IRSYAD AL-FATWA SERIES 30: VACCINE ACCORDING TO ISLAM’S PERSPECTIVE

Answer:

Alhamdulillah, praise and thanks to Allah for the countless blessings He has blessed us all with. Blessings and salutations to the Prophet Muhammad PBUH, his wives, his family, companions and all those that follow his teachings to the day of judgement.

I was previously invited to the National Symposium discussing Islam in Science and Medical Health. Thusly, I would like to detail the discussion in this series of Irsyad Fatwa so that it would provide a clear understanding to us all.

What’s interesting is, a person with strong faith does not only mean he is strong spiritually but also physically. A high spiritual level will protect people from the illness of the heart that will, in turn, strengthen the immunity of the body. According to al-Qudah (1987) there are several researches conducted that prove the status of a person’s psychological and spiritual level affect the healing process to several organic illnesses.

Definition of Vaccine

The word vaccine originates from the Latin word vacca (cow) and vaccinia (cowpox). A vaccine is an antigenic material that is used to produce an active acquired immunity of a certain disease that could prevent or decrease the infection of the natural or “wild” organism. A vaccine can be made from weakened virus or bacteria which are no longer infectious. A vaccine can also be made from dead organisms or purified forms of protein, peptide, or particles similar to a virus or bacteria. The vaccine will provide an active acquired immunity for humans and animals to be immune against the attacks of a certain pathogen, especially bacteria, virus or toxins. A vaccine could help the immune system to fight against degenerative cells (cancer). Vaccination or inoculation stimulates the immune system of the body to produce specific antibodies to protect the body from diseases that could be prevented through vaccination. There are several types of vaccine. However, no matter what type it is, the function is the same, which is to stimulate the immune response.

Types of Vaccine

Among the types of vaccines are:

• Live attenuated vaccine

A live vaccine made from weakened bacteria or virus where the virulence is weakened through repeated cultures, however, it can still stimulate the same immunological response of infections which happens naturally.

• Inactivated vaccine (killed vaccine)

A vaccine made from killed bacteria or virus; where the bacteria or virus are killed using chemicals such as formaldehyde or subjecting them to high temperatures. It can be from complete bacteria or virus, or only a part of the virus, bacteria or toxoid.

• Toxoid vaccine

A vaccine made from several types of bacteria which causes a disease by injecting the weakened toxoid into the bloodstream.

• Acellular or subunit vaccine

A vaccine made from certain parts in a virus or bacteria by cloning the gene of the virus or bacteria through recombinant DNA, vector virus vaccine and anti-idiotype vaccine.

Materials Used in Producing Vaccine

A vaccine is made from germs (or part of the germs) that causes disease. For example, pox vaccine is made from the pox virus, polio vaccine is made from poliovirus, measles vaccine is made from the measles virus and others. The difference is only in the process of the production of the vaccine.

There are 2 types of vaccine; either live or dead. To produce a live vaccine, the live virus must be weakened by injecting the virus into the tissues and blood of animals (such as the kidney of monkey and dog, chick embryo, bovine fetus serum, rabbit’s brain, pig’s or horse’s blood and pustule of cowpox) several times (through a gradual process) of approximately 50 times to decrease its potency.

Harmful Effects of Vaccine

Harmful effects of the vaccine on a human body are stated by several prominent figures, among them are:

• According to an independent analysis issued by Vaccine Adverse Event Reporting System (VAERS) in the US, in 1996 there are 872 tragedies reported by VAERS which involved children under the age of 14 years old who are injected with Hepatitis B vaccine who experienced life-threatening medical complications. 48 of the children died after receiving the inoculation.
• Medical information obtained includes examples of diseases caused by vaccines. Vaccine is linked with brain damage, low IQ, concentration problems, learning disabilities, autism and neurological issues.
• Mumps and measles vaccine given to children causes brain damage, cancer, diabetes, leukaemia and death (baby death syndrome).
• A 1992 a research published in The American Journal of Epidemiology reported an increase in the death of children of up to 8 times higher for a duration of 3 days after getting the DPT vaccination.
• In 1977, Dr Jonas Salk (discovered Polio salk vaccine) issued his and other researchers’ statement that 87% cases of Polio reported are a result of the Polio vaccine.
• Annually, 25, 000 cases of sudden death for babies are reported in America. Vaccination is the major cause of sudden death. Japan has increased the age of vaccination for children to be at least 2 years old which results in a drastic decrease of sudden death cases.
• Sweden banned cough vaccination in 1979, after the outbreak of this disease are reported in children who received this vaccination. Afterwards, the cases reported decreases without any death cases reported. This clearly shows that the vaccine is the cause of the disease.

