Does the Bible offer us any insight into whether we should take the COVID vaccine? I think it does when we think through the implications of the early chapters of Genesis.

Right before God made the first human beings, he declared why he was making them: “Let us make mankind in our image, in our likeness, so that they may rule over the fish in the sea and the birds in the sky, over the livestock and all the wild animals, and over all the creatures that move along the ground” (Gen. 1:26). God made us to be his earthly images who would represent him by ruling wisely and lovingly over the rest of creation. Then, immediately after making our first parents, he gave them what is often called the creation mandate; namely, “Be fruitful and multiply and fill the earth and subdue it, and have dominion over the fish of the sea and over the birds of the heavens and over every living thing that moves on the earth” (Gen. 1:28). God, as the psalmist puts it, gave the earth to us (see Ps. 115:16). We are meant to rule over it by exercising dominion over the animals and subduing whatever needs to be subdued.

We can do this because God formed the earth for us to be able to inhabit it:

For thus says the Lord,
who created the heavens
         (he is God!),
who formed the earth and made it
(he established it;
he did not create it a chaos,
he formed it to be inhabited!)

(Isa. 45:18)

The earth is inhabitable because God formed (or, according to the Hebrew, planned) it to be a hierarchically structured environment filled with created realities acting according to stable causal processes. As he created it, the world was “very good” because it constituted a cosmos—that is, as Henri Blocher has put it, “a diverse totality that is properly arranged, organized and differentiated,” where the earth’s living creatures “followed as perfect an order as the order of the heavens,” and where the whole constituted a model “of perfect obedience and of regular motion.”

We can live in this world because we are made in God’s image, which enables us to understand to some extent the order he has created and makes us capable of living lives that can reflect or mirror how he wants creation to be treated. This explains why, right after breathing into Adam the breath of life (see Gen. 2:7), God placed him in a garden “to work it and take care of it” (Gen. 2:15). The garden became Adam’s responsibility, the sphere over which he was to exercise dominion by grasping its potentialities, patterns, and processes. The fact that Genesis lists some of the natural resources that surrounded the garden hints at Adam’s ability to discover and utilize those resources (see Gen. 2:11-12). The tightly ordered, rhythmical repetitions punctuating Genesis 1:1-2:3 show that God was making a world that Adam could inhabit. He could understand and value the variety of plants and trees (see Gen. 1:11-12), know the seasons (see Gen. 1:14), and catalogue the different kinds of living creatures moving through the seas, the skies, and on the earth, recognizing how each should be treated given its nature (see Gen. 1:20-21, 24-25). Adam exhibited his understanding when he named the animals, realizing as he did so that, no matter how valuable each kind was, none of them could be his perfect companion, and then acknowledging Eve as being exactly that (see Gen. 2:18-23).

If our first parents had obeyed God’s command not to eat from the forbidden tree, then their filling the earth and exercising loving dominion over more and more of creation could have proceeded apace. But they disobeyed, undercutting their ability to work together to fulfill the creation mandate (see Gen. 3:7-13; 4:1-5, 14, 23-24) and prompting God to subject creation itself to corruption and futility (see Gen. 3:17 and Rom. 8:20-21). In one sense, even after their disobedience, everything remains the same, for God has preserved creation’s general order and regularity, pledging that until our Lord returns “seedtime and harvest, cold and heat, summer and winter, day and night will never cease” (Gen. 8:22). So the world’s structures and processes remain fundamentally stable and we are still called to understand them so that we can rule over them appropriately (see Ps. 8). Yet in another sense, everything has changed because we are now impaired in ways that make discovering creation’s structures and processes more difficult, and those structures and processes themselves are compromised in ways that mean they now convey not only health, wholeness, and life but also sickness, brokenness, and death. Indeed, anything painful, perplexing, frustrating, or abnormal that we encounter in our lives, anything that would make life ultimately futile if the gospel with its promise of resurrection life were not true (see 1 Cor. 15:1-34), has its root in Adam and Eve’s one disobedient act.

Scripture is very clear that both sickness and health come from God: “for he wounds, but he binds up; he shatters, but his hands heal” (Job 5:17-18; see Hos. 6:1). Throughout almost all of Scripture, health and healing is either attributed directly to God (see Exod. 15:26; Deut. 32:39; Luke 4:16-21) or is mediated to us through his priestly, prophetic, or ecclesiastical representatives (see 1 Kings 17:17-24; 2 Kings 5:1-14; Mark 6:7-13; Acts 3:1-10; 9:32-35; James 5:14-15). And so, on a first reading, medicine is almost invisible in Scripture, since physicians are seldom mentioned and reliance on them is sometimes considered useless (see Luke 8:43-48) or wrong (see 2 Chron. 16:12). But on a closer reading, medical practices and procedures appear. For instance, two Hebrew midwives play a pivotal role in the first chapter of Exodus. They appear to have a thriving cross-cultural practice, since Pharaoh knows about them, summons them, and after they disobey his command to kill male Hebrew babies on delivery, they defend themselves by claiming that Hebrew women are not like Egyptian women, for “they are more vigorous and have their babies so quickly that we cannot get there in time” (Exod. 1:19). Indeed, Scripture suggests that there was something like a profession of Hebrew midwifery since, as R. K. Harrison observes, when Tamar was in labor with twins (see Gen. 38:27-30),

the twins were apparently locked, and one of them was presenting transversely. A prolapsed arm was suitably marked by the midwife, who seems to have performed some sort of turning operation, with the result that the other twin was born first. . . . This difficult obstetrical situation was seemingly handled with great competence by the attending midwife.

