As smallpox ravaged Europe in the 16th century, Rabbi Isaiah Horowitz, a prominent rabbi and famed kabbalist, grew exasperated with his community’s unwillingness to show sufficient caution in the face of the disease.

Writing in what would eventually become his deeply influential work—indeed, he would become better known by the acronym of its title, ‘Shelah’—he shared his frustration: “Regarding the plague of smallpox ... which spreads among the children—may this never befall us!” he wrote. “Why aren’t the people careful to take their children away and take them out of the city?”

But as is often the case with influential rabbis of history, his comments—the continuation of which held parents liable for anything that might befall their children if they stayed in the city—were taken as a command. It was no longer Horowitz’s frustration with the people who did not leave smallpox-infested regions but, instead, his instruction: one must, as a matter of religious obligation, leave a town in which smallpox has taken hold, lest one’s children suffer.

Yet Horowitz’s “ruling,” first published a couple of decades after his death, was rarely observed.

In and of itself, this should not strike us as unusual (rabbi’s rulings are often ignored) but here there was a different reason: the discovery of preventative treatments for smallpox. Between inoculation, which arrived in Europe in the 18th century—in which some form of live smallpox was intentionally contracted by a person to gain immunity—and the smallpox vaccine, developed by Edward Jenner in 1796, Europe finally had a way of protecting itself against a deadly plague.

Thus, as Rabbi Yaakov Hayyim Sofer explained in his early 20th-century work “Kaf ha-Hayyim,” “there is no need to take one’s children out of the city anymore because nowadays there is a medication to inoculate against smallpox, along with expert doctors regarding this.”

Yet smallpox treatments did not come without risk.

Inoculation in particular carried a non-significant risk, given its method of intentional infection via a smaller dose of smallpox. Yet, despite this, rabbis insisted that the risks to any individual were far outweighed by the benefit to the people at large.

Rabbi Israel Lipschitz, the 19th-century leader of the Jewish community in Danzig, Poland, wrote in his influential commentary to the Mishnah, Tiferet Yisrael, that “it seems to me that it is permitted to inoculate against smallpox, even if one out of one thousand will die from the inoculation, for if the pox forms naturally the danger is much more likely. Therefore, it is permitted for a person to endanger themselves in an unlikely manner in order to save themselves from a much more likely one.”

That Lipschitz would elsewhere describe Jenner as a “hasid,” a pious person, for having developed the smallpox vaccine underscored the importance he assigned to the opportunity for a community to achieve immunity.

And while, for many decades, the views of Rabbis Horowitz, Lipschitz, and Sofer were intellectual curiosities at best—a window into how rabbis of the past reacted to diseases and their treatments—they have, in the past few months, gained far greater resonance.

At a time in which the world at large has vaccinations to halt a deadly pandemic, yet a significant number of people in the country describe themselves as “hesitant” to become vaccinated, it becomes even more important to read texts from Jewish tradition that also offer us a window into history. In doing so, we not only remember that we are not the first generation to be faced by a plague, but we also recognize that our opportunity to end it is nothing short of a responsibility.

 By Rabbi Mark Glass,
Congregation BIAV