC-5 and WI-38 cell stocks can be propagated in perpetuity and do not require any additional fetal tissue. These two particular cell lines are used during the manufacturing of vaccines for certain viruses, including rubella, hepatitis A, and varicella (chickenpox). The manufacturing process can sometimes be inaccurately portrayed as requiring an ongoing supply of fetal tissue from new abortions, but this is not true.

As Christians, we are clearly opposed to abortion, but what are we to think about the use of viral vaccines that were made using MRC-5 or WI-38 cell lines? Thinking through a parallel example can help clarify whether or not using a product obtained through immoral methods makes a downline consumer complicit in the original immoral act. Imagine a scientist who embezzled funds and then used that money to set up a research laboratory. He never steals again, and several years later his research team develops a life-saving treatment. Fifty years later, you become sick and find yourself in need of this treatment, with no sufficient alternative. Would using this treatment cause you to be morally culpable for participating in the embezzlement? Most would argue that the connection to the immoral act in this scenario is sufficiently remote so as to not constitute cooperation in evil. Likewise, the original act of abortion that led to the collection of seed tissues for MRC-5 and WI-38 cell lines was clearly immoral, but it is not so clear that any medical advances involving these cell lines (a list that includes much more than a few vaccines) should be rejected outright.

As stated by Justin Smith and Joe Carter in their helpful article on this important issue:

Unfortunately, we live in a fallen world where it is almost impossible to do good without some indirect connection to an act of evil. As Christians we should strive to avoid cooperating with evil and prevent it from occurring in the future (e.g., we should oppose the making of new vaccines using the ethically tainted tissue), but we should not risk the lives of our children in order to avoid a remote connection that is tangentially related to an evil act.

A Commitment to the Common Good 

Even with the weight of evidence demonstrating the individual benefits to vaccinated persons, this is not the most compelling reason for Christians to be pro-vaccination. Ultimately, we should be advocates of routine universal vaccination because that is what is best for our neighbor. Literally, for the person living next door who may have an increased risk of a serious infection due to an immune deficiency or a recent round of chemotherapy, but also our neighbor in the broader sense of our global community.

People who cannot receive certain vaccinations (due to a weakened immune system, an allergy, or young age) depend on the routine vaccination of the general population around them for the protective effect known as herd immunity. When the number of people susceptible to an infectious disease is low enough, transmission of that disease can be reduced to the point of elimination. In this way, vulnerable populations who cannot be vaccinated can receive a protective benefit from the actions of others in their community. Vaccines protect the vulnerable, individually and community-wide. This is pleasing to God and should be to his children as well. When considering a person’s responsibility to play their part in protecting the common good of their community, an important question may arise: What about balancing a person’s liberty to not vaccinate versus the privileges that come with participating in public institutions? There is a distinction between a person’s isolated existence and the privileges of many aspects of public life, and while that discussion is not without merit, it falls outside the immediate scope of this article.

As with all of medicine, vaccines are a common grace—a blessing that God bestows on all mankind that is not directly tied to our salvation. God sends the rain to the just and the unjust (Matthew 5:45) and the vaccines to the child and the adult. Rather than rejecting this undeserved gift, we should receive it with thanksgiving and seek to bless others because of it.

It is disheartening to see the nonchalance with which a growing number of Christians are abdicating their role in sustaining healthy communities. Vaccination glorifies God because it promotes the common good of society and contributes to human flourishing. As Christians, we should be pressing in to our participation in this blessing, not walking away from it.

*The author declares no financial conflicts of interest related to the content of this work.

Scott James

Scott James serves as an elder at The Church at Brook Hills. He and his wife, Jaime, have four children and live in Birmingham, Alabama, where he works as a pediatric physician. He is the author of The Expected One: Anticipating All of Jesus in the Advent, and Mission Accomplished: A Two-Week Family … Read More

Article 12: The Future of AI

We affirm that AI will continue to be developed in ways that we cannot currently imagine or understand, including AI that will far surpass many human abilities. God alone has the power to create life, and no future advancements in AI will usurp Him as the Creator of life. The church has a unique role in proclaiming human dignity for all and calling for the humane use of AI in all aspects of society.

