While various forms of deliberate infection for the purpose of developing resistance occurred much earlier, the first true vaccination was Edward Jenner’s smallpox vaccination in 1796. By the 20th century the use of vaccines to prevent disease had become a routine medical, and morally uncomplicated, practice.
However, in the 1950s Swedish researchers first used human fetal cell tissue to develop and manufacture a vaccine. With the relaxation of morality and abortion laws elsewhere, this practice, thought better for vaccines destined for human use, has greatly expanded since the 1960s.
Certain 1960s-era cell lines, and some others similarly acquired, have become standard tools in medical science. They are listed in biological catalogues by designations such as HEK-293 (Human Embryonic Kidney, and 293 for the experiment generating it), and are being regularly used in medical research, and in this case for the testing and development of vaccines. They are also used in the production/manufacturing process of some vaccines, with the disease virus being grown on a culture of human fetal cells, before being harvested and processed for vaccine use. The Measles, Mumps & Rubella vaccine (MMR) sold in the United States is an example.
Moral Cooperation in Evil
The decision to use such cells raises the question of moral cooperation in the abortions which made possible the human embryonic and fetal cells lines, as well as the furthering of such use in the future.
Moral theology distinguishes between the person who wills, does or approves of evil (formal cooperation) and those who have only a material connection to evil (material cooperation). For example, we are morally obliged to pay taxes, but not all uses of our taxes are moral. We purchase and use, whether by necessity and for convenience, many products, very few of which will be completely free of all immoral cooperation––whether from the source of the materials, the company’s labor or environmental practices, or the causes it supports with its money or business practices. Yet, the products themselves (food, clothing, electronics, etc.) are in themselves morally lawful. As Our Lord told the tax collectors and the soldiers (Luke 3), individuals working in very morally problematic circumstances, we at least must avoid sinning directly ourselves. The Church’s theology helps us to understand the connections with evil present in the world, and to avoid sinning ourselves.
Church Teaching Applied to Covid-19 Vaccines
Following Catholic moral principles on moral cooperation in evil, therefore, the Magisterium concludes that the use of vaccines with a remote material connection to abortion is justified. • Remote refers, not to time or place, rather, to the many moral actors involved in the chain of causes leading from the abortion to the vaccines. If the evil were not causally remote from the vaccines, their use would be gravely immoral. • Material means that while we intend the health and life the vaccine seeks to preserve, we do not intend or approve of the abortion which remotely provided the cells used in its production.
The Conditions to be fulfilled for remote material cooperation to be moral (i.e. without sin):
1. There is no fully moral alternative available to us.
In such a case, we may receive any of the vaccines which involve remote material cooperation • choosing those whose connection to the illicit cell lines is the most remote, testing, versus development or production • choosing those used in development & production if a more remote vaccine isn't available, or medical considerations suggest it
In the U.S., as of March 2021:
The Pfizer-Biotech vaccine, and the Moderna vaccine, are to be preferred over the Johnson and Johnson. • for most people, availability is the greatest issue, and in the end, any of the current vaccines may be received
2.We seek to forestall any scandal that our personal use may cause others. This can be done by word, for example, to care-givers, family, friends or colleagues who may learn we took one of the vaccines, explaining that Church teaching permits such remote material cooperation in the case of life-saving need. The purpose is that others who know of our actions may not be encouraged by our example to receive such vaccines sinfully, that is, agreeing with abortion or such cell use.
Broader Moral Protest
While it is unlikely that governments and pharmaceutical companies will be scandalized by our receiving the vaccines, our doing so gives some encouragement, especially financial, for them to continue using such illicit material, and even to acquire new material. The Center for Medical Progress demonstrated that Planned Parenthood, for example, sells fetal tissues, organs, and even whole bodies, to researchers, raising the possibility in the present of a gravely evil immediate material cooperation in such evils if medical therapies derive from such use. This ghoulish moral danger is magnified by the thousands of frozen human embryos sitting in in-vitro laboratory freezers around the world and the many evil uses to which they can be put.
