Every Tuesday, I spend my afternoon volunteering at Georgetown University’s Teaching Hospital. Most of the work I do is in pediatric oncology and hematology, though I also spend time in the transplant unit and working for the hospital’s child life program, which ensure sthat the hospital’s younger patients have the most comfortable hospital stay possible.

As you can imagine, my hours at the hospital are the most important hours of my week. They give me faith in the physicians who have dedicated their lives to caring for sick kids, and, most importantly, they fill me with admiration for the courage, humor, and resilience of children. In order to protect the privacy of the hospital and its patients, I don’t blog about my volunteer work, but I can tell you that it’s the part of my post-bacc experience that reminds me why I’m pursuing a career in health care.

It’s a fairly universal policy that hospital employees and volunteers have to get flu shots. Yesterday, I got mine. As you may know, the flu shot isn’t vegan; it’s incubated in chicken eggs. This wasn’t the first time I had to make a tough choice about vaccination, but it was the most thought provoking, and I’m here today to collect some of your feedback on a complicated topic.

I didn’t intend for this to be an epic post, but I realized as I was writing that there’s no simple way to talk about vaccinations on a raw-ish vegan blog! There is a lot of heated debate about the dangers of vaccines in holistic and raw health circles, so I should begin by saying that, from a health standpoint, I’m in favor of vaccinations. I know that many of my readers will want to draw and quarter me for this (!), but I believe that the evidence is squarely on the side of vaccines. I also concede that they carry risks, and I basically support the freedom of parents who choose to vaccinate selectively–though I’d also point out that the success of vaccines depends in part upon the majority opting in (this is called the herd effect).

From an ethical standpoint, my attitude toward vaccines becomes infinitely more complicated. The point of vaccination is to preserve life. Why, then, must we use chicken eggs and gelatin to do it? Saving human lives by damaging or taking animal lives is a zero sum game, and I think it’s high time for us to explore vaccinations that are developed without animal parts or products.

Right now, however, vegan vaccines are not readily available. Until a better alternative exists, we vegans have to make choices about vaccination that are troubling and imperfect. I’m opposed to vaccinations that are developed through cruelty to animals. I also believe that a world without vaccination—one in which childhood illnesses would become lethal once again, and diseases would turn into pandemics more readily—would be bleak one for humans and animals alike. As a friend pointed out to me yesterday, this would be a world in which medicines were constantly being developed to cope with sicknesses, and animals would die in that process, too. (To say nothing of the human animals we’d lose to meningitis polio, smallpox, and the like.) Vaccination forces us to pit a vision of this world against the realities of vaccination as it exists today.

I received most of my vaccinations before I became vegan, so this isn’t a set of issues I’ve had to confront much (I’m also lucky in that I don’t depend on any non-vegan medications to be healthy). In the last decade, I’ve gotten the meningitis vaccine, the HPV vaccine, and the MMR (measles, mumps, rubella) vaccine. The former two were in my early twenties, and the latter in June, before I began hospital work. Because I wasn’t yet a vegan at the time I got the meningitis and HPV vaccines, they were easy choices for me. As I enter the health care profession, however, I’m facing a lifetime of mandatory vaccinations. As a vegan, these will present me with moral dissonance. How do I weigh my vegan ethics against the fact that vaccinations are mandatory for hospital workers?

When faced with these sorts of conundrums, I often remember the words of Vegan Society founder Donald Watson:

“. . . “veganism” denotes a philosophy and way of living which seeks to exclude — as far as is possible and practical — all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose . . .””

I know I’ve bored you all to death with this quote, but it’s an important one to remember. What does possible and practical mean? I know that there are hundreds of things that I can practically do every single day to protect animals: first and foremost, I can avoid all animal food products. I can choose to buy shampoo, toothpaste, and other toiletries that aren’t tested on animals. I can avoid purchasing leather, wool, and fur. I can check food labels carefully for gelatin, casein, and other animal food derivatives. I can support organizations that protect and champion animal rights, and I can set an example in my own life by sharing a compassionate message with readers and friends.

Vaccination is more complicated, because it’s not only a matter of suspending either convenience or pleasure (both of which I’m happy to do). If I forgo vaccination, I run the risk of either getting seriously ill myself, or (way more important) putting others at risk. If I became sick, I might be treated with medicines that contain animal derivatives. If I made other people sick, they might become reliant on those same medicines. Is this a practical choice?

To put it in less morbid terms, let’s remember the car example, which I stole from Sayward: imagine everyone started boycotting cars because most (nearly all) car tires contain animal byproducts. Well, we’d be taking a stance against animal exploitation, but we also might run the risk of not being able to go to our jobs, take our kids to school, or travel for work. And let’s suppose that our line of work helps us to save animal lives: isn’t it better to keep doing it than to avoid tires? These scenarios are exaggerated for effect, but they illustrate a reality, which is that all vegans are occasionally forced to weigh the pressures of an imperfect world against a a rigid moral stance.

