Orthodox Reflections

As the doctor stitched up our son, we were busy reading up on the rabies vaccine. A farm dog, kept outside and never vaccinated, had really bitten his leg badly. Rabies was present in the environment around the hiking trail where he had been attacked. Rabies is rare, of course, especially in domestic canines, but was that good enough when your son’s life is potentially on the line?

We did our research on our phones, silently said some prayers, read the vaccine information insert, and had an in-depth discussion with the attending physician. Eventually we decided to begin the course of the rabies vaccine. Our son was young, but not too young, healthy, and unlikely to suffer an adverse reaction. It was completely our decision as the parents of a minor child. No one tried to sway or influence us one way or the other. The medical staff were professionals who gave us all the relevant information, but otherwise gave us the space needed to make a final decision based on informed consent.

In short, this decision was a text-book example of exactly how medical decisions should be made. Any number of factors could have influenced our decision to not have vaccinated. If our son were immunocompromised, if he were unhealthy in general, if he had had a previous vaccine reaction, if he had one or more preexisting conditions – then we may have opted to forego the vaccine. Any vaccine, just like any other medical treatment, carries with it some measure of risk. In the case of our son, while the risk of contracting rabies was certainly low, we judged that the risk was still higher than the potential for an adverse reaction to the course of treatment. Therefore, we played the odds and went with the vaccine. That decision could have very easily gone the other way.

And if our son had been injured in some way, via an adverse reaction to the vaccine, then it would have been our responsibility. We had understood the risks and benefits clearly, and the decision had been ours alone.

Ethical physicians, like those who belong to Physicians for Informed Consent, understand that final decisions on medical treatments, including vaccinations, should be made by the patient or the patient’s parents in case of a minor:

Informed consent involves the basic human right to consent or refuse a medical treatment or procedure, including vaccination. The consent must be voluntary. If a patient, or parent of a patient, is coerced or threatened in any way into consenting for vaccination (including statutory or government mandated exclusion from school), then the “consent” obtained is actually coerced consent, not informed consent.

We view vaccines as pharmaceutical drugs and/or medicines, and we respect everyone’s right to the informed consent (or informed refusal) of drugs and/or medicines. Therefore, this organization is not ideologically pro-vaccine or anti-vaccine, but rather is pro-health, pro-ethics, and pro-informed consent in vaccination (like any other medical procedure).

The right to voluntary, informed consent or refusal of a medical procedure is a basic human right. While the medical establishment tends to downplay vaccine risks, they absolutely do exist and vary from vaccine to vaccine. It is estimated that less than 10 percent of injuries from adverse vaccine reactions are reported. Even so, the United States government has awarded over $4.1 billion to victims of vaccine injury through the Vaccine Injury Compensation Program since 1986. This program exists to shield vaccine makers and physicians from liability in the case of vaccine injury.

The right to voluntary, informed consent is recognized and supported by the Russian Orthodox Church as shown in this statement from the  Patriarchal Commission on the Family:

It is well known that, along with the risk of infectious diseases, there is also a risk of serious complications — even death — as a result of prophylactic vaccination. In such a situation, it is the patient himself who should make the choice. In the case of a child, the parents should make their choice in each particular case, taking into account the advice and recommendations of specialists, as well as other information. No one has the right to make this choice for them, even if guided by the child’s own well-informed understanding.

The fundamental right of informed consent is particularly critical in this time of Covid-19. The Trump Administration is spending over $10 billion dollars on its Operation Warp Speed to develop a Covid-19 vaccine. That is a very large investment spread out across multiple companies. President Donald Trump has also stated that the United States military will be in charge of the logistics of distributing the vaccine, which he so far insists will be “voluntary.”

No vaccine exists for Covid-19, and there is no guarantee that one will. In fact, scientists have been trying unsuccessfully to create a coronavirus vaccine since at least 2002. None of the previous efforts even got close to a marketable vaccine. However, given the scale of effort under way, it is possible that one will emerge. (Over 90% of vaccines that enter human trials fail to make it to market, so we definitely should not count on this as a given.)

If  one does emerge, it is quite possible that governmental, business, and / or health care entities may decide to mandate its use for segments of the American population. Even President Trump may reverse his earlier statement and opt for coercion at the national-level. Particularly since it is estimated that close to half the U.S. population may not be willing to voluntarily take what has been billed as “the most expensive vaccine in world history.”

