In the year 2000, the Centers for Disease Control declared the measles eliminated in the United States, yet today we are in the midst of a measles outbreak that, according to the CDC’s latest count, has infected 102 people across the country, largely as the result of a December outbreak at the Disneyland theme park in California. Most commentators have concluded that the outbreak is attributable to the growth of anti-vaccination sentiment. Much of the focus has been placed on the “particular subculture of largely wealthy and well-educated families, many living in palmy enclaves around Los Angeles and San Francisco, who are trying to carve out ‘all-natural’ lives for their children,” to quote the linked article from the New York Times, but Catholics also make up a significant element of opposition to vaccinations. Why is this? Catholic bloggers Michael Sean Winters and Mark Shea argue that opposition to vaccinations represents the infiltration of a libertarian mindset, valuing individual liberty at the expense of the public good, in the U.S. Catholic fold. This is no doubt true, up to a point, but it does not explain the particularly Catholic resonance of the issue. I think an adequate explanation of this phenomenon must also take into consideration how the Catholic imagination is shaped by a particular historical experience of biopolitics, the use of state and other forms of power to regulate the creation and nurturing of human life.
The recent debate mostly focuses on the MMR (measles, mumps, and rubella) vaccine, thanks to a 1998 study led by researcher Andrew Wakefield published in The Lancet, claiming to link the vaccine to the onset of autism; although retracted by The Lancet because the results were deliberately fabricated, the study has led significant numbers of parents around the world to not vaccinate their children. Supporters of vaccination make the case that not only are vaccines such as that for MMR safe, but their widespread use protects not only the vaccinated, but also those for whom vaccination is unsafe due to a weakened immune system, and also those who for whatever reason refuse to be vaccinated. This “herd immunity” works because widespread vaccination hinders the disease’s ability to spread, leading to its eventual eradication. Both Winters (linked earlier) and Emily Reimer-Barry make a compelling case that Catholicism’s favoring of the common good over self-interest provides a sufficient rationale for vaccinating children. Reimer-Barry in particular shows how the Catholic understanding of the human person, grounded in a strong sense of interdependence and concern for the vulnerable, leaves little room for putting others at risk by failing to vaccinate one’s own children. As Winters notes, however, our culture’s excessive focus on “choice” has drowned out these concerns, even among many Catholics.
But that is not the whole story; a number of other quite different concerns drawn from the collective memory of U.S. Catholics also shape their perception of the vaccine issue. First among these is the long history of Catholic resistance to state interference in the relationship between parent and child, with particular regard to the issue of education. In 1922 the state of Oregon passed a law by popular initiative mandating that students attend public schools, fearing the “foreign” influence of Catholic parochial schools (this was also around the time America’s severe anti-immigration laws were passed). The Catholic Church argued that the primary responsibility for educating children belongs to parents, not the state, meaning that parents should have a choice in which institutions their children are educated. Ultimately, in the 1926 case Pierce v. Society of Sisters, the U.S. Supreme Court sided with the church. More recently, the increasingly common practice of homeschooling has aroused opposition; for example, the National Education Association argues (resolution B-83, p. 249) that homeschool educators must be licensed by the state and follow a state-mandated curriculum, and in 2008 the Court of Appeals in California ruled that homeschooled students must be taught by a credentialed teacher, therefore disallowing most homeschooling in the state, although the court later vacated the decision. It is easy to see how a similar fear of state encroachment on the rights of a parent contributes to opposition to mandatory vaccinations.
A second influence on Catholic perceptions of the vaccine issue is especially pertinent for the relatively small but committed subpopulation of Catholics who accept the Catholic Church’s prohibition on artificial contraception laid out in Paul VI’s Humanae Vitae, and instead practice natural family planning (NFP). Many of these Catholics subscribe to an interpretation of this teaching which views artificial contraception as an invasive, technological interference with the natural rhythms of the body and the natural union of the man and woman, in contrast to NFP which works with those rhythms. A similar line of reasoning has led opponents of vaccinations to propose the (false) argument that the body’s “natural immunity” which comes from exposure to germs in the environment is sufficient, and indeed that vaccines can “overload” a child’s immune system. Of course, this valuing of the “natural” over the “artificial” overlaps with the concerns of the largely secular progressives concerned with an “all-natural” lifestyle mentioned earlier.
