As Independence Day arrives in this year of the coronavirus, we begin to taste again the basic freedom of personal interaction with friends, family, colleagues, and with our Blessed Lord in the Most Holy Eucharist. Yet as public health restrictions are cautiously eased, a question of life and liberty looms on the horizon: the COVID-19 vaccination.
We should certainly welcome rapid and widespread access to an adequately tested, safe, and effective vaccine, but it is easier said than done. Some major ethical concerns include the use of abortion-derived human fetal cell lines in development, restrictions on proper consent, and disproportionate government intervention.
Abortion-derived human fetal cell lines should not be used in the production of any vaccine. The Catholic Church affirmed this in the instruction Dignitas Personae. Only a handful of the COVID-19 vaccines in development make use of these lines, so there is a hope that a morally sound candidate will be successful. Regardless, we are called to give witness to the dignity of human life by demanding that new vaccines have no ties to abortion.
At the same time, Dignitas personae clarifies that end users are permitted to seek and receive immunizations of immoral origin when there are gravely proportionate reasons — including serious risks to personal or public health — with no better alternative available. Some may refuse vaccination to give special witness to the dignity of unborn children, while others at high risk might opt to safeguard personal and community health by pursuing vaccination.
Origins aside, vaccination decisions demand consideration of the facts to make an informed judgment. With any treatment, a person has the right to know the expected benefits and burdens. Will the vaccine have an effectiveness rate of 80 percent or 25 percent? How extensive was the testing to rule out adverse side effects? Population health benefits do not automatically create obligations for individuals. The decisions remain personal, accounting for circumstances. Risks, including possible adverse side effects, must not be obscured.
A concern with fast-tracked vaccines is the reliability of information concerning effectiveness and risks, the very facts essential to informed consent. Experimental vaccines for coronaviruses in years past have never been approved; a COVID-19 vaccine would be a first for this whole family of viruses. Efforts by health care professionals, pharmaceutical companies, government, and media to push the vaccine by ignoring or vilifying those with reasonable misgivings will weaken an already-waning public trust in vaccination practices. Integrity and transparency about the methods, quality, and conclusions of the research are crucial. This includes clear admissions of what we simply do not know, identification of expected benefits and risks, discussion of the certitude of expectations, and respect for individual judgments.
Government overreach is another major ethical issue. The principle of subsidiarity is a fundamental precept of Catholic social teaching: matters should be handled at the most local level possible, with higher levels offering supportive intervention only when truly necessary. Given the varied ways COVID-19 impacts different regions, a vaccine mandate from federal or state governments would be too blunt an instrument. This would feed a lack of public trust. In a similar vein, proposals for contact tracing or vaccination “chips” raise profound privacy concerns, further erode public trust, and can even sow mistrust within communities.
Government has a rightful interest in protecting the public from widespread and serious illness. Yet when it comes to concrete vaccination decisions, human dignity demands witness to the value of life, provision of adequate and reliable information, freedom of conscience, protection of privacy, and prioritization of more local government over higher levels. Anything less jeopardizes life and liberty.
JOHN A. DiCAMILLO, PH.D., B e.L., is a staff ethicist at The National Catholic Bioethics Center in Philadelphia. He earned his graduate degrees at the Pontifical Athenaeum Regina Apostolorum in Rome. He lives in Lancaster County, PA, with his lovely wife Serena and their children.