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Yadrim Vaccination in Halacha HaRav HAGAON GAVRIEL ZINNER WITH Rawal BEREL GRUNWALD, DR. SruaRT DrrcHEK, DR. Max BULMASH Contents! Introduction ~ Facts about Vaccines for Measles Prevention 1 ~Measles is a Dangerous Illness u- ing One IlL—"The Torah Obligation to Follow Doctors Instructions IV We Do Not Fear U v Endang cf for the Sake of Saving Others ely Harm Resulting ftom Normal, Accepted Actions Earlier Poskin’s Positions on Vaccines VI Contemporary Poskim’s Positions on Vaccines “Tic arccle orginally appeared in Hebrew in the semiannual Or Yael Toca journal, published in Monsey, New York, Adar 1 5779/March 2019, 9.7, pp. 29-48, A revised and expanded article wat published i the si journal, published by The Dr, Falk Schlesinger Inettte for Medical Hlachic Research at she Shaure Zedek Medial Center, Jersaer, lta, lar 5779/May 2019, ns. 115-114 (vol 29,0812), pp 9-80 “The transasion containe al adios by Rabbi Zine chat were included in he xecond Hebrew edition, and yas reviewed and edited by Rabbi Brel Grunwald der the gidance ofthe author. The medical Content was rovemed and approved by Start Dtchek, MD, FAAP, and Max Bulmash, MD, FAAP, fomments by Dr. Ditchek ie printed inthe footnotes Te editor would ike to thank Rabbi Naf ein and Rabbi Leead Staller for tei asitance withthe taslaton and editing sponsored in memory of Chana Chava Chaya ba R. Mordechai Aryeh Leib, bam he translation ir “Hatin aR inner iv a rneaned pth ar autor of 01 value erie emit Nite Over. HaRaw HaGaon Gavaunt Zine | 7 ‘Chanukah 5779 (2018) ‘To my friends, trustworthy physicians, devoted to the mitavah of healing and saving lives, Dr. Mordechai Yoe! (Max) Bulmash and Dr. Yisroel Zvi (Stuart) Ditchek, may Hashem be with you You have asked me the following questions: A. Does a halachic obligation exist to receive an immunization shot against measles, especially during an outbreak? ‘There are those who wish to refuse to be vaccinated, on the grounds that the injection can be harmful is there a basis, from a halachic standpoint, for being concerned with these fears? B, Isitpermitted to post atthe entrance toa medical facility that twill not accept as patients those who voluntarily refuse to be vaccinated against measles, or ‘those who deny their children the vaccination, out of a concern that such, people might unknowingly introduce measles there? The consequences ofthat ‘might be that in order to prevent the spreading ofthe disease all infants that were admitted that day will have to be vaccinated (something generally not recommended); and they (the unvaccinated individuals) will be endangering ‘those infants and other frail and susceptible adult patients Introduction: The Facts about Vaccines for Measles Prevention Historically, vaccines have been a highly successfal means of fighting infectious diseases, Many previously common illnesses and epidemics were either eradicated or diminished, thanks to vaccines. Regarding the measles vaccine, ever since it was given to children in the USA (in 1963), the spread of measles dropped drastically in the country. The virus, which for generations was an unavoidable childhood disease,’ has now virtually disappeared, with the Almighty’s help. After 2000, the Federal government announced that during that ‘year not a single case of measles was reported in the entire country. Since then, minor instances of measles spreading have occurred, caused by someone who had traveled abroad and had not been vaccinated. This year, however, a spurt of measles cases has taken place in Orthodox neighborhoods in New York and New Jersey, brought about by several individuals who had not been vaccinated, who caused several other individuals, among them children, to become ill."This proves well that vaccination is very effective in preventing measles, and what the consequences are when people deliberately refrain 2 There is an old Yiddish expression fot a cil gong though childhood difclie:“Pok am mac whi ieraly meas, "havng the pox having she measles 8 | Yapaim from being vaccinated. Therefore itis everyone's responsibility to ensure that his or her children get vaccinated. ‘The Concerns of Those Who Refuse Vaccination ‘A small number of people deny their children the vaccination, primarily because they fear the children will be harmed by the shots. In particular, they claim that the injections cause autism in children, and they point to several pieces of research that support this claim, However, very prominent medical researchers, greater in both number and caliber, studied the matter and found no connection between the vaccination and autism.’ Some mild side-effects were found; any more severe side~ effects, such as an allergic reaction, are rare (about 1/1,000,000). We can conclude that the benefits of vaccinations are far greater than any negative consequences. Ir is, practically speaking, the opinion of almost all physicians and professors ‘of medicine that children should be vaccinated in order to prevent the spread of contagious diseases. Governmental Departments of Health in the USA, Europe, and Israel, directed by their respective health commissioners or health ministers and guided by top health professionals, instruct that all children be vaccinated, as do the Centers for Disease Control and Prevention of the United States Government (the CDC), the “American Academy of Pediatrics, and the World Health Organization (the WHO). Chapter I: Measles is a Dangerous Illness Pox and Measles in the Writings of the Poskim as Dangerous Infections ‘Measles spreads more rapidly than other infectious diseases. When we study the writings of earlier poskim (halachic authorities), we find that they considered measles 2 very dangerous epidemic disease. Many of them consider it the equivalent of smallpox, a disease which resulted in the deaths of tens of thousands of children. The authorities deals with how to cope with the spread of this illness from a halachic perspective, Some wrote that people are obligated to fs, in severe cases 45 [The medical study that ie quoted by those who refuse vaccinations was published in the United Kingdom by areseacher, Andeew Wakefield who was subrequetly dicovered to have fied data fo twelve cle with autism. ‘The study ws ected by dhe medical journal shorly alter and the physician fost his medical cease in England as aes ofthe adalat publication le was discovered that he was pid lage sums of money by an atorey who was atemptng to sue the MMR vacine ‘manuactute on behalf of those fies with these 12 aut children. Despite the discovery ofthe fiauduleat dita an the los of hit medi licens, the at-vceination community continues Yo quote ‘nb findings and have ize appa a evens to promote the ant-vaciaation agenda (Ds. , Ditch) HaRaw HaGaon Gavnunt Zinn | 9 Rabbi Yosef Karo,in his Shulchan Aruch,‘nuled:"...And also we fast over illnesses.” Rabbi Avraham Abele Gombines, in his commentary Magen Avraham,’ adds “The same is true when blisters (ie. smallpox) are breaking out among small children and causing fatalities, that a fast should be declared. The great sage Rabbi Moshe composed a sclichuh (penitents! poem) for this occurrence. The Séelai* wrote that everyone should ‘evacuate his children from the city at such a time, and ifthey fai to do so, they are liable [to pay] with thei lives, ‘The harsh words of the Shelah ate worth reading in their entiety: Tam astounded concerning the epidemic of small blisters (-smallpox), known a “late German, rampant among young children, God forbid — why are people not evacuating the young from the city? Undoubtedly, fathers will have to account forthe deaths of innocent infants and toddlers who did of this disease, and whose fathers did not care to evacuate them Every iod-fearing man should therefore fear and tremble over the prospect of such « misfortane, All these matters of ssf preservation ate inchaded in the [Biblical] warning of beware for youre, and guard your sol exceedingly. Te is alo

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