Should Christians use Covid-19 vaccines? I have been asked this question numerous times in recent months by pastors and laypeople. The primary moral concern raised to me regards the use of cell lines derived from abortions in the production of the vaccines. Earnest Christians with a commitment to the sanctity of human life are concerned about possible complicity with the evil of abortion. In what follows, I will argue using the Pfizer and Moderna vaccines clearly does not entail moral complicity with abortion. The Johnson & Johnson vaccine raises more difficult questions about complicity with evil, but I conclude its use is still morally permissible.
I will not be addressing the broader debate regarding the anti-vaccination movement. To be clear, I find anti-vaccination arguments unconvincing and based on poor argumentation, inaccurate summary of data, bad data, or conspiracy theories. My focus here is very narrow: As a person who believes vaccines have been an unusual blessing to humanity and celebrates the common good of immunization for public health, how do I respond when a profoundly effective method of preventing disease – vaccination – intersects with my moral opposition to abortion? For the sake of focus, I also will only be addressing the connection between Covid-19 vaccines and abortion and will save discussion of other recommended vaccines and abortion-derived human cell lines for another occasion.[1]
A Summary of the Three Covid-19 Vaccines and Human Cell Lines
Three Covid-19 Vaccines have been approved for use in the United States: Pfizer-BioNTech, Moderna, and Johnson & Johnson / Janssen. The process of developing these vaccines occurs in three stages: 1) design and development; 2) confirmatory lab tests on the vaccines; 3) actual production of the vaccines. The Johnson & Johnson vaccine used an abortion-derived human-cell line in all three phases; The Pfizer-BioNTech and Moderna vaccines used an abortion-derived human cell line only in the confirmatory lab tests phase, but not in the design nor production phases. The following chart shows the differences for each vaccine:
Covid-19 Vaccines and Use of Human Cell Lines[2]
Design & Development Confirmatory tests Production
Johnson & Johnson Yes Yes Yes
Pfizer-BioNTech No Yes No
Moderna No Yes No
The Pfizer-BioNTech and Moderna vaccines use the human cell line HEK293 – an acronym which stands for “Human Embryonic Kidney 293” – in the confirmatory lab tests phase. HEK293 was developed in Holland in 1973 by a team led by molecular biologist and virologist Alex van der Eb at the University of Leiden. The cell line originates from kidney cells taken from a female child aborted around the year 1972. The abortion was not specifically performed in order to provide cells for research, but the cells were acquired after the fact. In 2001, Van der Elb commented on the source of the cells and said: “The fetus, as far as I can remember was completely normal. Nothing was wrong. The reasons for the abortion were unknown to me. I probably knew it at the time, but it got lost, all this information.”[3]
These fetal kidney cells were then transformed by introducing Adenovirus-5 DNA into their genome. This means certain strands of Adenovirus DNA were introduced into the kidney cells to improve the cell-lines usefulness for research.[4] Normal human DNA can only replicate and divide a finite number of times, but the modified DNA in HEK293 can replicate for an apparently infinite number of times, making it useful in research. HEK293 is now one of the most widely used cell lines around the world.
The Johnson & Johnson vaccine uses an abortion-derived human cell line known as PER.C6 – an acronym which stands for “Primary Embryonic Retina Clone 6” – in the development, testing, and production phases. Also developed by Alex van der Eb’s team at the University of Leiden, this cell line was developed in 1995 from retinal cells taken from a child aborted in 1985. This abortion was not performed specifically to provide cells for research, but the cells were collected after the fact. Van der Eb described the original source of the cells, saying:
“So I isolated retina from a fetus, from a healthy fetus as far as could be seen, of 18 weeks old. There was nothing special with the family history [and] the pregnancy was completely normal up to the 18 weeks, and it turned out to be a socially indicated abortus . . . and that was simply because the woman wanted to get rid of the fetus.[5]”
The DNA in the PER.C6 line has also been modified to allow limitless reproduction. Pharmaceutical manufacturers like PER.C6 because it can be grown in huge 10,000 liter vats, allowing for large scale production of vaccine components.[6]
To summarize, Johnson & Johnson uses abortion-derived human cell lines in all three phases of production of its vaccine, but Pfizer-BioNTech and Moderna only used abortion-derived human cell lines in the confirmatory lab tests phase.
Use of Human Cell Lines: What Does that Mean?
To say human cell lines have been used in the production of a vaccine can lead to misunderstanding. This confusion has led to some imprecise discussions of the moral issues related to vaccine development. Clarifying the exact nature of the cell lines and their role in production helps one make a better decision.