First and foremost, we must recognize that individuals have the right to informed consent. Forcing an individual to undergo a medical procedure against his or her will is a grossly immoral violation of basic human rights. This applies to vaccines as well as any other medical procedure.

Further, we must recognize that concerns about this particular vaccine are not illogical and “anti-science.” The speed with which development is occurring is a concern, especially since reports from the drug trials indicate substantial side effects, even when testing on the most healthy of possible subjects. These safety concerns may not be properly resolved in the rush-to-market. Even if the vaccine is 100% effective, it may not be judged worth it by many individuals. Covid-19 results in death in only 1 in 6,670,000 contacts among middle-age Americans. So far, there have been deaths equal to 0.00039% of the entire U.S. population with very few of these attributable to COVID-19 alone. These numbers indicate that 19 million people would have to be vaccinated (assuming complete effectiveness)  for 1 person to avoid death.

While no coronavirus vaccine has made it to market, prior experience with flu vaccines indicate about 1% of those vaccinated required hospitalization and as many as 1 in 200 of those die. Similar results for Covid-19 vaccination of the entire U.S. population (328 million) could produce 3,280,000 vaccine-induced hospitalizations in a nation with only a 1-million bed healthcare system. In addition, even if the vaccine is perfectly safe for healthy adults, the very people most susceptible to Covid-19 (frail, elderly, diabetic, obese, autoimmune disorders) are also the ones whose immune systems do not respond well to vaccines and who are most subject to side effects. Therefore, it would be reasonable to expect that those most endangered by Covid-19 may also be among those least willing to be vaccinated.

Questioning the efficacy or cost-benefit of a particular vaccine is not “anti-science.” Rather, anti-science is the notion that a single medical treatment is appropriate for all people on Earth, regardless of age, physical condition, preexisting conditions, and location.

Given the totality of concerns listed above, it is quite probable that many Americans will opt out of the vaccine, if given a choice. And it is absolutely a moral imperative that they be given that choice. While the Russian Orthodox Church has clearly stated its support of informed consent, Orthodox Bishops on the North American continent appear to have not done so.

A search for affirmation of the right of patients to informed consent yielded no results for the Greek Archdiocese, the OCA, and the Assembly of Canonical Orthodox Bishops. The Greek Archdiocese has even gone to the effort of creating a very expansive “Social Ethos” document, in which only two references are made to vaccines. Both of those support vaccination, which is fine as vaccination is not the issue. Informed consent to medical treatment is, and that is completely missing from the document.

This lack of a clear statement is troubling for many reasons. First, without a clear statement (such as offered by the Russian Church) in favor of voluntary, informed consent, there could be bishops, priests, and laity who actively pressure others to get vaccinated. This is happening to some degree already in the Roman Catholic Church among some of her bishops, even though no vaccine is even available. There could be, also, individuals within the Orthodox Church who take the opposite stance, and try to interfere with the right to be vaccinated by those who wish it. The moral question is not whether to be vaccinated or not, the moral question should be clearly articulated as the right of the individual to make an informed decision free of coercion.

Second, while the Orthodox Church in the United States is relatively small, the global presence of the Orthodox Church ensures that a commitment by our Bishops to informed consent will be covered extensively in the media. The Orthodox Church is known for its commitment to morals and its cultivation of a deep spiritual life. A clear commitment to human rights could help influence the debate, and if necessary, could tilt the scales away from mandatory vaccines and in favor of voluntary, informed consent.

Finally, again while relatively small, the Orthodox Church in North America boasts many political, business, and community leaders. These individuals deserve clear, unequivocal guidance from the Orthodox Church. The stance of the Church on this matter could influence how they vote, how they donate their money, and how they influence our public policy. A petition against mandatory vaccines from LIfesitenews.com gathered over half-a-million signatures, with no discernible support from the Orthodox Church. Imagine how much greater the response could have been if our hierarchs and priests had also lent their support to this effort?

Just as the Russian Orthodox Church has done, now would be a most appropriate time for the Orthodox Church in North America to reconfirm our commitment both to science and to human rights.

Update 8/11/2020 – It turns out that Russia is claiming to have an actual Covid-19 vaccine. Time will tell. It is a wonderful thing that the Russian Church has endorsed informed consent for vaccines. All Orthodox Churches and all other Christian bodies should follow suit!

Nicholas, Greek Archdiocese of America