Everyone wants the best for their children. We want them to be happy. We want to give them protection. We want them to grow up strong and healthy. In this day and age where information is readily accessible, we could always refer to the social media in finding out what would be “the best” for our children.
The problem is, how can we be sure that information obtained from the social media is accurate and true? Not many people actually bothers to crosscheck and verify the authenticity and accuracy of postings shared on Whatsapp, Telegram, Facebook or Twitter. Many would readily accept the information “as is” and regard them to be canon, using the argument that “people would not share it if it is not true.” After all, as they say, “sharing is caring.”
In Malaysia, opinions on anti-vaccination seem to gather some traction circa 2012 partly due to the social media. A few personalities have also come on board the movement, and proudly announce that they do not vaccinate their children.
One of the popular arguments put forward by the anti-vaccination movement is that measles, mumps and rubella (MMR) vaccine cause autism. This argument is based on a scientific paper authored by Andrew Wakefield and 12 co-authors in the renowned British medical journal Lancet published in 1998. The authors of the article claimed that possible environmental triggers, i.e. the MMR vaccine, were “associated with the onset of gastrointestinal disease and developmental regression.
This “fact” is shared by proponents of anti-vaccination as proof to their argument. Unfortunately, when the paper was retracted by Lancet in 2010, no one seems bothered to share this development. The medical journal issued a statement on 2 February 2010 stressing that several elements of the paper published by Wakefield and his colleagues are “incorrect, contrary to the findings of an earlier investigation.”
Wakefield was found to have falsified the data used in his study, breached a number of ethical guidelines, and had his medical licence revoked.
However, the damage has already been done. In part due to this article, many parents opted not to vaccinate their children for fear of autism. Some even argued that vaccination is a part of a bigger conspiracy to enrich pharmaceutical companies. We can choose to engross ourselves with conspiracy theories if we want to, but in doing so, we sometimes turn a blind eye to a number of established scientific facts.
It must be clearly understood that vaccination is a form of preventive medicine, and not a cure or treatment. In an article entitled “Vaccination: A Personal Choice?” published on 27 April 2015 in The Malaysian Medical Gazzette, the author Dr. Kamal Amzan highlighted an often-neglected fact.
He wrote that, “Most modern parents have never seen the devastating effects that diseases like 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.
The bottom line that all of us have to understand is that vaccination is a preventive measure to keep these diseases at bay. Preventing an outbreak or an epidemic is definitely better in all sense of the word than to treat. In Islam, preventive medicine is considered to be the basis of medicine.
The concept of al-wiqayahkhairunmin al-‘ilaj (prevention is better than cure) is very much in line with Islamic teaching. In fact, one of the elements of Prophetic medicine is al-himya or prevention. In write-ups on Prophetic medicine, there are commentaries on al-Harith ibn Kalada, who was the only Islamic scholar well-versed in medicine based in Gundashipur during the time of the Prophet. When asked what the basis for health is, al-Harith’s reply was simply one word: “Prevention.”
Modern medicine is based on the scientific approach which have two important concepts, namely healthcare through prevention (hifz al-sihhah) and treatment (al-‘ilaj). Many scholars and historians of medicine are of the opinion that hifz al-sihhahis greatly influenced by the concept of al-himyafrom the Prophetic medicine.
Taking this spirit of hifz al-sihhah, we can argue that vaccination is an endeavour to prevent epidemics from occurring in our community and country. Should there be an outbreak, it would come with a great cost for all of us, in terms of financial, human capital and life.
The legal maxims in Islamic fiqhalso highlights that “deeds are judged by their goals and purposes.” Vaccination is carried out with the intention to safeguard the health interest of the society at large. It is to prevent a greater harm, i.e. to ensure that there is no outbreak of diseases that will pose a great health risk to the community at large.
This ties in to another legal maxim in Islamic fiqhthat states that “harm must be eliminated.” All these are very much in line with the higher objectives of shariah, in which two of the objectives is the need to protect lives (hifz al-nafs) and protect the progeny (hifz al-nasl).
Vaccination is often associated with Edward Jenner who successfully developed the smallpox vaccine in 1798. As such, some have the perception that vaccination is a “western idea” and “western agenda.”
Historically speaking, the practice of vaccination can be traced back to the Chinese author, Wan Quan in 1549. It has been recorded that inoculation for smallpox, using powdered smallpox scabs, was widely practiced during the ear of the Longqing Emperor of the Ming Dynasty.
Historical documents also showed that the Turkish Uthmaniah (Ottoman) Empire also practiced vaccination. Two reports in 1714 and 1716 highlighted the method of inoculation used in the Uthmaniah Empire.
The Uthmaniah inoculation process was introduced to Britain in 1721 by Lady Mary Wortley Montagu, who was the wife of the British ambassador to Constantinople. She herself had her five-year old son inoculated against smallpox in 1718 when they were in Constantinople. When she returned to London in 1721, she had her daughter undergo the same procedure, this time administered by Charles Maitland, during a smallpox epidemic in Britain.
It is unclear when exactly the practice of inoculation began in Uthmaniah Turkey. However, there are records that showed the understanding that Muslim biologists and medical doctors had on bacterial infections, for example as shown by the polymath Syeikh Aq Shamsuddin in the 15th century.
Syeikh Aq Shamsuddin wrote in MaadatulHayaat that there was a misconception that diseases “attack” humans on their own. What in fact happen, according to him, is that diseases are transmitted from one person to another. This shows the understanding on the concept of infectious diseases on the part of Syaikh Aq Shamsuddin.
It is further argued that, partly due to this understanding as to how bacteria infect humans, the army of Sultan Muhammad al-Fateh underwent preventive measures to ensure that they were not prone to infectious diseases during wartime.
Coming back to the present day, it is imperative that we all remember that vaccination is a preventive measure to minimise the risk of an epidemic. All parents want the best for their children, but parents who choose not to vaccinate are putting the health of other children at risk.
When the number of unvaccinated children increase above a certain point, then the “herd immunity” is compromised. Herd immunity refers to “the protection of a whole community from disease by immunising a critical mass of its populace.” When the threshold of the herd immunity is compromised, we will begin to see preventable diseases, and also eradicated diseases, returning to the community.
We must understand that vaccination does not only protect the person who is immunised. Vaccination also protects the people around the immunised person. The reverse is also true. A person who is not vaccinated, when contracted with an infectious disease, would risk infecting the people around him.
Looking from this point of view, vaccination is in essence crucial to protect the health of the community at large. It is not just about our own personal choice or preference. We have to look at this in terms of what is best for the community and nation.
Those who refuse to vaccinate may argue that it is their personal right by exercising their autonomy to decide. But does an individual’s autonomy take precedence over public interest especially when it comes to public health? This is something that we should think aboutvery seriously. Are we willing to compromise the health of the community by choosing not to vaccinate?
We want the best for our children. At the same time, we have to be certain that what we consider to be “the best health option” for our children do not present a health risk to other people’s children. Other parents also want the best for their children.