As the COVID-19 vaccine rollout in the US expands from health care staff to elderly citizens and essential workers, Americans are weighing whether to get the shot when given the chance.
Though the coronavirus vaccines from Moderna and Pfizer represent a new type of vaccine—using mRNA rather than a weakened form of the virus to trigger the immune response—some of the basic ethical questions around them stem from existing concerns over vaccination.
Vaccine hesitancy ranked among the World Health Organization’s top 10 threats to global health in 2019, before the pandemic began. Some American Christians have declined vaccines due to ethical and religious concerns over their formulation, and some share concerns with the vaccine-hesitant minority over safety and side effects.
The COVID-19 vaccine, so far, has been shown to be 94–95 percent effective, with side effects that go away within a few days. Still, 50 percent of white evangelicals and 59 percent of black Protestants say they won’t get it, while the majority of the US population overall (60%) says they will, according to the latest Pew Research Center survey.
Despite the ambivalence, Christians have historically advocated for vaccination as an expression of love for neighbors, saying the benefits far outweigh the chance of harm. In the 1700s, Puritan preacher Cotton Mather urged his congregation to be inoculated from smallpox before the first vaccination had even been successfully developed. Today, leading Christian medical professionals and ethicists promote vaccines.
With today’s generation of American faithful once again considering whether a vaccine is safe and ethical, many evangelical organizations and experts have already weighed in. Some of the following questions focus on whether the vaccines themselves are safe and ethical for individuals to use—starting with grappling over the common use of abortion-derived fetal cell lines in vaccine development—and some take a closer look at the ethics of distribution for the sake of local and global neighbors.
1. Does getting a vaccine made using cells from aborted fetuses violate pro-life convictions?
The Christian Medical and Dental Association commended the Moderna and Pfizer vaccines, which use mRNA technology, because they do not contain fetal cells and do not rely on fetal cells for in production.
The companies did use fetal cell lines in testing—to check for potential side effects or damage to cells—as is standard practice for vaccine review. The fetal cell lines themselves do not contain fetal tissue; they were grown in labs from fetal cells obtained decades ago.
To produce many of today’s vaccines, manufacturers use fetal cell lines obtained through two abortions in the 1960s that have been cultured and frozen in storage for long-term use. At the time, fetal cells were thought to be the best way to host the virus in a living cell, and they’ve been used to develop vaccines for rubella (the “R” in the MMR), rabies, hepatitis A, chickenpox, shingles, and polio (though not the version used in the US).
Newer vaccines are moving away from fetal cell lines, as scientists find alternatives such as animal cells and non-fetal human cells to create viable treatments. The Charlotte Lozier Institute, the research arm of the pro-life Susan B. Anthony List, created a chart to explain when fetal cells were used by vaccine candidates that received funding from Operation Warp Speed, the government’s vaccine-development program.
The institute distinguishes between vaccines like Moderna and Pfizer that used the cells for testing to confirm the antibody response and others that rely on the abortion-derived fetal cells to produce the vaccine itself.
Though they are not yet approved for use in the US, the AstraZeneca and Johnson & Johnson vaccines used the old fetal cell lines to develop and create the vaccine itself, as well as in lab testing. AstraZeneca’s vaccine was approved in four countries in the last week. Both companies have signed an agreement with the recently formed global consortium COVAX to distribute vaccines to low- and middle-income countries. Their vaccines are also cheaper, making them more accessible for some countries.
Two other vaccine candidates, Novavax and Sanofi Pasteur, are still in trials but will likely be used as well. They do not use the fetal cell lines in development. Both of these are “protein subunit” vaccines, which use a protein from the virus to trigger an immune response.
But even in the case of those requiring fetal cell lines for production, many pro-life leaders say still they’re not opposed to getting vaccines. The Catholic Church says that those who choose immunization are not culpable for the sin of an abortion. The Southern Baptist Ethics & Religious Liberty Commission also said receiving the vaccine is morally permissible.
The Center for Bioethics and Human Dignity (CBHD), housed at Trinity International University, suggests that the way to right the past wrong is to advocate for ethically derived cell lines or better production methods for vaccines. The Christian Medical and Dental Association joined three other pro-life medical associations in calling researchers to develop ethical COVID-19 vaccines free of abortive fetal cells in any stage of development.
