by Robert Edelman, M.D.
On January 5, the CDC, under the
direction of Health and Human Services Secretary Robert F. Kennedy Jr.,
released a revised vaccine schedule for children. Instead of 18 mandatory
vaccines, there are now 11. The major contagious childhood diseases – such as
measles, DTaP, and polio – are still required, while six vaccines fall under
the category of “shared decision making” between parents and doctors, centering
on such issues as whether the child is “high risk.” This move is laden with
controversy, pitting the anti-vaccine views of RFK against those of the medical
and public health establishment. As a result, many parents are confused and are
looking for guidance.
As a retired Professor of Medicine at
the University of Maryland School of Medicine, I will summarize some basic information
regarding vaccines, focusing on anti-vaccine myths, which play a central role
in the controversy. I hope the facts
presented help parents better clarify their attitudes toward vaccines and
vaccination for themselves and their children.
Two-Hundred Years of Vaccination
A vaccine helps protect you from
serious – and sometimes deadly – infectious disease. A vaccine is composed of a
safe attenuated or killed form of the virus or bacteria. After it is injected,
it instructs your body’s immune system to recognize and neutralize the more harmful
germ before it can infect you and cause illness. Vaccines are among the most
closely monitored medical products in the world. They have been carefully
studied and used safely for 100 years, employing modern scientific protocols
and research ethics.
Edward Jenner, an English physician,
pioneered the world’s first vaccine in 1796 by using cowpox virus to protect against
the deadly smallpox virus. He observed that after milkmaids got mild cowpox infections,
they never developed lethal smallpox infections. He then proved his theory by
inoculating a boy with cowpox and later exposing him to smallpox, with no
illness resulting, marking the birth of vaccination. This breakthrough led to
the term “vaccination” (from Latin “vaka” for cow) and paved the way for
mass vaccination campaigns. These campaigns eventually led to smallpox being
declared globally eradicated by the World Health Organization in 1980, saving
millions of lives. Vaccines against infectious diseases represents one of the
greatest advances in public health ever invented and have saved literally
billions of lives.
Unfortunately, anti-vaccine myths
have been perpetuated ever since Jenner’s vaccine was invented. A myth is a
belief, opinion, or theory that is not based on fact or reality. These myths cause
persons to shun vaccines, which in turn leads to illness, death, and economic
loss caused by vaccine-preventable infections.
I am particularly concerned with
these myths because parents of young Jewish families, echoing anti-vaccine
myths in the press and social media, have asked me why they must get their kids
vaccinated in view of “the damage they can do.” Some parents justify their fears
citing the recent downgrading of vaccine recommendations by the federal
government. In this article, I have summarized some of these myths. I explain why
they are either misleading, unproven, or patently false.
Like any medical intervention,
vaccination admittedly involves some risk. But consider that risks are
associated with other events of daily life. Simple examples include the risk of
being struck with lightning while walking in a thunderstorm, the risk of slipping
and injuring oneself in the shower, or the risk of one’s car crashing while
driving to Seven-Mile Market. We consciously or unconsciously analyze these
risks and decide to walk, shower, or drive because our collective experience informs
us that the benefits greatly exceed the risks. So, too, with vaccines; although
risks are associated with all licensed vaccines, their off-setting health
benefits clearly justify those risks.
Myths about Vaccination
Listed below in random order are
some common myths and my rebuttals:
Myth 1: Vaccines have damaging and
long-term side-effects that are yet unknown. Vaccination can even be fatal.
FALSE: Licensed vaccines are very safe.
Most vaccine reactions are minor and temporary, such as a sore arm or mild
fever. Serious health events are extremely rare and are carefully monitored. Vaccine
safety and efficacy have been proven by hundreds of scientific trials involving
thousands of subjects followed for many years. These trials prove conclusively that
one is far more likely to be harmed by an infectious disease than by the vaccine
against that disease. For example, polio virus infection can cause paralysis
and death, measles virus can cause encephalitis, blindness and death, and other
vaccine-preventable infections can result in cancer and other permanent injuries.
While any serious injury or death caused by vaccines is one too many, the
benefits of vaccinations greatly outweigh their risk, and many more injuries
and deaths would occur without them.
Myth 2: Vaccines cause autism.
FALSE: In 1998, a prominent British
medical journal published a study that raised concerns about a possible link
between the measles-mumps-rubella (MMR) vaccine and the development of autism.
