This week, the chairs of the U.S. bishops' conference committees on doctrine and pro-life activities issued a statement advising Catholics awaiting a COVID-19 vaccine to choose, if possible, the Pfizer or Moderna vaccines over the recently approved Johnson & Johnson's one due to a less remote connection between this newest vaccine and abortion. A previous statement by the New Orleans Archdiocese characterized the Johnson & Johnson vaccine as "morally compromised." A handful of other bishops have concurred.
Interpreted by the media and Catholic faithful as episcopal guidance to avoid the Johnson & Johnson vaccine, these diverse and sometimes conflicting pronouncements have sowed "pastorally dangerous" confusion. Catholic health systems are scrambling to figure out what to do with the allotments of the Johnson & Johnson vaccines they have already received. Should they refuse further shipments? Some individual Catholics have decided to forego the vaccine, putting their own health and that of others at risk.
All this threatens to impede the vaccination effort in the U.S., the country with the highest global COVID-19 mortality, with 518,000 excess deaths over the past year, a figure that continues to compound at well over 1,000 deaths per day. Without global progress on vaccination, the virus will continue to spread and mutate, potentially undermining currently effective vaccines and costing even more lives.
I fear that in the zeal to advance the cause against abortion, outdated advice on Catholic teaching may have inadvertently led this handful of bishops to take a position that is — ironically — anti-life. What might have led them to articulate a position that urges Catholics to privilege a theoretical moral purity over the value of their own lives, the lives of others and the common good?
Four questions require answers: Do these pronouncements follow "guidance from the Vatican," as they claim to? Can a vaccine be "morally compromised?" Would such "conscientious objection" in any way diminish the current practice of abortion? And might this "pro-choice" position on vaccines compound current health disparities with moral disparities?
Let's start with the Vatican. In December 2020, both the Congregation for the Doctrine of the Faith and by the Vatican COVID-19 Commission in collaboration with the Pontifical Academy for Life addressed this very question. These bodies had full knowledge of the slate of vaccines that had been in production since the beginning of the pandemic. People were already being "jabbed" with the Pfizer and Moderna vaccines. The AstraZeneca, Johnson & Johnson and many more vaccine candidates were in the pipeline. Knowing that some of the vaccines had been produced using two cell lines from fetuses aborted in 1964 and 1970, what did they say?
The shortest answer: they said that all the vaccines are morally acceptable. The Congregation for the Doctrine of the Faith noted that due to the very production and distribution challenges currently in place in the U.S. and globally, "it is morally acceptable to receive Covid-19 vaccines that have used cell lines from aborted fetuses in their research and production process." They continue that due to the "grave danger" presented by the "uncontainable spread of a serious pathological agent — in this case, the pandemic spread of the SARS-CoV2 virus that causes Covid-19," "all vaccines recognized as clinically safe and effective can be used in good conscience." And they emphasize that while vaccination — like all medical interventions — is voluntary, there is a moral "duty to protect one's own health [as well as] the duty to pursue the common good." (All italics here are in the original).
Apart from one allusion to potentially "ethically irreproachable" vaccines, there is no claim that any of the COVID-19 vaccines are "morally compromised." There is no counsel that any of vaccines should be avoided. Rather, the message is the opposite: If someone chooses to avoid the vaccines for "reasons of conscience," the onus is on them to take all measures possible to avoid infecting others.
This position of the Congregation for the Doctrine of the Faith was confirmed and discussed in greater detail by the Vatican COVID-19 Commission, established by Pope Francis under the Dicastery for Integral Human Development. As the commission notes, Francis "has affirmed the need to make the now imminent Covid-19 vaccines available and accessible to all." In analyzing the moral aspects of the entire life cycle of vaccine production, the commission also affirms a 2017 analysis by the Pontifical Academy for Life that concluded that "all clinically recommended vaccinations can be used with a clear conscience and that the use of such vaccines does not signify some sort of cooperation with voluntary abortion."
Given the clarity of the Vatican guidance on the COVID-19 vaccines, where does this claim that the Johnson & Johnson vaccine is "morally compromised" come from? The New Orleans Archdiocese cites the National Catholic Bioethics Center (NCBC), an organization that has long advised some U.S. bishops on issues of bioethics. In a statement issued prior to the Vatican guidelines, "the NCBC holds that there is a clear ethical hierarchy among vaccines." They base this hierarchy on the extent to which a particular vaccine engages the two 50-year-old fetal cell lines in design, testing and/or particularly manufacturing.
It appears in their reasoning that the more a given vaccine engages these cell-lines, the less remote — and therefore, more ethically problematic — its cooperation becomes. But as the Pontifical Academy for Life noted in 2017, all contemporary vaccines "are very distant from the [two] original abortions." To use an analogy: Jupiter is less remote to us than Saturn or even the Pluto, but none are proximate in any meaningful way. Likewise for these vaccines. Thus, this putative "ethical hierarchy" is based on distinction without a moral difference.
The National Catholic Bioethics Center position also entails a second problem. As again clarified in 2017 by the Pontifical Academy for Life: "the 'wrong' in the moral sense lies in the actions, not in the vaccines or the material itself." This is worth repeating. The wrong lies in the actions — of those involved in the original abortion or in the decision to turn tissues from these fetuses into research materials or of those who decide to use these tissues in their own research and so on — not in the vaccines themselves.
Catholics are not gnostics. We do not designate any aspect of God's good creation as "morally compromised" in and of itself. And, as we know from the Gospels, we cannot become "morally tainted" from any aspect of God's good creation (Matthew 15:11).
Again, I am sure the recent statements are no doubt motivated by sincere concerns about abortion. But they miss the mark. Current vaccines have no relationship with contemporary abortions. Thus, whether one receives or avoids a particular vaccine neither impedes nor advances the industry. Certainly, as every Vatican statement on this topic has made clear, the church remains committed to advocacy efforts aimed at "ensuring that every vaccine has no connection in its preparation to any material originating from an abortion." But putting human lives at grave risk of mortality or lifelong morbidity is not an ethical advocacy strategy.
Many further questions could be asked, but let me raise one final concern: if we grant that a particular vaccine is less morally pure than another, who has the luxury of choosing? Right now, providers have no control over which vaccines they get on a given day. Given the disparities that we have already seen in vaccine distribution in the U.S. — with wealthy white people being vaccinated well ahead of people of color — it is less likely that people of color will be able to "choose" the Pfizer or Moderna vaccine.
We can also imagine that the less expensive Johnson & Johnson vaccine will find its way to poorer neighborhoods. And, as I have argued previously, by December 2020, the rich countries of the world had already reserved most of the stocks of the mRNA vaccines, which also cannot be stored or transported in much of the Global South anyway. How will this problematic framing of some vaccines as morally better than others compound entrenched racial stereotypes, adding moral disparity to health disparities?
Just this morning, I learned of two elderly sisters living in a congregate facility — women at the highest risk of dying — who have stated that based on the bishops' statements, they will refuse the Johnson & Johnson vaccine. Will their "choice" put others at risk as well? Will their community meet the same fate as the Adrian Dominican Sisters in Michigan, the Felician Sisters in Michigan, the Sisters of St. Joseph of Carondolet in New York, or the School Sisters of Notre Dame in Wisconsin and others?
The Vatican has made clear that all the COVID-19 vaccines are morally acceptable. Let us pray that this deeply pro-life position will be proclaimed with one voice by our global church as we work together to protect life and advance the common good.