When it comes to flu vaccines, I’m resolved for now to opt out unless I’m professionally bound to opt in. This will be a reality for me nearly every year as a hospital employee. If I should choose to have children later on, I will immunize them, because the “herd effect” is salient primarily in school aged children. Might these views change over time? Sure. But that’s where I stand today, faced with conflicted feelings and imperfect options.

While I’m at peace with the choice to get the vaccine this year, I did note that the hospital mandate about the flu shot seemed to carry some contradictions. There’s a good reason for GUH’s flu shot policy: as a volunteer in pediatric oncology, I come into contact with children who have impaired immune systems. No matter how many times I disinfect and wash my hands, or put on gloves, masks, and gowns, I’m still a risk to those kids if I carry around an aggressive virus. In protecting me from some strains of influenza, the flu vaccine also protects the kids I work with from contracting a virus that would probably spare me, but might very well prove fatal to them.

What I find interesting about the flu vaccination requirement, however, is that it allows for two exemptions: 1) severe egg allergy, and 2) religious exemption. For the former, you need a doctor’s note; for the latter, a note from a rabbi, priest, or other religious guide. I couldn’t claim an allergy, but I did point out to my nurse practitioner that veganism is comparable to religion, insofar as it gives my life moral structure. Was there any chance, I asked, that it might count as exemption on those grounds?

When I mentioned this idea, my nurse practitioner replied that veganism is dietary, not religious. I disagree. Veganism is unlike religion in many ways, but the two share similarities: both are world views that animate ethical choices, consumer habits, diet, and lifestyle. Both make claims about how people ought to live their lives. Religion is considered to be an acceptable ground for vaccine exemption. Should other sets of organized and unified beliefs about right and wrong—even if they’re secular—be honored, too?

It’s an interesting question to ponder. To raise a parallel, at one point in time, the grounds for conscientious objection in the United States were exclusively religious, but the courts overruled that monopoly in United States v. Seeger and Welsh v. United States. They declared “In the United States, there are two main criteria for classification as a conscientious objector. First, the objector must be opposed to war in any form…Second, the objection must be sincere…That he must show that this opposition is based upon religious training and belief was no longer a criterion after cases broadened it to include non-religious moral belief.”

Veganism is nothing if not “non-religious moral belief.” (Interestingly enough, vegans have been granted conscientious objector status.) Today, the grounds for conscientious objection are “freedom of thought, conscience, or religion.” Should hospitals expand their own policies about exemption from vaccines to include freedom of thought and conscience as well as religion?

Objecting to wartime service and objecting to a vaccine are two very different things. One might argue that opting out of a vaccine but choosing to work in a critical care unit at a hospital anyway means directly endangering the lives of patients. Conscientious objectors never put fellow soldiers directly at risk; they simply choose not to serve. But let’s also remember that hospitals do allow for flu vaccine exemptions on religious grounds. If the stakes are life-and-death—if refusing vaccination as a hospital worker means that you are directly endangering the lives of patients—should any exemptions exist at all? And if they do, shouldn’t they be governed by moral belief, rather than religious affiliation? I’m ultimately tempted to say that the flue shot should either be mandated universally, or the exemptions ought to include non-religious moral belief. But not an in between.

George Bernard Shaw—one of my favorite dramatists—was anti-vivisection, anti-war, and anti-vaccination. And he was also a vegetarian. Donald Watson, our eloquent coiner of the word “vegan,” was a conscientious objector. If nothing else, remembering these figures in history reminds me that the complex choices I sometimes encounter as a vegan–how to navigate a non-vegan world in a way that is responsible to animals and to others–have been pondered before, and are being pondered constantly by others with the same concerns.

Alright, people. Long post—sorry. Thank you for listening as I open up; there is no group of people I’d rather be candid with than you! I’d love to hear how you all feel about vaccinations and vegan ethics. Until vegan vaccines exist, how do we handle the vaccines we have? What about medications? Many prescription and OTC drugs are not vegan. Yet they are vital to people suffering from physiological and mental illness. How do you feel about them? Do we reject them, or do we put them in the context of “we all do our best?” When comes to vaccines, do you think that veganism should be observed as a grounds for exemption if religion is?

Finally, I want to point out that GUTH’s flu vaccine policy is not unique. It’s universal in hospitals and clinics, and GUTH handles it far more delicately, I’m sure, than many institutions do. In spite of how hard the choice was, I was also grateful to my nurse practitioner for her patience in answering questions, giving me literature to read, and trying to make sure that I was comfortable with my choice. I wasn’t, but her kindness did not go unnoticed.

xo