Can Christians receive a Covid vaccine with a clear conscience? Or should we refuse to be vaccinated? This has been a matter of some debate, because all of the currently available vaccines have been developed or tested using cell lines derived originally from aborted babies. Some Christians have therefore stated strong opposition to receiving a vaccine. In this post, I’m going to argue that Christians can receive, and administer, any of the currently licensed Covid vaccines with a clear conscience. In what follows, the small print sections fill in some details. I hope they’re helpful, but if you skip them, you’ll still get the main points. For a really brief summary, see here.
Before I begin, let me register some caveats. First, bioethics is a highly complex area, one in which I can claim no expertise: my training and knowledge are more general. I’ve been scrambling to get up to speed and I’m heavily reliant on the expertise of others, although I’m also aiming to bring my own understanding of theological, ethical and pastoral perspectives to bear. (It’s worth noting that Dr John Ling, who does have the expertise and who teaches bioethics at London Seminary, has addressed the vaccine question on his website and reached the same conclusion I do.) Secondly, for the sake of simplicity and because it’s how the debate has been framed, I’m going to talk about the ethics of receiving a vaccine. But there will also be those in our churches who are involved in distributing and administering vaccines: as drivers, medical receptionists, doctors, nurses etc. What I say applies to them too. It’s permissible to receive and to give a Covid vaccine. Thirdly, I’m not going to address the question of whether it’s permissible to be involved in the development and testing of vaccines using foetal stem lines. Some people in some churches may be involved in research and development and testing at universities and pharmaceutical companies. But there are specialist resources available, and it’s a less pressing issue for most churches. Finally, what I say will also apply to some (not all) other vaccines, for example, MMR. There are also other ethical questions around the research and development of other medical treatments. But I’m going to focus my attention simply on Covid vaccines and stem lines derived from aborted foetuses.
Why is this Controversial?
Vaccine ethics are complex. The Center for Bioethics and Human Dignity has a helpful summary of the issues. The major issue at stake for Christians with Covid vaccines has to do with how the vaccines are developed and tested. Perhaps many in our churches will be unaware that this is even a question worth asking. But the reason it’s controversial is that all three of the Covid vaccines currently licensed in the UK have either been developed or tested using cell lines originally created from the tissue of aborted foetuses. (As this table shows—summarising information from articles in peer-reviewed scientific journals—some, but not all, other potential vaccines also face the same questions.)
The AstraZeneca/University of Oxford vaccine used HEK-293 cells in design and development and in production. It also used abortion-derived cells during testing. The Pfizer/BioNTech vaccine used an abortion-derived stem line in testing. The Moderna vaccine used HEK-293 cells during testing. The HEK-293 stem line originates with tissue taken from a female baby aborted in the Netherlands 1972. The reasons for the abortion are unknown.
It is important to realise that no foetal cells were used during the making or testing of any of these vaccines. And there are no foetal cells in the vaccines themselves. The production of vaccines does not require tissue from newly aborted foetuses, nor is there any evidence that the original abortions were carried out for the purpose of producing material for scientific testing. Rather, as the Center for Bioethics and Human Dignity explains, ‘The cell lines are perpetual lines whose origins are morally problematic, but their use is temporally distant.’ Cell lines aren’t immortal (despite was is sometimes said), but they do last for decades, and there is no need for any child to be aborted to provide new tissue to create new lines.
Christopher Tollefsen, a philosopher who is strongly opposed to the use of foetal tissue in medical research, makes a helpful distinction when he states that what he calls ‘cell lines of illicit origin’ should never have been brought into existence. However, these cell lines ‘contain no actual cells from the aborted child’s tissue, and are often used with little awareness of their origins.’ With this in mind, the title given to John Piper’s ‘Ask Pastor John’ piece, ‘Can I Take a Vaccine Made from Aborted Babies?’ is badly misleading. Thankfully, Piper’s actual answer to the question makes the necessary distinctions.
