Vaccination

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"In the case of an influenza pandemic, existing vaccines would likely be ineffective against a radically new strain. Developing and globally distributing a new pandemic influenza vaccine will likely take 4-6 months (4 months to produce first doses of vaccine, and 6 months to produce enough to give to a large number of people), even while mathematical models demonstrate that pandemic influenza could spread globally within 6 months. Another complicating factor to pandemic influenza vaccine production involves how the vaccine is made. Since the 1940s, seasonal and pandemic influenza vaccines have been produced in chicken eggs. The virus is introduced in the allantoic fluid of the fertilized egg (this is the fluid that bathes the embryo and yolk sac), and it replicates in the membrane surround the fluid. After about three days, the virus-containing fluid is harvested from each egg, and the rest of the manufacturing process proceeds. Dependence on egg-based vaccine production is, however, problematic even with non-pandemic seasonal influenza vaccine. First, eggs must be available in large quantities when vaccine production is to begin. Any disruption in egg supply – such as disease affecting chickens, or bad weather interfering with the shipping of eggs – can mean a delay in vaccine production. Second, some influenza strains grow more slowly or less robustly than others, which can result in delays or in lower yields of vaccine virus from each egg. Third, it is possible that some viral vaccine strains, given the origin of some influenza viruses in birds, may be toxic to eggs. In that case, egg-based influenza vaccine production methods would be useless."

- Influenza vaccine

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"Production capacity is another limitation to deployment of pandemic influenza vaccine. Current global capacity for pandemic influenza vaccine production is less than 3 billion doses per year, far short of the 7 billion doses that would be needed for universal coverage. To address some of these problems with egg-based vaccine production, some pharmaceutical companies are attempting to eliminate eggs from the process altogether. Novartis produces influenza vaccine from virus cultivated in cells derived from canine kidney cells (see the FDA information on this vaccine). Protein Sciences Corporation produces influenza vaccine using recombinant DNA technology and an insect virus system (see the FDA information). Other companies are developing influenza vaccine produced from different types of cell lines. Given that it takes roughly the same amount of time for influenza virus to replicate in eggs and in cell culture, shifting to cell culture will not necessarily speed up this phase of production. However, using cell culture technology will eliminate the lead time necessary to secure fertilized eggs for vaccine production and will reduce some of the variables related to the quantity of vaccine virus achieved with eggs. Additionally, egg-based influenza vaccine production requires a step in which the influenza virus is altered so that it reproduces well in eggs. If cell-based manufacturers can skip that step, they can begin vaccine production 4-6 weeks earlier than egg-based manufacturers."

- Influenza vaccine

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"Other approaches to accelerating influenza vaccine production involve use of what are referred to as dose-sparing technologies. These are innovations that allow less antigen to be used for each vaccine dose, without compromising immunogenicity or safety. Dose-sparing technologies have the potential to markedly increase vaccine production potential in a pandemic. Adjuvants (compounds that enhance the immune response to a vaccine and therefore reduce the amount of vaccine virus required for each dose) are one such technology. The most commonly used adjuvant today is an aluminum compound found in many childhood vaccines, but which is not used in influenza vaccine. Oil-in-water emulsion adjuvants show the greatest advancement and promise in terms of dose sparing for influenza vaccines. Other potential technologies might involve self-adjuvanting recombinant or molecular vaccines that have built-in antigen-sparing properties. Other promising candidates and technologies may emerge that lead to development of a universal influenza vaccine, which is the ultimate goal for many influenza vaccine programs. Such a vaccine might need to be given only once, rather than every year as with current seasonal vaccines. Such a universal vaccine would ideally provide protection against all, or at least most, of the many strains of influenza capable of making people sick, including future pandemic influenzas. Plant-produced influenza vaccines are in clinical trials and may prove to be a useful alternative to egg- and cell-based vaccines."

- Influenza vaccine

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"The lack of vaccinations of the population indicates a serious health risk of diffusing dangerous and often lethal diseases and infections that had been eradicated in the past, such as measles, rubella, and chickenpox. As noted by the Italian National Health Institute, since 2013 there has been a progressive trend in decreasing vaccination coverage. Vaccination coverage data for measles and rubella decreased from 90.4$ in 2013 to 85.3% in 2015, contrary to WHO indications that recommend 95% vaccination coverage to eliminate virus circulation. In the past, vaccines had been prepared using cells from aborted human fetuses, however currently used cell lines are very distant from the original abortions. The vaccines being referred to, the ones most commonly used in Italy, are those against rubella, chickenpox, polio, and hepatitis A. “It should be noted that today it is no longer necessary to obtain cells from new voluntary abortions, and that the cell lines on which the vaccines are based in are derived solely from two fetuses originally aborted in the 1960's.” From the clinical point of view, it should also be reiterated that treatment with vaccines, despite the very rare side effects (the events that occur most commonly are mild and due to an immune response to the vaccine itself), is safe and effective. No correlation exists between the administration of the vaccine and the onset of Autism."

- Use of fetal tissue in vaccine development

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"In 2005 the Pontifical Academy for Life published a document entitled: "Moral reflections about vaccines prepared from cells of aborted human fetuses" which, in the light of medical advances and current conditions of vaccine preparation, could soon be revised and updated. Especially in consideration of the fact that the cell lines currently used are very distant from the original abortions and no longer imply that bond of moral cooperation indispensable for an ethically negative evaluation of their use. On the other hand, the moral obligation to guarantee the vaccination coverage necessary for the safety of others is no less urgent, especially the safety more vulnerable subjects such as pregnant women and those affected by immunodeficiency who cannot be vaccinated against these diseases. As for the question of the vaccines that used or may have used cells coming from voluntarily aborted fetuses in their preparation, it must be specified that the "wrong" in the moral sense lies in the actions, not in the vaccines or the material itself. The technical characteristics of the production of the vaccines most commonly used in childhood lead us to exclude that there is a morally relevant cooperation between those who use these vaccines today and the practice of voluntary abortion. Hence, we believe 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. While the commitment to ensuring that every vaccine has no connection in its preparation to any material of originating from an abortion, the moral responsibility to vaccinate is reiterated in order to avoid serious health risks for children and the general population."

- Use of fetal tissue in vaccine development

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"In 1972, a female child was aborted in the Netherlands, and cells from her kidneys were extracted and developed into the cell line now known as "HEK293." "HEK" stands for "Human Embryonic Kidney." Cells from the HEK293 line have been commonly used in biologic research since the late 70s. The vaccinations produced by Pfizer and Moderna did not use HEK293 in their design, development, or production, but did use cells from the line in a confirmatory test, said the bishops. "While neither vaccine is completely free from any connection to morally compromised cell lines, in this case the connection is very remote from the initial evil of the abortion," said the bishops. Conversely, the vaccine produced by AstraZeneca "should be avoided if there are alternatives available," said the bishops, as this 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," said Rhoades and Naumann. The two compared the AstraZeneca vaccine to the current rubella vaccine, which also was reliant on "morally compromised cell lines." In the case of the rubella (German measles) vaccine, explained the bishops, the risk posed to an unborn child and the community at large by the illness outweigh the morality concerns related to the development of the vaccine. "In such a situation, parents are justified in having their children vaccinated against rubella, not only to avoid the effects of rubella on their children, but, secondarily and just as importantly, to prevent their children from becoming carriers of rubella, as the spread of rubella can lead to the infection of vulnerable pregnant women, thereby endangering their lives and the lives of their unborn children," said the bishops. Rhoades and Naumann acknowledged that while Catholics should avoid the AstraZeneca vaccine in preference for one of the other two, it may not be possible for someone to do this without putting society at risk from the coronavirus. If this were to happen, a Catholic would be permitted to receive that vaccine."