One persistent rumor claims infants are currently being aborted to manufacture vaccines. This is completely false. No ongoing abortions supply fetal cells for vaccine production. The question about Covid-19 vaccines revolves around two abortions: One in 1972 and one in 1985. And to be clear, neither of these abortions took place specifically to provide cells for research; the researchers took advantage of the abortions after the fact.
Another false claim which continues to circulate is that vaccines contain fetal parts. This widely disseminated rumor is based on a misunderstanding of what it means to say human cell lines are used in research or development of vaccines. Both HEK 293 and PER.C6 are called immortalized cell lines. The adjective immortal can be confusing, and leads some people to think the original cells from the aborted fetuses have been kept alive forever and are somehow present in a vaccine, but this is incorrect. Immortalized cell lines are cells that have been manipulated to multiply and divide indefinitely and thus can be cultured for long periods of time.[7] The current HEK293 and PER.C6 cell lines are significantly modified and innumerable generations distant from the cells originally cultured decades ago. There are extremely small, residual quantities of trace DNA from the original abortions in the cell lines, but this is quite different from the defective assertion that vaccines contain fetal parts. The cells used in the modern HEK293 and PER.C6 cell lines are not the same cells as those taken from the aborted children.[8]
The specific moral question regarding Covid-19 vaccines involves one’s possible complicity with the evil of abortion. To be complicit means one is cooperating in an evil act. Reasonable Christians ask, “If I take the vaccine, am I tacitly participating in the abortions used to found the HEK293 and PER.C6 cell lines?” Others ask, “If I take the vaccines, am I indirectly approving of abortion?” Most troubling for many Christians is the fear that taking the vaccine will encourage future abortions.[9]
Moral Reflection
The term sanctity of human life is a shorthand way of referring to the value God gives to all human life along with its inherent preciousness. The sanctity of life is theologically grounded in our belief that God is the creator of human life and that humans are made in God’s image (Genesis 1:26 – 28). As such, the right to life is the basis of all other human rights, natural and legal, and the foundation of a civilized society.[10] The concept begins with an affirmation of the beauty and richness of biological human life itself.[11] The word sanctity means human life has ultimate importance and is not to be violated. The principle of the sanctity of human life demands that a human being, regardless of prenatal stage of development, age, health, gender, or race, is always treated with respect and that a person’s life not be ended prematurely, unduly, carelessly, without Biblical warrant, or merely for reasons of utility.[12] Southern Baptists believe in the sanctity of human life from conception to natural death.[13]
We decry the abortions which provided the fetal tissue for the development of both HEK293 and PER.C6 because they violate the sanctity of human life. Pharmaceutical companies should find morally licit ways of developing vaccines that do not raise questions of complicity with the evil of abortion. Doing so removes a major moral concern for Christians who affirm the benefit of vaccines.
When considering sanctity of life concerns, we must also consider the lives which can be saved by the vaccines. When we are vaccinated, we are protecting the lives of other people by helping prevent the spread of the deadly Covid-19 virus. Doing so also shows love for our neighbor (Leviticus 19:18; Matthew 22:39) by acting in a responsible way that helps lessen the possibility we might inadvertently pass along a potentially terminal disease. In this way, receiving a Covid-19 vaccination reflects a commitment to the sanctity of human life by preventing the infection of others. When we are vaccinated, we are protecting our neighbor, and affirming our neighbor’s value as a human. At the same time, Christians with a deep concern for the sanctity of human life are disturbed by the use of abortion-derived human cell lines in testing or producing the Covid-19 vaccines. Is there a way forward? I think there is.
Again, the moral question is, “Am I complicit in the evil of abortion if I receive a Covid-19 vaccine?” For the Pfizer-BioNTech and Moderna vaccines, I think the answer is clearly no. While both to these vaccines used abortion-derived human cell lines in confirmatory lab tests, no human cell lines are used in either development or production.
The answer to the question is a bit more difficult for the Johnson & Johnson vaccine since abortion-derived human cell lines are used in all three phases of its production, but I conclude its use is still morally permissible. The distinction between formal and material cooperation with evil helps in evaluating the problem. Formal cooperation in evil means one directly participates in an evil act; it takes place when a person intends in his or her action to further the wrongdoing of the principle agent. In our case, the person in question is someone receiving a Covid-19 vaccine and the principle agents are the abortionists themselves. Formal cooperation is always wrong, because it is not permissible intentionally to perform an evil act, even for a good end.[14] Taking the Johnson & Johnson vaccine does not entail formal cooperation in evil since we did not assist in the abortion which provided tissue for PER.C6.