Arguments Against Receiving the Vaccine
Whatever else we would want to say, it cannot be denied that the death of the baby girl who was the origin of the HEK-239 cell line was tragic. Although we don’t know the circumstances of her abortion, we should grieve that it happened. However, some Christians would go further. In light of how the available Covid vaccines were made and tested, John Piper has published a short piece arguing that Christians should not receive a vaccine. Dave Brennan, the Director of brephos, has also addressed the issue in more detail in a series of blog posts and has reached the same conclusion. I’ll come to Brennan’s arguments later.
Piper gives four reasons to refuse the vaccine: First, we should never do evil that good may come (Romans 3:8). He argues that ‘We shouldn’t turn the wickedness of killing children into a wonder drug.’ To do so is to desecrate their bodies and treat them as though they can be killed and the tissue harvested for our benefit. Secondly, Christ is more valuable than preserving life; our concern should be to testify to his value. Thirdly, avoiding products derived from aborted foetuses is one way of testifying to the value of human life. Fourthly, God blesses principled action in his name: we may not see how good could come from this; we may worry about goods being lost (immunity against a virus); but we should trust that God can work good.
The real point at issue here is Piper’s first argument. If it does not stand, his other arguments fail, because their relevance to the question of vaccination depends on a prior belief that receiving a vaccine is sinful. If this premiss (which is hidden in arguments 2-4) is granted, they serve as powerful motivations to urge us to action. But if the hidden premiss is not granted, arguments 2-4 do not themselves show that being vaccinated is sinful. Yet, while the principle of argument 1 is valid—we must never do evil that good may result—Piper misses some important distinctions and so misunderstands what is at stake in receiving a vaccine. I’ll articulate these distinctions below, when I offer arguments in favour of having a vaccine.
Regarding Piper’s second point, this is undoubtedly true, but it’s not a zero sum game. This argument is only relevant if Piper’s first argument is true. Regarding his third argument, again, this is true enough. But, as Piper notes there are plenty of other ways of testifying to the value of the lives of unborn humans. The real question is not whether refusing a vaccine is a way of testifying to the value of human life, but whether it is a necessary way. Again, that will depend on whether his first argument is compelling. If it isn’t compelling, we can turn argument three around. To risk life—especially the lives of the highly vulnerable—by refusing a vaccine would be to fail to testify to the value of life (especially the lives of the vulnerable). With regard to Piper’s fourth argument, once more, this is marvellously true. But given the stakes involved in refusing a vaccine, we might equally be inclined to ask whether God blesses well-intentioned but foolish action in his name. We might well feel that we’d need a compelling moral reason to refuse the vaccine: again, that will depend on whether his first argument holds water. If it doesn’t, those in positions of pastoral responsibility for others, or indeed any Christians who speak or write publicly on this issue also need to ask the question: can we expect God to bless the illegitimate binding of people’s consciences in his name? This is not intended as an attack on John Piper, who is no doubt speaking from good motives and after careful thought. But I hope it at least gives us pause as we consider our own responses. There are dangers on both sides of this debate.
Two Arguments in Favour of Receiving the Vaccine
The goal of medicine is the good of health, my own and my neighbour’s. In other words, medicine falls under the rubric of both parts of the second great commandment: ‘You shall love your neighbour as you love yourself’. This in turn is governed by the first and greatest commandment: ‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ (Matt 22:34-40) That there is a right love of self means I am bound to look after my own health. That I am to love my neighbour as I love myself means that my health is not the only consideration. I must not be indifferent to the physical and mental wellbeing of others. This is particularly relevant when considering vaccines, which are designed not only to protect individuals but also communities.
However, more than that, loving my neighbour as I love myself means that I must always treat my neighbour as an end—a fellow person whose good I also seek—and never as a means to serve other ends, other than within the end of all things in the glory of God. We cannot use a subset of our neighbours (e.g., unborn children) as means to the end of our own health, or the health of other neighbours. Any assistance someone gives (e.g., through organ donations, or by risking their own health to care for others) should be given by them freely and without coercion. This immediately means that using tissue from aborted children for medical purposes is a great evil. The act of killing a baby itself contravenes the sixth commandment (‘You shall not murder’). To then use that child’s body to create a benefit for their fellow humans—even if that benefit is for a whole society—is not to mitigate, but to compound the evil.