- Use of fetal tissue in vaccine development

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"1. As the Instruction Dignitas Personae states, in cases where cells from aborted fetuses are employed to create cell lines for use in scientific research, “there exist differing degrees of responsibility” of cooperation in evil. For example, “in organizations where cell lines of illicit origin are being utilized, the responsibility of those who make the decision to use them is not the same as that of those who have no voice in such a decision”. 2. In this sense, when ethically irreproachable Covid-19 vaccines are not available (e.g. in countries where vaccines without ethical problems are not made available to physicians and patients, or where their distribution is more difficult due to special storage and transport conditions, or when various types of vaccines are distributed in the same country but health authorities do not allow citizens to choose the vaccine with which to be inoculated) it is morally acceptable to receive Covid-19 vaccines that have used cell lines from aborted fetuses in their research and production process. 3. The fundamental reason for considering the use of these vaccines morally licit is that the kind of cooperation in evil (passive material cooperation) in the procured abortion from which these cell lines originate is, on the part of those making use of the resulting vaccines, remote. The moral duty to avoid such passive material cooperation is not obligatory if there is a grave danger, such as the otherwise uncontainable spread of a serious pathological agent--in this case, the pandemic spread of the SARS-CoV-2 virus that causes Covid-19. It must therefore be considered that, in such a case, all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive. It should be emphasized, however, that the morally licit use of these types of vaccines, in the particular conditions that make it so, does not in itself constitute a legitimation, even indirect, of the practice of abortion, and necessarily assumes the opposition to this practice by those who make use of these vaccines. 4. In fact, the licit use of such vaccines does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted fetuses. Both pharmaceutical companies and governmental health agencies are therefore encouraged to produce, approve, distribute and offer ethically acceptable vaccines that do not create problems of conscience for either health care providers or the people to be vaccinated. 5. At the same time, practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary. In any case, from the ethical point of view, the morality of vaccination depends not only on the duty to protect one's own health, but also on the duty to pursue the common good. In the absence of other means to stop or even prevent the epidemic, the common good may recommend vaccination, especially to protect the weakest and most exposed. 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."

- Use of fetal tissue in vaccine development

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"Two human cell lines (MRC-5 and WI-38) that are used to grow these weakened virus strains have their origins in cells derived from the lung tissue of aborted fetuses (Dan Maher, “On the Use of Certain Vaccines,” unpublished manuscript [1998, NCBC]). Although these human cell lines could have been produced using cells taken from other sources (thus avoiding the moral problem entirely), the fact is that they were not. In many cases, there is no other choice than either to make use of a tainted vaccine or to forgo vaccination altogether. Thus “Meruvax,” a widely used vaccine for rubella (German measles) sold by Merck & Co., Inc., uses the WI38 cell line. The chicken pox vaccine “Varivax,” produced by the same company, uses both MRC-5 and WI-38. SmithKline Beecham offers a vaccine called “Havrix” that has its origins in MRC-5. “Havrix” guards against scarlet fever, rheumatic fever, kidney inflammation, and other hepatitis A infections. Whether immunization with these vaccines is permissible depends upon whether their use involves the Catholic in cooperation with evil. Briefly, formal cooperation arises when an individual shares in the intention or the action of another who does what is wrong. Immoral material cooperation occurs when one who cooperates makes an essential contribution to the circumstances of a wrongdoer’s act. Thus the question about vaccines derived from aborted fetuses concerns whether or not their use involves the Catholic in immoral cooperation with the evil of abortion. The answer, in short, would appear to be “no.” For it seems impossible for an individual to cooperate with an action that is now completed and exists in the past. Clearly, use of a vaccine in the present does not cause the one who is immunized to share in the immoral intention or action of those who carried out the abortion in the past. Neither does such use provide some circumstance essential to the commission of that past act. Thus use of these vaccines would seem permissible."

- Use of fetal tissue in vaccine development

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"Yet another objection concerns the problem of scandal. When a Catholic allows himself to be immunized with these vaccines it may appear to others that he acts hypocritically. Catholics, it will be said, talk a lot about moral principles, but when it comes to their own health or that of their children, they appear willing to abandon all previous moral conviction. There would appear to be no objective basis for the charge that one who uses these vaccines cooperates in moral wrongdoing; therefore, any scandal caused by their use must be purely subjective in character. Appearances, however, can be important. For this reason, some Catholics decide to refuse vaccination in order to express their strong opposition to the practice of abortion. Still others are convinced, contrary to the arguments offered here, that vaccination does involve some form of cooperation with abortion. They believe that refusal is the only way to avoid complicity. Nonetheless, refusal appears to represent a course of action that goes beyond what is morally required. When carried out in the light of a fully formed conscience, heroic acts based on sound moral principle can be highly praiseworthy. That would seem to be the case here. Those in the medical profession who refuse to be immunized with tainted vaccines often suffer harm to their careers. Health care facilities require that all employees be properly immunized against infectious diseases. When health care employees refuse to do so, they can expect to be dismissed from their posts."

- Use of fetal tissue in vaccine development

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"From a theoretical standpoint, therefore, the path would seem to be clear. Parents who reject all association with abortion should feel free to refuse vaccination for themselves and for their children. Nonetheless, when this approach is put into practice, many difficulties arise. For example, objectors often face a problem when they attempt to place their children into a school system, whether public or private. School administrators, who have both a moral and legal obligation to protect the health and well-being of their students (as well as their teachers, school administrators, and all who work there), routinely prohibit attendance by children who have not been vaccinated against rubella and other contagious diseases. Many states offer exemptions from immunization requirements; some do not or only for very specific reasons. Thus a state may accept a religious exemption, but may refuse one based on medical concerns if they are deemed unjustifiable. In cases where an exemption is denied, parents find themselves with very few options. The difficulty is heightened for Catholics because there is no official teaching of the Church on the question of whether the use of these vaccines is permissible. There are, it is true, various “probable opinions” issued by respected Catholic theologians and Catholic organizations, but the Church itself has taken no position. Thus Catholic parents who object to immunization with vaccines implicated in abortion can make no appeal to official church teaching, and if they attempt to do so, they are likely to be shown a statement from some recognized Catholic authority that contradicts their views. Can an appeal to conscience serve as a ground for an exemption to vaccination when there is no Catholic teaching on this matter?"

