Vaccination: Personal Choice vs. Public In Interest Shaikh Mohd Saifuddeen Shaikh Mohd Salleh, PhD. Senior Fellow/Director, Centre for Science and Environment Studies, Institute of Islamic Understanding Malaysia (IKIM)
Causes of Refusal Preference to Immune Vaccine Safety Halal Status Natural Capacity Issue Immunity Overload
1. . Vaccine Safety Is Issues • It is claimed that vaccines contain chemically dangerous substances that may harm the body. • This includes the claim that vaccine is linked to the development of autism in children. • This controversy was due to a journal article by Andrew Wakefield et al. (1998) where it was reported through his research that autism is linked to the combined measles-mumps-rubella (MMR) vaccine.
Regarding the safety of vaccines: • The Ministry of Health Malaysia has given the assurance that there is no dangerous substances are used in vaccines. • Thimerosal which is added as a preservative do not cause any toxic effect on the body as there is no evidence indicating such condition. • In the process of stimulating body defence against contagious diseases, vaccines will cause minimal side effects. It must be noted that those side effects are minimal compared to the harm that might be inflicted by contagious diseases if they are not prevented. • This is in line with the maxim: • Yuzal al-darar al-ashaddu bid-darar al-akhaff [The greater evil (harm) is repelled by the lesser evil (harm)].
Regarding vaccine-autism link: • Wakefield’s findings were investigated in several different studies and the findings could not be replicated (DeStefano & Chen, 1999; Taylor et al. 1999). • Article by Wakefield et al. was retracted in 2010 from Lancet due to: • (1) undeclared conflict of interest; • (2) manipulated evidences (they picked and chose data that suited their case; they falsified facts); • (3) broken ethical in research conducts (conducted invasive investigations on children without obtaining the necessary ethical clearances) (Rao & Andrade, 2011) • Subsequent studies conducted by the Center for Disease Control (CDC) and Prevention the American Academy of Pediatrics, Institute of Medicine of the US National Academy of Sciences, UK National Health Service and the Cochrane Library found no evidence linking MMR vaccine to autism. • It is also reported that MMR is safe and effective in the prevention of diseases (Demicheli et al. 2012).
Wakefieldism effect: • Following the vaccine-autism controversy, vaccination (specifically MMR) compliance among community dropped (e.g. 92% in 1996 to 84% in 2002 in UK) as reported by Mclntyre (2008). • This cause epidemic effects: • Increase of measles & mumps cases in the UK (Asaria, 2006; Gupta 2005). • Diseases (measles & mumps ) outbreak in Austria, Italy & Switzerland as reported by European Centre for Disease Prevention & Control (2008). • Laurie Garrett, a senior fellow at the Council on Foreign Relations blamed "Wakefieldism" for an increase in the number of unvaccinated children in countries and the epidemic effect that follows after that (Harlow, 2014). • Mufti of Federal Territory in “Bayan Linnas Series 59: Vaccine in the Perspective of Fiqh and Maqasid Shariah ” emphasizes the necessity of vaccination in diseases prevention as well as protection of public safety.
2. . Dispute on Halal Status of f Vaccine • It is claimed that vaccines that are produced contain religiously forbidden (haram) substances. • It triggers reluctance among Muslim parents to vaccinate their children fearing that it is forbidden in Islam due to its contents.
• Islam forbids the use of religiously forbidden things in medicine as being stated by Prophet SAW. • However, it is also noted that in the event where there is no cure except the one that contains forbidden substance, Islam grants permission on the basis of emergency (Dharurat). This is based on Islamic jurisprudence method: • Al-Dharurat tubikhu al-Mahzhurat (Dharurat situations permits that which is forbidden) • Fatwas from the National Fatwa Committee regarding vaccination: • Rubella immunisation – permissible & no forbidden substances being used (22 Sept. 1998). • Hepatitis B immunisation - permissible & no forbidden substances being used (24 Nov. 1998). • Pox, TB, pertussis, Diphtheria, Tetanus & Polio immunisation – permissible (5-6 Jun 1989) • The use of Biothrax & Rotateq vaccines that contain swine DNA – currently not permissible due to non-urgency state & non-availability of halal source (31 March 2008) • HPV immunisation - permissible & no forbidden substances being used (15-17 Dec. 2010) • Meningococcal Meningitis Vaccine - (from cattle) permissible, (from swine) prohibited (27 Nov. 2002) • Meningitis Menveo Vaccine – Permissible (17 July 2013) • Meningitis Monumune Vaccine – Initially prohibited (2002), and subsequently permissible (2014) after being revised.