However, the sixth commandment is not simply negative—a prohibition on the taking of life. Rightly understood it is also positive—it requires doing all within our power to promote the life and flourishing of our neighbours and ourselves. And so, the Westminster Larger Catechism includes among the duties required in the sixth commandment, ‘all careful studies, and lawful [NB!—there are unlawful ways of doing this that are therefore forbidden] endeavours, to preserve the life of ourselves and others’. It also includes ‘the sober use of meat, drink, physick [medicine], sleep, labour and recreations’ (WLC Q.135). Thus, as we make every effort to preserve our own and other people’s lives, the right use of medicine is included within the sixth commandment. In the case of vaccines this will include among others, ourselves, any children we are responsible for, the elderly in our churches and communities, and those with pre-existing conditions that make them particularly vulnerable to Covid. Whatever our opinions about Covid or vaccines, it is a sin to be reckless with respect to our own health or the health of our neighbours. Nevertheless, in a culture where abortion is rampant, this concern for the well-being of others will obviously also include our responsibilities to unborn children and their parents.
The preservation of physical life is not the only or even the most important consideration, however. It is important to distinguish various different kinds of good, and how they relate to one another. And it is here that Christian ethics, and indeed much classical ethics, differs markedly from the mores of contemporary western societies. We live in societies that exalt financial and material security and gain, that fear physical death but not spiritual death, and that prize physical (and mental) wellbeing above almost anything. In contrast, within a Christian approach to ethics, the least important kind of goods are external goods (e.g., wealth, reputation, success). More important are bodily goods (e.g., strength and health—both physical and mental). More important still are natural goods of the soul, both intellectual and moral (e.g., wisdom, justice, courage). But most important is the supernatural good of faithful, loving, obedient friendship with God (the first command, says the Lord Jesus, is also the greatest). When these goods collide, it is right to choose the higher good over the lower. So, for example, it is never right to seek friendship for the sake of money. But it might well be right to seek money for the sake of a friend. More starkly, as the Lord Jesus warns us, ‘What does it profit a man to gain the whole world, yet forfeit his soul?’ In the case of vaccination, this means that the physical well-being of ourselves or our neighbours is important, but it is not the primary concern. Moral well-being—our own and that of our society—is more important; the spiritual well-being of faithfulness to Christ, and eternal life in his name, is most important.
The most common argument for the acceptability of Christians receiving a vaccine like the ones currently on offer for Covid rests on the principle of remote cooperation with evil. This recognises that abortions are evil. But it argues that those who receive a vaccine developed from a foetal stem line do not share in the guilt of that evil act. This argument was applied to vaccines in 2005 by then Cardinal Ratzinger (later Pope Benedict XVI). Ratzinger argued that the principle of remote cooperation means that Catholics can receive such vaccines in good conscience, provided that they also make their opposition to abortion clear.
Austin Fagothey explains the principle in his classic introduction to ethics, Right and Reason (2nd edn; C. V. Mosby, 1959, pp. 338-40). When we consider cooperation with evil, we need to distinguish formal and material cooperation. Formal cooperation occurs when someone does something evil, and you share in their act while willing the same evil—driving the getaway car after the bank robbery, handing the gun to the assassin, the acts and desires of all those involved in procuring an abortion. Material cooperation occurs when you help someone perform an evil act, but without approving of it. Material cooperation is not wrong by nature (because you don’t will the evil), but only by circumstance. The closer you are to the act, the greater your cooperation in the evil and so the greater your moral responsibility. Proximate material cooperation involves a close association with the act—a waitress serves a drunk customer another beer, a man drives his partner to get an abortion, albeit under protest. Remote cooperation happens at ever greater degrees of distance, perhaps distance in time, perhaps also because you are distanced from the act by one or more intermediaries.