- Use of fetal tissue in vaccine development

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"But let us suppose that it should turn out that those who refuse vaccination are mistaken in their judgment. Let us say that the Church issues a directive stating that there is no illicit cooperation with abortion in the case of these vaccines. Nonetheless, the obligation to follow an erroneous conscience remains. We cannot oblige a person to violate his conscience, but we must respect that decision even if we ourselves are convinced that it is wrong. On all of these grounds, therefore, one can argue forcefully that parents who do not want to have any association with the practice of abortion, and who refuse to have their children vaccinated, should be free to do so. Certainly, it would be wrong to force parents to vaccinate their children. We cannot compel anyone to act against his will except as punishment for a crime. Beyond this, however, it is difficult to know what more one can be said about the refusal to vaccinate on the basis of conscience. Catholic teaching holds that there is an objective moral order that ought to guide the activity of conscience. Obviously, we are not free to decide whatever we wish—every moral person will agree on this point. The moral order that ought to guide our conduct does not depend upon the judgment of Church officials, but exists independently of all human decision. The mind must conform to reality in order to know the truth, but in the absence of any announced position by the Church, one can only appeal to the authority of one’s own conscience, which will hopefully be well-grounded in observation and sound thinking. The more our appeal takes its bearings from a knowledge of the facts and the true principles of morality, the more likely it will be that our exercise of conscience will successfully choose the good."

- Use of fetal tissue in vaccine development

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"Having considered the previous cases, we arrive at the question of what kind of cooperation with abortion obtains when a parent decides to immunize a child against rubella. The parent has no intention of participating in abortion and, living in the present, has no connection whatsoever to the abortions performed in the past. Neither does the parent make use of the cells taken from an abortion, but makes use of a vaccine that was grown in descendant cells. The capacity of these cells to duplicate in culture shows that their use applies little to no pressure on others to perform abortions. There is an abundant supply. If there were some remaining level of cooperation here, it could only be remote. This cooperation would be completely permissible because 1) parents have no choice but to use these products if they wish to protect their children and society from these serious diseases; and 2) the good that parents are seeking to secure through vaccination exceeds any harm that might be caused by that use. Thus it would represent a very harsh judgment, in my opinion, if someone were to say that unborn children must face the risks of serious birth defects or even death because others feel an obligation to make a strong statement against the evil of abortion. The fault surely lies with the original tissue researchers and, less directly, with the pharmaceutical companies or those who made imprudent decisions at the time these products were first manufactured. The fault does not lie with the parents and surely not with the children who suffer the risk. If the above reasoning is correct, and there is no immoral cooperation with abortion in the use of these vaccines, then we are led back to the problem of conscience from an entirely new perspective. One who properly exercises conscience will recognize that he has a moral obligation to protect the life and health of his neighbors and that he must therefore ensure that he and his children are vaccinated as a correct means to that end. He will recognize that there is a moral question at issue in the use of vaccines, but he will also see that there can be no justification for risking the health and life of unborn children who have had absolutely no hand in the original wrongdoing. He will bear in mind that his own children will learn from his decision and that the occasion presents him with an opportunity to explain to them how to think about difficult moral problems. The formation of conscience is a responsibility that a parent has toward his child throughout his time in the home. What will the child learn from a parent who refuses to vaccinate him out of an exaggerated concern that the use of these vaccines is immoral? Hopefully, the entire event will pass without his notice."

- Use of fetal tissue in vaccine development

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"There is an even more fundamental question at stake. Can a parent exercise a right of conscience for a child? How can I risk your health in order that I might make a strong stand against abortion? This, in fact, is impossible because it is contrary to the very nature of conscience, which is always the personal act of a particular individual19 I cannot carry out an act of conscience for you. Only you can do that for yourself. But someone will say, “In this case the child is not old enough to decide for himself; therefore, the parent must decide on his behalf.” Exactly, and that is all the more reason to act for the sake of the child’s health. That is the moral principle that ought to govern all decisions in this area. Just as the demand for an exemption to a law mandating vaccination seems unjustifiable, so does the appeal to the right of conscience. No one can exercise the right of conscience for someone else—not even for one’s own child. All one can do is act for the sake of child’s life and health. Hence, an adult is free to appeal to the right of conscience in order to justify his own refusal to vaccinate himself, but he cannot appeal to the right of conscience in order to justify his decision not to vaccinate those who are under his supervision and who rely upon him for their medical care. We should not allow the one who carried out an abortion in the past to hold our children hostage in the present."

- Use of fetal tissue in vaccine development

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"Unlike bacteria, viruses do not replicate on their own. To make viral vaccines, large numbers of viruses must be grown in cell cultures specific to each virus. Some licensed viral vaccines (i.e., some formulations ofhepatitisA, poliovirus, rabies, rubella, and varicellazoster viruses or combination vaccines containing such component viruses) are produced by growing viruses that infect humans in WI-38 or MRC-5 cell cultures. WI-38 and MRC-5 represent two commonly used lineages of human diploid cell cultures, batches of immature cells with twice as many chromosomes as sperm or egg cells. Embryonic diploid cells are valuable in vaccine manufacture, because each aliquot ofthese cells can propagate several dozen times before senescence. Each of these cell lines started with cells harvested from a deliberately aborted fetus. The cell lines are used to grow the viruses, then discarded and not included in vaccine formulations. These cell lines cannot form a human being. TheWI-38 line was developed attheWistar Institute in Philadelphia in 1961, with lung cells from a female fetus of 3 months gestation aborted in Sweden, whose parents feltthey had too many children. Similarly, British scientists funded by the Medical Research Council developed the MRC-5 line in September 1966 with fetal lung fibroblasts “taken from a 14-weekold male fetus removed for psychiatric reasons from a 27-year-old woman. . .”. These cell lines, still in use today, gradually replaced primary cultures of monkey, duck, rabbit, chicken, dog, or mouse tissue, an approach vulnerable to contamination with viruses and bacteria."

- Use of fetal tissue in vaccine development

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"In the late 1990s—early 2000s, teams of ethicists at the National Catholic Bioethics Center and then at the Vatican’s Pontifical Academy for Life and elsewhere considered the virology, epidemiology, and theology of the matter in detail. Their considerations included both cooperation with evil and the principle of double effect. In this case, the cooperation related to those involved with the specific abortions in the 1960s. The principle of double effect applied insofar as using implicated vaccines today could appear to endorse or acquiesce to the acceptability of additional abortions in our current time. These teams concluded that the association between implicated vaccines and abortion was noncomplicit, and that using these vaccines is not contrary to a principled opposition to abortion. These centers reasoned that, because the abortions that enabled the production ofthese vaccines are in the past and (critically) the abortions were not undertaken with the intent of producing the cell lines, being immunized does not involve any sharing in immoral intention or action of others. In short, they are morally separate actions. In 2008, this position was elevated to the status of official Roman Catholic teaching. The bioethicist teams agreed that use of a vaccine in the present does not involve sharing in the action of those who carried out the abortion in the past. Further,they foundthatparents have a moral obligation to provide for the life and health of their children by means of immunization. The situation with vaccines differs morally from ongoing harvest of fetal tissue for pharmaceutical manufacturing or research, which could be used to justify future abortions. Still, these ethicists concluded that alternate vaccines should be used if available. They also recommended that parents and clinicians should speak out against abortion by asking governments and vaccine manufacturers to stop using cell lines that have links to aborted fetuses."

