Americans of my generation remember the incredible sight of the first human footprints on the moon. In 1969, the United States celebrated one of the greatest technological achievements in human history. The Apollo 11 mission took man into space, landed him on the moon, and brought him back safely. Less than a decade before that historic moment in July of 1969, President John F. Kennedy announced that going to the moon ought to be the nation’s goal. Declaring it should happen and making it happen, however, are two fundamentally different things—and the United States did it. The achievement is still breathtaking.
Compare that to recent developments in the last several months: Just months after the COVID-19 virus was detected and entered into our vocabulary, a successful vaccine has now been developed. As of late last week, the Food and Drug Administration (FDA) provided emergency authorization for the Pfizer vaccine against the coronavirus.
This is an unprecedented event in medical history. In terms of technology, it hearkens back to the Apollo moon mission.
The development of this vaccine came under the auspices of Operation Warp Speed. It generally takes years for the development of a successful vaccine, if indeed a vaccine is ever developed. Medical science and development, however, has shattered those typical expectations. Not only was one vaccine completed in record time, but another vaccine produced by Moderna is expected to come before the FDA to receive the same emergency authorization that was announced last week for Pfizer. Shots in arms could begin as early as today.
This is the first step in bringing an end to the COVID-19 pandemic in America—and it was achieved in an unprecedented time frame with demonstrable results.
But, what should Christians think about vaccines and their use? What ethical and theological questions arise? Do the COVID-19 vaccines bring unique moral questions? What does the Christian worldview have to say about the entire set of questions?
Let me offer seven points for consideration.
First, Christians do not believe in medical non-interventionism. Instead, we believe in the moral legitimacy of medical treatment. A Christian worldview authorizes treatment—and we do so as an extension of the doctrine of creation and the dominion God has given to humanity as revealed in the opening chapter of Genesis. Pressing against disease and viruses is part of our mandate. Some might say, “I believe in the sovereignty of God, and if God wants me to have this virus then he will give me the virus. I don’t need medical intervention because I trust God.” That kind of logic, if pressed to its logical conclusion, however, is untenable—we wouldn’t treat any sickness, cancer, or injury. Medical treatment is an extension of God’s common grace and Christians have always understood this. That is why, throughout history, where you found Christians you found hospitals and the church treating the sick.
Thus, it is not wrong for Christians to take measures to avoid getting sick or coming down with the virus. It is not wrong to take the vaccine against COVID-19.
There is background to this, of course, in American evangelical history. Consider, for example, Jonathan Edwards, who died on March 27, 1758 of a wrongly administered inoculation. The most important point is that Edwards took the inoculation, demonstrating the legitimacy of inoculations, based in the Christian worldview assertion that science and medicine are predicated on the world as orderly and intelligible – because the Creator made the world this way.
Thankfully, we have come a long way from the medical science of 1758, but the essential point remains: Christians see the prevention and treatment of disease as a biblical mandate.
Secondly, we must consider the derivation of the vaccine itself—what kind of technology was involved in the development of a vaccine? As is the case with many vaccines and in the background of medical treatments, many advances come through morally problematic cell lines. This, of course, brings us to the issue of abortion and the issue of human cells as well as tissue taken without consent.
In most of the major COVID-19 vaccines, there was a use of fetal cell lines, which are known as HEK-293. The original cells for that line were taken from tissues derived from an abortion in the Netherlands in the 1960s. The cell line developed around 1972. There is also the HeLa line that goes back to 1951. These cells were taken from an African American woman, Henrietta Lacks, who suffered from terminal cancer. Cells were taken from her body without her consent or knowledge. This makes the use of cells from that line a complicated issue within medical ethics.
How then ought Christians think about all of this? First of all, we must condemn in the strongest of terms the use of any tissues from aborted human babies. That is a nonnegotiable issue for Christians as we consider medical advances and treatments. There are, however, complexities involved as Christians contemplate these incredibly serious moral questions.
Specifically, with the issue of the COVID-19 vaccine, Christians need to understand that no step in producing these vaccines had any direct involvement in an abortion of a single child. There is also the issue of proximity. The further you go in history, the harder it is to keep a clear line of culpability in morally significant events. That said, the good news about the COVID-19 vaccines is that even as these cells (most importantly from HEK-293) were used to create the basic shape of the vaccine, no fetal tissue was used.
