Vaccinating Against Swine Flu

[Be-Ahavah U-Be-Emunah – Vayishlach 5770 – translated by R. Blumberg]

Question: Do you oppose vaccinating against swine flu?
Answer: That is not a question for rabbis. Rabbis are not physicians. Obviously, you can have a Rabbi who is a physician, because he studied medicine in university, but he didn’t study medicine in yeshiva. There, he learned Torah. We greatly admire physicians, for they do holy work, as Rambam said in his Shemoneh Perakim. All the same, however, rabbis are not physicians, but engage in a different holy work. They don’t deal with curing the body, but with curing the soul, which is more lofty than the body. Therefore, regarding medical matters, please turn to physicians. As the Torah states, “He must provide for his complete cure” (Shemot 21:19), regarding which our Sages commented, “Here we derive the permission that physicians have to cure people.” The Ba’al Ha-Tanya wrote that “only the prophets had additional knowledge regarding various matters such as [medicine and economics]… but now there are no more prophets, and even great Torah scholars like the scholars of the Mishnah and Talmud do not understand medical or economic matters, or the like” (Igeret Ha-Kodesh 22).

The rule is this: Rabbis don’t deal with medicine or economics or the army. Yet they do deal with medical ethics, business ethics and death in battle. Therefore, there is a place for responding to five medical arguments from the sphere of halachah.

Argument 1: There are, indeed, physicians who are in favor of the vaccination, but others are against. So how can we know what to do? Perhaps everyone should choose based on what seems best to him? And if so, it would be better not to be vaccinated, because a “shev ve’al ta’aseh”, sitting and doing nothing when faced with an uncertain risk, is best.
Answer: Just as in a disagreement between rabbis we follow the majority, so, too, in a disagreement between physicians. For example, if there are physicians who say a patient should violate the Sabbath or should eat on Yom Kippur, and others say he should not, the Shulchan Aruch rules that we must follow the majority. In our own case, it is not a majority against a minority, but almost all of them against a few individuals, a hundred to one in favor of the vaccine. Moreover, it is not just physicians in Israel, but also in Europe, America and in the World Health Organization.

Argument 2: I heard that the vaccinations against flu are dangerous, and that in the past, dozens of people were hurt by severe side effects.
Answer: That is true, but on the other hand tens of millions have been vaccinated and nothing happened to them, and they were saved from danger of death. Here as well, according to Halachah, we follow the majority. Here, it’s no longer a majority of a thousand to one, but of a million to one. Moreover, since then more than thirty years have passed, and the medical field has amassed much experience as far as vaccinating against flu. As far as the swine flu vaccination, no problem has been identified so far. By contrast, many people have died from this flu, including here in Israel, where several dozen have died. In any event, we follow the majority and don’t lead our lives based on the exceptions.

Argument 3: If someone is healthy right now, why should he, by his own actions, place himself in danger – however remote – just to save himself from a danger that does not exist at this moment, and perhaps will not exist in the future?
Answer: First of all, we said that this vaccination does not pose a remote danger but a danger that is considered halachically negligible. Yet the crux of the matter is that Argument 3 does not relate specifically to the vaccination against swine flu, but to any vaccination. For that matter, arguments 1 and 2 relate as well to all vaccinations. Thus, Rabbi Yisrael Lipschitz, the author of Tiferet Yisrael on the Mishnah, has already dealt with this as it refers to Mishnah Yoma chap. 8 #3, regarding the vaccination against the Black Plague. He proved from several Talmudic sources that a person is allowed, by his own actions, to place himself in low-level danger of 1/1000 in order to save himself, in the future, from a high danger. As noted above, swine flu poses a serious danger. Therefore, those groups marked by the physicians as meant to receive the vaccination should not relate to it lightly.

Argument 4: G-d made man’s body healthy and strong, and man has the strength to overcome all sorts of illnesses alone, on condition that he is healthy and does not have to introduce all sorts of artificial substances into his body from the outside. Man has surprising vibrancy and he can overcome anything.
Answer: Obviously, this claim already goes beyond any complaint against swine flu vaccinations, or vaccinations in general, and confronts modern medicine. It brings us back to “Vitalistic Medicine”, which built its foundations on faith in an omnipotent, vital force found in the body. In effect, it turns us back to Hippocrates, the ancient Greek physician. We owe him a lot, and he is considered, in some sense, the father of medicine, because until his time, physicians tried to heal patients by way of witchcraft, imprecations and other pagan nonsense. Unfortunately, many similar superstitions still survive in our day. Hippocrates said that we have to cure the body from within the body itself, by way of the processes taking place within it. Indeed, he deserves our kudos, but since then, a lot has happened. Much has been discovered. Especially, a hundred years ago, it was discovered that bacteria are responsible for illness, and against them we use vaccinations and antibiotics. Obviously, he also spoke about the need, in general, to strengthen the body, and in our own case, to be as hygienic as possible, washing one’s hands, etc., but sometimes, specific treatment is required.

In any event, we are presently faced with choosing between new medicine and old medicine. According to Halachah, we have to follow the physician of our own day, just as we do the Torah luminary of our day, as it says, “You shall approach the judge who will be there in your own time” (Devarim 17:9). You shouldn’t say that the sages of yesteryear were greater. Certainly they were greater, and “if the early ones were like angels, then we are like people, and if the early ones were like people, then we are like donkeys” (Avot) – and we are not like the donkey of Rabbi Pinchas ben Yair [which refused to work on the Sabbath]. All the same, the Halachah follows the more recent sages, because they knew what other early Sages said, and they saw other arguments, and in their intense reverence they decided what they decided.
All the more so that this applies regarding medicine, for medicine develops. Many things in medicine have been proven and many others have been disproven. There are additional means of research. There are statistical tools that allow one to distinguish between anecdotal phenomena and more full-proof phenomena, etc., etc. The Post-Talmudic Gaonim commented on Tractate Gittin, which contains full pages of medical advice, that one should make no mistake – rabbis are not physicians, this medical advice is not from Mount Sinai, but from medical sources. Hence in effect, all of that advice is null and void, except for one piece of advice, which earned the approbation of physicians from our own times.

Argument 5: Surely we have to believe in G-d and in divine providence. If G-d has decreed that I should be well, then I don’t need all the physicians. And if G-d has decreed that I will be sick, then all the physicians won’t help. We need faith and trust in G-d, and that is what will cure us, not going to a physician.
Answer: That’s a fine question, but Rambam has already answered it in his commentary on Mishnayot Pesachim. There he argued that based on the same logic we could say, “Don’t eat. If G-d has decreed that one must die, he will die even if he eats. And if G-d has decreed that one must live, he will live even if he does not eat. So don’t eat!
Obviously, that’s nonsense. Certainly G-d does all, but He does it by way of His emissaries, both His destructive angels, like bacteria, and His ministering angels, like the physicians. And if you refuse to let G-d’s benign emissaries help you, you deserve a punishment. The punishment can be that the ministering angels will abandon you and the destructive angels will harm you (see Mesillat Yesharim, chap. 9 at length).
In conclusion, my friend, do what the doctors tell you and don’t try to doctor yourself. We greatly value independent, critical thinking, but you also need a bit of common sense and humility. It’s very nice that we take an interest in medicine, but it’s not a normal situation for our country to have five million physicians and five million economists, five million prime ministers and five million rabbis and five million psychologists. No. we don’t know everything. It’s not enough to read a popular article or to hear a scientific radio program to understand a particular topic. You’ve got to study for many years, with great toil.

So, my dear friends, go to the mainstream physicians who live in your age and may you live a long life as a result.