Re: “Faith, freedom, fear all factor into rural America’s COVID vaccine skepticism” [April 30, Health]:

Freedom of belief and behavior are a fundamental principle in America. That’s what the Bill of Rights is about. But ideas written on paper in the 18th century must be remembered and interpreted in their moment.

It is important that the biological basis of infection and antisepsis was unknown when the Constitution was written. In 1880, Louis Pasteur began to publish his ideas about vaccination. The idea of “teaching” the immune system what an infectious disease looks like so that the host may already have defense mechanisms ready when exposed to that organism is a proven method for halting its spread at little or no cost to the host. While individuals may elect not to be vaccinated as a right, there are the rights of others to be considered.

It is troubling that the evangelical community often puts liberty ahead of responsibility. Matthew reported Christ to have said, “Thou shalt love thy neighbor as thyself.” The spread of contagion is mostly accomplished by people who are unaware they harbor infection. That’s why the new increases in COVID-19 infection and death predictably follow spring break when people congregated unsafely in places like Florida, then returned home to infect susceptible people.

Richard Rapport, M.D., Seattle