Moreover, as Harrison notes, postnatal medical procedures are described in Scripture, including cutting the umbilical cord, washing the newborn, and removing “the uterine sebaceous material . . . by means of salt,” after which the newborn was swaddled, powdered with crushed myrtle leaves, and often rubbed with oil (see Ezek. 16:4 for all but the last two details).

Jesus’ story of the good Samaritan who, on finding a man beaten by robbers and left half-dead on the side of the road, had compassion on him, binding up his wounds and pouring oil and wine on them, involves the administration of first aid (see Luke 10:29-35). Paul’s advice to Timothy to stop drinking only water and “use a little wine for the sake of your stomach and your frequent ailments” (1 Tim. 5:23; cf. Ps. 104:15) is also medical advice, perhaps suggested to Paul by his companion Luke, “the beloved physician” (Col. 4:14).

Given the fact that Adam and Eve’s disobedience has hindered fulfillment of the creation mandate, it is noteworthy that sometimes God commanded his people to act in ways that modern medical science’s progress in fulfilling that mandate can finally explain. In Leviticus, God commands the priests to quarantine some individuals for some skin conditions (see Lev. 13, especially vv. 3, 5, 8, 45-46), to burn some moldy garments (see Lev. 13:52, 55), and to destroy the houses in which some molds were growing (see Lev. 14:43-45). This means he was in effect commanding the Israelites to practice medicine before they knew enough to understand the reasons for the practice.

In fact, given the infrequency of miraculous healings to ordinary cycles of health and sickness in the Scriptures, it is clear that God generally exercises his providential care for his people through the world’s ordinary structures and processes. People generally reap the fruit of their ways, good or bad (see Prov. 14:14). Achieving much in life takes work, and so lazy people find that no matter how strong their cravings are they get nothing, while those who are diligent are satisfied (see Prov. 13:4). Not to plow in season means there will be no harvest (see Prov. 20:4). Evildoing generally redounds upon evildoers (see Prov. 1:29-31).

Medical advances extend the same principle. The reason medicine doesn’t figure more prominently in the Old Testament is that the means for making significant medical advances were not yet discovered. The intertestamental books begin to have a higher view of medicine because it then began to be based on firmer grounds. The intertestamental book of Sirach (also known as Ecclesiasticus), for instance, includes this remarkable passage, celebrating the physician’s skill in deploying insights into the world’s ordinary structures and processes as a consequence of God’s having formed the world to be a hierarchically structured environment filled with created realities acting according to stable causal processes, while still affirming that health and healing ultimately come from God:

Make friends with the doctor, for he is essential to you;
         God has . . . established him in his profession.
From God the doctor has wisdom . . . .
God makes the earth yield healing herbs
         which the prudent should not neglect . . . .
He endows people with knowledge,
         to glory in his mighty works,
Through which the doctor eases pain,
         and the druggist prepares his medicines.
Thus God’s work continues without ceasing
         in its efficacy on the surface of the earth. 

My son, when you are ill, do not delay,
         but pray to God, for it is he who heals.
Flee wickedness and purify your hands;
         cleanse your heart of every sin. . . .
Then give the doctor his place
         lest he leave; you need him too,
For there are times when recovery is in his hands.

(Sirach 38:1-2, 4, 6-10, 12-13)

These insights help us fulfill God’s mandate to exercise dominion over the rest of creation. As Howard Clark Kee sums up this second-century-before-Christ perspective on medicine, “Physicians are the divinely instructed instruments through which these powers which God has built into the created order may become available for human well-being,” yet “these insights . . . are not inherent in humanity.” They only become available to us through the sort of investigation of creation that God mandated when he commanded our first parents to subdue the earth and exercise dominion over the earth’s living creatures.

In issuing that mandate, God was enjoining it on all humanity. It was to be the task of all of us. Genesis 4 through 11 shows that God’s mandate has often been unintentionally fulfilled by rebellious human beings. Cain’s unrepentant descendants were the first to build cities, to dwell in tents and tend livestock, to make musical instruments, and to forge tools from bronze and iron (see Gen. 4:17-22). Yet all of these innovations were to be incorporated into the life of God’s people. Even the deliberately rebellious attempt of some post-Flood people to make a name for themselves by building a city so that they could avoid being “dispersed over the face of the whole earth” (Gen. 11:4) is redeemed in the vision of “the holy city, new Jerusalem, coming down out of heaven from God, prepared as a bride adorned for her husband” (Rev. 21:2) where all God’s saints will dwell and where the sound of voices and instruments making music to the Lord will be heard forever.