We deny that AI will make us more or less human, or that AI will ever obtain a coequal level of worth, dignity, or value to image-bearers. Future advancements in AI will not ultimately fulfill our longings for a perfect world. While we are not able to comprehend or know the future, we do not fear what is to come because we know that God is omniscient and that nothing we create will be able to thwart His redemptive plan for creation or to supplant humanity as His image-bearers.

Genesis 1; Isaiah 42:8; Romans 1:20-21; 5:2; Ephesians 1:4-6; 2 Timothy 1:7-9; Revelation 5:9-10

Article 11: Public Policy

We affirm that the fundamental purposes of government are to protect human beings from harm, punish those who do evil, uphold civil liberties, and to commend those who do good. The public has a role in shaping and crafting policies concerning the use of AI in society, and these decisions should not be left to those who develop these technologies or to governments to set norms.

We deny that AI should be used by governments, corporations, or any entity to infringe upon God-given human rights. AI, even in a highly advanced state, should never be delegated the governing authority that has been granted by an all-sovereign God to human beings alone. 

Romans 13:1-7; Acts 10:35; 1 Peter 2:13-14

Article 10: War

We affirm that the use of AI in warfare should be governed by love of neighbor and the principles of just war. The use of AI may mitigate the loss of human life, provide greater protection of non-combatants, and inform better policymaking. Any lethal action conducted or substantially enabled by AI must employ 5 human oversight or review. All defense-related AI applications, such as underlying data and decision-making processes, must be subject to continual review by legitimate authorities. When these systems are deployed, human agents bear full moral responsibility for any actions taken by the system.

We deny that human agency or moral culpability in war can be delegated to AI. No nation or group has the right to use AI to carry out genocide, terrorism, torture, or other war crimes.

Genesis 4:10; Isaiah 1:16-17; Psalm 37:28; Matthew 5:44; 22:37-39; Romans 13:4

Article 9: Security

We affirm that AI has legitimate applications in policing, intelligence, surveillance, investigation, and other uses supporting the government’s responsibility to respect human rights, to protect and preserve human life, and to pursue justice in a flourishing society.

We deny that AI should be employed for safety and security applications in ways that seek to dehumanize, depersonalize, or harm our fellow human beings. We condemn the use of AI to suppress free expression or other basic human rights granted by God to all human beings.

Romans 13:1-7; 1 Peter 2:13-14

Article 8: Data & Privacy

We affirm that privacy and personal property are intertwined individual rights and choices that should not be violated by governments, corporations, nation-states, and other groups, even in the pursuit of the common good. While God knows all things, it is neither wise nor obligatory to have every detail of one’s life open to society.

We deny the manipulative and coercive uses of data and AI in ways that are inconsistent with the love of God and love of neighbor. Data collection practices should conform to ethical guidelines that uphold the dignity of all people. We further deny that consent, even informed consent, although requisite, is the only necessary ethical standard for the collection, manipulation, or exploitation of personal data—individually or in the aggregate. AI should not be employed in ways that distort truth through the use of generative applications. Data should not be mishandled, misused, or abused for sinful purposes to reinforce bias, strengthen the powerful, or demean the weak.

Exodus 20:15, Psalm 147:5; Isaiah 40:13-14; Matthew 10:16 Galatians 6:2; Hebrews 4:12-13; 1 John 1:7 

Article 7: Work

We affirm that work is part of God’s plan for human beings participating in the cultivation and stewardship of creation. The divine pattern is one of labor and rest in healthy proportion to each other. Our view of work should not be confined to commercial activity; it must also include the many ways that human beings serve each other through their efforts. AI can be used in ways that aid our work or allow us to make fuller use of our gifts. The church has a Spirit-empowered responsibility to help care for those who lose jobs and to encourage individuals, communities, employers, and governments to find ways to invest in the development of human beings and continue making vocational contributions to our lives together.

We deny that human worth and dignity is reducible to an individual’s economic contributions to society alone. Humanity should not use AI and other technological innovations as a reason to move toward lives of pure leisure even if greater social wealth creates such possibilities.

Genesis 1:27; 2:5; 2:15; Isaiah 65:21-24; Romans 12:6-8; Ephesians 4:11-16

Article 6: Sexuality

We affirm the goodness of God’s design for human sexuality which prescribes the sexual union to be an exclusive relationship between a man and a woman in the lifelong covenant of marriage.

