Over this past week, multiple people inside and outside the church have asked about navigating matters of conscience and healthcare when it comes to COVID-19 vaccine mandates. As mandates multiply across society, how should one respond? Should those who have previously declined vaccination pursue a religious exemption, or should they get vaccinated? What should one do if there is no religious exemption? As these questions come to the forefront, it is important that we consider how the church has applied Scripture to navigate similar issues in the past. With that in mind, let us look three centuries backward to review how the church responded to the smallpox inoculation controversy of 1721.
The Boston Smallpox Epidemic of 1721
As a smallpox epidemic arrived in Boston in the 1720s, whether or not to receive inoculation became the controversy of the hour. When the epidemic began, the population of Boston was about 11,000, and many fled with their families to escape the disease. This epidemic would take 844 lives before it came to an end. It was in the midst of this public health crisis that Cotton Mather began to promote an experimental inoculation that he had learned about from his slave Onesimus.
Mather convinced one doctor by the name of Zabdiel Boylston to begin inoculations. The method used by Boylston would deliberately infect healthy persons with a live smallpox virus. A sample would be taken from someone who was sick, a small cut would be made in the skin of the one to be inoculated, and the sample would then be rubbed into the cut. This would result with the inoculated patient being sickened, though usually with a less severe case of the smallpox. Among those who were not inoculated, the mortality rate was 15 percent. Among those who were inoculated, the mortality rate dropped to 2 percent.1 Though inoculation protected most of those who received it, this success came at the price of human life, as a few of those who were sickened through inoculation died.
Inoculation Controversy: Cotton Mather, Jonathan Edwards, and John Newton
The same year that Cotton Mather began inoculations in Boston, his father Increase Mather published a pamphlet entitled Several Reasons Proving that Inoculating or Transplanting the Small Pox is a Lawful Practice, and that it has been Blessed by GOD for the Saving of Many a Life.2 In this work the elder Mather sought to discredit the death of an inoculation patient, and argued that inoculation was a way of keeping the sixth commandment. While equating “You shall not murder” to “get inoculated,” he resorted to using shame and attacking the reputation of those who opposed inoculation. He caricatured those who were “fierce Enemies to Inoculation” as “Children of the Wicked one.” Instead of being associated with such persons, he argued for his audience to join with such worthy persons as himself and the other pastors who supported inoculation, which included Solomon Stoddard of Northampton. Despite these tactics, it is surprising to note that Increase Mather did not want anyone to receive inoculation contrary to conscience, but instead for them to be persuaded to change their minds.
As inoculation was first introduced, there was significant opposition in the medical community and in the church. Multiple pastors preached against it, such as William Douglass who condemned those who received inoculation as being guilty of a sinful distrust of God, though he would change his mind in later years. Mather also faced violence as a bomb was thrown through the window of his house on November 13, 1721, with the attached note: “Cotton Mather, you dog, dam[n] you! I’ll inoculate you with this; and a pox to you.”3
In response to opposition, a Bostonian pastor by the name of William Cooper wrote a pastoral letter entitled A reply to the objections made against taking the small pox in the way of inoculation from principles of conscience. Cooper’s letter makes the case for allowing inoculation as a legitimate means to avoid suffering and preserve life. He rejected the legalism of pastors who sought to prohibit inoculation, and called for freedom of conscience in choosing or refusing inoculation.4
One particular moment that is worth noting during a subsequent smallpox outbreak is the death of Jonathan Edwards. On March 22, 1758, Edwards died after receiving the smallpox inoculation. This is chronicled by his great-grandson, Sereno Edwards Dwight, in The Works of President Edwards with a Memoir of His Life. Dwight provides a narrative of Edward’s careful consideration of inoculation and his seeking of counsel before receiving the treatment that caused his death.5 Edwards and multiple family members received the inoculation believing that it was a wise course of action, while entrusting themselves to the Lord. Edwards’ daughter Esther, who was also inoculated, died shortly after her father.
Controversy continued in New England, and also back in London. On July 8, 1772, Edmund Massey preached a sermon at St. Andrew’s Holborn of London entitled A sermon against the dangerous and sinful practice of inoculation.6 This text was republished and circulated in Boston, with Massey denouncing inoculation as a dangerous and sinful attempt to escape God’s judgment or to avoid the testing of one’s faith. Instead of receiving inoculation, Massey argued that one should trust the Lord. In addition to this, Massey argued that medical practitioners are assuming the role of God in intentionally giving the disease to their patients.
John Newton and Liberty of Conscience
As questions of conscience continued with this debate, John Newton wrote a letter of pastoral counsel addressing the ethics of whether or not one should receive inoculation. Instead of taking a position, he offered balanced counsel and argued for the individual to make a decision based upon faith, whether it be to receive inoculation or not, and for all to entrust themselves into the Lord’s providential care.7
In reading multiple sermons and letters from this period, opposing sides of the inoculation debate would manipulate Scripture to advocate for their position, sometimes with both sides using the sixth commandment to argue their case. In contrast to these polar opposites were the voices that appealed to Romans 14 and viewed inoculation as an issue of the liberty of conscience. Over time, this conviction gathered momentum. Instead of a false dilemma between faith and medical care, the emerging consensus was that one could receive the inoculation in faith, and that inoculation was a lawful and legitimate use of means to remove oneself from the harm of the smallpox. Though one’s interpretation of Scripture and medical data might shape one’s decision on whether or not to receive inoculation, the decision must still be made in light of one’s conscience.