On this argument, someone administering or receiving a vaccine developed or tested using a foetal stem line is materially, but not formally, involved. They are not approving of, or willing the abortion. And their cooperation is very remote. It is remote in time (all foetal stem lines come from a small number of babies aborted in the 1970s and 1980s; these cell lines now perpetuate themselves; and they contain no foetal tissue). There are also multiple intermediaries—the scientist who first developed the cell line, the pharmaceutical companies and scientists who selected this cell line to use in developing the drug, those who funded the development, the government board that approved the drug. Christian ethicists therefore tend to agree that although it would be far better if vaccines were developed and tested using other methods, there is no moral guilt in receiving vaccines developed in this way. Refusing the vaccine will do nothing to change an abortion that happened nearly 50 years ago. And against this, we must also weigh the potential damage to other human lives, and our own, if we refuse a vaccine.
Perhaps it is also worth observing that these kinds of vaccines are far from the only ways in which we cooperate remotely in evil. In fact, there are many things that involve closer cooperation in evil than receiving these vaccines, as this article demonstrates. The sad reality, is that it is impossible to live in this world without at some level cooperating remotely with evil every day. Further, in relation to the vaccines, absolute purity is not possible. The University of Oxford received £65.5 million in British government funding for its Covid vaccine development. This means that all British taxpayers are, willy-nilly cooperators to some degree in the development of this vaccine, even if unwillingly.
However, although the argument from remote cooperation is the most common among pro-life Christian ethicists, Christopher Tolleson has argued, to my mind persuasively, that it’s a mistake to frame the discussion in terms of cooperation. He argues that,
The wrongful act at issue was performed decades ago, and is not part of a recurring pattern or project. The actions of the wrongdoers are beyond our reach, and so there is no possibility of cooperation of any sort.
Instead, says Tollefson, the question is one of appropriation—not helping a wrongdoer, but benefiting from their acts. He draws a comparison with the end of World War II. American peace with Japan was secured through unjust means—the dropping of A-bombs on Hiroshima and Nagasaki. This involved indiscriminate and disproportionate killing of many civilians, contravening even a generous interpretation of Just War theory. However, although it was secured through great injustice, no one would say that we should forfeit that peace. Accepting the outcome is not doing evil that good may come from it. Rejecting the outcome would, in fact, be to add evil on top of evil. Someone might object that those born or already living in the US did not choose to benefit from the peace. They are merely passive appropriators of it, so this is different from choosing to receive a vaccine. But the argument also holds for someone who chooses to leave a war-ravaged nation and moves to the US in order to benefit from the peace. This is a perfectly legitimate thing to do, and in no way involves approving of or cooperating in evil.
In relation to vaccines, if the use of stem cell lines involved a regular pattern of procuring tissue from newly aborted foetuses, the moral situation would be very different. But it does not. And so we are free to use vaccines developed from foetal stem lines with a clear conscience.
The way Scripture describes God sovereignly governing for good the sinful actions of sinful people supports this understanding of the legitimacy of this kind of appropriation. The supreme example is, of course, the crucifixion of God’s Son, which involved many evil actions (Judas, Pilate, etc). And yet, by faith, we appropriate all the benefits of Christ’s death that God intended to give us. The classic example from the OT is Genesis 50:20. The actions of Joseph’s brothers in plotting his death, and then selling him into slavery, were evil. And yet, even as they intended it for evil, God intended it for good, for the saving of many people. Were Joseph’s family, or the Egyptians, wrong to accept and eat food from Joseph because it had its root in the sin of his brothers? Surely not. Similarly, might we not argue that although the historic abortions from which stem lines were developed were evil, nevertheless in his mysterious wisdom God also, without willing an evil action, willed to bring good out of it, the saving of lives? This is absolutely not to suggest that we may do evil with the hope of bringing good out of it. By no means!Nor does it mean that we can intend for someone else to do evil in the hope that it can be used for good. Nor should we call evil deeds anything but evil. But as we look to past evil actions from which good has come, can we not see, and marvel at, God’s wise and sovereign goodness working to distribute gifts, including vaccines, both to the righteous and the unrighteous alike? And can we not appropriate those gifts with humble gratitude for his undeserved favour?