- Use of fetal tissue in vaccine development

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"In 1964, the Wistar Institute developed the RA 27/3 strain of rubella virus. The rubella virus isolate “was recovered from the explanted [kidney] tissue of a fetus obtained at therapeutic abortion from a mother who had been infected with rubella virus”. The scientific literature of that era indicates that the abortion was not conducted with the motive of isolating the virus, but rather because the mother was infected with rubella virus and risked major birth defects. After the RA 27/3 strain was isolated, it has been propagated serially in human diploid cells. The RA 27/3 strain produced superior antibody responses and was better tolerated, compared with other rubella vaccine strains available in the 1960s. No further abortions are necessary to sustain the manufacture of additional batches of rubella RA 27/3-strain vaccine. Use of the RA 27/3 rubella virus strain was also considered by the National Catholic Bioethics Center and the Pontifical Academy for Life. Using the same logic, they reasoned that because the one abortion that yielded the viral isolate was not undertaken with the intent to retrieve the virus and because no additional abortions are needed to obtain more virus, being immunized is morally acceptable and also associated with parental duty. The same provisions for preferring alternatives and petitioning governments and manufacturers also apply. Some find it meaningful that rubella vaccination prevents many cases of fetal death and congenital rubella syndrome that would otherwise occur if women were infected with rubella virus during pregnancy. Immunized women exposed to the virus during pregnancy are no longer confronted with the question (what some religions might consider temptation) of whether to terminate their pregnancies on that basis."

- Use of fetal tissue in vaccine development

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"It is important to note that the use of these vaccines, generated from fetal tissue of elective abortions, can only occur on a temporary basis, as it represents a “very remote mediate material cooperation” (Pontifical Academy for Life 2006, 547) with the original illicit act of abortion. The distinctions between the different forms of cooperation were established by St. Alphonsus Liguori and can be categorized by the proximity of actions to the original illicit act. An example using vaccines generated from fetal tissue of an elective abortion follows: Principal agent: The mother who elects to terminate her pregnancy. Formal cooperator: The abortionist who agrees with the actions of the principal agent and supports her by performing the abortion. Immediate material cooperator: A nurse who does not agree with the actions of the principal agent but supports the abortionist in performance of the abortion. Mediate material cooperators: The nurse who does not agree with the actions of the principal agent but prepares her for the abortion and monitors her recovery post-abortion. Remote mediate material cooperators: The technicians at the abortion clinic that process and package fetal tissue for future use in scientific research. The scientists who arrange to receive aborted fetal tissue from the clinic for their research. Very remote mediate material cooperators: Individuals utilizing a product, for example a vaccine that was generated utilizing aborted fetal tissue. Even the distant cooperation represented by these vaccines needs to be avoided as it is: moral coercion of the conscience of the parents, who are forced to choose to act against their conscience or otherwise, to put the health of their children and the population as a whole at risk. ...[Therefore,] doctors and fathers of families have a duty to take recourse to alternative vaccines (if they exist), putting pressure on the political authorities and health systems so that other vaccines without moral problems become available. (Pontifical Academy for Life 2006, 549, 547–8)"

- Use of fetal tissue in vaccine development

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"Recently, two articles were published in the New England Journal of Medicine that char acterized fetuses of elective abortions, one being thirty-two weeks old, from mothers who contracted Zika virus in the first trimester of pregnancy (Mlakar et al. 2016; Driggers et al. 2016). These studies identified Zika virus in the microcephalic brains of the fetuses indicating an association between in utero Zika virus infection and microcephaly. More research on human subjects with similar experimental designs has been proposed to better understand fetal infection (Check Hayden 2016). These studies would also involve pregnant women who have been exposed to Zika virus infection that are followed for microcephaly by ultrasound throughout pregnancy. They would be informed of ultrasound results and, if microcephaly was demonstrated, would receive counsel on the prognosis of their child and options available, including termination of the pregnancy. If the mother elects to abort her child and provides her consent, the aborted fetal tissue would then be utilized in research procedures. This experimental design denies the intrinsic right to life of unborn human beings as the success of the study is predicated on the decisions of mothers to abort their babies. The U.S. Department of Health and Human Services Code of Federal Regulations (CFR) Title 45 Part 46 Subpart B, “Additional Protections for Pregnant Women, Human Fetuses, and Neonates involved in Research,” indicates that: The risk to the fetus is caused solely by interventions or procedures that hold out the prospect of direct benefit for the woman or the fetus; or, if there is no such prospect of benefit, the risk to the fetus is not greater than minimal and the purpose of the research is the development of important biomedical knowledge which cannot be obtained by any other means. (U.S. Department of Health and Human Services 2009)."

- Use of fetal tissue in vaccine development

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"While the ultrasound procedure presents minimal risk to the fetus, diagnosis of microcephaly by ultrasound has the potential to place the fetus at greatest risk due to the mother’s decision to abort the fetus. To minimize the possibility that involvement in research will influence a mother’s decision to terminate a pregnancy, 45 CFR 46, Subpart B, indicates that, “no inducements, monetary or otherwise, will be offered to terminate a pregnancy” (U.S. Department of Health and Human Services 2009). In addition, it “excludes researchers from any decisions as to the timing, methods, or procedures used to terminate a pregnancy, or determinations on the viability of the fetus at the termination of the pregnancy” (U.S. Department of Health and Human Services 2009). Nevertheless, it is very challenging to design experimentation that identifies microcephaly in utero, which would not increase the number of elective abortions regardless of whether research scientists desiring aborted fetal tissue were excluded from involvement with patients’ decision making. Here, the Catholic Church’s perspective is invaluable: “sick and disabled people are not some separate category of humanity; in fact, sickness and disability are part of the human condition and affect every individual, even when there is no direct experience of it” (Congregation for the Doctrine of the Faith 2008, no. 22). Therefore, only an experimental design that recognized the dignity and legal status of both healthy and diseased fetuses would effectively discourage elective abortion in research studies. This design would not only protect the unborn but also limit scandal (Catechism of the Catholic Church, no. 2284), a behavior that leads another to do evil, from the actions of mothers and scientists. Development of a vaccine against Zika virus is a top priority; and as the virus infects fetal brain tissue, it is likely that cultivation of Zika virus for use in vaccines could occur in fetal tissue derived from elective abortions. However, alternative tissue that is not derived from elective abortions could be equally effective and should be investigated."