The paper was later found to be seriously flawed, because the author falsified
the results. As a result, the paper was retracted by the journal, and the
author lost his license to practice medicine. Since 1998, more than a dozen
well designed studies conducted in the U.S. and overseas have failed to show
any link between MMR vaccine and autism, despite occasional anecdotal reports to
the contrary not based on scientifically proven causation. Unfortunately, the
autism myth has endured. Its publication set off a worldwide panic that led to
dropping immunization rates against MMR and other childhood vaccines. This, in
turn, led to outbreaks of these diseases.
Myth 3: Better hygiene and sanitation will
make diseases disappear; in fact, some of our vaccines may not be necessary.
FALSE: The diseases we can vaccinate
against will return if we stop immunization programs. If people are not
vaccinated, some respiratory infections transmitted by talking, coughing, and
sneezing will quickly reappear. Measles, nearly eliminated in North America and
Europe a decade ago, has now reappeared. A measles epidemic involving nearly
900 infants and children is now exploding in South Carolina; 96% of these infected
children were unvaccinated. Measles has now spread to unvaccinated communities in
17 states and Canada, and measles deaths are being reported. Similarly, other
respiratory virus infections, such as influenza and respiratory syncytial virus
(RSV), have and will continue to spread in the face of lagging public health
vaccination programs. While better toilet hygiene, handwashing, pasteurization,
and clean water help protect individuals, respiratory and gastrointestinal infections
can spread regardless of how clean our hands are.
Myth 4: Because some vaccine-preventable
diseases have become uncommon in the United States, there is no reason to vaccinate
against them.
FALSE: Although some vaccine-preventable
diseases have become uncommon in the U.S. and many other countries, the
infectious agents that cause them continue to circulate in other parts of the
world. In our highly interconnected world, infected travelers can cross geographical
borders quickly by plane or foot and infect unprotected individuals. For
example, measles outbreaks have occurred in unvaccinated Europeans by infected travelers
from non-European countries. Unvaccinated members of Orthodox communities in
New York, the United Kingdom, and Israel have suffered outbreaks of imported
measles and mumps. Consequently, two key reasons to get vaccinated are to
protect ourselves and to protect those around us from getting our infection.
Successful immunization programs depend
on the cooperation of every individual to ensure the good of all. We should not
rely on people around us to stop the spread of disease. We, too, must do what
we can. Jewish law commands it. According to Rabbi Yitzchak Breitowitz of Ohr Somayach
Yeshiva in Jerusalem, there are two related halachic principles that would seem
to make vaccination mandatory. The first is that it is forbidden for a Jew to
place his life or health in unreasonable danger. The Torah teaches us that our
body is not our own property but belongs to G-d to be used in His service and
to be protected and preserved until such time as He chooses to reclaim it. Certainly,
if we do not have the right to endanger ourselves, we do not have the right to
endanger our children by denying them vaccinations.
The second principle focuses on the
duty that is owed to others. The Torah commands us to remove impediments or
stumbling blocks that cause dangers to others. Rabbi Akiva Tatz MD summarizes
several rabbinical rulings as follows: Failure to immunize would amount to
negligence; refusing vaccinations based on unsubstantiated fears of vaccine
side-effects is irresponsible; the danger of precipitating epidemics of
measles, Covid-19, and other morbid or lethal infections is far more real than
the dangers attributed to vaccines based on anecdotal claims.
Myth 5: Vaccine-preventable childhood
illnesses are just an unfortunate fact of life.
FALSE: Vaccine-preventable diseases do not
have to be “facts of life.” Illnesses such as measles, mumps and rubella are
serious and can lead to severe complications in both children and adults, which
can include pneumonia, encephalitis, blindness, diarrhea, ear infections. And congenital
rubella syndrome (blindness or deafness) if a woman’s fetus is infected with
rubella in early pregnancy. Fourteen measles deaths have occurred recently in Israel
among unvaccinated chareidi infants and children. Failure to vaccinate
against these diseases is inconsistent with Jewish law and leaves children unnecessarily
vulnerable.
Myth 6: Giving a child more than one
vaccine at a time, which can overload the child’s immune system, can increase
the risk of harmful side-effects. And too many vaccines given early in life
predispose children to health and developmental problems.
FALSE: Scientific evidence shows that
giving several vaccines at the same time has no adverse effect on a child’s
immune system. Every day, children are exposed to several hundred foreign
substances that trigger an immune response. The simple act of eating food
introduces new antigens into the body. A child is exposed to far more antigens
from a common cold or sore throat than they are from vaccines. It has been
estimated that infants have the theoretical capacity to respond to at least
10,000 vaccines at one time! Key advantages of having several vaccines at once
is fewer clinic visits, which saves time and money, and children are more
likely to complete the recommended vaccinations on schedule. Also, a combined
vaccination, e.g. for measles, mumps, and rubella (MMR) and for tetanus, diphtheria,
and whooping cough (DTP) means fewer injections.