Though the controversy surrounding inoculation would subside as the practice became more widely accepted in medicine and in the church, many are faced with similar questions regarding the COVID vaccine today. John Newton’s letter of pastoral counsel regarding smallpox inoculation easily bridges the gap from the past to the present, and it contains wise counsel for today. While Newton was not an advocate for inoculation, he advocated for liberty of conscience while calling his audience to trust the Lord.
Read the full text of Newton’s letter below:
June 3, 1777
It seems I must write something about the small-pox, but I know not well what: having had it myself, I cannot judge how I would feel if I were actually exposed to it. I am not a professed advocate for inoculation; but if a person who fears the Lord should tell me, I think I can do it in faith, looking upon it as a salutary expedient, which God in his providence has discovered, and which therefore appears my duty to have recourse to, so that my mind does not hesitate with respect to the lawfulness, nor am I anxious about the event; being satisfied, that whether I live or die, I am in that path in which I can cheerfully expect his blessing; I do not know that I could offer a word by way of dissuasion.
If another person should say, My times are in the Lord’s hands; I am now in health, and am not willing to bring upon myself a disorder, the consequences of which I cannot possibly foresee. If I am to have the small-pox, I believe he is the best judge of the season and manner in which I shall be visited, so as may be most for his glory and my own good; and therefore I choose to wait his appointment, and not to rush upon even the possibility of danger without a call. If the very hairs of my head are numbered, I have no reason to fear that, supposing I receive the smallpox in a natural way, I shall have a single pimple more than he sees expedient; and why should I wish to have one less? Nay, admitting, which however is not always the case, that inoculation might exempt me from some pain and inconvenience, and lessen the apparent danger, might it not likewise, upon that very account, prevent my receiving some of those sweet consolations which I humbly hope my gracious Lord would afford me, if it were his pleasure to call me to a sharp trial? Perhaps the chief design of this trying hour, if it comes, may be to show me more of his wisdom, power, and love, than I have ever yet experienced. If I could devise a means to avoid the trouble, I know not how great a loser I may be in point of grace and comfort. Nor am I afraid of my face; it is now as the Lord, has made it, and it will be so after the small-pox. If it pleases him, I hope it will please me. In short, though I do not censure others, yet, as to myself, inoculation is what I dare not venture upon. If I did venture, and the outcome should not be favorable, I would blame myself for having attempted to take the management out of the Lord’s hands into my own, which I never did yet in other matters, without finding I am no more able than I am worthy to choose for myself. Besides, at the best, inoculation would only secure me from one of the innumerable natural evils the flesh is heir to; I should still be as liable as I am at present to a putrid fever, a bilious colic, an inflammation in the bowels, or in the brain, and a thousand formidable diseases which are hovering round me, and only wait his permission to cut me off in a few days or hours: and therefore I am determined, by his grace, to resign myself to his disposal. Let me fall into the hands of the Lord, (for his mercies are great,), and not into the hands of men.
If a person should talk to me in this strain, most certainly I could not say, Notwithstanding all this, your safest way is to be inoculated.
We preach and hear, and I hope we know something of faith, as enabling us to trust the Lord with our souls. I wish we had all more faith to trust him with our bodies, our health, our provision, and our temporal comforts likewise. The former should seem to require the strongest faith of the two. How strange is it, that when we think we can do the greater, we should be so awkward and unskillful when we aim at the less!
Give my love to your friend. I dare not advise; but if she can quietly return at the usual time, and neither run intentionally into the way of the small-pox, nor run out of the way, but leave it simply with the Lord, I shall not blame her. And if you will mind your praying and preaching, and believe that the Lord can take care of her without any of your contrivances, I shall not blame you. Nay, I shall praise him for you both. My prescription is to read Dr. Watts, Psa. cxxi. every morning before breakfast, and pray it over until the cure is effected. Probatum est.
Hast thou not giv’n thy word,
To save my soul from death?
And I can trust my Lord
To keep my mortal breath.
I’ll go and come,
Nor fear to die,
Till from on high
Thou call me home.
Pray for Yours, &c.
Newton’s application of the doctrine of liberty of conscience is gracious and charitable, and it is far from where we are today. Instead of giving one another the liberty of conscience, many are all too willing to embrace coercion when persuasion has failed.
The Bible does not instruct us as to whether or not one should receive a vaccine, but it is clear when it comes to the doctrine of the liberty of conscience.
Liberty of Conscience and Religious Liberty
The doctrine of the liberty of conscience was prominent and instrumental in shaping religious liberty in the United States. It was ascribed to by both Christians and Deists, and was foundational to Thomas Jefferson’s authorship of the Virginia Statute of Religious Freedom. This was passed by the General Assembly on January 16, 1786, and served as a forerunner to the First Amendment’s protection of religious liberty. It should be noted that liberty of conscience was recognized as being granted by God, and that it did not proceed from the state.