The Johnson & Johnson vaccine does raise more specific questions about material cooperation in evil. Material cooperation in evil refers to cooperating in an evil act in ways not directly related to causing the act in question. Two distinctions within this category are vital: Proximate material cooperation and remote material cooperation. Someone who is proximate to the evil in question makes a direct contribution to the act that leads to the commission of the act. Taking the Johnson & Johnson vaccine seems clearly not to be making a direct contribution to the act of abortion, so a person taking the vaccine is not guilty of proximate material cooperation.
Remote material cooperation means one makes a contribution to an evil act but his or her contribution does not lead to the commission of the act. I think when most Christians express concern about abortion-derived vaccines, they are expressing concern about remote material cooperation and want to avoid complicity in evil in even a manner which is far removed from the original acts of abortion. They feel using the vaccine contributes to the wrong-headed thinking of our culture that abortion is permissible, and in this way might promote additional evil acts of abortion.
We should celebrate Christians who have a tender conscience. Certainly, we live in a day when, as the prophet Jeremiah said, “People don’t even know how to be ashamed” (Jeremiah 6:15). Yet, I believe it is possible to use the Johnson & Johnson vaccine and in the process not contribute to the furtherance of the evil of abortion. At the same time, I prefer using vaccines in which the use of abortion-derived cell lines is not raised at all, thus I personally chose the Moderna vaccine.
Christians burdened by concerns about remote material cooperation in the evil of abortion can take the Pfizer-BioNTech and Moderna vaccines since no abortion-derived cell lines are used in their production. But if, for some reason, health concerns mean one can only take the Johnson & Johnson vaccine, I suggest it is morally permissible to do so in an effort to avoid the danger of spreading Covid-19 to other people who may be immuno-compromised and at extremely high risk for death from the disease. Keep in mind, the human-cell line used to develop the Johnson & Johnson vaccine does not contain cells from an aborted fetus. I concur with Arbo, Mitchell, and Walker when they say, “We should concede the ethical validity of vaccine use while not ignoring the problematic origins of its development.”[15]
At a deeper level, I think most Christians want to avoid becoming religiously-minded ethical utilitarians. Paul warns in Romans 3:8, “And why not say (as we are slanderously reported and as some claim that we say), “Let us do evil that good may come”? Their condemnation is just.” Without getting into a discussion about Paul’s opponents, it is clear the apostle forcefully rejects the idea that salvation by grace and Christian freedom grants moral right of way to some twisted form of utilitarian thinking enabling us to justify any means by well-intended ends. In this light, the entire point in the discussion about Covid-19 vaccines is that Christians are not doing the evil act of aborting the child, nor do we condone it. Furthermore, no abortions are ongoing to produce the vaccines.[16]
Perhaps an illustration can help us think about Covid-19 vaccines and abortion-derived human cell lines. Imagine an evil father attacks his three-year-old child. The child is rushed to an emergency room where the ambulance is met by a distraught mother, a woman who had not been present when the father flew into a rage. Despite the best efforts of medical personnel, the child dies. Several floors up at the same hospital is another three-year-old child needing a transplant of some sort, and the deceased child is an ideal match. No one would think the grieving mother would have sinned by donating her deceased child’s organs to save another child’s life. While this scenario is not exactly analogous to the elective abortions which provided the original fetal cells for HEK293 and PER.C6, the cases are similar in that the original evil in both cases – killing an innocent child – cannot be undone. In neither case – killing of a child by a violent father and killing of a child via an abortionist – do we affirm the evil act. But the child who received the transplant is not considered complicit in the evil act of murder. Likewise, I do not think taking a vaccine makes us complicit in the evil of abortion.
Let me be explicitly clear: I want modern science to give us human cell lines developed in ways that do not raise any concerns about the sanctity of human life. I am confident that smart people with a commitment to moral excellence can achieve this goal. Because vaccines are a benefit for all people, developing such cell lines will, I think, encourage greater compliance with vaccinations.