“The 10 vaccines meant for the national immunisation schedule issued by the Health Ministry are free from pork gelatine, a family medicine specialist confirms. Dr Suhazeli Abdullah said the hydrolysed gelatine used as a stabiliser in the MMR (measles, mumps, and rubella) vaccines was from bovine source . “ The Islamic authorities of vaccine producing countries and international ulamaks have emphasised on the need to use vaccine,” he said in a Facebook post yesterday.” - The Star (27 July 2016).
• It is remarked by a number of Islamic authorities that: • Vaccination to curb the spread of contagious disease is highly encouraged (Dar al- Ifta ’ al -Misriyyah, Majma ’ al -Fiqh al-Islami, National Fatwa Committee Malaysia, Syeikh Abdul Aziz Bin Abdullah Bin Baz, Al-Syeikh Dr. Ali Jumaah). • Syeikh Dr. Yusuf al-Qaradhawi emphasized that vaccination is fardhu (obligatory). This view is also supported by the Union of African Muslim Scholar. • Mohammed Ali al-Bar also stated in his work, Ahkam al-Tadawi wa al-Halat al- Mai’us minha wa Qadiyyat Maut al-Rahmah that authorities have the right to mandate vaccination on people even without their consent for the greater good. • This is inspired by hadith, “La Dhara wa La Dhirar ” (Let there be no harm or reciprocating harm). • Vaccinations serve to trigger immune system to fight contagious diseases. • Any act to preserve life is in line with maqasid shariah and upholds the spirit of al-wiqayah khairun min al- ‘ ilaj (prevention is better than cure).
• Even when there is a vaccine derived from non- halal sources, it is the collective responsibility of the Muslim ummah to create a demand for halal vaccines. • Pharmaceutical companies owned by Muslims or based in Muslim countries should take this as an obligation to develop halal vaccines. • “…the 2008 MUI verdict rejecting the use of porcine-based vaccines persuaded the pharmaceutical industry to develop alternative non- porcine based vaccines. Indeed vaccine supply for a market greater than 200 million persons was a sizeable motivation to innovate. Thus in effect the more ‘stringent’ fatwa provided Muslims with agency to transform an industry ” ( Aasim Padela, 2013).
3. . Preference to Natural Immunity “Natural Immunity Is Better Than Vaccine -acquired Immunity ”? • Some people argued that the immunity gained from surviving a natural infection provides better protection than that provided by vaccines. While it is true that natural immunity lasts longer in some cases than vaccine- induced immunity can, the risks of natural infection outweigh the risks of immunization for every recommended vaccine. • Eg. • Wild measles infection causes encephalitis (inflammation of the brain) for one in 1,000 infected individuals, and, for every 1,000 reported measles cases, two individuals die. • The combined MMR (measles-mumps-rubella) vaccine, however, results in encephalitis or a severe allergic reaction only once in every million vaccinated individuals, while preventing measles infection. • The benefits of vaccine-acquired immunity way outweigh the serious risks of natural infection, even in cases where boosters are required to maintain immunity.
4. . Im Immune Capacity Overload • There is a misconception that a child’s immune system can be “overloaded” if the child receives multiple vaccines at once. • This concern first began to appear as the recommended childhood immunization schedule expanded to include more vaccines, and as some vaccines were combined into a single shot. • However, studies have repeatedly demonstrated that the recommended vaccines are no more likely to cause adverse effects when given in combination than when they are administered separately (Offit et al. 2002). • Some parents decide to “spread out” the time period during which their children receive vaccinations “just in case” this misconception is accurate. • There is no scientific evidence to support this approach, and delaying vaccinations puts children at risk of contracting preventable diseases.
Conclusion • Vaccination is a form of preventive medicine, and not a cure or treatment. • Most modern parents have never seen the devastating effects that diseases such as polio, measles and whooping cough (pertussis) can have on a family or community. While these diseases have been ‘eradicated’, it does not mean that they no longer exist. Anti - vaccination parents risk the return of these diseases, causing big problems to not just the health authority but to the community and nation.” (Kamal Amzan, 2016).
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