Use of fetal tissue in vaccine development

"Then in 1962, Hayflick made another discovery. “Without it, you and I might not even be alive,” says Stuart Jay Olshansky, an expert in biodemography and gerontology at the University of Illinois, Chicago. It began when a nameless woman who was three months pregnant had a legal abortion in Sweden. As the author Meredith Wadman wrote in her book, The Vaccine Race: Science, Politics and the Human Costs of Defeating Disease, the foetus wasn’t incinerated, buried or thrown away – instead it was wrapped in sterile green cloth and sent to the Karolinska Institute in northwest Stockholm. At the time, Hayflick was sourcing the cells he used for his research from this institution. In his laboratory at the Wistar Institute in Philadelphia, he managed to incubate some of the tissue in several glass bottles at 37C (98F). He added an enzyme to break down the protein that bound the cells together, as well as "growth medium", a solution which contained the nutrients they needed to divide. After a few days, he was left with a continuous sheet of cells. One of these cells eventually turned into the cell line “WI-38”, which stands for Wistar Institute foetus 38."

"Over the ensuing years, frozen vials of the cells were flown to hundreds of laboratories across the world, WI-38 is now one of the oldest and most widely available cell lines on the planet. As Hayflick has noted previously – although perhaps rather insensitively – as early as 1984, WI-38 had become “the first cultured normal human cell population to ever reach voting age”. Today the cells are routinely used to make vaccines against polio, measles, mumps, rubella, varicella zoster (chicken pox), herpes zoster, adenovirus, rabies and Hepatitis A. Why are the cells so special? And how can we justify continuing to use them?"

"Soon after Hayflick discovered that cells are mortal, he realised that if you siphon some off each time they divide and freeze them, a single source can theoretically provide an almost unlimited supply – around 10,000,000,000,000,000,000,000 (10 sextillion) in total. And though WI-38 cells are mortal, because the cells had divided relatively few times when they were collected, they can be grown for longer before they reach the Hayflick limit. Most WI-38 cells have 50 divisions left, which each take 24 hours to complete, so they can be grown continuously for 50 days before you need to start again. Though there are hundreds of cell lines available in the United States, WI-38 makes up the majority of the cells used."

"Another reason WI-38 has become so ubiquitous is that a quirk of the American legal system at the time of its discovery: it wasn’t possible to patent living things. This means their use was never restricted, and scientists around the world were able to share them freely with colleagues. Though there are hundreds of cell lines available in the United States, WI-38 makes up the majority of the cells used, together with just one other. “MRC-5” cells, named after the initials of the Medical Research Council where they were collected, were obtained from the lungs of another three-month-old foetus. This time the abortion happened in England in 1966 for “psychiatric reasons”. WI-38 was fundamental for the development of vaccines against polio, measles, mumps, rubella, varicella zoster (chicken pox), herpes zoster, adenovirus, rabies and Hepatitis A, as well as in the production of many early vaccines. Today it's still used to make the rubella vaccine – part of Merck's measles, mumps and rubella (MMR) jab – and Teva's adenovirus vaccine for the US military."

"Finally, foetuses are thought to be the “cleanest” possible source of cells, since they are less likely to have picked up any viruses from the outside world which might contaminate vaccines or confound the results of experiments. Back in 2017, Hayflick asked Olshansky to quantify exactly how many lives the cells had spared until that point. By comparing the global prevalence of certain infectious diseases in the 1960s, when the cell line was discovered, with the prevalence of infectious diseases then, he calculated that vaccines made with WI-38 may have prevented around 4.5 billion infections. In total, the cells are likely to have spared 10.3 million lives."

"There has been some controversy surrounding the origins of the cell line, however. Apart from the fact that some people feel uncomfortable about its links to abortion, the woman whose foetus the cells came from, who Wadman has named “Mrs X”, did not consent to its use. In fact, she didn’t even know about it until years later, when she was contacted by someone from the Karolinska Institute who was hoping for a more detailed medical history. The incident is unlikely to happen again today, because human tissue is regulated in the United States. Any material collected is subject to the Common Rule – a set of ethical standards introduced in 1981, which researchers must comply with in order to receive federal funding. Chief among them is the requirement for informed consent. However, the rule doesn’t apply retrospectively, and there are many examples of tissue which was effectively stolen and continues to be used to this day."

