Mukadimah
Recently, the issue of vaccine has grabbed the attention of our society. If we browse social medias such as webpages, blogs, Facebook, Twitter and others, we would find people are divided into two groups; some who are pro vaccines while the rest hold the opposite opinion. Thus, in this series of Bayan Linnas, we would give an explanation regarding the issue of vaccine through Islamic views.
Introduction to Vaccine
A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe (virus or bacteria), its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future. To date, most vaccines are in the form of a combination; which are a few types of vaccines combined into one injection for children, to protect them from several diseases through only one injection, making it more practical and minimizing the pain. See Frequently Asked Questions Regarding Vaccines and Immunisations; Ministry of Health Malaysia & JAKIM.
Ingredients of Vaccine
Vaccine contains active ingredients known as antigens. These antigens are either in the form of live viruses, dead viruses, purified viral proteins, toxins that have been weakened or part of the bacterial structure. Vaccine also contains additional components such as preservatives, stabilizers, adjuvants and some other components. Each substance in a certain vaccine has its own function and contributes to the quality, safety and efficacy of a vaccine. Vaccine does not contain substances that are harmful to the body. Preservatives in some vaccines acts as a stabilizer as well as prevent bacterial and fungal growth. The usual preservative is thiomersal (or thimerosal). It contains a type of mercury called ethyl mercury. It has no relation with any toxic effects of methyl mercury. Methyl mercury is toxic to the nervous system. Thiomersal has been used in vaccines for the past 80 years, in very little quantity. To date, there is no scientific evidence of its harmful effects or potential danger. After studying the latest epidemiological evidence on thiomersal and its pharmacokinetic profile, World Health Advisory Committee for Vaccine Security under the World Health Organization has concluded that there is no evidence of mercury-toxic effects on infants, children or adults exposed to thiomersal in the vaccine.
Furthermore, many studies have found that there is no evidence suggesting defects in the nervous system or development such as autism caused by the use of thiomersal vaccine. The stabilizer material works to prevent the component of the vaccine from sticking to the wall of the vaccine bottle. It maintains the safety and efficacy of the vaccine under varying conditions and temperatures. Gelatin and lactose-sorbitol are examples of stabilizers. Adjuvants are added to vaccine to increase the immune system response towards the vaccine. The adjuvants often used in vaccines are aluminum salt (known as alum). The intake of aluminum from the vaccine is lower than the daily intake of food or drugs such as antacids. Research on all studies related to diphtheria, tetanus and pertussis vaccine containing aluminum (whether separately or in combination) indicates that no evidence of aluminum salt in the vaccine causes any serious side effects or long-term side effects. Redness and swelling on the injection site are usually associated with a vaccine containing aluminum compared to vaccines that do not contain aluminum, but this effect is usually mild. See Frequently Asked Questions Regarding Vaccines and Immunisations; Ministry of Health Malaysia & JAKIM.
The Ruling of a Vaccine Depend on Its Contents
In this regard, there are a few factors that needs to be considered:
First: Vaccine that contains permissible and beneficial contents.
Undoubtedly, the usage of this type of vaccine is permissible. Furthermore, it is among the blessings of Allah SWT to His creations. Medical achievement such as the development of vaccine contributes greatly to the treatment and eradication of epidemics today.
Second: Vaccine that contains permissible contents. However, it could do more harm than good to the body. Or it is unbeneficial to begin with.
This type of vaccine is prohibited, for we are prohibited to harm ourselves through our food, drinks, medicines and others.
Third: Vaccine that contains prohibited contents or is najis (impure) originally but have been treated with chemicals that changes the name and characteristics of it through the process of istihalah (the process of changing to the permissible) and have beneficial effects.
The usage of this type of vaccine is permissible. The reason is the transformation process that results in the change of its name and characteristics, changes its ruling along with it.
The Opinions of Religious Authorities Agencies and Islamic Scholars Regarding the Issue of Vaccine
We divide the opinions into two parts:
First: Religious Authorities Agencies
- Dar al-Ifta’ al-Misriyyah
Vaccines that are used as a preventive measure for body or organ defects for a child is commanded by syarak. Refer www.dar-alifta.org
- Union of African Muslim Scholars
In an article published by Unity of African Islamic Scholars, they issued the following statement: There are general vaccines, and vaccines especially for children, to protect them against diseases. Thus, it is an obligation in religion for it is a human need. Refer africanulama.org
- Majma’ al-Fiqh al-Islami
Majma’ Fiqh Islami issued a declaration regarding the issue of vaccine entitled: “An Explanation to Encourage Vaccination as a Preventive Measure of Bodily Defects in Children”. The long statement includes seven important points, and Majma’ states the permissibility of vaccination of children in preventing bodily defects in children. See http://www.iifa-aifi.org/2647.html
- National Fatwa Muzakarah
The 107th National Fatwa Muzakarah on the Ruling of the Usage of Menactra Vaccine (a vaccine for the protection of a nine-month-old baby) with the following sighah:
- Having examined the facts, arguments and views presented, Muzakarah states that, in principle, the consensus of scholars’ state that food including medication are only permissible in Islam if the ingredients are good (toyyib) and halal (permissible in syarak), and it does not contain any ingredients or elements that are harmful to human health and well-being.