Doctors and Medical Specialists Who Oppose Vaccine

Among them are:

• “There are numerous evidences that children immunization has a greater harm than benefit.” (Dr J. Anthony Morris, Vaccine Specialist)
• “The greatest threat of infectious disease in children is during an ineffective prevention age and dangerous through mass immunization.” (DR R. Mendelsohn, Author of How to Raise a Healthy Child in Spite of Your Doctor and Pediatric Professor)
• “All vaccine functions are to change the blood to the characteristics of cancer or leukaemia… DO vaccine could cause cancer and leukaemia.” (Professor L.C. Vincent, developed Bio-eletronic Methodology)
• “Official data showed that large-scale vaccination failed to produce a significant result in the prevention of diseases that should be protected.” (Dr A. Sabin, developed the oral Polio vaccine, in his speech in front of doctors in Piacenza, Italy, 7^th December 1985)
• “Other than clear cases of death as a result of this program, there are still long-term effects that are impossible to be determined with certainty. There are dangers in the whole procedure of vaccine where the widespread and unnecessary usage of it should be prevented.” (Sir Graham Wilson in the Hazards of Immunization).

Vaccine: History, Hope and Its Future in Malaysia

Immunizations have a great impact on the health of children. It is the easiest and cheapest method of disease prevention in children. Immunization services in Malaysia have started since the time of the British colonization in the year 1868. At the time, only smallpox immunization is given. It starts in the Straits Settlements and it is given by the headmasters – Malay headmasters in a Malay community. In the year 1950, smallpox immunization is given to the whole country. It is an effort of the government to eradicate smallpox at the time, immunizations are made compulsory and who fails to get it will be fined RM 1000. The mass immunization managed to decrease the outbreak of smallpox and afterwards, smallpox was successfully eradicated in the year 1980.

In the early 1990s, a vaccine for diphtheria and tetanus are introduced; these diseases have a high mortality rate. With the advancement of technology, in the year 1961, the BCG immunization to prevent tuberculosis is given as the country’s effort to control the disease. Poliomyelitis immunization starts in the year 1972 after the outbreak of the disease is reported the previous year. In the same year, the Ministry of Health Malaysia (MOH) starts the National Children Immunization Program organized with the cooperation of the World Health Organization (WHO).

To date, immunizations under the Immunization Program MOH are given to prevent 12 types of diseases. This service is provided for free in Government Medical Clinics. While immunizations service given by private clinics and hospitals covers a wider range of diseases. However, customers will have to pay for the vaccine and consultation costs. See Vaksin: Sejarah, Harapan dan Masa Depan Di Malaysia (Vaccine: History, Hope and Its Future in Malaysia) by Dr Rohani Jahis, MOH.

Director-General of Health Malaysia and Director General of the Department of Islamic Development Malaysia Press Statement

Among them are:

• Ministry of Health Malaysia (MOH) and Department of Islamic Development Malaysia (JAKIM) realize that parents are concerned and doubtful in giving vaccination or immunization to their babies due to news and rumours that state that vaccines contained haram components and are harmful to one’s health and life. There are also statements saying that the purpose of the immunization program by the government is to weaken the Muslim ummah. The spread of such news is done by irresponsible people that could expose our children and society with risks of dangerous infections that are life-threatening.
• The National Children Immunization Program has been conducted since the 1950s. These immunizations’ purpose is to prevent 12 types of diseases caused by certain bacteria and viruses, administered free to babies and children in government clinics. The death of children decreases as much as 85% between 1970 and 2000 of which is a result of both the improvement in the scope of medical services which includes immunizations. Immunizations have also successfully eradicated smallpox in the world. While polio has been eradicated in most countries of the world including Malaysia. Immunization does not only protect the recipient but also prevent the spread of the disease.
• Vaccines do not contain harmful materials to the human body. It contains active materials from bacteria or virus which is the antigen to fight against diseases when infected. The vaccine also contain other components such as preservatives and additives as well as adjuvants. Every component has an important role in quality control, efficacy and safety of the vaccine.
• All vaccines used by the Ministry of Health Malaysia (MOH) is registered with the Drug Control Authority (DCA). These vaccines are evaluated according to the international standard requirements including the World Health Organization (WHO) in terms of their quality, safety and efficacy aspects.
• The side effects of immunizations are usually mild and not harmful compared to the effects of the disease itself. Side effects that are usually reported are fever and soreness in the area of injection. Adverse Effects of Medicines National Monitoring Center, National Pharmaceutical Regulatory Agency and the Ministry of Health (KKM) always monitor the side effects of immunizations in all medical facilities. To date, no regulatory actions have been made against vaccines for their side effects.
• Any side effects from vaccines are also reported to WHO and the data is shared with all countries. Thus, any harmful side effects will be handled through integrated efforts internationally.

The Ruling of Using Vaccine as a Preventive Measure Against Diseases

• Encouragement to get suitable treatment and medication. Islam encouraged its followers to always seek treatment to any disease he is experiencing, for every sickness there is a cure that should be found, researched and analysed, in line with the statement of the Prophet PBUH:

لِكُلِّ دَاءٍ دَوَاءٌ فَإِذَا أُصِيْبَ دَوَاءُ الدَاءِ بَرَأَ بِإِذْنِ اللهِ عَزَّ وَجَلَّ

“There is a remedy for every malady, and when the remedy is applied to the disease it is cured with the permission of Allah, the Exalted and Glorious.”

Sahih Muslim (2204)

• In this case, it is permissible. The reason is a treatment which precedes an outbreak or fear of a disease is permissible. This is in accordance with the hadith of the Prophet PBUH:

مَنْ تَصَبَّحَ بِسَبْعِ تَمَرَاتٍ مِنْ تَمَرِ المدينةِ لمَ ْيضره سِحْرٌ ولا سم

"He who eats seven 'Ajwa dates every morning, will not be affected by poison or magic on the day he eats them."

Sahih al-Bukhari (5445)

This includes preventive measures against a disease before it happened. The same is for when there are concerns of a certain disease or infection in a certain place or anywhere else, then it is not an issue, for it is included as a prevention. The same for a disease that needs treatment and also a disease that is trying to be prevented.

• So true are the words of the Prophet PBUH:

لَا يُورِدَنَّ مُمَرَّضٌ عَلَى مُصَحٍ

"Do not put a patient with a healthy person (as a precaution)"

Sahih al-Bukhari (5771)

• The same is done by Saidina Umar al-Khattab when he avoided entering an area where there is an outbreak of the plague and he was asked: “O Amirul Mukminin are you scared of the qada’ of Allah and you run from it? Saidina Umar al-Khattab answered: “I’m running from the qada’ of Allah towards His qadar.” This is also stated by another companion of the Prophet PBUH, Abdul Rahman bin Auf who said that the Prophet PBUH said:

إِذَا سَمِعْتُمْ بِهِ فِي أَرْضٍ فَلا تَقْدَمُوا عَلَيْهِ ، وَإِذَا وَقَعَ بِأَرْضٍ وَأَنْتُمْ بِهَا ،

فَلا تَخْرُجُوا فِرَارًا مِنْهُ

"If you hear that it (plague) has broken out in a land, do not go to it; but if it breaks out in a land where you are present, do not go out escaping from it."

Sahih al-Bukhari (5730)

The modern terminology used is quarantine.

