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I recently received a stirring lecture from a pharmacist who learned that I had been for my first COVID-19 vaccination. Strongly arguing the benefits of Ivermectin, he simply could not fathom why I would permit toxic substances to be injected directly into my body. (I had received a similarly stirring lecture from him before when Neka let it slip that she had been for a childhood immunisation that day.)

Questions surrounding the wisdom and ethicality of receiving the COVID-19 vaccine have raged ever since the vaccines were granted emergency permission for use in the fight against the novel coronavirus. Objections range from the conspiratorial (it’s the mark of the beast) to the concerned (it has not been sufficiently tested) to the ethical (it supports abortion) to the protection of biblical and constitutional liberties.

I don’t wish to address the question of whether Christians should take the vaccine, but I do want to address one aspect of the ethical objection, which I have encountered several times in recent weeks: Given its link to abortion, may Christians receive the vaccine? To keep my thoughts as brief as possible, I will limit my focus to the two major vaccines widely available in South Africa at the time of writing: those by Pfizer and Johnson & Johnson.

This question rests on the claim that the vaccines support and encourage elective abortion. One claim I read was that “thousands of babies were murdered” to produce the vaccines that are presently in circulation. A more measured version of the question asked, “Can I take a vaccine made from aborted babies?” It is important to recognise the way that the question and statement are framed: They assume that the manufacture of the vaccines directly require and therefore support abortion on demand.

The abortion argument has long been promoted as perhaps the strongest ethical argument in opposition to vaccines and the debate has returned with particular ferocity in light of the COVID-19 vaccines. How should Christians think in a principled fashion about this question? Here are three preliminary principles to bear in mind as we consider this question.

First, Christians should avoid thinking fatalistically. The same Bible that tells us that God has numbered our days (Job 14:5; Psalm 139:16) cautions, “Do not be overly wicked, neither be a fool. Why should you die before your time?” (Ecclesiastes 7:17). Christian thinking does not argue for a rejection of medical intervention (including vaccines) on the basis of divine sovereignty.

Second, Christians should oppose abortion. Scripture consistently treats the unborn as fully human (see Psalm 139:13–16; Jeremiah 1:5; Job 31:15; Psalm 22:10–11). Luke 1:41–43 not only calls the first-trimester John a “baby” but portrays him as leaping in the womb when he came into proximity with the unborn Jesus. Humans are uniquely created as divine image-bearers and, except where God has expressly granted authority, it is morally wrong to take a human life (Genesis 9:6). A biblical and ethical case might be made for the permissibility of abortion to save the mother’s life (though this is debated even among Christians), but elective abortion is clearly contrary to God’s revealed word. If vaccine production in some way supports the ongoing murder of humans in the womb, Christians should not support it. But before you jettison the COVID-19 vaccine into the ethical oblivion, consider the claims more carefully.

Third, Christians should care about truth. Of all people, Christians should be the last to promote lies. A lying tongue and a false witness are an abomination to the Lord (Proverbs 6:16–19) and Christians are instructed to speak the truth in love (Ephesians 4:15). Christians should take care to check the truth of any claim they promote. It is deeply unchristian to claim that “thousands of babies were murdered” to produce COVID-19 vaccines, or that the vaccines are “made from aborted babies,” unless the claim is substantiated by empirical evidence.

How do these three principles help us to think through the question of abortion and the COVID-19 vaccine?

In many countries, human foetuses who die prematurely, whether by miscarriage or abortion, can be legally donated for medical purposes. When it comes to vaccine production, the practice in question is the creation of “immortalised cell lines.” In this practice, foetal cells, taken from the deceased child, which would ordinarily stop reproducing after a finite period, are cultured in a laboratory so that they continue to replicate indefinitely. These cells can then be made available widely and cheaply for medical research purposes. This is immediately pertinent to the COVID-19 vaccines.