- Muzakarah also found that in the process of producing Menactra Vaccine, no raw material or component containing animal or doubtful substances in the aspects of syarak was used and no sharing of processing channels with non-halal vaccine products.
- In this regard, the Muzakarah agreed to decide that the ruling for the usage of Menactra Vaccine is permissible.
Second: Contemporary Scholars’ Opinions
- Syeikh Abdul Aziz bin Abdullah bin Baz
Samahah al-Syeikh Abdul Aziz bin Abdullah bin Baz Rahimahullah was asked regarding seeking treatment before contracting a disease, similar to the issue of vaccine. He answered:
“There is no harm in seeking treatment to prevent a disease if there is an epidemic or other factor that cause fear of a certain disease. There is no issue in seeking medication or treatment to prevent a certain feared disaster. This is in accordance with the words of the Prophet PBUH:
مَنْ تَصَبَّحَ بِسَبْعِ تَمَرَاتٍ عَجْوَةً لَمْ يَضُرَّهُ ذَلِكَ الْيَوْمَ سُمٌّ وَلاَ سِحْرٌ
“He who eats seven 'Ajwa dates every morning, will not be affected by poison or magic on the day he eats them.”
Sahih Muslim (2047)
The above hadith is from the chapter of preventing disasters before it happens. Hence, if there is a fear of a certain disease and vaccines are administered to prevent the epidemic from happening or spreading, then there is no issue regarding this matter.” Refer Fatawa Ibn Baz (6/21).
- Al-Syeikh Dr Ali Jum’ah
Dr Ali Jum’ah was once asked regarding the ruling of vaccination as a preventive measure of children from contracting diseases. Is it permissible or not in Islam? He answered:
“Vaccination to prevent any disease in children is a type of treatment that are used as a protection and is commanded by syarak and the rulings of Syariah Islamiyyah. It is obligatory for every Muslim to cooperate in the effort of protecting young children from diseases that they could contract if their vaccinations are not administered.” Refer www.dar-alifta.org.
- Syeikh Sa’ad bin Nasir al-Syathiri
He said: “Among the issues regarding epidemics is: The rulings regarding vaccination injections as a preventive measure. Hence, we state the following:
Administered vaccines used today are something that have been researched and identified through experiments as a preventive measure of certain diseases by the will of Allah SWT. It falls under the rulings of treatment and medication. The reason is, it is included under the Prophet PBUH’s hadith, where he said, ‘Seek treatment O slaves of Allah SWT,’. Thus, it follows the ruling of seeking treatment.”
He further adds: “There is no issue in vaccination. It is considered as qurbah (worship). The reason is, it is not harmful, and it could prevent a dangerous disease. This is a clear evidence that it is not prohibited.” Refer Ceramah Bertajuk Hukum-Hakam Fiqh Yang Berkaitan Dengan Wabak (Sermon Entitled Fiqh Rulings Regarding Epidemics).
- Syeikh Dr Yusuf al-Qaradhawi
Dr Yusuf al-Qaradhawi was asked during the program Fatawa Mubasyirah regarding the administration of vaccines to young children as a preventive measure of diseases or non-functioning body parts. He answered:
“Taking it (vaccination) is an obligation. It is a religious obligation in Islam. If the child is not vaccinated, then the child would contract a dangerous disease. There was an incident where I saw a young child praying tarawih with us and he walks using a stick, while he is healthy, Masha Allah. I asked him about it and he told me to ask his dad. His dad said: ‘We did not get the child his vaccinations that results in his inability to walk properly.’” Refer the following link https://goo.gl/ji7L9x .
- Syeikh Muhammad bin Soleh al-‘Uthaimin
Syeikh Ibn al-Uthaimin Rahimahullah was asked regarding the vaccination for meningitis (inflammation of the meninges – protective tissue layers of the brain), is it considered as a form of denial towards the concept of tawakkal? Hence the Syeikh answered:
“Indeed, this act (vaccination), is a part of tawakkal. The reason is, tawakkal is depending on Allah SWT and putting effort doing all you can. This is why the leaders that have the utmost tawakkal went to war with the Prophet Muhammad PBUH wearing body armour, to prevent grievous body injuries. The usage of vaccine injections is a form of effort on your part in preventing dangers.” Refer to the following link https://goo.gl/2iThC7 .
- Datuk Mohamad Shukri Mohamad, Mufti of Kelantan
He said: “Islam permits the usage of vaccine even if it contains prohibited ingredients, if there is no other better treatment.” He further explained: “Vaccine is permissible in Islam, for it is al-Wiqoyah (method) of protection (healthwise).” Refer to Bernama
Maqasid Syariah and Fiqh Regarding the Issue of Vaccine
Among the prioritized maqasid in Islam is hifz al-nafs (protecting of life). We are commanded to protect and maintain life through the effort of eating, drinking, and punishing anyone that endangers life. Islam also prohibits any acts that would lead to harming of life.
