Volume 64 Number 22 
      Produced: Sun, 14 Apr 19 06:49:28 -0400

Subjects Discussed In This Issue:

Measles vaccinations (3)
    [Sammy Finkelman  Ben Katz, M.D. Hillel (Sabba) Markowitz]
Not wearing glasses in public (4)
    [Stuart Wise  Robert Israel  Dr. William Gewirtz  Hillel (Sabba) Markowitz]


From: Sammy Finkelman <sammy.finkelman@...>
Date: Tue, Apr 2,2019 at 06:01 PM
Subject: Measles vaccinations

Irwin Weiss wrote (MJ 64#19):

> There is currently a serious measles outbreak in Rockland County where Monsey
> along with some other Haredi and Chassidic enclaves are located.
> Can someone explain the rationale for parents to reject science and refuse to
> vaccinate their children, thus exposing the children to dreadful diseases, and
> potentially exposing others as well? Does their refusal have any halachic 
> basis? Or, on the contrary, is there a halachic obligation to vaccinate one's 
> children (except in the few cases where they may be allergic to components of 
> the vaccine or have some other medical counterindication)?

There is no rationale for parents to reject science. They just don't know the
difference between true science and false science. And there is a propensity to
rely on minority opinions in medical matters because they just don't trust
conventional secular wisdom very much although, halachically, they should really
do so.  But then, when one counts different medical opinions, one tends to count
any number of doctors who think identically as only one doctor - i.e. they goes
by dayos and ignore the numbers supporting each one.

In fact, their refusal does have a halachic basis in "Asay L'chah Rav" and Da'as
Torah. Apparently some Rabbis in Israel have been convinced that vaccination can
possibly be dangerous.

Judaism, especially Haredi Judaism, is, in practice, very decentralized. Nobody,
for instance, pays attention to the Chief Rabbinate of Israel as a Halachic
authority, leaving it open to very many people to act as a posek. The
anti-vaccine propagandists have apparently gotten to some Rabbis, mainly in
Israel, and the government of Israel doesn't interfere, although they are trying
to do something against the doctors who oppose vaccination (these are practicing
homeopaths apparently, but licensed doctors.)


There could also maybe be social pressure if non-vaccination is prevalent among
people they associate with. Maybe it could even affect marriage prospects.

Then, some of what they are being told doesn't make sense, such as that
vaccination can cause autism. (they don't even know what autism is, so of course
they don't know what causes it either)  

They also find it difficult to accept that the vaccine is truly necessary, when
they being asked to consent to it. They reason that, if agreeing is mandatory,
why do they need to read warnings and then query what they are being asked to
sign away. Other questions are:

1. Why is measles, which most children used to recover from unscathed, so much
more important than other diseases?

2. Why was the age that the vaccine was recommended for reduced from 15 months
to six months? (the answer to the latter is probably because it is pointless to
vaccinate any baby below the age of 6 months since it carries the mother's
antibodies, and the vaccine will have less of chance of causing measles and more
chance of being effective if people wait, but now with an epidemic they want to
minimize the window of vulnerability.) 

Also there's a lot of crazy stuff that comes off the Internet and gets to them
some way.

Rav Nachman of Breslov, who despised doctors, and said they are assistants of
the Malach Hamoves, said that there a halachic obligation to have one's children
vaccinated against smallpox, which was being introduced in his time.

Finally, I think there is no allergy issue with any components of the vaccine,
but there are some people with weakened immune system, sometimes as a result of
medical treatment for cancer, which wasn't so much around in the 1960s.

From: Ben Katz, M.D.<BKatz@...>
Date: Mon, Apr 8,2019 at 03:01 PM
Subject: Measles vaccinations

Ari Trachtenberg wrote (MJ 64#21):

> I am not a medical doctor but I fear that Ben Katz (MJ 64#20) who, as far as I
> know, is a very well respected one, is overly simplifying the halachic
> obligation to vaccinate.

Ari may not be a medical doctor but is a very bright fellow. I probably did
simplify some of my arguments, but I also have some areas of disagreement.

> Let me state outright that the main childhood vaccines literally save lives,
> and I agree that, as a result, there is an affirmative requirement from the
> Torah to accept them, wherever possible.
> For the less widely used vaccines, such as chickenpox for example, there
> appears to be some evidence that natural infection provides stronger later
> immune response (for the elderly who are more susceptible to serious
> complications) than vaccination:
> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563790/ 

There is no doubt that natural immunity is stronger in many cases, BUT SO ARE

Here are the numbers for chickenpox: Prior to the introduction of vaccination,
about 100 deaths per year in the US, half children, half adults.  After its 
introduction, about 10 deaths/year and 80% fewer hospitalizations.