"These ethical transgressions have become even more problematic with the advent of affordable genetic sequencing. Human cell lines contain human DNA – and WI-38 will share 50% of its DNA with the foetus’ mother. In this light, the cell line is considered by some as potentially representing a privacy risk."

"[T]he benefits of using the cells are widely thought to vastly outweigh them, and many religious organisations which are otherwise anti-abortion have publicly announced their support for the use of vaccines manufactured this way when no other alternatives exist, including the Catholic Church, although it did express a need for alternative sources of vaccines."

"The connection between the chilling origins of many cell lines and the benefits they provide is perhaps most striking in the development of the rubella vaccine. Though it’s produced in WI-38 cells to this day, its early development relied heavily on cells taken from several different aborted foetuses – many of which had been aborted for the very reason that their mother was infected with the virus. Rubella can cause a number of serious consequences during pregnancy, such as stillbirth and miscarriage. If a woman is infected early on, she has a 90% chance of passing the virus to her unborn child, where it can lead to “congenital rubella syndrome” and a constellation of health problems, from brain damage to hearing loss. “You have to think, well what about the ethical consequences of not using the cell line?” says Olshansky. “Just keep in mind that they are a critical link in the chain, in the development of viral vaccines.”"

"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."

"Vaccine manufacturers have few options for viral culture media, for reasons of microbiology and safety. It is not possible to simply replace one cell line with another, because various viruses grow abundantly only in some kinds of cell lines. WI-38 and MRC-5 lines are well described and understood, with experience accumulated via hundreds of millions of vaccinations, important for safety-assessment reasons. The fetal origins of WI-38 and MRC-5 cell lines pose an ethical or moral problem for people who disapprove of abortion. Critically, the two abortions were not conducted for the purpose of harvesting the cells that were transformed into these cell lines. This lack of intention is a key element in breaking the complicity link that could otherwise make use of the vaccines unacceptable. No additional abortions are needed to sustain vaccine manufacture. The cell lines are not the final product, and no human cells are present in the final vaccine formulations."

"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."

"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."

"The Catholic Church permits temporary use of vaccines generated using aborted fetal tissue to protect children from preventable diseases until alternative vaccines that do not use aborted fetal tissue are available. In medical research, cell lines that were generated from elective abortions should be avoided and alternative cell lines of licit origin utilized."

"The HAVRIX vaccine provides protection against hepatitis A infections (Innis 1994). However, hepatitis A is not endemic in the United States. Hepatitis A is also spread by the fecal-oral route; therefore, improvements in hygiene and sanitation significantly reduce infection (CDC 2006). Nevertheless, some individuals are at risk for hepatitis A infections, which can cause severe liver disease, presenting a grave inconvenience imposing vaccination. These include those traveling to areas where hepatitis A virus is endemic, men who have sex with men, intravenous drug users, those with clotting disorders, those working with nonhuman primates, and those having sexual intercourse with someone who has hepatitis A (CDC 2006)"

"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)"

"The human embryonic kidney (HEK) 293 cell line, derived from an elective abortion in the 1970s, is routinely used for production of proteins and cultivation of viruses due to the ease of transfection with gene constructs that are efficiently translated into appropriately folded proteins (Wong 2006). A PubMed search with the term “HEK,” lists more than thirty thousand citations, testifying to the extensive use of this cell line.1 The Catholic Church’s position on the use of HEK293 cells, or other cell lines generated from elective abortions, in medical research is that they should be avoided because other-wise this creates a “contradiction in the attitude of the [researcher] who says that he does not approve of the injustice perpetrated by others, but at the same time accepts for his own work the ‘biological material’ which the others have obtained by means of that injustice” (Congregation for the Doctrine of the Faith 2008, no. 35). Again, alternatives should be explored. Utilization of fetal tissue from spontaneous abortion (miscarriage) is licit. In addition, COS-1 cells that are not derived from elective abortions are effective for production of proteins that could be utilized in some studies (Smith 2009). Unfortunately, COS-1 cells are of monkey origin. Hence, xenogeneic differences between monkey and human proteins limit their use in the generation of vaccines."