Catholics opposed to contraception sometimes raise three related concerns, as well. First, they suggest that to some degree the Catholic case against contraception does not get a fair hearing due to the influence of a medical profession and pharmaceutical industry that benefit financially from the widespread use of oral contraceptives and other forms of artificial contraception, rather than natural family planning, which requires no medical expertise and is relatively cost-free. These suspicions overlap with feminist concerns about the technological objectification of women’s bodies and their relationship with their children by a culturally masculine medical profession. For example, most obstetricians recommend physician-supervised hospital births, usually with heavy medication, whereas an increasing number of women are pursuing the alternative of home births supervised by midwives. Likewise, in the mid-twentieth century, pediatricians gave their support to the use of commercially-manufactured infant formula as a replacement or substitute for breast milk, although in recent decades there has been a resurgence of breastfeeding and almost all health professionals now recognize its health benefits. Catholic opposition to vaccinations clearly draws on these suspicions of self-interested medical professionals and drug companies, and the gendered relationship between the medical profession and mothers.
Finally, Catholic opponents of contraception see Paul VI’s warning that increasing acceptance of contraception could encourage states to engage in coercive population measures, such as sterilizations, as prophetic of later policies such as Indira Gandhi’s sterilization program in India. Catholic opposition to these measures meant to control the growth of the population hearkened back to similar opposition to state-backed eugenic measures in the early twentieth century, carried out in the name of public health and the common good. Linking vaccinations with forced sterilization and eugenics is no idle fantasy; given the long history of pharmaceutical companies performing drug tests without adequate consent in Africa, including tests of sterilizing drugs, the Kenyan Catholic bishops’ claim that the tetanus vaccine used in a World Health Organization-sponsored program contained a component that causes sterility, although probably false, is at least understandable. The point here is not at all to equate mandatory vaccinations with forced sterilizations or eugenics, but rather to explain the grounds for suspicion over handing the government the right to perform medical procedures on minors against their will and the will of their parents in the name of the public good.
Thirdly, and probably most explicitly, reticence about vaccinations among Catholics is linked to their opposition to abortion. Vaccines are grown in cell cultures, and in some cases these cultures come from cell lines derived from aborted fetuses. As a FAQ at the National Catholic Bioethics Center points out, “It is important to note that descendent cells are not the cells of the aborted child. They never, themselves, formed a part of the victim’s body.” A 2005 statement from the Pontifical Academy for Life insists that, while it is gravely immoral for pharmaceutical companies to use cells from aborted fetuses in the manufacture of vaccines, it is morally permissible to use those vaccines, in particular if there is no alternative, because doing so only involves remote material cooperation with evil, to use the traditional terminology. Nevertheless, the statement does not claim that vaccinating children is obligatory, providing leeway for anti-vaccination advocates to defend their position as a moral stand against abortion. Pro-life Catholics fear that acquiescing to participation in the evil of abortion in this case may make it easier to compel more immediate material cooperation with abortion in other cases, as well.
Winters writes that in the libertarians’ “binary vision of ‘the state’ versus ‘individual freedom’ there is as little room for civil society, and the Church, as there is in your worst collectivist nightmare. If it is all one or the other, there is no role for mediating institutions or, at least, they will quickly be relegated to the sidelines of political and intellectual discourse.” As the above cases show, however, the historical experiences undoubtedly shaping the imagination of many Catholic anti-vaccination advocates were cases where Catholics stood in defense of these mediating institutions—marriage, the family, the school, the church itself—against individualism, the overweening power of the state, and technological objectification. The Catholic biopolitics of the past century has insisted that human life flourishes best in a society where these institutions are strong, with the state having a definite but limited authority over the body.
It is probably true that opponents of vaccinations have too easily been swayed by individualism and excessive emphasis on choice, but perhaps this is because our digital culture and the general fragmentation of society has created an environment in which the viruses of misinformation and bad arguments can spread. As Catholics we should take responsibility for advocating for the reasonableness and public necessity of vaccinating our children, but our first resort should be to make the case within our own communities, in a way consistent with our historical experience, to help promote “immunity” against bad ideas. We should be hesitant about calling upon the state to mandate vaccinations without conscience exemptions. For one, the eradication of the measles, albeit temporary, was achieved with these exemptions in place, and as Winters notes, many European nations have achieved even higher rates of vaccination without a mandate. Second, the Catholic historical experience tells us that we should not assume that what the state and what Catholic teaching consider to be in the public good will always be so easily aligned. In many cases Catholics have appealed to the freedom of conscience in order to protect the very mediating institutions that “strengthen the social fabric, preventing society from becoming an anonymous and impersonal mass” (Centesimus Annus #49), and to give up that freedom in the name of the public good in one case may mean giving up the freedom to work toward the public good in others.