Today’s routine childhood
immunization schedule in the U.S. includes vaccines against 14 diseases. Children
in the first years of life can receive as many as 26 vaccine injections, and as
many as five injections at one time. Numerous carefully designed scientific
studies have shown that the immune system of infants and children is perfectly
capable of handling the large number of antigens in vaccines, without increased
risks of adverse health outcomes later in life.
Myth 7: Influenza is just a nuisance,
and the vaccine is not very effective.
FALSE: Influenza is much more than a
nuisance. It is a serious disease that kills 300,000 to 500,000 people
worldwide every year. During last year’s flu season in the U.S. there were 280
pediatric deaths; 89% of these children were unvaccinated. Pregnant women,
small children, elderly people with poor health, and those with a chronic
condition, such as asthma or heart disease, are at higher risk for severe
infection, prolonged hospitalization, and death. Vaccinating women late in their
pregnancy has the added benefit of protecting their infants in utero. (There is
currently no flu vaccine for babies under six months.) Although it may not
completely prevent illness in some persons (the vaccine is 30 to 60% effective),
vaccination is the best way to reduce one’s chances of severe flu and of
spreading it to others. Avoiding the flu means avoiding extra medical care
costs and lost income from missing days of work or school.
Myth 8: It is better to be immunized
through disease than through vaccines.
FALSE: Vaccines interact with the immune
system to produce an immune response like that produced by the natural
infection, but they do not cause the disease itself or put the immunized person
at risk of its potential complications. The price paid for getting immunity
through natural infection might be mental retardation from Hemophilus
influenzae type b (Hib), birth defects from rubella, liver cancer from
hepatitis B virus, or death from measles. Vaccines are not associated with
these risks.
Myth 9: Doctors can get rich by
vaccines.
FALSE: One of the loudest claims circulating on social media currently
is that clinicians recommend vaccines because they profit from them. This libelous accusation was amplified
by Robert F. Kennedy, Jr. and by a formal investigation launched by the Texas
Attorney General to “ensure that Big Pharma and Big
Insurance don’t bribe medical providers to pressure parents to have their
children vaccinated.” These
claims matter because they erode trust in physicians and public health programs.
When parents believe their pediatrician’s recommendations are driven by profit
rather than their child’s health, they are more likely to delay or decline
vaccines, putting children at risk for preventable diseases. In fact, rather
than profiting from vaccines, many pediatric practices struggle financially to
provide them. Nearly one in four pediatricians has considered abandoning
vaccine delivery, not because they doubt the science but because the financial
burden threatens their practice’s viability. Nevertheless, the majority of pediatricians
continue to vaccinate to protect their patients and can be relied upon to
provide accurate advice.
Myth
10: Polio, measles, and other
vaccines should be optional, because personal autonomy is paramount.
FALSE: A pediatric cardiologist, who
is chair of the Advisory Committee on Immunization Practices (ACIP) of the Center
for Disease Control (CDC) and federal government, recently said that “shots against
polio and measles – and perhaps all diseases – should be optional and offered only
after consultation with a clinician.” He argues that making the vaccines
optional rather than requiring them for entry into public schools nationwide,
as is now the case, reflects his opinion that “personal autonomy is paramount.”
Public health experts, supported by abundant medical evidence, maintain
that changes in vaccine policy based on “personal autonomy” would result in
unnecessary morbidity and deaths among children. It is important to remember that
the halachic principles summarized in Myth #4 do not support personal autonomy in
regard to vaccination but, rather, personal responsibility to protect ourselves
and others via vaccination.
Current Immunization Practice for Schools in Maryland.
The current immunization policy of Jewish day schools in Maryland
follow the same state-mandated immunization schedule required for all K–12
schools because Maryland law does not create a separate vaccine schedule for
private or religious schools. The 2025-2026 Maryland vaccine guidelines follow the
American Academy of Pediatrics (AAP)-recommended immunization schedule, which rejects
the scaled-back CDC guidance. The AAP recommends that children be vaccinated
against 18 diseases. The AAP and six other prominent medical and public health
groups are suing the government to disband the ACIP, claiming the panel now
serves “as a megaphone for spreading misinformation (myths) about immunization
and infectious diseases.”
The complete list of required immunizations is available on
students’ Magnus Health Portal and on the Maryland Department of Health website
at phpa.health.maryland.gov. The AAP has created a parent-friendly immunization
schedule at HealthChildren.org.
In summary, by following Maryland
state vaccine policy, we become responsible for our own health and the wellbeing
of others!