The purpose of protest, in such a case, is to encourage medical practices and institutions to make ethical versions available to their patients, to encourage corporations to only produce ethical versions, and ultimately to convince governments to ban the dehumanizing and gravely immoral use of human embryonic and fetal tissue.
Personal Decision Making
In the case of any of the vaccines, as in all medical decisions, there are personal considerations that the individual patient must judge, taking medical advice where applicable, and deciding conscientiously and prayerfully. These include the objective medical risks the manufacturer and government agencies have determined through the testing process, as well as the personal risks based on one's medical history, and even the sorrow or repugnance at using such vaccines (despite their licitness in the circumstances). In the latter case, as the Congregation for the Doctrine of the Faith has pointed out in its “Note on the morality of using some anti-Covid-19 vaccines,” the individual has a further moral responsibility.
5. . . . Those who, however, for reasons of conscience, refuse vaccines produced with cell lines from aborted fetuses, must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent. In particular, they must avoid any risk to the health of those who cannot be vaccinated for medical or other reasons, and who are the most vulnerable.
Moral Status of Available Vaccines
U.S.C.C.B. Statement of 11 December 2020,
“In view of the gravity of the current pandemic and the lack of availability of alternative vaccines, the reasons to accept the new COVID-19 vaccines from Pfizer and Moderna are sufficiently serious to justify their use, despite their remote connection to morally compromised celllines. In addition, receiving the COVID-19 vaccine ought to be understood as an act of charity toward the other members of our community. In this way, being vaccinated safely against COVID-19 should be considered an act of love of our neighbor and part of our moral responsibility for the common good.”
"The AstraZeneca vaccine is more morally compromised. The HEK293 cell line was used in the design, development, and production stages of that vaccine, as well as for confirmatory testing. The current vaccine for rubella, though developed earlier, relies on morally compromised cell lines in much the same way as the newly developed AstraZeneca vaccine. The AstraZeneca vaccine should be avoided if there are alternatives available."
Given the complexities of the science, there may be slight differences in evaluation. Generally, it is enough to know that the moral cooperation is considered remote material, and justified if a completely ethical version is not be available to us.
National Catholic Bioethics Center (Ethical Profile/Preference: Good, Poor and Very Poor)
Actual Sin and Active Scandal. To scandalize someone is to give the bad example of sinning. If we commit an objective sin then it is easy to see how others can be scandalized, led into the imitation of our sin. Such active scandal is a feature of the life of all sinners. There is also passive scandal, which means the person who takes scandal at the sin of others.
Pharisaical Scandal. The Pharisees were scandalized by Our Lord’s miracles and teaching, even calling him evil. If the good we do scandalizes someone, it may be such pharisaical scandal. Such scandal is not true scandal, and like Our Lord we should continue to do good and ignore those whose false consciences and moral rigidity cannot see the good in what we do.
Scandal of the Weak. Additionally, there is scandal of the weak, when those whose weakness of faith lets them be easily led astray. St. Paul talks about this in 1 Corinthians 8, regarding meat sacrificed to idols - which was often the only meat available in the marketplace. Knowing idols are not real, the Christian has the freedom to buy and eat such meat. However, if a Christian is not strong enough in the faith to understand his freedom, then we should voluntarily forego the use of ours out of charity. This is necessary because a person who thinks they sin and then doing it, are culpable of sin in the conscience before God, even though it is objectively permissible.
In addition to the possibility of others being scandalized by our being vaccinated, taking it not as a life-saving or life-preserving measure, but as agreement with abortion, is approval of abortion, there is the larger question of the continued use of human fetal and embryonic material for scientific, medical and commercial purposes. We should all be concerned that this practice end, not just because of abortions years ago, but because of the potential for continued use of such sources by new research in science and medicine.