- Use of fetal tissue in vaccine development

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"Quite apart from the health benefits and risks associated with using or not using vaccines, some people oppose the use of certain common vaccines—such as Varivax (for chicken pox) and Meruvax II (for rubella)—because of the connection between the production of these vaccines and elective abortion. The production of these and some other vaccines involves a stage in which viruses are grown in human cell culture. Because viruses can reproduce only inside living cells, they are placed in the human cell culture and allowed to grow in large quantities. The viruses are removed from the cell culture, inactivated or modified, and then processed further in order to produce the vaccine. There are two human cell lines that provide the cell cultures needed for producing vaccines. One of these lines, called WI-38, was developed in 1961 in Philadelphia from the normal lung tissue of a three-month-old female fetus obtained by surgical abortion.19 The other line, called MRC-5, was developed from normal lung tissue of a fourteen-week-old male fetus, aborted “for psychiatric reasons.” The WI-38 human diploid cell line … has been shown to have one of the broadest human virus spectra of any cell population that has been tested and is especially useful for isolation of rhinoviruses. The cells are free of contaminating viruses, mycoplasmas or any other microorganism and do not form tumors when inoculated subcutaneously into terminal human cancer patients.21 MRC-5 cells replicate more rapidly and are less sensitive to adverse environmental factors than WI-38 cells. The MRC-5 cell line, like WI-38 (ATCC CCL-75), is susceptible to a wide range of human viruses, is suitable for the production of viral vaccines, and has been useful in senescence studies."

- Use of fetal tissue in vaccine development

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"These cell lines are maintained in such a way that they have an indefinite lifespan, providing all the cells needed for the production of vaccine and for some other uses. It is said to be unlikely that any additional human cell lines will be produced or needed for two reasons. First, for scientific purposes, it is desirable to make use of well-known cell lines that have proven over the years to be useful for these purposes and to be free of complicating or contaminating factors (as described in the preceding quotations). Second, any cell line such as these must be approved by the Food and Drug Administration, which means that it is probably financially prohibitive to try to gain the same approval for other lines when these have already proven effective. This situation generates a difficulty for people who both oppose abortion in principle and would like to have the benefits of these vaccines. Opposing abortion “in principle” here means moral condemnation of elective abortion itself without regard to circumstances, motives, or beneficial consequences. The various reasons, theological or philosophical, that people might bring forward to support this opposition are not immediately relevant; it is necessary only that the opposition be principled. This kind of attention to moral good, i.e., moral good understood as decisively superior to goods of health and life, opens the door to a different order of opposition to vaccination. For using the vaccines produced in the manner described above appears to involve profiting from abortion and it is a question whether someone can both use these vaccines and oppose abortion without moral incoherence. Is the moral integrity of a person opposed to abortion compromised by benefitting from the research following the abortion, which research has led to the development of several powerful vaccines? Is it immorally opportunistic, vulture-like, or hypocritical for someone to take advantage of something he or she condemns as evil? Or, on the other hand, since the abortions have already been accomplished, is not the best course of action to pursue whatever good can be derived from these abortions? To answer these questions, it is necessary to try to determine the moral relationship of the use of these vaccines to the two abortions25 that have already taken place and to try to determine whether the use of these vaccines either condones or promotes further abortions."

- Use of fetal tissue in vaccine development

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"When aborted fetal tissue is transplanted into others for experimental or therapeutic purposes, the very use of the tissue uses it up and additional uses require an additional supply of tissue, normally made available by further abortions. In vaccine production, the currently available cell lines provide all the fetal material that is needed now and, apparently, in the future. Indeed, the success of these particular cell lines makes it unlikely that any new lines will be developed (whether from induced or spontaneously aborted children). Hence, the production techniques themselves do not require further abortions. The moral difference between vaccine technology and tissue transplantation is not changed by the fact that the product labeling for Varivax, for example, states that each dose contains “residual components of MRC-5 cells including DNA and protein.” These trace particles do not function in any sense as active components in the effectiveness of the vaccine. Still, it remains necessary to inquire into the relationship between the production of the vaccines and the two abortions that yielded the tissue. According to all available reports, in both cases the decision to abort was independent of the desire to make use of fetal tissue. In other words, the abortions would have taken place whether or not the cell-line research would have followed. This means that the abortions were not undertaken in order to produce vaccines or to fulfill any other research purpose. Moreover, nothing indicates that the vaccine production requires cell lines from electively aborted fetuses; tissue that is sufficiently healthy to produce cell lines of the type requisite for vaccine production might have become available from a fetus that died from some other cause. Granted, healthy tissue is more commonly found in electively aborted fetuses, but nothing indicates that such tissue is necessarily unavailable from other sources. These points suggest that vaccine production and, hence, use is morally separable from abortion, even though current production in fact depends upon cell lines derived from aborted fetal tissue. Vaccine production and abortion are morally independent, which is to say that vaccine use and opposition to abortion are in principle morally coherent."

- Use of fetal tissue in vaccine development

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"One pertinent detail that I have not been able to discover is the exact manner in which the tissue was transferred from those who performed the abortions to those who initiated the research. Did the research teams make it known that they were seeking certain types of tissue in a certain condition and did this influence the time or manner of the relevant abortions? This is significant because it can determine the moral quality of the initial research work relative to the abortions. This can be seen clearly by considering the differences between ordinary abortions and abortions that might be performed with a view to using fetal tissue for therapeutic or research purposes. In some of these cases it could happen that the manner of the abortion would be dictated by the need for certain amounts of, say, neural tissue in a certain condition. And so it might become necessary for fetal tissue collection to take place while the fetus still lives, or, more accurately, it might be necessary that the manner of fetal tissue collection itself be the cause of fetal death. If some similar relationship obtained between the original abortionists and the researchers who developed the cell lines, these researchers would be morally implicated in the abortion. Nevertheless, judging those actions is not now the primary concern. Knowing the exact manner of the transfer of tissue would be significant for evaluating the moral character of the initial research uses of the fetal tissue, but it is not, I argue below, decisive for evaluating the use of the vaccines today."

- Use of fetal tissue in vaccine development

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"Now, in the present case, the only opportunity for cooperation in abortion occurs in connection with the initial transfer of tissue. Today, when a person receives a vaccine injection, there simply is no cooperative action with whoever performed the abortions. The vaccine user provides no material assistance in the abortion nor acts in such a way as to will that the abortions take place. It is true as a matter of fact that the cell lines used to produce vaccines come from abortions, but abortion is not essentially necessary as a means to this end. This does not mean that the use of the vaccine is totally unrelated to abortion, but only that the distinctions that help to assess cooperation in evil do not provide a coherent moral analysis. Considering the independence—not only in time and place, but also morally—of vaccination from abortion, one comes to see that one achieves a morally coherent understanding of vaccination without essential relation to one’s moral condemnation (or for that matter, approval) of abortion. The use of these cell lines for the production of vaccines is somewhat akin to the use of the organs of a murder victim for transplantation in order to benefit others. A murder victim’s organs are available because of a morally reprehensible deed, but their use to benefit someone else does not make the transplantation team or the recipient complicit in the murder. Once again, there simply is no cooperative action between the murderer and the organ recipient or even the transplantation team. Acknowledging that it is distasteful to draw personal benefit from another’s suffering, one must yet recognize that taking advantage of this situation in this manner is not, as such, morally evil or morally incoherent. Just as it would be preferable to receive organs without any murder having occurred, in the same way, it would be preferable if the vaccines had no connection with abortion. Nevertheless, the use of the vaccine is accidentally, not essentially related morally to those two abortions."