In 1972, cells were taken from the kidney of a healthy Dutch female foetus. Records pertaining to the child’s death have been lost, leaving it uncertain as to whether the death was the result of abortion or miscarriage. Elective abortion was legalised in the Netherlands in 1984, which means that, before then, only a foetus aborted to save the mother’s life could be legally donated for research purposes. The human embryonic tissue (HEK) was successfully immortalised after 293 attempts and has since come to be known as HEK-293.

During the research phase, manufacturers at Pfizer utilised HEK-293 cells to test the vaccine’s efficacy. The vaccine does not contain HEK-293 cells but was tested using these cells. HEK-293 cells are replicated from the original cells in the 1972 death. No babies were aborted to produce these cells.

In its production and manufacturing stages, the Johnson & Johnson vaccine utilised cells from another immortalised line (PER.C6). These cells were taken from the retina of a child electively aborted in 1985. Use in production does not mean that the final product is “made from aborted babies.” Dr Amesh Adalja, infectious disease doctor and senior scholar at the Johns Hopkins Centre for Health Security, explains, “Though foetal cells are used in the production of the vaccine, they do not remain after the production process. The contents of the vaccine are filtered in a way that removes extraneous material prior to packaging.”

It should be noted that the use of these cell lines is not unique to the COVID-19 vaccine. Various flu vaccines, as well as vaccines for rotavirus, measles, smallpox, polio, rabies, encephalitis, Ebola, and tuberculosis have similarly employed these cell lines in testing phase or manufacture, as have various treatments for cancer (e.g. thymoquinone), diabetes (e.g. Metformin), and other medical conditions. HEK-293 is also widely used in testing the safety of various cosmetic products and even in the food and beverage industry to test new formulations of flavour or scent additives.

So how should Christians think about using vaccines and other products manufactured or tested with immortalised cell lines? Here are three brief considerations.

First, think truthfully. It is factually inaccurate to claim that “thousands” of abortions—or any abortions, for that matter—were performed to produce the COVID-19 vaccine. The cell lines used in testing and/or manufacture are replicated cells from decades-old abortions. Biomedical researcher Nicanor Pier Giorgio Austriaco explains that “it is unheard of for a vaccine manufacturer to seek out new human foetal cells from a recent abortion.” He comments, perhaps coldly, that this is economically unviable and would constitute a massive waste of valuable time and resources when existing cell lines are cheaply and readily available and approved for use.

Second, think deeply. Don’t just react to the very emotive claim that babies were killed to produce the vaccine. Ethical considerations are usually more complex than initial, knee-jerk reactions. For example, Christian ethics have long sought to distinguish between “formal” and “material” cooperation in wrongdoing.

Formal cooperation, which is always wrong, takes place when you join the evil intent of the wrongdoer. Deliberately performing an abortion with the express intent of harvesting cells for medical research is formal cooperation. As we have seen, this has not happened in the production of the COVID-19 vaccines.

Material cooperation might utilise cells harvested after an abortion, when the abortion was not performed with the express intent of harvesting tissue. The user did not join the evil intent of the wrongdoer. Material co-operation might also take place while using organs from the body of a murder victim: An evil act (murder) ended the victim’s life but, assuming the murder was not performed with the express purpose of harvesting organs, organs can be ethically used in surgical transplants and forensic science.

It is problematic to suggest that receiving a vaccine manufactured with the help of immortalised cell lines makes the recipient culpable of an abortion performed decades ago. This is similar to accusing the recipient of a kidney from a murder victim of being complicit in the murder.

Third, think charitably. Ultimately, every person must decide for him- or herself whether he or she will receive the vaccine. There is wisdom in consulting one’s medical practitioner in the decision-making process. Be careful of accusing those who choose not to receive the vaccine of nefarious motives. Be careful of accusing those who do receive the vaccine of not caring about human life. Poor anti-vaccine reasoning—particularly conspiratorial and factually inaccurate claims—should be jettisoned, while concerns about insufficient testing and uncertainty about long-term effects should be carefully investigated and evaluated. Then, before God, every Christian must make his or her decision without casting aspersions on the decision that others make.