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By Jim Coggins
 CONSERVATIVE Christians who refuse vaccinations have been linked to an outbreak of mumps in British Columbia. The controversy has raised ethical issues, and sparked debate over the limits of religious rights.
Douglas Todd, religion writer for The Vancouver Sun, has covered the story extensively.
Todd cited medical ethicists who questioned the Christian group's position. Alister Browne, director of ethics and law at the University of British Columbia medical school, said, "I don't think this issue is a small matter." He added that the ethical importance of a society protecting the health of children and others against infectious disease must be weighed against a person's right to religious freedom, and the level of risk to others when immunizations are refused.
Michael McDonald, a professor in the Maurice Young Centre for Applied Ethics at the University of British Columbia, went further. He argued that adults in the Chilliwack community may be ethically required to accept vaccinations to protect their children and members of the larger society, since the health and safety of others -- particularly children -- is a justified "limit to religious freedom."
Some online readers who responded to Todd's articles were even more critical, calling the group "intentionally ignorant," "criminally irresponsible" and "religious fanatics." One argued that "immunization against common community diseases should be made law irrespective of one's beliefs" and that those who refuse should be put into colonies like lepers. Another suggested that "religion must be somewhere at the bottom" of the hierarchy of human rights.
The Fraser Health Authority has refused to name the group involved, but medical officer Dr. Elizabeth Brodkin told Todd that the group interprets scripture to believe that agreeing to an immunization shows a lack of faith in God's ability to provide protection. Evidently, some Dutch Reformed Christians, drawing on Calvinist theology, believe God's providence determines whether they will become ill -- and thus, they should not use preventive measures such as vaccinations.
However, while all Dutch Reformed believe in God's providence, opposition to vaccinations is an application of that theology which is held by what one Dutch Reformed pastor in Chilliwack described as "only a small community within the community." The pastor said his congregation also trusts in God's protection, but "we use the means that God has made available."
The pastor added that there had also been suspicion some years ago that aborted fetuses were used in the preparation of vaccines.
He and other pastors contacted by CC.com were reluctant to speak for -- or about -- the religious community in question, because they have little contact with it, and acknowledged that they are not very familiar with it.
There are about a half-dozen Reformed congregations in the Chilliwack area, belonging to as many different denominations, and opposition to vaccinations is apparently prevalent in only one of them. This congregation was described by another pastor as somewhat "isolationist." He said it is an "extreme" branch of conservative Dutch Reformed movements which are suspicious of modern trends in the church and the world.
An third pastor, who spoke only on the condition that he could do so anonymously, said that about 10 percent of the members of his congregation are opposed to vaccinations for theological reasons; another 10 percent are opposed to vaccinations for medical reasons; and the rest of the congregation accept vaccinations. He said, "We are cooperating fully with health authorities."
There are some other Christian groups in North America which also refuse vaccinations, such as some Old Order Mennonites and Amish. Their reasons have nothing to do with the providence of God, but with a desire to remain separated from the world.
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Dr. Brodkin told CC.com that the current outbreak of mumps began when the disease was brought to Chilliwack in February by two people from Lethbridge, Alberta, who were visiting the Christian community in question. It spread rapidly in that community because "immunization rates were very low." This created a base from which the disease could spread to others.
The Authority has also stated that some Chilliwack residents who contracted the disease had not been vaccinated for mumps for medical and philosophical reasons which have nothing to do with religion. One of Todd's articles reported that people in the U.S. have sometimes claimed religious reasons for refusing vaccinations -- when, in fact, they refused for other reasons.
Some opponents of vaccinations claim the procedure leads to other health problems, including autism. Brodkin said there is "always some risk with any medical intervention" but that the "overwhelming benefits" of vaccination far outweigh the "very small risk."
However, Brodkin said forced vaccinations "will not happen" - because, in Canada, "we put a lot of importance on the rights of the individual." She added that "there is no mandatory vaccination in British Columbia for any reason."
Brodkin stated there has been no suggestion that anyone "deliberately infected" others. However, those who make the decision not to be vaccinated must accept the responsibility to do their best not to infect others.
She admitted that could be hard to do in this case, because of the nature of the disease. A third of those who get the disease show no symptoms, a third have only cold-like symptoms, and the rest have the classic swollen throat and other symptoms. The disease is spread through saliva, through such means as shared cigarettes, drinks and musical instruments. Every person is also surrounded by a one-metre "cloud of respiratory droplets" which can easily infect others. The spread of infection can be reduced by coughing into one's sleeve or wearing a mask.
Fraser Health Authority news releases suggest the larger community is at risk -- because one vaccination provides immunity in only about 80 percent of cases, two vaccinations provide immunity in 90-95 percent of cases, and those percentages tend to tail off in 15-20 years. Even those people who have contracted the "wild virus" in the past do not have 100 percent immunity.
Widespread vaccination for mumps began in B.C. in 1970, but second (booster) vaccinations only began in 1995. Most at risk are those born after 1970 who have had no contact with the wild virus -- and who have not received even one vaccination, for whatever reason.
Brodkin says that while mumps causes few serious problems for most people, the current outbreak has already caused complications such as meningitis, deafness and testicle infection -- and if it continues, could even result in death. The epidemic has also consumed a great deal of health resources, in addition to the time lost from work and school for those infected.
Brodkin states that there is some evidence under-vaccinated groups in Alberta played a role in the spread of the disease in that province. However, news releases from Alberta suggest it is not true that Dutch Reformed Christians were at the root of the "Canadian mumps outbreak." The Alberta outbreak in late 2007 was mainly focused on the University of Calgary and the University of Lethbridge. That outbreak in turn may have come from an outbreak in Nova Scotia in early 2007 which was centred on Dalhousie University.
News reports about those outbreaks made no mention of issues such as ethics or forced vaccinations. In Alberta, university students were considered "a difficult-to-reach population for vaccinations" because they were "too busy with papers, parties and part-time jobs." Health authorities and schools considered innovative approaches such as reaching out to students through websites such as Facebook and offering immunization clinics in places where students congregate, such as food courts, residences, classrooms and bars.
September 4/2008
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