> For other vaccines, like for influenza, the effectiveness can be fairly low in
> some years, and it may be reasonable to balance the risk of infection against
> any unpleasant side-effects.  

Flu vaccine protection generally ranges from 40-60% each year, and those who get
the flu despite vaccination usually have milder cases.  We definitely need a
better vaccine and one that does not need to be given every year. That being
said, flu kills 30-80,000 American adults every season, mainly elderly, and about
about 150 children each year as well.  As a pediatrician I know the pediatric
data better and it is mainly unvaccinated children who die.

> I cannot state this with medical or halachic conviction (I have neither
> credentials), but it logically makes sense that there is some threshold at
> which point the uncertainty of a benefit is outweighed by the likelihood of
> discomfort.  I would be interested in reading a cogent halachic discussion of
> the commonly made argument that one must vaccinate in order to provide herd
> immunity to those who cannot vaccinate, especially for these less widely used
> vaccinations.
> With respect to doctors obscuring evidence, they most certainly do!  For
> example, most doctors are well aware that people have a poor intuitive
> understanding of probability, and will choose not to dwell (or, in some cases,
> even explain) low-probability side-effects to patients who might blow them out
> of proportion and, consequently, refuse necessary medical procedures.   In its
> less innocuous version, medical professionals may publicly understate or
> obscure the risks of medical treatments that they consider to be largely
> safe. Likewise, doctors may lie to patients in order to induce a placebo
> effect, which, studies show, may provide real medical value. We all
> understand that there is a value in these medical 'lies', but we should
> not be surprised when they consequently lower public trust in the profession,
> sometimes with deadly consequences.  As the Biblical adage proclaims: "From
> falsehood you should distance yourself" (Exodus 23:7).

Ari is here making the mistake that the ancient Greeks made - equating truth
with goodness.  Even God tells a white lie in Genesis when explaining to Abraham
why Sarah laughed.  When a mother asks me how her newborn got a terrible
infection I don't usually tell her "YOU gave it to her"!

Hag kasher vesameach to all.

Ben Katz

From: Hillel (Sabba) Markowitz <sabbahillel@...>
Date: Tue, Apr 9,2019 at 10:01 PM
Subject: Measles vaccinations

Carl A. Singer wrote (MJ 64#21):

> Our synagogue (Young Israel of Passaic-Clifton) does not allow children who 
> are not vaccinated to participate in our youth groups. Like most things this 
> is on the "honor system" -- sending one's child to the youth groups implies  
> that they are vaccinated.
> With Pesach around the corner there will be many visiting families -- some 
> from communities known to have issues with measles, vaccinations, etc.
> Any thoughts or suggestions how we should handle this?

One of the shuls in Baltimore has explicitly forbidden anyone who has not been
vaccinated from entering the shul. Here is the notice they sent out. The
Baltimore Va'ad harabonim has explained what must be done and emphasized that
everyone who can, must be vaccinated unless forbidden by their doctor.
This is a matter of pikuach nefesh. Note that the message includes both adults
and children in the requirement to be vaccinated.


Any individual that has not received those vaccinations required by Maryland
State for students attending school (a current listing can be 
found at health.maryland.gov

may not enter the Suburban Orthodox Congregation Toras Chaim (SOTC) premises.
SOTC will not allow any exceptions to this policy on the basis of a claim of
religious exemption. However, if someone has a medical contraindication, they
may request an exemption by contacting the SOTC office
<mailto:<office@...>, and such request will be 
considered by the SOTC Board of Directors.

A full letter from the Baltimore Va'ad HaRabonim can be found below.


Notice from Va'ad HaRabonim

April 7, 2019

Dear Community Members,

Unfortunately, this past Friday, a child in our own community was diagnosed with
measles. This has caused great alarm in our community and, with planned Yom Tov
travel of many families to and from other communities with numerous measles
cases, many have questioned the level of protection carried by various age
segments of our community.

In order to obtain clear guidance for our community, telephone conferences have
been held between representatives of the Vaad HaRabbonim, Hatzalah, our
community's schools, physicians, the leadership and infectious disease team at
Sinai/Lifebridge, and State, City and County Health Departments. The medical
professionals and governmental officials emphasized that while our community
should exercise caution, at this time there is not an epidemic of any kind in
our community. Over the next few days, they, in conjunction with the Vaad
HaRabbonim and community representatives, will develop guidance and
recommendations for us on specific questions, and on the advisability of 
holding an MMR Clinic as has been done in other cities to provide vaccinations.

