In the race to create a safe vaccine for COVID-19, arguments about the safety and ethical dilemmas of vaccines are plentiful.
Here at Micah we respect the decision of individuals to choose when it comes to vaccines. But we thought it important to outline some of the answers to the frequently asked questions many Christians have, and explain why the development of a vaccine is important in helping to End COVID For All.
Recently the Australian government has made several significant announcements regarding the development and access to safe and effective COVID-19 vaccines for the people of Australia and our closest Asia-Pacific neighbours.
The first announcement came on August 18, when the government announced that they had signed a ‘letter of intent’ for a vaccine under trial at Oxford University in the UK with global biotech company AstraZeneca.
The government made a commitment that, every single Australian will be able to receive the University of Oxford COVID-19 vaccine for free, should trials prove successful, safe and effective. The Prime Minister also announced that Australia would look to secure early access to an effective vaccine for our Pacific Family and closest South East Asian neighbours.
Then on September 7, it was announced that a global biotech company CSL Limited, would also supply the Australian Government with 51 million doses of The University of Queensland’s COVID-19 vaccine candidate if it proves successful.
And most recently, on September 22, the government announced it was joining the COVAX facility with a funding commitment of $123.2 million. The COVAX facility enables rich and lower income countries to pool their purchasing power to drive vaccine R&D and manufacturing globally, in order to help ensure vaccine access for those who need it most, regardless of their country's ability to pay, with the goal of ending the acute phase of this pandemic by the end of 2021.
So, what is a vaccine, what are the ethical implications and what are the nuances and contours of this debate?
What is a vaccine?
According to the World Health Organisation (WHO), vaccines are made to “train your immune system to create antibodies”, just as it would if you had contracted the disease.
Vaccines contain weakened or killed forms of the disease to trigger the production of antibodies, without causing the disease or “putting you at risk of its complications”.
Vaccines strengthen your immune system by training it to recognise and fight against specific germs and disease.
When a person come across that disease or virus in the future, their immune system rapidly produces antibodies to destroy it. In some cases, they may still get a less serious form of the illness, but are protected from the most dangerous effects.
Why are vaccines beneficial?
Over the last few hundred years, vaccines have been successfully developed for over 20 life-threatening diseases. Currently, WHO estimates that vaccines prevent approximately 2-3 million deaths every year.
Not only do vaccines protect the health of individuals—they are also a crucial component of controlling major infectious disease outbreaks all over the world.
In fact, vaccination has become the most effective public health measure for the control of infectious diseases after the provision of clean drinking water.
As such, a successful vaccine for COVID-19 is widely believed to be the most effective way of ending the pandemic.
The Importance of Vaccinations in the Developing World:
In the developed world where issues like child mortality and preventable disease are not a constant threat, it’s sometimes easy to forget the enormous contribution vaccines have made to global health, especially in developing nations.
In 1974 WHO’s Expanded Programme of Immunization began with a focus on six diseases: diphtheria, whooping cough, tetanus, measles, poliomyelitis and tuberculosis.
It’s important to note that prior to this, in the 1960’s, the vast majority of deaths attributable to the common infectious diseases of childhood preventable by vaccination, were occurring in children in the developing world.
At this time, about one-third of African children did not reach the age of 5 years old. Infectious diseases, particularly measles, accounted for a majority of these deaths.
It was within this context that the Expanded Programme of Immunization began.
In 1974, only 5% of the world’s children were protected from the six killer diseases targeted by the Programme. Today, that figure is 86%, with some developing countries reaching more than 95% immunization coverage.
Since this time, Polio has almost been eradicated and success in controlling measles makes this infection another potential target for eradication.
WHO estimates that at least 10 million deaths were prevented between 2010 and 2015 thanks to vaccinations delivered around the world.
What is the Ethical Dilemma?
For Christians, a significant feature in the ethical debate on the issue of vaccines, comes from the belief that aborted baby cells have been used to develop many vaccines, including many of the current COVID-19 vaccine candidates.
So, is this true?
The Oxford Vaccine currently under trial is being developed and grown in fetal cell lines that have been derived from an aborted fetus.
