There is a particular concern on the part of Catholic parents about being granted exemptions from immunization requirements for admission to Catholic schools. We offer this brief statement as a clarification of the position of The National Catholic Bioethics Center (NCBC). There are generally three types of exemptions from immunization requirements for school admission granted by authorities: 1) a religious exemption, 2) a conscience exemption, and 3) a medical exemption. Regrettably legislatures, health care agencies and school systems do not always use the terms consistently and with precision. Furthermore, there are different kinds of vaccines targeting different kinds of diseases. We make a broad distinction between two types of infectious diseases. These definitions are provided by the Centers for Disease Control and Prevention. Communicable disease: an infectious disease that that can be transmitted from one source to another by bacteria or viral organisms. Contagious disease: a very communicable disease capable of spreading rapidly from one person to another by contact or close proximity. Examples of contagious diseases would be measles, mumps, rubella and chicken pox. Examples of communicable diseases which are behaviorally transmitted would be HPV and HIV. The NCBC supports mandated universal immunization for contagious diseases as defined above. It also supports a requirement that children be immunized against contagious diseases as a condition for admission to a school if a significant threat to the health of others exists. Such a requirement should allow for exemptions under certain conditions as is explained below. The NCBC does not support mandated universal immunization and immunization as a condition for admission to schools for communicable, behaviorally transmitted diseases such as HPV. The NCBC holds that while there is no moral objection to vaccination against HPV in and of itself, the choice to have a child immunized against HPV must ultimately rest with the parents. The NCBC strongly opposes the mandating of vaccinations for non-highly contagious but communicable diseases because they do not pose the same public health threat as do the highly contagious diseases. The Center also opposes such vaccinations as a condition for admission to public or private schools since the diseases transmitted by behavior do not pose the same public health risks as contagious diseases as defined above. The exemptions from immunization for admission to school provided by government and school authorities fall generally into three categories. The categories are described below and the position of the NCBC with respect to each category will be briefly explained. Religious Exemption. A religious exemption from immunization would be granted if the teachings of the Faith of the parents held that vaccinations were immoral and contrary to God's will. Many jurisdictions do not require that there be any specific religious teaching on the matter, but hold that whatever religious parents hold to be contrary to their Faith should be respected and an exemption granted - as long as there is not a clear and present risk to public health by admitting the child to the school. Some Catholic parents know and accept the clear teaching of the Church on the immorality of abortion. When they discovered that the vaccines for measles, mumps, rubella and chicken pox were grown in cell lines that had their origin in tissue from two aborted children decades ago, they feared that they would be cooperating in abortion if they had their children immunized with these vaccines. However, the Catholic moral tradition holds that the parents would not be guilty of immoral cooperation in the evil of abortion if they had their children immunized with these vaccines especially if there were no other vaccines readily available. Since there is no Catholic teaching that the use of these vaccines is sinful, schools cannot allow Catholic parents to claim a religious exemption from the requirement of immunization. Conscience Exemption. A conscience exemption from immunization would be granted by school authorities if the parents in conscience believed that it was immoral to have their children vaccinated. It is Catholic teaching that one must follow one's practically certain conscience even if one is in error because the conscience is our last best judgment about what is right or wrong. If we would go against our conscience we would show that we were willing to do what was known to be immoral. Some Catholic parents erroneously believe that it would be a sin to have their children immunized with the vaccines with a historical association with abortion. The public schools, and indeed, Catholic schools ought to respect the consciences of these parents and grant a conscience exemption as long as there is not a health risk in doing so. The health risk is to be assessed by public health authorities. To provide an example. If the Centers for Disease Control judge measles to be virtually eliminated and public schools grant conscience exemptions because public health authorities have determined that to do so would not a public health risk, then it is our opinion that Catholic schools should also grant conscience exemptions. However, those in positions of responsibility in Catholic school systems are the ones who have to assess whether or not a risk to public health would exist if non-immunized children were admitted to the schools. Medical Exemption. A medical exemption from immunization would be granted by the authorities if the child could not be vaccinated without facing serious health risks in the judgment of the physician because of conditions such as certain allergies, immunodeficiency, or neurological disorders. The authorities would grant such an exemption if, in their judgment, admitting such a child posed no serious health risk to the rest of the school community, children and staff. It is the opinion of the NCBC that a medical exemption should most definitely be granted by Catholic school authorities if in their judgment, based on the opinion of public health authorities, admitting the child would not constitute a health risk. Some Catholic school authorities have read the statements of the NCBC on vaccines and have wrongly concluded that the NCBC did not believe that any exemptions should be granted children. However, it is our opinion that only religious exemptions from vaccination for Catholics should be disallowed because there are no Catholic teachings that vaccinations as such are immoral. It is further our opinion that conscience and medical exemptions should be granted if public health authorities have judged that there is no risk to public health by admitting to school children who have not been immunized. On the other hand we also believe that it would be wrong, and would be following an improperly formed conscience, for parents to refuse to have their children vaccinated against highly contagious diseases unless it were for medical reasons, if in doing so they would place their children - and others - at risk. We must sound a cautionary note. Fortunately, through systematic programs of vaccination the Centers for Disease Control has declared many diseases virtually eliminated in the United States. It is important to acknowledge, however, that we live in a global society which brings with it certain hazards to unvaccinated populations. In May 2005 there was a serious outbreak of measles in Indiana and Ohio because an adolescent child returning from Romania to her home was infected with the virus causing measles while doing missionary work there. It took intensive efforts by public health authorities to contain the outbreak. Measles, mumps, rubella and chicken pox remain highly contagious diseases and are wide-spread in some parts of the world. Parents must always be aware of the risks to which they subject their children and others if they do not have them immunized. |
