As the global COVID-19 pandemic continues with no apparent end in sight to the death toll and disruption to our lives, scientists are desperately seeking a means to end the crisis. Perhaps our biggest hope is a successful vaccine. The Pfizer BioNTech and the Moderna candidates have both shown a remarkable 94-95 per cent efficacy rates in preliminary phase three trials. This is very encouraging news. If proven successful, there are hopes for a mass vaccination programme by the spring.
But there are still huge challenges ahead.
The development and distribution of a vaccine poses many ethical challenges that Christians are going to need to understand if we are to respond positively. Do we have to accept that in our complex world some kind of ethical compromise may be necessary and that there may be no straightforward answer to the complex issues that arise? It is our responsibility as believers to act in ways which we see as just and in the best interests of our neighbour. But how can we ensure we are doing this amidst the ethical dilemmas we face?
There are several such dilemmas to consider. Firstly, many of the vaccine candidates in preliminary trials may make use of challenge trials to speed up their development. These have been successfully performed over many decades. However, they raise some major ethical concerns. Volunteers would be deliberately infected with the virus, using the lowest possible dose, after having received the candidate vaccine in order to see if they have developed immunity. This clearly goes against the guiding principle of medical practice to ‘do no harm’.
As Christians, what level of risk should we allow others to take for the good of society, even if they give fully informed consent? Do we have a moral imperative to develop an effective vaccine as soon as possible despite the potential risks? It could be argued that in modern medicine it is, in fact, impossible to do no harm and that all treatments or advances in science are about finding a balance between the benefits to patients and any possible harmful effects.
How should we respond to God’s call to love our neighbour and respect the preciousness of human life, both before and after birth? Would supporting such trials compromise this, or by objecting to the studies are we equally neglecting God’s creation by putting many more lives in danger? Some of the vaccines currently in trials have been developed using ‘immortal cell lines’, as they are useful for producing large quantities of viral protein. However, as we have previously discussed, many of these once came from aborted human foetuses. This clearly challenges our belief as Christians that life is sacred from the moment of conception: ‘before I formed you in the womb I knew you’.
As COVID-19 is so recent, we have limited knowledge about what the risks to health are. However, it is hoped that by conducting challenge studies in young, healthy individuals, these risks are minimised as much as possible. Even so, there have been reports of young people experiencing ‘long-COVID’, with long-lasting symptoms thought to occur in around ten per cent of 18-49-year-olds who contract the disease. Could this put you at a higher risk of developing illnesses such as dementia later in life? We simply have no way of knowing. Could this be the start of a slippery slope of lack of trust in vaccines or medical research in general if harm were to occur? We must accept that an effective vaccine may not even result, and even if it does, it may not be useful to the elderly or other vulnerable groups.
Another ethical issue concerning vaccine development is the quality of the end product. As the pharmaceutical company which is first to develop an effective vaccine stands to make a huge amount of money there is a risk they may rush the development process resulting in a weaker end product. Clearly, there need to be strict safeguards in place to prevent corruption or the manipulation of data.
There is also a concern amongst the medical community, that the countries with the most funds may hoard vaccine stocks. This could result in the poorest countries having to face the ongoing social and economic burden of the pandemic with the subsequent widening of global inequality. More people could end up dying overall as a result. We have a responsibility to ensure that there is a just equity of vaccine access.
If an effective vaccine is developed, what is the fairest way to distribute it across a population? Should it be made compulsory by law or remain just an advisory practice? Should you be able to buy yourself to the front of the queue or does everyone have to wait their turn equally? Do we have a moral responsibility to take a vaccine as part of loving our neighbour? Distribution of COVID-19 vaccines will need to maximize the public health benefits of the limited availability, which will involve serious ethical choices about who gets priority.
Hopefully, we will see it as our responsibility to continually weigh up these ethical considerations as the world eagerly waits for a vaccine. We can pray for scientists and political leaders, with the hope that the most just and safe research practices are adhered to. There is clearly no straightforward answer to the complex ethical questions involved, so we need to be as informed as possible in order to keep asking questions of ourselves and encouraging others to do the same whilst trying to make our voice heard in the national and international dialogue.
Amy Smith is a volunteer working with CMF’s Communications and Public Policy Teams