"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)."

"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."

"Researchers have estimated that vaccines made in WI-38 and its derivatives have prevented nearly 11 million deaths and prevented (or treated, in the example of rabies) 4.5 billion cases of disease."

"Two main human cell strains have been used to develop currently available vaccines, in each case with the original fetal cells in question obtained in the 1960s. The WI-38 cell strain was developed in 1962 in the United States, and the MRC-5 cell strain (also started with fetal lung cells) was developed, using Hayflick's technology, in 1970 at the Medical Research Center in the United Kingdom. It should be noted that Hayflick's methods involved establishing a huge bank of WI-38 and MRC-5 cells that, while not capable of infinitely replicating like immortal cell lines, will serve vaccine production needs for several decades in the future."

"Some of the COVID-19 vaccines being studied in clinical trials use cells originally isolated from fetal tissue (often referred to as fetal cells) in vaccine development or manufacturing. This research does not require fetal cells from new abortions; they use existing historic cell lines that are many decades old. Historical fetal cell lines were derived in the 1960s and 1970s from two elective abortions unrelated to vaccine development. Fetal cell lines have been used to create vaccines for diseases such as hepatitis A, rubella, and rabies. The fetal cell lines being used to produce some of the potential COVID-19 vaccines are from two sources: * HEK-293: A kidney cell line that was isolated from a terminated fetus in 1972 * PER.C6: A retinal cell line that was isolated from a terminated fetus in 1985"

"ARE THE PFIZER AND MODERNA COVID-19 VACCINES DEVELOPED USING FETAL CELL LINES? The mRNA COVID-19 vaccines produced by Pfizer and Moderna do not require the use of any fetal cell cultures to manufacture the vaccine. Early in the development of mRNA vaccine technology, fetal cells were used to demonstrate how a cell could take up mRNA and produce the SARS-CoV-2 spike protein. The Pfizer and Moderna vaccines were found to be ethically uncontroversial by the pro-life policy organization the Charlotte Lozier Institute. Further, Brian Kane, senior director of ethics for the Catholic Health Association of the United States, in an interview for the America: The Jesuit Review stated: “In terms of the moral principles of being concerned about the use of any pharmaceuticals that were developed from aborted fetuses, that is certainly an issue that we all want to be cognizant of and try to avoid their use. With that in mind, the Pfizer and Moderna COVID vaccines that are coming out are not even tainted with that moral problem."

"“When ethically irreproachable COVID-19 vaccines are not available … it is morally acceptable to receive COVID-19 vaccines that have used cell lines from aborted fetuses.” — U.S. CONFERENCE OF CATHOLIC BISHOPS"

"IS THE JANSSEN (JOHNSON & JOHNSON) COVID-19 VACCINE DEVELOPED USING FETAL CELL LINES? The vaccine produced by Janssen does require the use of fetal cell cultures, specifically PER. C6, in order to produce and manufacture the vaccine. The Catholic Church and the Southern Baptist Ethics & Religious Liberty Commission have both stated that receiving a COVID-19 vaccine that requires fetal cell lines for production or manufacture is morally acceptable."

"The U.S. Conference of Catholic Bishops has stated, “When ethically irreproachable COVID-19 vaccines are not available … it is morally acceptable to receive COVID-19 vaccines that have used cell lines from aborted fetuses in their research and production process. However, if one can choose among equally safe and effective COVID-19 vaccines, the vaccine with the least connection to abortion-derived cell lines should be chosen. Therefore, if one has the ability to choose a vaccine, Pfizer or Moderna’s vaccines should be chosen over Johnson & Johnson’s.” It should be noted that due to the fact that demand currently outpaces supply of COVID-19 vaccines, as well as the overwhelming benefit of immediate vaccination weighed against the dangers of waiting, healthcare experts encourage all those eligible to accept the vaccine being offered to them. The U.S. Conference of Catholic Bishops have also stated that “receiving a COVID-19 vaccine … should be considered an act of love of our neighbor and part of our moral responsibility for the common good.”"