We deny that the pursuit of sexual pleasure is a justification for the development or use of AI, and we condemn the objectification of humans that results from employing AI for sexual purposes. AI should not intrude upon or substitute for the biblical expression of sexuality between a husband and wife according to God’s design for human marriage.

Genesis 1:26-29; 2:18-25; Matthew 5:27-30; 1 Thess 4:3-4

Article 5: Bias

We affirm that, as a tool created by humans, AI will be inherently subject to bias and that these biases must be accounted for, minimized, or removed through continual human oversight and discretion. AI should be designed and used in such ways that treat all human beings as having equal worth and dignity. AI should be utilized as a tool to identify and eliminate bias inherent in human decision-making.

We deny that AI should be designed or used in ways that violate the fundamental principle of human dignity for all people. Neither should AI be used in ways that reinforce or further any ideology or agenda, seeking to subjugate human autonomy under the power of the state.

Micah 6:8; John 13:34; Galatians 3:28-29; 5:13-14; Philippians 2:3-4; Romans 12:10

Article 4: Medicine

We affirm that AI-related advances in medical technologies are expressions of God’s common grace through and for people created in His image and that these advances will increase our capacity to provide enhanced medical diagnostics and therapeutic interventions as we seek to care for all people. These advances should be guided by basic principles of medical ethics, including beneficence, non-maleficence, autonomy, and justice, which are all consistent with the biblical principle of loving our neighbor.

We deny that death and disease—effects of the Fall—can ultimately be eradicated apart from Jesus Christ. Utilitarian applications regarding healthcare distribution should not override the dignity of human life. Fur- 3 thermore, we reject the materialist and consequentialist worldview that understands medical applications of AI as a means of improving, changing, or completing human beings.

Matthew 5:45; John 11:25-26; 1 Corinthians 15:55-57; Galatians 6:2; Philippians 2:4

Article 3: Relationship of AI & Humanity

We affirm the use of AI to inform and aid human reasoning and moral decision-making because it is a tool that excels at processing data and making determinations, which often mimics or exceeds human ability. While AI excels in data-based computation, technology is incapable of possessing the capacity for moral agency or responsibility.

We deny that humans can or should cede our moral accountability or responsibilities to any form of AI that will ever be created. Only humanity will be judged by God on the basis of our actions and that of the tools we create. While technology can be created with a moral use in view, it is not a moral agent. Humans alone bear the responsibility for moral decision making.

Romans 2:6-8; Galatians 5:19-21; 2 Peter 1:5-8; 1 John 2:1

Article 2: AI as Technology

We affirm that the development of AI is a demonstration of the unique creative abilities of human beings. When AI is employed in accordance with God’s moral will, it is an example of man’s obedience to the divine command to steward creation and to honor Him. We believe in innovation for the glory of God, the sake of human flourishing, and the love of neighbor. While we acknowledge the reality of the Fall and its consequences on human nature and human innovation, technology can be used in society to uphold human dignity. As a part of our God-given creative nature, human beings should develop and harness technology in ways that lead to greater flourishing and the alleviation of human suffering.

We deny that the use of AI is morally neutral. It is not worthy of man’s hope, worship, or love. Since the Lord Jesus alone can atone for sin and reconcile humanity to its Creator, technology such as AI cannot fulfill humanity’s ultimate needs. We further deny the goodness and benefit of any application of AI that devalues or degrades the dignity and worth of another human being. 

Genesis 2:25; Exodus 20:3; 31:1-11; Proverbs 16:4; Matthew 22:37-40; Romans 3:23

Article 1: Image of God

We affirm that God created each human being in His image with intrinsic and equal worth, dignity, and moral agency, distinct from all creation, and that humanity’s creativity is intended to reflect God’s creative pattern.

We deny that any part of creation, including any form of technology, should ever be used to usurp or subvert the dominion and stewardship which has been entrusted solely to humanity by God; nor should technology be assigned a level of human identity, worth, dignity, or moral agency.

Genesis 1:26-28; 5:1-2; Isaiah 43:6-7; Jeremiah 1:5; John 13:34; Colossians 1:16; 3:10; Ephesians 4:24