- Use of fetal tissue in vaccine development

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"The argument above holds that the use of vaccines whose production involves the use of fetal cell lines does not create a situation of cooperation with abortion or complicity with the original abortions. This use is not, however, entirely unrelated to abortion, and the fact that using the vaccines is not cooperation in abortion does not settle the matter. The gravity of abortion might require us to make extensive efforts to avoid wherever possible association with abortion, abortion providers, and people who promote abortion in one manner or another. Donum vitae addresses this concern: The corpses of human embryos and fetuses, whether they have been deliberately aborted or not, must be respected just as the remains of other human beings. In particular, they cannot be subjected to mutilation or to autopsies if their death has not yet been verified and without the consent of the parents or of the mother. Furthermore, the moral requirements must be safeguarded, that there be no complicity in deliberate abortion and that the risk of scandal be avoided. Also, in the case of dead fetuses, as for the corpses of adult persons, all commercial trafficking must be considered illicit and should be prohibited.38 This excludes “complicity in deliberate abortion,” and if being complicit means being an accomplice, it appears that avoiding complicity requires avoiding cooperation in or contributing to the performance of abortion. If it is true, as has been argued above, that the use of the vaccines in question cannot be understood to be a case of complicity in abortion, it would appear that there is no objection on the basis of this text. The matter is, however, not so simple. The Latin version of the pertinent sentence—translated above as “Furthermore, the moral requirements must be safeguarded, that there be no complicity in deliberate abortion and that the risk of scandal be avoided”—reads as follows: Praeterea, semper salva legis moralis praescriptio esse debet, quae excludit quamlibet cum abortu voluntario societatem et scandali periculum. Literally: “Furthermore, the prescription of the moral law ought always to be preserved, which excludes the danger of scandal and any association with voluntary abortion.” Now, excluding “any association” appears to be a stronger requirement than excluding complicity. An associate is more loosely related to some thing than is an accomplice. Still, societas is not a technical term, and it is necessary to determine what Donum vitae means by this wrongful association."

- Use of fetal tissue in vaccine development

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"In addition to concern for the moral formation of their children, parents making decisions about the use of the vaccines under consideration might also question whether this use would appear to others as indifference to the moral quality of abortion, thereby lending some positive encouragement to others to have abortions or perhaps leading others to indifference or misunderstanding. Here it is necessary to distinguish, in the traditional language, between scandal given and scandal taken. Scandal is given when someone acts in such a way that an observer can be expected to be led astray. Scandal is taken when someone is led astray upon observing another person’s behavior, whether that behavior has been rightly or wrongly interpreted. People who take moral matters seriously take reasonable steps to avoid giving scandal when possible, but there does not seem to be any limit to how much might need to be done to preclude the possibility of someone’s taking scandal by misinterpreting one’s own upright behavior. Plainly, it is sufficient to be reasonably cautious. This means that questions of scandal require prudence to evaluate the circumstances and the likely course of the actions of others. Consider the following two scenarios. Someone could argue that the use of these vaccines displays an indifference to abortion. Indeed, some people do appear to believe that if the production of the vaccines involves aborted fetal tissue in any manner whatever the vaccines must be rejected.41Knowing this, anyone using the vaccine must also anticipate that another person may take scandal at one’s actions, thereby leading the scandalized person to believe that the vaccine user does not genuinely oppose abortion, but only when it is convenient. In their own way, the children being vaccinated might be susceptible to this view. Further, someone could believe that the availability and use of these vaccines might lead to further abortions by allowing ambivalent women to take consolation that some good might come out of having an abortion. This possibility is remote, admittedly, and yet it is not inconceivable as a contributing motivating factor. Hence, this argument would lead one to refuse to use these vaccines, not because their use is in principle bad, but because someone else might through misunderstanding be led to some error."

- Use of fetal tissue in vaccine development

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"Nevertheless, these considerations, while plausible, are not compelling. Someone could respond to these arguments, with at least equal plausibility, by saying that a woman deciding whether or not to abort her own child is likely to be completely unconcerned with whether the children of others have been adequately vaccinated. It is hard to imagine any drastic increase in the number of abortions because of vaccines; people have abortions for other reasons. Further, it could be argued that even if a woman were swayed in her decision by the presence of these vaccines, that would amount to no more than an excuse and a way to silence feelings of doubt or remorse. One person is not ordinarily responsible for another’s rationalizations. Finally, this argument would say that the bare possibility that some hypothetical woman might be swayed to have an abortion is not as significant as the genuine responsibility of parents to protect their existing children from harmful, even deadly, diseases. In some cases (e.g., rubella, varicella, and adenovirus), there is not available an equally good vaccine that is produced without the use of cell lines from aborted fetuses. Moreover, the health benefits at issue do not accrue only to their own children, but to all people within the community to which the children belong. In the face of these opposing arguments regarding the relation of the use of these vaccines to future abortions, it would seem that more than one practical option is morally coherent. People who want to make a strong stand against abortion could refuse to use the vaccines, assuming that they could find adequate ways to protect themselves and others from disease. When there are children involved, parents must recognize that they are responsible for reasonable measures to protect the children (and to prevent the children from being a contagious threat to society). This threat is no trivial element of what parents must examine when they consider whether their children will join them in making an equally strong stand against abortion. At the same time, someone else who understands and deplores the accidental relation of these vaccines to abortion, who thinks that his or her use of the vaccine will have no significant effect on any future abortions, and who finds no alternative, equally effective ways to guard against infectious diseases readily available could make use of these vaccines without falling into moral incoherence. No further harm is necessarily generated by using the vaccine; no obvious good is necessarily achieved by refusing it, and there are a variety of other ways parents might communicate the moral character of abortion to their children. Alternatively, some people might want to be especially rigorous in their opposition to abortion, much as some people will participate in public abortion protests. Such public opposition cannot be understood to be morally implied by opposition to abortion since it is unclear how or if those protests have any significant effect on the number of abortions one way or the other."

- Use of fetal tissue in vaccine development

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"After all of this has been said, if one judges that the use of these vaccines is indeed morally coherent for those who condemn abortion, even if it is not unqualifiedly desirable, one must be prepared for a further challenge. If the use of these vaccines despite their connection with abortion were to become customary, and if people cease to be uncomfortable with the regrettable origins of these vaccines, it will probably become more difficult to maintain the distinction between the use of existing fetal cell lines for vaccines and the use of fetal tissue for research and transplantation, not to mention the various experimental uses of frozen human embryos. The distinction articulated above—between a noncomplicit, accidental relationship and an association that is incoherent with principled opposition to abortion—will probably become more difficult to defend in public. As the practice of fetal tissue research and transplantation spreads, the sorts of arguments presented above are likely to be recast and used in support of this sort of research and transplantation.47 This suggests that it is rhetorically difficult to display the moral coherence of using these vaccines while simultaneously opposing proliferation of the therapeutic use of aborted fetal tissue. This difficulty is not decisive for the question of vaccines, but neither is it irrelevant. Whatever the future may hold in this regard, it is essential to think seriously about the moral significance of these matters. It would be irresponsible to condemn vaccines and other powerful therapies for superficial or accidental moral reasons. The health benefits at issue are considerable, and weighty moral reasons must be given before it is coherent to accept what may be a serious loss of control over vaccine-preventable diseases."