"WHY ARE FETAL CELLS USED TO MAKE VACCINES? To develop and manufacture some vaccines, scientists working with pharmaceutical companies prefer human cell lines over other cells because: 1. Viruses need cells to grow, and the viruses tend to grow better in cells from humans than animals (because they infect humans); 2. Fetal cells can be used longer than other cell types; and 3. Fetal cells can be maintained at low temperatures, allowing scientists to continuing using cells lines from decades ago."

"“Receiving a COVID-19 vaccine … should be considered an act of love of our neighbor and part of our moral responsibility for the common good.”"

"No, the COVID-19 vaccines do not contain any aborted fetal cells. However, fetal cell lines – cells grown in a laboratory based on aborted fetal cells collected generations ago – were used in testing during research and development of the mRNA vaccines, and during production of the Johnson & Johnson vaccine."

"It is true that decades ago, scientists decided to use fetal tissue to start the cell lines we use to test drugs today. However, the description of ongoing modern fetal tissue harvesting to create vaccines is dishonest sensationalism. As a practicing Catholic, I think the moral balance of indirectly benefitting from an abortion that occurred 50 years ago in order to take a vaccine that will prevent further death in the community is a no-brainer – especially considering that so many of the over 620,000 American deaths have occurred in the most vulnerable and marginalized in our society. We need to focus on saving lives right now. We need to care for our neighbors. The Vatican and bishops agree. The Vatican has issued clear guidance that permits Roman Catholics in good faith to receive COVID-19 vaccines that use fetal cell lines in development or production."

"Fetal cell lines are cells that grow in a laboratory. They descend from cells taken from abortions in the 1970s and 1980s. Those individual cells from the 1970s and 1980s have since multiplied into many new cells over the past four or five decades, creating the fetal cell lines I mentioned above. Current fetal cell lines are thousands of generations removed from the original fetal tissue. They do not contain any tissue from a fetus."

"When it comes to the Pfizer and Moderna COVID-19 vaccines, fetal cell line HEK 293 was used during the research and development phase. All HEK 293 cells are descended from tissue taken from a 1973 abortion that took place in the Netherlands. Using fetal cell lines to test the effectiveness and safety of medications is common practice, because they provide a consistent and well-documented standard. For the Johnson & Johnson vaccine, fetal cell lines were used in the production and manufacturing stage. To make the Johnson & Johnson vaccine, scientists infect PER.C6 fetal cell lines to grow the adenovirus vector. (Learn more about how viral vector vaccines work.) All PER.C6 cells used to manufacture the Johnson & Johnson vaccine are descended from tissue taken from a 1985 abortion that took place in the Netherlands. This cell line is used because it is a well-studied industry standard for safe and reliable production of viral vector vaccines."

"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."

"See also the comments of Albert Moraczewski, O.P., as reported in a Pittsburgh newspaper article (source uncertain) by freelance writer James McCoy (“New Pox Vaccine Began with Abortions,” December 8, 1995): “Turning an abortion into a vaccine, Fr. Moraczewski concluded, means ‘being an accomplice to the act of abortion’.” Other common vaccines available in the United States produced using human cell lines are: Adenovirus Vaccine type 4 and type 7; Havrix and Vaqta (for Hepatitis A); MMR II (measles, mumps, and rubella); Imovax Rabies, Ipol, and Poliovax (inactivated poliovirus vaccines). It should be added that according to Roberge’s report, the strain of virus used in Meruvax is itself taken from a boy who was aborted because his mother contracted rubella during pregnancy. For this Roberge cites S. A. Plotkin, “Development of RA 27/3 Attenuated Rubella Virus Grown in WI-38 Cells,” International Symposium on Rubella Vaccines (London 1968)."

"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."

"The analysis given below to these two abortions applies also to the third abortion (mentioned in footnote 18 above), from which has been obtained a virus strain (as distinct from fetal parts) and which therefore is not more directly involved in vaccine production."