One aspect of God’s having created us in his image is that we are capable not only of knowing truths about the world but also truths about ourselves. We can know, for instance, that human testimony is only significantly reliable when there are multiple witnesses (see Deut. 19:16; 2 Cor. 13:1), that bearing false witness is an abomination (see Prov. 6:16-19), that a true witness gives honest evidence (see Prov. 12:17), and that “a truthful witness saves lives” (Prov. 14:25). We also know that only untrained, overly credulous people believe everything and that the prudent give thought to their steps (see Prov. 14:15). We have an obligation, in other words, to discover truths that should guide us regarding what we should believe (see Prov. 26:22-25; 1 John 4:1). The discovery of reliable methods for discovering medical truths is one step towards fulfilling that obligation, no matter whether the search for those methods is the result of conscious obedience to the creation mandate or not. The process of discovering those truths began with careful observation of medical conditions and potential cures around the time of Hippocrates in the fifth-century before Christ. The subsequently increased reliability of medical treatment explains why Jewish authors like Ben Sira held physicians in honor when he wrote Sirach around the second-century b.c. It is probably part of the reason why the physician Luke held an honored place in the apostle Paul’s entourage.

Of course, medicine did not really come into its own until well after the rise of modern science, after new tools like microscopes were invented for observing some of nature’s substructures and new laboratory techniques like petri dishes and nutrient broths were developed for cultivating specific organisms. These new tools and techniques extended the range of questions scientists could pose to nature so that they could begin discovering new truths about creation. Germ theory, which was anticipated by God’s commands regarding infectious skin conditions and molds in the book of Leviticus and developed in rudimentary forms in ancient India (c. 6th century b.c.) and by Muslim physicians in the Middle Ages, began to gain acceptance by European doctors with the work of Louis Pasteur in the 1850s and ‘60s. Its acceptance was virtually complete by 1890. The discovery of viruses began around that time, and bacteriology began in earnest after that, resulting in the ongoing identification of many of the micro-organisms that cause disease.

About the same time, new procedures, such as Robert Koch’s four postulates for reliably demonstrating that a disease was caused by a particular microorganism, were instituted for testing medical claims regarding what promotes health and prevents disease. Today many would consider randomized double-blind clinical trials the gold standard for establishing the efficacy of a particular treatment to prevent or ameliorate a particular disease. The final authorization by the F.D.A. of the Pfizer-BioNTech vaccine for COVID19 for people 16 and up that was recently announced involved such clinical trials, plus other ongoing studies to monitor the safety, effectiveness, and manufacturing quality of the Pfizer vaccine.

So should Christians take this vaccine? I think so. Of course, while vaccines have become much safer over the centuries, there is no way in a sin-scarred world to preclude all risk. For instance, it was clear, long before the two virus variants that cause smallpox were discovered, that inoculation against smallpox was generally effective and cut dramatically the percentage of deaths from smallpox (estimated to be around 30% in the uninoculated and about 0.5-2% after inoculation). Yet Jonathan Edwards died in 1758 of a smallpox inoculation, which he had taken in part to encourage others to get inoculated. During the Revolutionary War, George Washington mandated smallpox inoculations for all inductees into the Continental Army who had not previously had the disease. Given the capacity of smallpox to decimate an army, it is worth asking whether we could be debating our government’s imposition of the COVID vaccines if Washington had not imposed the smallpox inoculation (which is a kind of vaccine) on his troops.

While our understanding of viruses and their prevention by means of vaccines has increased exponentially since those days, even the best randomized double-blind clinical trials cannot control for all of the variables that factor into the safety of a given vaccine. Some very unlikely or utterly unforeseen negative side effect of these vaccines may appear. Yet the track record of medical science since the 1880s has been remarkable. The average lifespan in the United States in 1900 was just under 50 years. In 2020, it was 78.8 years before COVID cut it back to 77.3 years. Before 1890 and the widespread acceptance of germ theory, it is estimated that 200 to 300 infants out of every thousand died in infancy worldwide. In 1900 the number had dropped to around 165 deaths per 1000 births. By 1997 there were 7 deaths per 1000 births, largely due to the elimination by vaccination of diseases such as diphtheria, pertussis (whooping cough), and measles. Probably 50% of us could not be reading this article because we would not be alive except for the advances of modern medical science. These statistics show that God has indeed created an inhabitable world that we can exercise some dominion over, subduing by God’s grace some of the suffering introduced by our first parents’ sin.

It should be part of our thankfulness as Christians to recognize that God so planned the world that even those who are not aware of the creation mandate or who deny God’s existence have, by virtue of his having breathed into Adam the breath of life, the capacity and sometimes the motivation to explore the hierarchically structured realities and stable causal processes that he has created. Virtually any human being, simply by being made in God’s image, may serve as one of God’s providential instruments to discover some feature of his creation that conveys the health and healing that, ultimately, comes only as a gift from him. The COVID vaccine is, I think, one of those gifts.  

Mark R. Talbot is an Associate Professor of Philosophy at Wheaton College, where he has been on faculty since 1992. His areas of academic expertise include philosophical theology, philosophical psychology, the epistemologies of the early modern philosophers, and the works of David Hume, St. Augustine, and Jonathan Edwards.

published September 16, 2021