Prophets, Activists, Reformers and the Conscience
In a series of thoughtful blog posts,1 Dave Brennan has argued that it is morally imperative for Christians to refuse to be vaccinated. He argues that we are complicit today—through our silence, and the social benefits we receive from ‘appeasing our culture’—in the daily killing of hundreds of babies in the ‘baby genocide’ in the UK alone. In his view, it is hypocrisy to say that we oppose abortion and then to receive a vaccine created from foetal stem lines. Rather, we should take this opportunity to be prophets, reformers and activists, refusing to be vaccinated and so communicating our hatred of abortion. Against arguments about remote cooperation with evil, Brennan claims it is ‘totally flawed’ to see things this way, an example of straining a gnat to swallow a camel. Against the argument that this is a matter of conscience—allowing different Christians to reach different legitimate judgements—Brennan argues that 1 Corinthians 10 in fact teaches that for the sake of others’ consciences, namely the consciences of unbelievers, we must refuse to be vaccinated, lest others think that abortion is okay.
In summarising his position, I’ve tried to use Brennan’s own powerfully emotive language. Talk of genocide, appeasement, hypocrisy, straining gnats, being pedantic, arbitrary and negligent, undoubtedly packs a rhetorical punch. And the call for obedience to what he regards as a divine command has the great merit of being clear and honest as to where he stands, and loving in issuing an uncomfortable call to obedience. His zeal is commendable, and we can agree with him that abortion is a great evil, and the silence over abortion from much of the British church is tragic. At the very least, that we are discussing the issue of abortion is a healthy reminder of our duty to speak up and defend the rights of the most vulnerable members of society.
Ultimately, however, Brennan’s position seems to be an example of the excluded middle fallacy: either you refuse to have a vaccine or you communicate approval of the killing of hundreds of babies today; there is no middle option. But is this really the case? Undoubtedly many of us need to repent of our silence in the face of abortion (myself included). But are there not many ways of protesting abortion, arguing for changes of attitude and law, caring for women who are considering an abortion, that can communicate loud and clear our love for every human life? It seems to me that, in his desire to protest the evil of mass-scale abortion Brennan unhelpfully conflates questions that need to be distinguished. In doing this, he skews the debate in favour of his position and unintentionally muddies the waters, hindering clear thinking.
In addition, it is a mistake to think that all Christians are called to be ‘prophets, reformers and activists’. Most of us are not. And even those who are given this vocation by God are not called to be prophets, reformers and activists on every issue. To walk even a short way down that path would quickly lead to exhaustion, insanity and uselessness. It is a perennial temptation for activists and reformers of every stripe to feel that everyone should share the burden of their calling. And it is a temptation to be strongly resisted, because it risks laying intolerable burdens on other people, burdens the Lord has no desire to place upon them. So, we can make another important distinction: all Christians are called to love our neighbours, only some are called to do so as activists and reformers. Some are called as prophets, activists and reformers concerning abortion; all are commanded to love the unborn. But there are many ways of doing this. Supporting the work of brephos would be one excellent way. Addressing it in our preaching and teaching another. Nurturing church cultures in which single parents are welcomed and supported another. Catholic social teaching urges those who receive vaccines made from foetal stem lines to take it as an opportunity also to indicate their opposition to abortion, and to ask if there are alternative vaccines in the production of which foetal stem lines have not been involved. If we are clear, not just in our own minds, but with others, about our opposition to abortion, I see no reason at all why we may not also receive, or administer, a vaccine.
With regard to the question of conscience, Brennan graciously invites interaction, noting that if he’s wrong this is serious. I do not have space to engage all the exegetical questions surrounding 1 Corinthians 10:23-33, which are complex.2 However, I am unpersuaded that the ‘someone’ for the sake of whose conscience the Corinthians are to act (v.28) is an unbeliever. Rather, it seems more likely that it refers to Christians, ‘brothers’, with sensitive consciences (cf. 8:7-13) who are also at the meal with them. If this is right, what we might lead unbelievers to think is here beside the point. What matters is the way we treat the consciences of our brothers and sisters. If this does apply to Covid vaccinations, it suggests that we are wrong to bind the consciences of those who think that getting a vaccine would be sinful, because for them, to get a vaccine against their conscience would indeed be sin. However, and importantly, in the absence of clear scriptural mandate, it is equally wrong to seek to bind the consciences of those who believe it’s okay to receive a vaccine.