Below are a few key excerpts:
Whereas, Almighty God hath created the mind free; that all attempts to influence it by temporal punishment, or burthens, or by civil incapacitations, tend only to beget habits of hypocrisy and meanness, and are a departure from the plan of the Holy Author of our religion, who, being Lord both of body and mind, yet chose not to propagate it by coercions on either, as was in his Almighty power to do . . .
Be it enacted by the General Assembly, that no man shall be compelled to frequent or support any religious worship, place, or ministry whatsoever, nor shall be enforced, restrained, molested, or burthened in his body or goods, nor shall otherwise suffer on account of his religious opinions or belief; but that all men shall be free to profess, and by argument to maintain, their opinion in matters of religion, and that the same shall in no wise diminish, enlarge, or affect their civil capacities.
In 2021, the multiplication of COVID vaccine mandates makes it clear that liberty of conscience is quickly fading from public consciousness. Those who mandate vaccines give little room for liberty of conscience. Many are refusing to give religious exemption to anyone, and those who make allowance for them are often looking for some strange doctrinal tenet, such as “Our obscure religious sect does not allow members to receive medical care.” Many employees are not allowed to self-certify their own convictions, and instead are being asked to submit letters written by their pastors. Some members of the military are being required to be interviewed by chaplains, with the intent of determining the legitimacy of one’s convictions. This vetting of beliefs should be alarming to any who value religious liberty. Religious authority must never be ceded to the state or to employers to determine whether or not one’s convictions are legitimate.
Mandates and Conscience
The Bible does not instruct us as to whether or not one should receive a vaccine, but it is clear when it comes to the doctrine of the liberty of conscience. In matters that are unspecified by God’s Word, the Christian is to consider the teachings of Scripture, and remember that all things must proceed from faith and be done for the glory of God. In that sense, there is no anti-vaccine tenet of the Christian faith. However, if one’s application of Scripture, wisdom, and conscience leads one to decline a particular medical treatment, this is an application of the doctrine of liberty of conscience. The religious objections of some may be as simple as holding the conviction that the human body is created by God, that one’s health is a matter of stewardship, and Scripture places that responsibility on the individual and not the state. Others, in application of the doctrine of the sanctity of life, will refuse AstraZeneca and Johnson & Johnson, while choosing Pfizer or Moderna, or rejecting them altogether.
If an employer is mandating the vaccine, you must consider your position. Can you receive the vaccine in faith? Is it a matter of preference or a matter of conscience? If conscience does not permit you to receive the vaccine, seek to learn your options about a religious exemption. If that is not an option, seek counsel with your church as you weigh the decision of receiving the vaccine versus remaining at your place of employment.
A Call for Liberty of Conscience
I am not seeking to support or oppose the COVID vaccine. Rather, I am arguing for the liberty of conscience. As you make the decision to receive or decline medical treatment, it is responsible for one to review whatever medical information is available, and to make an informed decision. It is also worth noting that there are important differences between today’s COVID vaccines, and the historic practice of inoculation through which one would be infected with a live virus. Regardless of these differences, decisions should be grounded in faith, and with trust in the Lord for whatever the outcome may be. There is a spiritual component to our healthcare decisions, for all we do must be for the glory of God, and should proceed from faith (Rom 14:23, 1 Cor 10:31). For some, this will mean choosing to getting vaccinated, and for others, it will mean declining the vaccine altogether.
When it comes to the church, instead of the legalism of binding others’ consciences beyond the teachings of Scripture, we would do well to consider the wisdom of Newton’s letter. Whatever does not proceed from faith is sin. Let us not insist that anyone receives a medical treatment contrary to conscience, and let us not trample on the consciences of our brothers and sisters. Instead, let us walk in faith and love by giving one another liberty of conscience. May the church recover and exercise the doctrine of liberty of conscience, and may our healthcare decisions be made in faith for the glory of God.
 Matthew Niederhuber, “The Fight Over Inoculation During the 1721 Boston Smallpox Epidemic,” Harvard University Medical School. Accessed August 1, 2021
 Increase Mather. Several reasons proving that inoculating or transplanting the small pox, is a lawful practice, and that it has been blessed by God for the saving of many a life (Boston: S. Kneeland, 1721).
 Elizabeth A. Fenn. Pox Americana: The Great Smallpox Epidemic of 1775-82 (New York: Hill and Wang, 2001).
 William Cooper. A reply to the objections made against taking the small pox in the way of inoculation from principles of conscience (Boston: Stationers Arms, 1730).
 Sereno Edwards Dwight, The Works of President Edwards with a Memoir of His Life, 10 vols., (New York: S. Converse, 1829).
[6.] Edmund Massey, A sermon against the dangerous and sinful practice of inoculation (London: Angel in Cornhill, 1722).
 John Newton, The Works of John Newton, 4 vols., (Edinburg: The Banner of Truth Trust, 2015), 617-619
This article was originally posted here.