The Advantages of Preventive Measures Against Diseases in Islam

According to al-Qudah (1987), the principle of prevention of diseases in Islam has several advantages, among them, are:

• Pioneer

The principle of prevention in Islam is sourced from the revelation of Allah SWT and the sunnah of the Prophet PBUH. If we review it, the principle is included in several syarak rulings that have always been practised by Muslims regardless of whether there are medicinal benefits. There are several civilizations before the emergence of Islam in the Arab Peninsular. The Arab land is surrounded by two huge civilizations during the time; Rome and Persia. However, if we analyse the ruins and history of both these civilizations, it can be said that there are no evidences that showed that they practise any medical preventive measures. In short, Islam is the pioneer in the principle of medicinal preventive measures against diseases.

• Credibility

Islam does not need anything to support the guidance that it contains. However, with the advancement of science and technology, the truth of the teachings of Islam are becoming apparent. This can be seen regarding the principles of prevention measures against diseases in Islam is in line with today’s scientific discovery. Thus, this increases and reinforces the faith of the Muslim ummah on the truth of Islam.

• Moderation and ease

The principle of prevention of diseases in Islam is an easy step to employ. It does not call for huge financial budget nor a long time to be realized in society.

The Ruling of the Usage of Vaccine

• In this matter, if it is made using halal, clean and pure materials then it is permissible.
• If it is made from najis material, then it is divided into two situations:
• If there is another alternative, then it is prohibited to use vaccine made from najis. The reason is there is a hadith of the Prophet PBUH from Abu Darda’ R.Anhu: “Indeed Allah has sent down illness with its cure and He has made every illness its own cure, then you must seek treatment and do not seek treatment from the prohibited.”
• If there is no other alternative, it is permissible for it is included in exigent matters. There is a maxim that is applicable in this situation.
• The maxim which states الضرورات تبيح المحظورات which means dharurah (exigent circumstances) permits what is prohibited. However, this maxim is bound to another maxim which states الضرورات تقدر بقدرها which means in dharurah (exigent circumstances) take only what is the necessity.
• In the ruling that involves the application of the concept of dharurah, there are several conditions that should be fulfilled as the following:
• Dharurah is really happening, not just an assumption that destruction on live or property will happen. Even if the concern is based on genuine fear, the assumption must be a strong assumption of which it is through experience and observation.
• The person in the dharurah situation does not have any other way permissible by syarak to avoid great harm. For example, a person who decides to take a loan, he must choose a loan without any elements of usury, for now, there are alternatives to get a loan without the system of usury.
• The person in the dharurah situation must strive to not choose something that clearly contradicts the basic principles of syarak and usul aqidah of Islam, for example, it is impermissible for him to choose to commit fornication, murder, choosing to disbelief, take the rights of others for mafsadah (harmful) matters. This means, if one is forced to choose from several haram ways to escape from the exigent situation he is in and if there is no halal way available, then he must choose the least harmful that does not clearly contradict the basic principles in Islam.
• When escaping from the dharurah situation a person is in, it must be done according to the necessity of it. He should not be comfortable committing the prohibited act according to the maxim that state dharurah is in accordance with its levels.
• In the issue that it is necessary to consume medicines from haram products in order to protect life, an additional condition should be fulfilled where the medication or treatment must be taken after being advised by a trusted specialist doctor of whom his religious belief is firm and it has been proven that there is no other halal medication for it. See Penentuan Produk Halal-Haram dan Fatwa Vaksin di Malaysia (The Determination of Halal-Haram Products and the Fatwa of Vaccine in Malaysia) by Prof. Madya Dr. Nurdeng Deuraseh, UPM.

Several Fatwa Regarding the Usage of Vaccines in Malaysia

• The Usage of Menactra ® Vaccine

107^th National Muzakarah Council Fatwa Committee on Islamic Religious Affairs Malaysia which convened on 10-11 February 2015 has discussed the Ruling of the Usage of Menactra ® vaccine. The Muzakarah has decided as the following:

• After analysing the presented facts, arguments and opinions, Muzakarah affirms that on principle the scholars have agreed that food which also includes medications that are permissible in Islam must be from good (toyyib) and halal ingredients and does not contain elements that are harmful to the health of body and mind of humans.
• Muzakarah also found that in the process of the production of Menactra ® , there is no component of raw materials that are sourced from animal or doubtful materials according to syarak used and the processing channels are not shared with the production of non-halal vaccines.
• Thus, the Muzakarah agreed to decide that the usage of Menactra ® vaccine is permissible.