- Use of fetal tissue in vaccine development

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"The woman was four months pregnant, but she didn’t want another child. In 1962, at a hospital in Sweden, she had a legal abortion. The fetus — female, 20 centimetres long and wrapped in a sterile green cloth — was delivered to the Karolinska Institute in northwest Stockholm. There, the lungs were dissected, packed on ice and dispatched to the airport, where they were loaded onto a trans- atlantic flight. A few days later, Leonard Hayflick, an ambitious young microbiologist at the Wistar Institute for Anatomy and Biology in Philadelphia, Pennsylvania, unpacked that box. Working with a pair of surgical scalpels, Hayflick minced the lungs — each about the size of an adult fingertip — then placed them in a flask with a mix of enzymes that fragmented them into individual cells. These he transferred into several flat-sided glass bottles, to which he added a nutrient broth. He laid the bottles on their sides in a 37 °C incubation room. The cells began to divide. So began WI-38, a strain of cells that has arguably helped to save more lives than any other created by researchers. Many of the experimental cell lines available at that time, such as the famous HeLa line, had been grown from cancers or were otherwise genetically abnormal. WI-38 cells became the first ‘normal’ human cells available in virtually unlimited quantities to scientists and to industry and, as a result, have become the most extensively described and studied normal human cells available to this day."

- Use of fetal tissue in vaccine development

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"When Hayflick opened up that icy package from Sweden in 1962, he was working at the vanguard of virus research in the United States. At the time, the Wistar Institute was led by Hilary Koprowski, a polio-vaccine pioneer who hired Hayflick to run the centre’s cell-culture laboratory and supply cells to researchers. But Hayflick also began investigating whether some human cancers might be caused by viruses. To do so, he needed a resource that did not yet exist: verifiably normal human cells that could be reliably grown in the lab. Fetal cells, he thought, were an ideal candidate, because they were less likely to have been exposed to viruses than adult cells. Although abortions were technically illegal in Pennsylvania at the time, they were still performed when doctors said they were medically necessary. Hayflick says he was able to obtain fetuses straight from the operating room of the University of Pennsylvania Hospital across the street from Wistar. Unless the tissue was put to some use, he reasoned, “it was definitely going to end up in an incinerator”. The University of Pennsylvania says that it is unable to find records to confirm the source of fetal tissues used by Hayflick. Hayflick developed 25 different fetal-cell strains, numbered WI-1 to WI-25. But several months into the project, he began to notice something strange. Scientific orthodoxy held that cells in culture, properly treated, would replicate forever. But his oldest cell strains were beginning to replicate more slowly. Eventually, they stopped dividing altogether."

- Use of fetal tissue in vaccine development

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"Hayflick also supplied WI-38 liberally to aspiring vaccine-makers. One was Stanley Plotkin, a Wistar scientist and a physician who had seen at first hand the effects of the huge rubella epidemic that swept the United Kingdom and the United States in the early 1960s. Rubella can be devastating to fetuses whose mothers are infected: those that are not killed in utero are frequently born blind, deaf, mentally disabled or with some combination of these conditions. Working at the Wistar, Plotkin grew rubella in WI-38 at 30 °C, cooler than body temperature, creating a weakened strain that still fired up the immune system enough to protect against future infections. Trials showed that his vaccine induced better immunity against rubella than competitors. Plotkin’s vaccine was licensed in Europe in 1970 and in the United States in 1979. A version made by the pharmaceutical company Merck, based in New Jersey, is today the only rubella vaccine available in the United States, and GlaxoSmithKline uses Plotkin’s weakened virus in a rubella vaccine that it markets in Europe and Australia. The rubella vaccine was only one of many made using WI-38. In the 1960s, a WI-38-based measles vaccine was licensed in the former Soviet Union and Koprowski developed a rabies vaccine using the cells. In the early 1970s, the pharmaceutical company Wyeth (now part of Pfizer) launched an oral adenovirus vaccine developed using WI-38 and Pfizer, based in New York, used WI-38 to make a vaccine against polio. Today, the cells are also used by Merck to make vaccines against chickenpox and the painful nerve infection shingles."

- Use of fetal tissue in vaccine development

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"“Other vaccines are produced in a completely morally non-objectionable way. So why aren’t we doing this with all vaccines?” says Debi Vinnedge, the executive director of Children of God for Life, a group based in Largo, Florida, that opposes the use of WI-38 in vaccine-making. In 2003, Vinnedge wrote to the Vatican asking for an official position on whether Catholics could ethically receive vaccines made using cells from aborted fetuses. She waited two years for an answer. The letter, when it came, concluded that where no alternative exists, it is “lawful” for parents to have their children immunized with vaccines made using WI-38 and MRC-5, to avoid serious risk to their own offspring and to the population as a whole. Still, the Vatican wrote, faithful Catholics should “employ every lawful means in order to make life difficult for the pharmaceutical industries” that use such cells. Merck, a major producer of Plotkin’s rubella vaccine, has been a perennial target of abortion opponents, who have pressed the issue at Merck’s US shareholder meetings. (Merck said in a statement to Nature that “it would be exceedingly difficult, if at all possible, to develop and test an alternative”, and emphasized the vaccine’s long record of safety and effectiveness.) The irony of the protest is not lost on Plotkin. “I am fond of saying that rubella vaccine has prevented thousands more abortions than have ever been prevented by Catholic religionists,” he says."

- Use of fetal tissue in vaccine development

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"Report, p. 379: "Several letters [from the Association of American Medical Colleges and others] … suggest that human fetal tissue is used for modern vaccine production. In reality, none of the nearly 75 vaccine formulations currently licensed in the United States is produced using human fetal tissue …" Fact: The WI-38 and MRC-5 cell lines, derived from two fetuses that were aborted, respectively, in 1962 in Sweden and in 1966 in the United Kingdom, are used to produce the following vaccines, all licensed and marketed in the United States: *Sanofi-Pasteur's Imovax rabies vaccine is propagated in MRC-5 cells. When they were introduced in the 1970s, human fetal cell–propagated rabies vaccines supplanted dangerous and occasionally fatal animal tissue–produced rabies vaccines. * Merck's chicken pox and shingles vaccines are propagated in MRC-5 cells; they are produced at a relatively new company plant in North Carolina. The weakened "Oka" virus used in both vaccines was initially attenuated in WI-38 cells. * Merck's rubella vaccine—the "R" component in the MMR vaccine given to U.S. infants and preschoolers—is propagated in WI-38 cells on the company's campus northwest of Philadelphia, Pennsylvania. Merck has shipped nearly 700 million doses of the rubella vaccine since its launch in 1979. Also known as German measles, rubella, like Zika virus, attacks and damages fetuses in the womb. *Hepatitis A vaccines are marketed in the United States by both Merck and GlaxoSmithKline; both companies propagate their vaccines in MRC-5 cells. *The polio component of Sanofi Pasteur's U.S.-marketed Quadracel vaccine (which also protects against diphtheria, pertussis, and tetanus) is propagated in MRC-5 cells. *The adenovirus vaccine that since 1970 has protected nearly 10 million members of the U.S. military from respiratory infections is propagated using WI-38 cells. (In seeming contradiction, the report goes on to state, one page later, that "11 [current vaccines] … are produced using historic, fetal-derived cell lines.")"