To summarize, neither the Pfizer-BioNTech nor Moderna vaccines are produced from abortion-derived human cell lines. The Johnson & Johnson vaccine is produced from abortion-derived human cell lines. There clearly is neither formal nor material cooperation with evil in using the Pfizer-BioNTech or Moderna vaccines. From my perspective, using the Johnson & Johnson vaccine also does not entail either formal or material cooperation in evil. Christians concerned about possible remote material cooperation in the evil of abortion should use the Pfizer-BioNTech or Moderna vaccines. But using the Johnson & Johnson vaccine is morally permissible for those who cannot safely use the Pfizer-BioNTech or Moderna vaccines. There are no ongoing abortions supplying human cells for any vaccine. Furthermore, the Johnson & Johnson vaccine does not contain cells from the aborted child, though it does contain extremely small amounts of residual DNA from the aborted infant. Pharmaceutical companies should respect the sanctity of human life and work to develop vaccines which do not raise concerns about complicity with the moral evil of abortion. Doing so will eliminate one further objection to vaccines.
[1] Five recommended vaccines are developed from cell-lines derived from abortions: Varicella (chickenpox), rubella (the “R” in the MMR vaccine), hepatitis A, one version of the shingles vaccine, and one preparation of rabies vaccine.
[2] Christian Medical and Dental Association, “Courage in the Crisis: CMDA and Covid-19,” March 4, 2021, https://cmda.org/coronavirus/.
[3] Testimony of Alex van der Eb before United States Food and Drug Administration Center for Biologics Evaluation and Research meeting in Gaithersburg, MD, May 16, 2001, 81. https://web.archive.org/web/20170516050447/https://www.fda.gov/ohrms/dockets/ac/01/transcripts/3750t1_01.pdf. Alvin Wong, “The Ethics of HEK 293,” The National Catholic Bioethics Quarterly 6.3 (Autumn 2006): 477. Catholic physician Alvin Wong has argued forcefully that though the exact circumstances surrounding the abortion in question are uncertain, “It is already known that the cells are embryonic in origin, so there is a high probability that they are from an induced abortion.” Alfred Wong, “The Ethics of HEK 293,” The National Catholic Bioethics Quarterly 6.2 (Autumn 2006): 477.
[4] A portion of human adenovirus 5, nucleotides 1-4344, is integrated into chromosome 19 of the HEK cells. Washington State University, “HEK 293 Cell Lines,” https://biosafety.wsu.edu/?s=HEK293.
[5] Testimony of Alex van der Eb before United States Food and Drug Administration Center for Biologics Evaluation and Research meeting in Gaithersburg, MD, May 16, 2001, 91. https://web.archive.org/web/20170516050447/https://www.fda.gov/ohrms/dockets/ac/01/transcripts/3750t1_01.pdf.
[6] Mark Reid, “This Professor Laid the Foundation for the Corona Vaccine,” Mare March 11, 2021, https://www.mareonline.nl/en/science/this-professor-laid-the-foundation-for-the-corona-vaccine-and-trumps-medication/.
[7] Matt Carter and Jennifer C. Shieh, “Cell Culture Techniques,” Immortalized Cell Line, Guide to Research Techniques In Neuroscience, 2nd ed. (2015): https://www.sciencedirect.com/topics/neuroscience/immortalised-cell-line.
[8] Christopher O. Tollefsen, “Vaccines, HEK293 Cells, and Cooperation With Evil: A Response to Michael Pakaluk,” The Public Discourse April 26, 2021, https://www.thepublicdiscourse.com/2021/04/75494/.
[9] Edward J. Furton, “Vaccines Originating in Abortion,” Ethics and Medics 24.3 (March 1999): 3.
[10] Thomas Wood, “Life, Sacredness of,” The Westminster Dictionary of Christian Ethics, James F. Childress and John MacQuarrie, eds. (Philadelphia: The Westminster Press, 1986), 353.
[11] This definition is my revision of Thomas A. Shannon, An Introduction to Bioethics, 3rd ed. (New York: Paulist Press, 1997), 46.
[12] I’ve modified and expanded this sentence from Stanley J. Grenz and Jay T. Smith, Pocket Dictionary of Christian Ethics (Downers Grove, IL: InterVarsity Press, 2003), 71. I believe Scripture allows for taking of human life in cases of self-defense, executions performed by a legitimate state authority as punishment for capital crimes, and in a just war.
[13] The Baptist Faith and Message, Article XV, “The Christian and the Social Order.”
[14] M. Cathleen Kaveny, “Complicity With Evil,” Criterion 20 (Autumn 2003): 24
[15] Matthew Arbo, C. Ben Mitchell, and Andrew T. Walker, “Why We Plan to Get Vaccinated: A Christian Moral Perspective,” Public Discourse December 8, 2020, https://www.thepublicdiscourse.com/2020/12/73110/.
[16] If, hypothetically, some a vaccine was developed which required procurement of fresh human tissue from ongoing abortions, using such a vaccine would be material cooperation with evil.