I doubt that this passage in fact applies so clearly to the issue at hand, at least in support of Brennan’s case. (1) There is a big difference between receiving a vaccine (on Brennan’s understanding) and the Corinthians eating meat offered to idols (on Paul’s understanding). Paul is clear that eating meat that has been offered to idols is, of itself, morally neutral. The Corinthian Christians are entirely free to eat with a clear conscience. And when they willingly forego the right to eat for the sake of someone else’s conscience, they do so without it in any way impinging on their liberty to eat with thankfulness. This is an exercise of freedom for the sake of others, but it is an exercise of freedom. With regard to the vaccine, Brennan does not believe this is the case: there is no moral freedom; receiving the vaccine is, in itself, morally evil. (2) Absent other ethical questions, eating meat and receiving a vaccine are not strictly comparable activities. Whether I eat meat or choose a vegetarian meal is a matter of indifference with respect to health. The decision whether or not to receive a vaccine has potentially fatal consequences for myself and others, especially the most vulnerable. (3) Even if I’m wrong about the identity of the ‘someone’ in 1 Corinthians 10, and they are an unbeliever, I am sceptical that receiving a Covid vaccine communicates much of anything to our culture about our attitude to abortion. Most people will be entirely unaware how the vaccines are made. (4) In any case, 1 Corinthians 10 does not envisage a general prohibition on eating meat offered to idols. Quite the reverse. The Corinthians were free to go to the market and buy meat without raising questions of conscience, when it would have been common knowledge that much of the meat would have been sacrificed to idols. The situation is, rather, a meal where someone immediately present personally raises the issue. So, a more accurate parallel with 1 Corinthians 10 might be the unlikely situation where the medic preparing to inject you says, ‘This vaccine has been created from foetal stem lines. Are you okay with that?’ And even then, as I’ve argued above, there is good reason to be able to answer, ‘Yes. I’m far from okay with abortion. But I’m very happy to receive this vaccine.’
My aim in writing this piece is not to tell anyone what they should do. Christians, pastors, elders, churches will have to weigh the arguments and reach their own conclusions. However, if what I’ve argued is correct, it follows that commanding people not to receive a vaccine, and saying that if they do they are (guiltily) complicit in hundreds of abortions happening daily, is itself a sin. It is a sin of recklessness, which may have the unfortunate consequence that people die because they, or others, refuse a vaccine. It is also a sin because of the intention of binding Christian consciences beyond what may legitimately be deduced from Scripture. In so doing, it may leave Christians who decide to receive a vaccine, or who have already received a vaccine, plagued with false guilt and damaged consciences. Alternatively, it might persuade people that they cannot, in conscience receive a vaccine. This will mean that they will do so because their consciences have been malformed by this teaching. And it is no light thing to contribute to the disfigurement of someone’s conscience.
Just as I’m grateful to Brennan’s challenges and openness to correction, I also want to issue this warning to those who hold his position: binding people’s consciences beyond Scripture is a serious matter. Again, I do this with the acknowledgement that I may be wrong about the vaccine. If I am, then for my sake and for the sake of the church, I’d be glad to be corrected. But I offer this argument in the hope of aiding pastors in particular as they shepherd their congregations, but also all Christians as they reflect on their decisions in this difficult, but far from unique, situation. I hope that what I’ve written will aid clarity of thought and discussion. I also hope that it will promote the peace and unity of Christ’s church, helping us to talk together about a potentially emotive issue, and to respect one another’s decisions without rancour or judgement.
1 In order, Dave Brennan’s posts on this subject are:
‘My Response to the EA’s Webinar on the Ethics of Covid-19 Vaccines’
‘Why the Mainstream Christian Approach to Covid-19 Vaccine Ethics is Wrong’
‘A Fresh Approach: From Consumers to Activists’
‘Black and White or a Conscience Issue? What Does the Bible Say?’
2 Representative samplings, careful treatments, and differing conclusions can be found in Gordon D. Fee, The First Epistle to the Corinthians, NICNT (Eerdmans, 1987), 475-91, and Anthony C. Thiselton, The First Epistle to the Corinthians, NIGTC (Eerdmans, 2000), 779-97.