"The use of fetuses and fetal tissue in research was initially governed (between 1969 and 1973) by the Uniform Anatomical Gift Act. The 1975 Report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research added further qualifications, including that “those harvesting tissue could not have any part in the timing, method, or procedures used to terminate a pregnancy.”31 Following a 1987 Mexican report of improvement in Parkinson’s patients who had received fetal neural tissue transplants, the National Institutes of Health convened the Human Fetal Tissue Transplantation Research Panel to consider ethical, legal, and social implications of this sort of research in the United States. “A substantial majority” of the panel members concluded that this was acceptable public policy, although they had some reservations concerning the need to separate the decision to abort from the decision to donate tissue. Despite this report, there was a presidential ban on federally funded research from 1988 until January of 1993, at which time the ban was lifted. The central concern in the debates on this issue has been determining the nature and significance of the connection of the research and transplantation to voluntary abortion."

"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."

"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."

"Showing how the initial researchers may have been cooperatively involved in the two abortions helps to make clear how vaccine producers cannot be understood to be cooperatively involved. In the context of vaccine production, the principle of cooperation is (at most) applicable to evaluating the relationship between the people who performed the abortions and the people who initially obtained the tissue. This is because the principle of cooperation applies only when there is some shared, cooperative action. The two fundamental kinds of cooperation are called material and formal. At the simplest level of analysis, material cooperation occurs when someone contributes something that enables another person to perform some action. For example, a nurse assisting at an operation and someone who lends another person money cooperate materially in the operation and in the use of the money. Theologians distinguish many degrees and kinds of material cooperation, some forms of which are so closely connected to the principal action that the cooperator shares in the moral responsibility of that action. Nevertheless, this is not always the case. For example, an employer pays employees and thereby cooperates in their financial activities, but the employer remains normally free of moral responsibility for how employees use their money."

"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."

"The only way in which this can be construed as cooperation is by turning the issue around and charging the abortionist with material cooperation in today’s vaccination. But this is stretching the matter. Even supposing that a part of the abortionist’s intended end were that the resulting tissue would become useful for therapeutic research, the indefiniteness of that end from the abortionist’s perspective would make it difficult to call him or her a formal cooperator in the production of vaccines. Even though the tissue taken from the abortions has been used for vaccine production, it does not appear to be the case that the abortions were undertaken as part of the means for vaccine production."

"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."

"Scandal is a theological concern in the sense that its technical meaning involves leading someone to sin or causing confusion as to what is a sin. Even apart from the matter of sin, awareness of the significance of one’s actions relative to the moral instruction of others has special relevance to the question of vaccinations, which is a concern primarily for parents. That is to say, if parents endeavor to teach their children that some actions, such as abortion, are bad in principle, they need to consider carefully whether the use of certain vaccines does not constitute a source of confusion for their children, who might at some point become cognizant of the factual dependence of some vaccines upon voluntary abortion. Can one coherently and plausibly defend the view that abortion is bad in principle and that yet the use of these vaccines is good? Can one teach one’s children to understand this, or will it happen that they will understand the actions of their parents to belie their words? Will the lesson that is actually learned be that abortion is usually wrong, but sometimes it is beneficial, and that parents who try to hold otherwise are deluding themselves?"

"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."

"“In carrying out research and treatment of human (or nonhuman) diseases, it is immoral to use embryonic and fetal tissue obtained from intentionally induced abortions. A major reason for opposing use of such tissue is that this is a form of complicity in moral evil,” William E. May, Testimony before the NIH Human Embryo Research Panel, February 2, 1994. See the comments of Albert S. Moraczewski, O.P., quoted in note 18 above. See also Henry Greely et al., “The Ethical Use of Human Fetal Tissue in Medicine,” New England Journal of Medicine 320 (April 20, 1989): 1095."

"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."

"The rabies vaccine exists in two forms, one produced using MRC-5 cells and one produced using a fetal rhesus lung cell line. There are some treatment alternatives for preventing hepatitis A and poliomyelitis."

"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."

"A small but growing number of parents who object to vaccinating their children on religious grounds say they do so because many common vaccines are the product of cells that once belonged to aborted fetuses. There is a grain of truth to this statement. But even religious leaders, including a future pope, have said that shouldn't deter parents from vaccinating their children."