Among the maqasid regarding the issue of vaccine is:
First: Exigent or dire situation permits the prohibited
Fiqh scholars state:
الضَّرُورَات تُبِيْحُ المَحْظُورَات
“Exigent situations made the impermissible permissible,” Refer al-Asybaah wa al-Nazha’ir, Ibn Nujaim. pg. 85.
An example of the above is when someone is in extreme hunger while there is no food available. All he could find is a carcass of dead animal, then it is permissible for him to eat it, even when it was originally prohibited, to prevent him from dying.
Second: Exigent situation is assessed according to its proportion.
الضَّرُورَةُ تُقَدَّر بِقَدَرِهَا
“Exigent situation is according to the proportion or magnitude of it,”
An example of the above is when someone is in extreme hunger. However, there are no food available. All he could find is a carcass of dead animal, then it is permissible for him to eat it, even when it was originally prohibited.
However, a question arises, even if it is permissible to eat the carcass, how much of it should he eat? Thus, the above legal maxim explains the answer to this, the amount that is permissible for him is just enough so that he can live and more than that is prohibited.
Relating back to the issue of vaccine, then we should only administer vaccine only according to the need of the situation, overcoming the exigent situation.
Third: When two mafsadah or harm collides, then the less harmful is chosen. This is in accordance with:
أَنَّ أَدْنَى المَفْسَدَتَين يُرتَكَب مِنْ أَجْلِ دَفْع أَعْلَاهُمَا إِذَا كَانَ لَابُدَّ مِنْ مُوَافَقَةِ إِحْدَاهُمَا
“Indeed, the less harmful between the two mafsadah is chosen to prevent a greater harm when one of the two must be chosen,”
An easy example for the above Islamic legal maxim is in the medical treatment of a patient, where the doctor gives an option of cutting off the patient’s leg. It is done to prevent the disease from spreading further to all parts of the body. Even if it is a harmful thing towards the patient to have his leg cut, however, compared to the other, it is a less harmful thing.
Hence, in the issue of vaccination, even if there are minor side effects, such as mild fever and others, the greater harm of contracting a fatal disease is prevented.
The Importance of Immunizations in Lowering the Risks of Contagious Disease
Immunizations for children is a popular topic in our society. There are claims that immunizations result in fatalities in young children. This situation gives a bad perception of immunizations in our society. Parents are worried about the safety of immunizations and their children’s health.
Re-education regarding the acceptance and the importance of immunizations is critical and should be prioritized by authorities. Immunizations have been proven effective in eradicating smallpox, polio, rubella, measles and other contagious diseases in children, teens and adults.
World Health Organization (WHO) reported that approximately two to three million lives are saved through the administration of immunizations. In the United States, immunization decrease the mortality rate and the rate of morbidity from bacterial and viral contagious diseases. Generally, immunization is successful in preventing certain diseases. The failure of administering immunization according to the scheduled times increases the risks of the disease in children.
Children who did not receive optimal immunization have a higher risk of fatality compared to children who received immunization. In countries with high immunization rate, they have a lower rate of contagious disease.
Contradictory to some opinions, immunization does not weaken the immune system, but helps strengthening it, enabling it to respond immediately towards bacteria or viruses for contagious diseases. When babies are born, they are exposed to countless bacteria and viruses. They are able to withstand the attack of these pathogens thanks to the antibodies they inherited from their mothers. However, these antibodies only remain for a couple of months in their system. Hence, immunization is important in strengthening their immune system.
Immunization does not increase the risk of other contagious diseases. A research done by Sanford, Kimmel, et.al (2007) reported that there are no increased risks of the recurrence of the diseases in multiple sclerosis patients receiving tetanus, influenza and hepatitis B vaccines. See Laporan Majlis Professor Negara Chapter USM, Kluster Kesihatan dan Perubatan (Report of State Professor's Chapter USM, Health and Medical Cluster).
Statement by Mufti of Federal Territories
After analysing this issue regarding vaccine, its usage and the effects of it on human body, we hold the opinion that the usage of vaccine is permissible. It is included as a form of treatment for diseases, for it helps in the prevention of diseases. This is in line with the opinions of scholars stated above. Hence, we are inclined towards the permissibility of vaccination on the following conditions:
- There is a necessity or exigent situation
- It has been proven having positive effects
- Avoid anything that is najis (impure) unless if it is unavoidable
- The use of it as a preventive measure of certain diseases is proven
- There are no side effects and harm that are greater than if they are not given the immunization injection
If all of the above conditions are fulfilled, then vaccination is one of human necessities in today’s world.
We are also of the opinion that:
الوِقَايَةُ خَيْرٌ مِنَ العِلَاجِ
“Prevention is better than cure.”
We pray that the efforts that the Ministry of Health Malaysia (MOH) have taken in increasing the quality of health for everyone in Malaysia will be successful, while the misunderstanding regarding the issue of vaccine is resolved in our society.
Lastly, let us all reflect on ourselves and always refer to the experts of the field regarding any issue that we have no clear knowledge on. If it is related to health, surely the Ministry of Health and their experts are the most knowledgeable in this field. May this brief explanation give us understanding. Ameen.