- Use of fetal tissue in vaccine development

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"Senior Catholic leaders in the United States and Canada, along with other antiabortion groups, are raising ethical objections to promising COVID-19 vaccine candidates that are manufactured using cells derived from human fetuses electively aborted decades ago. They have not sought to block government funding for the vaccines, which include two candidate vaccines that the Trump administration plans to support with an investment of up to $1.7 billion, as well as a third candidate made by a Chinese company in collaboration with Canada's National Research Council (NRC). But they are urging funders and policymakers to ensure that companies develop other vaccines that do not rely on such human fetal cell lines and, in the United States, asking the government to "incentivize" firms to only make vaccines that don't rely on fetal cells. "It is critically important that Americans have access to a vaccine that is produced ethically: no American should be forced to choose between being vaccinated against this potentially deadly virus and violating his or her conscience," members of the U.S. Conference of Catholic Bishops and 20 other religious, medical, and political organizations that oppose abortion wrote to Stephen Hahn, commissioner of the U.S. Food and Drug Administration (FDA), in April. "Thankfully, other [COVID-19] vaccines … utilize cell lines not connected to unethical procedures and methods." "We urge your government to fund the development of vaccines that do not create an ethical dilemma for many Canadians," wrote Archbishop of Winnipeg Richard Gagnon, president of the Canadian Conference of Catholic Bishops, and 17 other antiabortion religious, medical, and politic groups and individuals in a 21 May letter to Prime Minister Justin Trudeau. "The … manufacture of vaccines using such ethically-tainted human cell lines demonstrates profound disrespect for the dignity of the human person.""

- Use of fetal tissue in vaccine development

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"Cells derived from elective abortions have been used since the 1960s to manufacture vaccines, including current vaccines against rubella, chickenpox, hepatitis A, and shingles. They have also been used to make approved drugs against diseases including hemophilia, rheumatoid arthritis, and cystic fibrosis. Now, research groups around the world are working to develop more than 130 candidate vaccines against COVID-19, according to the World Health Organization; 10 had entered human trials as of 2 June. At least five of the candidate COVID-19 vaccines use one of two human fetal cell lines: HEK-293, a kidney cell line widely used in research and industry that comes from a fetus aborted in about 1972; and PER.C6, a proprietary cell line owned by Janssen, a subsidiary of Johnson & Johnson, developed from retinal cells from an 18-week-old fetus aborted in 1985. Both cell lines were developed in the lab of molecular biologist Alex van der Eb at Leiden University. Two of the five vaccines have entered human trials (see table, below). In four of the vaccines, the human fetal cells are used as miniature "factories" to generate vast quantities of adenoviruses, disabled so that they cannot replicate, that are used as vehicles to ferry genes from the novel coronavirus that causes COVID-19. When the adenoviruses are given as a vaccine, recipients' cells begin to produce proteins from the coronavirus, hopefully triggering a protective immune response. The fifth vaccine, which has shown promise in monkeys and is headed for human trials as soon as this summer, is what is known as a protein subunit vaccine. Researchers at the University of Pittsburgh use HEK-293 cells to manufacture the coronavirus' spike protein—a vital part of its structure—which is used to trigger an immune response. The vaccine is delivered through a skin patch with 400 tiny needles. The fetal cell lines are key to producing both types of vaccine. "HEK-293 [cells] are essential for making protein subunit vaccines," says Andrea Gambotto, a vaccine scientist at the University of Pittsburgh School of Medicine and the vaccine's lead developer. Their human origin is important, he says: "Cultured [nonhuman] animal cells can produce the same proteins, but they would be decorated with different sugar molecules, which—in the case of vaccines—runs the risk of failing to evoke a robust and specific immune response." (Among the developers of the five vaccines, only Gambotto responded to a request for comment.)"

- Use of fetal tissue in vaccine development

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"In 2009 and 2012, the Gates Foundation funded tests of experimental HPV vaccines, developed by Gates’s partners GSK and Merck, on 23,000 girls 11–14 years old in remote provinces of India. ... At least 1,200 of the girls in Gates’s study—1 in 20—suffered severe side effects, including autoimmune and fertility disorders. Seven died—about 10x the US death rates for cervical cancer, which almost never kills the young. India’s Federal Ministry of Health suspended the trials and appointed an expert parliamentary committee to investigate the scandal. Indian government investigators found that Gates-funded researchers at PATH committed pervasive ethical violations: pressuring vulnerable village girls into the trial, bullying illiterate parents, and forging consent forms. Gates provided health insurance for his PATH staff but not to any participants in the trials, and refused medical care to the hundreds of injured girls. The PATH researchers targeted girls at ashram paathshalas (boarding schools for tribal children), to dodge the need to seek parental consent for the shots. They gave the girls “HPV Immunization Cards” that were printed in English, which the girls couldn’t read. They did not tell the girls that they were part of a clinical trial and instead hoodwinked them with the lie that these were “wellness shots” that would guarantee “lifelong protection” against cancer. That was not true. PATH conducted the trials in impoverished rural areas that lacked mechanisms for tracking the adverse effects and had no system for recording major adverse reactions to the vaccines, something legally mandated for large-scale clinical trials...."

- Vaccination in India

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"To overcome such meddling from India’s prying medical community, in 2005 Gates funded, through GAVI, a four-year, $37 million study of mass vaccination with Hib jabs in Bangladesh intending to showcase the vaccine’s benefits. GAVI’s Bangladesh study backfired, showing no advantage from Hib vaccination. In response, a formidable coterie of superstar international health experts—all of them, coincidentally, from Gates-funded organizations WHO, GAVI, UNICEF, USAID, Johns Hopkins Bloomberg School of Public Health, the London School of Hygiene and Tropical Medicine, and CDC—issued a deceitful proclamation that fraudulently claimed that the Bangladesh study proved a Hib jab protects children from “significant burden of life-threatening pneumonia and meningitis.” … Based on Gates’s orchestrated guile, WHO in 2006 took the official position that the “Hib vaccine should be included in all routine immunization programmes.” Once again, the Indian government caved in to Gates and mandated Hib vaccines in India, where Hib invasive disease was nearly nonexistent. In self-congratulatory articles, GAVI boasted triumphantly of its role in rescuing the Hib vaccine project in India after the Bangladesh study proved the vaccine a worthless waste of money. GAVI’s article notes that, since there was little burden from Hib disease in India, it had been a great challenge to gin up support for WHO’s recommendation. GAVI bragged—in technocratic argot—that it twisted WHO’s arm to revise WHO’s Hib vaccine policy from a weak permissive statement to a firm recommendation calling for universal vaccine introduction in all countries. WHO’s volte-face dragooned reticent Indian health officials to recommend the useless vaccine."

- Vaccination in India

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