In the meantime, we have received the following practical guidance for Yom Tov
family gatherings and otherwise large crowd exposure:

  * If you suspect you or your child has or may have been exposed to
    measles, call your doctor about the symptoms before showing up in
    the waiting room.

  * The patient should not attend childcare, school, work, or any other
    public place until he or she is no longer contagious.

  * Anyone who has received both recommended MMR vaccine doses can be
    comfortable in public places.

  * Parents of children who received the first MMR dose at ~12 months
    should contact their pediatrician to determine if they are eligible
    to receive a second dose, as early this week as possible, to allow
    maximum protection by the time crowds gather for Yom Tov.

  * Individuals who choose not to vaccinate themselves or their children
    must avoid public places and group settings of all kinds, as their
    presence poses a serious risk to the community at large.

  * Immune-compromised people should avoid public gatherings.

  * Pregnant women should contact their Ob/GYN or family physicians
    regarding their immunity concerns. If they have immunity or have had
    2 MMR vaccines, they should be fine in all situations, and if not,
    they should avoid public gatherings.

Please consult with your family doctor for specific advice for your situation. We
will continue to communicate with you as we receive guidance from the health

We pray that HKBH continue to watch over all of us.

Vaad HaRabbonim of Baltimore
Hatzalah of Baltimore
Bais Yaakov of Baltimore
Bnos Yisroel of Baltimore
Ner Israel Rabbinical College
Yeshivas Chofetz Chaim/Talmudical Academy of Baltimore
Kochav Yitzchok/Torah Institute of Baltimore

Hillel (Sabba) Markowitz


From: Stuart Wise <stuart.wise@...>
Date: Tue, Apr 9,2019 at 05:01 PM
Subject: Not wearing glasses in public

Carl A. Singer wrote (MJ 64#21):

> An acquaintance (I'm deliberately being vague) informed us that her son who is
> learning in Israel now removes his glasses when walking in public so as not to
> (chas v' challilah) see women who may not be dressed to his standards of 
> tsnius. Apparently, his friends do the same.

I have heard this before and I guess it appeals to those who want to outfrum the
next person, or someone who is very aware of his strong sensitivity to the sight
of women, especially one not dressed modestly, and his consequent susceptiblity
to indecent thoughts. 

It makes me think of what I heard months back in Israel (not sure Beit Shemesh
or Ramat Beit Shmesh) where some women took to wearing burkas like the Arabs.  I
suppose whatever floats their boats, but if it were halachically based, maybe
more people would do so. 

But doing so also creates a danger for the person taking off his glasses and
others in his path.

Yisroel Wise

From: Robert Israel <israel@...>
Date: Tue, Apr 9,2019 at 06:01 PM
Subject: Not wearing glasses in public

In response to Carl Singer (MJ 64#21)

This may or may not be effective, depending on the degree of his 
nearsightedness. However, if he is so nearsighted that it it effective, it 
would come with a significant risk of actually bumping into the women he is 
trying not to see. Surely that could be halachically worse than just seeing 
them? Not to mention the danger of walking into lamp-posts, cars etc.

Robert Israel

From: Dr. William Gewirtz <wgewirtz@...>
Date: Tue, Apr 9,2019 at 09:01 PM
Subject: Not wearing glasses in public

In response to Carl A. Singer (MJ 64#21):

I was reminded of an occurrence well over 50 years ago when someone challenged
the Rav ztl's assertion that toothpaste is not rauy leakhilat kelev [suitable to
be eaten by a dog] by asserting that his dog ate toothpaste. 

The Rav's response: 

You have a crazy dog. Ve'hamaivin Yavin [Those who comprehend will understand].

From: Hillel (Sabba) Markowitz <sabbahillel@...>
Date: Tue, Apr 9,2019 at 10:01 PM
Subject: Not wearing glasses in public

In response to Carl A. Singer (MJ 64#21):

I would say that this is a medical matter and that he should first consult with
his ophthamologist and his rav. The way that Carl describes the matter, seems to
be something that his "aquaintance" has done on his own without actually asking
his rav.

If that is the case, then it can be an improper action that can cause danger to
him. If his rav tells him to wear his glasses, then he should do so as a matter
of "veshamru es nafshoseichem".

Hillel (Sabba) Markowitz


End of Volume 64 Issue 22