The cell line (HEK-293) was collected from a female fetus which was aborted in the late 1960’s. The HEK-293 cell line was cultured in the early 1970’s, by Alex Van der Eb, a scientist based in Holland.
Through a process known as ‘tissue culture’, the cells have been continuously divided and grown, which has allowed the same cell line to be used in vaccine development for decades—including the current development of the Oxford vaccine for COVID-19.
It’s important to point out the abortion did not take place with the purpose of obtaining cells for medical research. But neither can we know that the parents would have given consent for this purpose, as the parents are unknown.
Speaking to Eternity News recently, Denise Cooper-Clarke,(a graduate of medicine and theology, with a PhD in medical ethics) said:
“I think that it’s really important to make the point that these babies – there’s two babies, we think, from two cell lines which are both used in vaccine development – were aborted back in the late 1960s. They weren’t aborted in order to obtain fetal cells. They were aborted for other reasons,” Cooper-Clarke says.
“Now, if it were the case that all vaccines – or even some vaccines – relied on a continuous supply of aborted fetuses, or if it were the case that some abortions were taking place in order to obtain fetal cells for vaccine, that would be a really different situation.”
How are human cell lines used?
Human cell lines like this one play an important role in the beginning stages of vaccine development for two main reasons:
- They provide the ideal environment for the production and growth of the antigens used in the final vaccine.
- They allow researchers to closely observe the interaction of the antigen with the virus at a cellular level.
Once the antigen has been successfully generated, it is removed from the cell line and isolated from the virus as much as possible, before being purified, strengthened, and tested. For a more detailed outline of this process, click here.
Why are fetal cells used over older human cells?
Speaking to The Guardian, Robert Booy—a University of Sydney professor of vaccinology—says that the main reason that fetal cells are used, is that they can be replicated so frequently.
“Fetal stem cells can go through scores of 50 replications, whereas older cells in humans, their cells can only replicate a shorter number of times,” he says.
Do other Vaccines and medical treatments use Fetal Cells?
The answer is yes.
Fetal tissue has been used in biomedical research since the 1930s, including for the first polio vaccine.
The polio vaccine is now estimated to save 550,000 lives worldwide every year.
Many of our other common vaccines, such as chicken pox, rubella and shingles, have been produced in tissue derived from these two electively aborted pregnancies from the 1960s.
And more recently, fetal cell lines have been sued for research and treatments for degenerative diseases such as Parkinson's disease.
Does the final vaccine contain human DNA?
In short, the answer is ‘no’.
While the antibodies come into contact with the cell, the purification process that takes place ensures that there is no human DNA in the final vaccine.
Where can I find out more about the Guidelines around this type of research?
There are a number of safeguards in place when it comes to research using human tissue.
In Australia, it’s the National Health and Medical Research Council which oversees the guidelines for medical research with human cells and tissue.
You can read the ethical conduct guidelines for it by clicking here.
Is it safe to rush the development of a vaccine?
Developing a vaccine is a long and extremely complex process, which generally takes between 10 and 15 years.
Before a vaccine can be licensed and distributed, it must successfully undergo three rounds of clinical trials in humans. According to Gavi—a co-leader of COVAX—the vaccine is also continuously monitored for safety and effectiveness during and after its distribution.
In order to reduce the production time of the COVID-19 vaccine, COVAX is looking at innovative ways of compressing the testing phase. Click here for a more detailed look at these methods.
What does it mean when they talk ‘Equitable Access’ to a Vaccine?
Equitable access to a vaccine means every country and individual has access to an affordable vaccine.
Getting suitable vaccine is one thing, the distribution of the vaccine across the world, and the infrastructure needed to do so, is a whole different issue.
The concern is that developed nations with more power (and money) will be able to procure and distribution the vaccine more easily than developing nations.
Since this time, it has helped to dramatically improve access to life-saving vaccines and reduce the time lag between the availability of vaccines in rich and poor countries.
Over the last two decades it has supported 496 vaccine programs in the 73 poorest countries and helped supply them with 600 million vaccine doses every year. While Gavi’s main focus is children, it has helped provide vaccines for people of all ages for epidemic-causing diseases such as yellow fever and meningitis.
GAVI is a key partner of COVAX (see below).
What is COVAX?