2. Is the mRNA technology safe and ethical to take?
As Christian ethicists Matthew Arbo, C. Ben Mitchell, and Andrew T. Walker wrote last month for Public Discourse, “Because of the rapid pace of development under Operation Warp Speed, it seems natural to worry that COVID-19 vaccines may not be as safe and effective as they would have been if they were developed more slowly.”
“Although it is true that the vaccines have been developed quickly, the same scientific process has been followed,” they said. “In fact, because the stakes are so high, the scrutiny and oversight have never been more intense.”
Scientists have studied mRNA to make immunotherapies since the 1990s, even though it’s only now being used in vaccines. Going off of what they learned about coronaviruses during the 2002–2004 SARS virus outbreak and the 2012 MERS outbreak, scientists knew they could use mRNA to target the spike protein that causes transmission.
Less than two weeks after reporting the novel coronavirus to the World Health Organization, Chinese researchers sequenced the DNA of the virus and made it publicly available. Within days, Moderna researchers had applied past research and finalized the sequence for the mRNA vaccine.
The Pfizer and Moderna COVID-19 vaccines use a synthetic strand of mRNA, which tells human cells how to make the spike protein that sits on the surface of the novel coronavirus, activating an immune response. This is not DNA; it’s RNA, so it degrades easily and cannot insert itself into human genetic code.
Usually, any major problems with vaccines will turn up within the first few months of a trial, according to National Institutes of Health director and Christian geneticist Francis Collins. So far, none of the side effects or risks have been much different than other vaccines. But scientists won’t know long-term effects of mRNA vaccines until more time has passed.
The CBHD believes vaccine companies and US regulatory agencies have mitigated risk as much as possible, despite the record-breaking speed of the discovery. The ERLC agrees, viewing prioritization by the US government as instrumental in the speediness of the regulatory process.
3. Do we have a Christian obligation to get a COVID-19 vaccine?
The CBHD explored this question, concluding that scientists need to know more about the COVID-19 vaccine to adequately provide an answer. The organization suggested that in the future, any moral obligation might be similar to that of getting an annual flu vaccine. However, right now many see a moral imperative to receive it because of the ongoing spread of the SARS-CoV-2 virus and rising deaths. Some assume herd immunity—where enough people are immune after having COVID-19 that it protects those who have not yet had the disease—can be achieved without the vaccine, but it will not be without a high price of likely many more deaths, said Collins.
Scientists don’t know how much of the population needs to be vaccinated to achieve herd immunity. It was initially estimated to be 70 percent, but immunologist Anthony Fauci has more recently shifted to a higher number. For very contagious diseases, like measles, that percentage is 95 percent and still small outbreaks can occur.
Albert Mohler, president of the Southern Baptist Theological Seminary, suggested that people who approach vaccination as a personal choice with consequences that affect only them should think more broadly about their susceptible neighbors.
“There are third parties—people who cannot take the vaccine or do not yet have access to it that could still be infected by those who refuse to take the vaccine,” he wrote. “The general principle of the common good comes down to benevolence, love, care for others, laying down personal priorities for the service of others. Christians thinking about the issue of the vaccine must weigh this key biblical principle as part of their thinking.”
Mohler said he would get vaccinated and encourage other Christians to do the same, but he opposed efforts by the government or others to coerce people to get the vaccine.
Some Christian colleges, along with mandating COVID-19 safety precautions, required students to get a flu shot and could require a COVID-19 vaccine when doses are available. It remains to be seen whether employers or other settings—even churches—might consider the benefits of requiring vaccination.
“Just as states and localities have vaccination requirements for entry to daycares and public schools, we may soon see COVID vaccines required to engage in many areas of community life—perhaps even in churches,” wrote Joe Carter for The Gospel Coalition. “Discussions about such mandates should be rooted in neighbor love (Mark 12:31) and wisdom (Prov. 4:7). To do this well requires we seek out the most accurate information possible and base our judgment on God-given reason and prudence.”