• The Ruling of the Usage of BioThrax and RotaTeq Vaccines Which Contain Elements of Swine in Their Production Process.

81^st National Muzakarah Council Fatwa Committee on Islamic Religious Affairs Malaysia which convened on 31^st March 2008 has discussed the Ruling of the Usage of Biothrax and Rotateq Vaccines Which Contain Elements of Swine in Their Production Process. Muzakarah has decided the usage of both BioThrax and RotaTeq vaccines is impermissible because:

• This is not considered as an exigent situation
• There are other elements or alternative medication without the elements of swine in the production process of both vaccines; and
• There is no strong data supporting that the citizen of this country is in need of both vaccines.

Explanation/Arguments:

• Anthrax is an acute contagious disease and it could cause sudden death and haemorrhage from all open cavities. Anthrax infection can happen in the skin (cutaneous anthrax), intestine (gastrointestinal anthrax) and lungs (respiratory anthrax). BioTrax vaccine is used as an immunization or immunity injection to help protect a person from anthrax infection. While RotaTeq vaccine is to prevent rotavirus cases that cause vomiting and diarrhoea in children.
• Islam permits medicating with haram materials only in dharurah situations where there are no other alternatives according to the statement of Allah SWT:

وَمَا لَكُمْ أَلاَّ تَأْكُلُوا مِمَّا ذُكِرَ اسْمُ اللَّهِ عَلَيْهِ وَقَدْ فَصَّلَ لَكُمْ مَا حَرَّمَ عَلَيْكُمْ إِلاَّ مَا اضْطُرِرْتُمْ إِلَيْهِ وَإِنَّ كَثِيراً لَيُضِلُّونَ بِأَهْوَائِهِمْ بِغَيْرِ عِلْمٍ إِنَّ رَبَّكَ هُوَ أَعْلَمُ بِالْمُعْتَدِينَ

“And why should you not eat of that upon which the name of Allah has been mentioned while He has explained in detail to you what He has forbidden you, excepting that to which you are compelled. And indeed, do many lead [others] astray through their [own] inclinations without knowledge. Indeed, your Lord – He is most knowing of the transgressors.”

Surah al-An’am (119)

• The majority of scholars of madhhab Hanafi, Maliki and the sohih opinion from madhhab Syafie and Hanbali state that medicating with najis such as liquor is haram and impermissible. In this context, Prof Syeikh Dr Wahbah al-Zuhayli hold the opinion that basically, it is haram for us to medicate with najis or haram elements.

Conclusion

Among the evidences that Islam emphasized the maintenance of health is as the following:

• Placing health as the greatest blessing after the blessing of faith.
• Placing an easy concept of avoiding hardship in the shariah of Islam.
• Numerous evidences regarding the prevention of diseases.
• The commandment to get treated and the permissibility of medicating using haram elements in dharurah

Al-‘Aili Abdul Hakim in his book Mausu’ah Huquq al-Insan fi al-Islam, state that maintaining the health of an individual is a commandment of religion and life, where it will benefit the whole lives of the Muslim ummah. In this issue, a vaccine is no longer a choice but a necessity of the general public. The phenomena where parents are reluctant or refuse to get their children vaccinated in clinics is worrying. This action is harmful not only for their children but also for our future generation, for it could be the cause of an outbreak of dangerous diseases.

In this matter, Islam emphasizes the safety of humans. When implementing or deciding on something, it must not contradict the maslahah (benefit) of the ummah and Maqasid Syar’iyyah which is to protect the religion, life, intellect, lineage and property. According to jurists, any disease should be prevented, treated and medicated. In the context of the prevention of any form of outbreaks that could harm the health and lives of people, this is the priority of the teachings of Islam.

Hopefully, this explanation will ease our worries in permitting the usage of vaccine by the Ministry of Health Malaysia for the maslahat (benefit) of our society.