The COVAX collaboration has come about in response to the severity of COVID-19 and the urgent need for a vaccine.
COVAX is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO. Its aim is to accelerate the development and manufacturing of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world. COVAX's core aim is to have 2 billion vaccine doses available by the end of 2021 to end the acute phase of the pandemic. To increase the chances of success, COVAX has created the world’s largest and most diverse portfolio of these vaccines, with nine candidate vaccines already in development and a further nine under evaluation from a total pool of 160 global candidates.
Recently the Australian Government has made two announcements in relation to the COVAX facility, both of which contribute to its core goal:
- The first announcement was a commitment to provide $80 million to the COVAX Facility Advance Market Commitment (COVAX AMC) to improve access to COVID-19 vaccines specifically for 92 lower income countries in our region and around the world. This was funded out of Australia's existing aid budget.
- The second more recent announcement of $123 million to the overarching COVAX Facility, assists the global initiative more broadly to achieve its goals, while also giving Australia access to the facility's pool of vaccine candidates for the coverage up to 50 per cent of the Australian population should we require it. In essence, it acts an 'insurance policy' for Australia if the above two candidates don't work.
The Australian Government has outlined in it’s COVID-19 Vaccine and Treatment Strategy stating that:
The global impact of COVID-19 requires a global response. The Australian Government has contributed to the Coalition for Epidemic Preparedness Innovations (CEPI), one of the international organisations that established the COVID-19 Vaccine Global Access (COVAX) Facility. The facility enables participating governments, including lower income countries, to access safe and effective vaccines for 20 per cent of their population.
The Government has also submitted an expression of interest to participate in the COVAX Facility, so we can participate in its design and implementation. The Government is considering further contributions to COVAX to support access to a vaccine by lower income countries.
How should Christians Respond to the vaccine debate?
As you would expect, the Christian response to this issue has been varied and diverse.
An open letter to Prime Minister Scott Morrison was recently penned by three Christian Leaders asking that the government pursue similar arrangements for alternate vaccines that do not raise the same ethical concerns, so that Australians will have a choice when it comes to vaccination.
The letter was signed by three Archbishops: Anthony Fisher, the Catholic Archbishop of Sydney, Glenn Davies of the Sydney Anglicans and the Greek Orthodox Archbishop of Australia, Makarios Griniezakis.
The Catholic Church has long weighed into this debate and has a clear and consistent position that includes three important points:
- When a choice exists between an ethically compromised vaccine and another vaccine which is not ethically compromised, we have a grave responsibility (all other things being equal) to use the latter vaccine.
- When only ethically compromised vaccines are available, we should make known our moral objection to these vaccines, and lobby governments and healthcare systems to prepare and make available vaccines which are not ethically compromised.
- Until ethically uncompromised vaccines are developed, we can and should use ethically compromised vaccines so as to prevent serious health risks both for ourselves and for everyone.
The Pontifical Academy for Life stated this third point very clearly in 2017. It said that: “we believe all clinically recommended vaccinations can be used with a clear conscience ... the moral responsibility to vaccinate is reiterated in order to avoid serious health risks for children and the general population.”
Focus on the Family’s Physicians Resource Council, which last updated a statement in 2015, suggests that Christians have the moral freedom to receive vaccines, though it also respects those Christians who come to a different conclusion after consideration and prayer.
For Christians this topic and decision is worth thoughtful consideration due to the impacts not just on us as individuals, but on the most vulnerable in our society.
One of the main considerations for Christians needs to be around the common good of their fellow human beings.
As the Gospel Coalition recently noted:
“The harm done to children from not getting vaccinated is exponentially greater than the harm—both physical and moral—of using the vaccines. Because of herd immunity, the choice to vaccinate our children protects those who cannot receive certain vaccinations due to allergies, ages, or a weakened immune system. We must always consider whether we are using our religious liberty or concern for parental rights as cover for a choice that may cause significant harm to the neighbors we are commanded to love (Matt. 22:36-40).”
If we believe we are called to ‘seek the common good’ (Jermiah 29:7) and protect the vulnerable – we should deeply consider our decision and the impact a choice not to get the vaccine will have on others, especially those vulnerable to the virus.