At the same time, however, the vaccine’s structure relied upon the cell line of HEK-293, which originated with an aborted fetus. This is a tragedy of history. A horrifying wrong was done—but that does not mean that good cannot come from that harm, even as it is a good tainted by the realities of a sinful world. This idea is expressed, for Christians, as the doctrine of double effect. Some actions have more than one effect. For Christians, the primary intention must aim at virtue and good. The intention behind an act must never seek harm or evil or any moral reality and outcome against God’s will. We must never be complicit in intending sin, and certainly this applies to every dimension of abortion. But the Christian also acknowledges a potential double effect, for every moral act can lead to consequences not intended, but unavoidable. If the abortion of even a single human baby was required for this vaccine, or if abortion-derived materials were included in the vaccine, Christians would be rightly outraged. This is not the case. The vaccine can be taken by pro-life Christians with legitimacy.
The third moral principle Christians must consider deals with efficacy and safety of the vaccine. At this point, the medical community demonstrates enormous confidence in the vaccine. In the United States, the Food and Drug Administration does not merely require that a vaccine prove to be safe—it must also prove to be effective. To be sure, some people, especially those who have a specific allergic pattern, might have to carefully consider whether they should take any vaccine. For most, however, the vaccine is both safe and effective. This is certainly not a closed question—when it comes to medical treatment, there are very few closed questions. With any serious sickness or disease, we often have to weight this treatment over that treatment; this surgery over this therapy. Nothing in a fallen world is ever easy. We must, under the circumstances, do that which appears to be the most right, the safest, and the most good.
The fourth issue is whether or not a medical treatment is made mandatory by governing authority. Given the political reality and context in the United States, as well as the constitutional limits on the federal government, I think it is doubtful that Americans will face a federally mandated vaccine. That being said, the federal government can utilize certain coercive policies. For instance, the federal government possesses the power to decide who does and does not get to enter the United States. It has the power to decide who (other than citizens) may remain in the country. The federal government has authority over interstate commerce and transportation—including who rides on trains and who flies on a plane. Thus, there are some massive areas where the federal government could effectively enact a mandate for vaccination.
When it comes to state governments, it is doubtful that states will enact an absolute mandate—but much like the federal government, the state does have authority, for example, over who can and cannot attend public schools. The extent of state policies that approximate a mandate will depend upon whether or not you find yourself in a red or a blue state.
Though a universal mandate for a vaccine is unlikely, state by state and sector by sector we may confront what amounts to mandates. Christians will have to judge these policies as they come.
The fifth principle for Christians thinking about vaccines deals with the common good—the issue of love of neighbor. Some people might approach the issue of vaccination through self-defined terms. Such a person might say, “If a vaccine is available, then people can take it who want it. I’m not taking it. I pose no threat to anyone. I’ll deal with the consequences of my own actions.”
Here is the problem with this kind of moral equation: There are third parties—people who cannot take the vaccine or do not yet have access to it that could still be infected by those who refuse to take the vaccine.
The common good argument is extremely powerful in the Christian tradition. Indeed, it is the second greatest commandment listed by Jesus Christ: to love our neighbors as ourselves. The general principle of the common good comes down to benevolence, love, care for others, laying down personal priorities for the service of others. Christians thinking about the issue of the vaccine must weigh this key biblical principle as part of their thinking.
The sixth principle pertains to the integrity of the family and the authority of parents. We ought to be wary of any government or other intrusion into the family structure—in this case, we should stand against government policies that give vaccines to children and adolescents over and against (or without the knowledge of) the convictions of their parents.
Those on the left increasingly advance this notion of an absolute right to moral consent on behalf children, even if those decisions go against the authority of the child’s parents. To be sure, there are cases where the government must intervene, especially in extreme cases when the life of a child is at risk. There is no time to seek parental consent when a child needs blood transfusion or is in an emergency situation. There are extreme cases where authority must intervene—but again, those cases are extreme and must be rare.
Reasonable Christians and Christian parents will differ over whether or not to take the vaccine. But, speaking personally, I will take this vaccine as soon as it is available to me. I will take it not only for what I hope will be the good of my own health, but for others as well. I will seek to encourage others to take the vaccine. Encouragement, however, is very different from coercion.
The seventh and final moral principle has to do with access and priority, which is perhaps the easiest of the seven to understand. Those who are at greater risk or serving on the frontlines of this pandemic ought to be the first in line to receive the vaccine.
This is an absolutely historic and crucial moment. This pandemic has wrought untold destruction—and we are, I pray, in the final months of this contagion’s deadly advance. The creation of vaccines in such a short amount of time is something to be celebrated. And as Christians begin to decide whether or not to take the vaccine, it is important to understand the serious moral complexities involved. We must think biblically about this vital issue.
That is our first and primary responsibility.
ALBERT MOHLER is president of the Southern Baptist Theological Seminary.