LEICESTER, United Kingdom – As news continues to be released about positive results in several COVID-19 vaccine trials, questions are being raised about how some of them were developed.

Vaccines are developed using cell lines that continue multiplying indefinitely from a tissue sample. Two such cell lines, the HEK 293 from the 1970s and the PER C6 cell line from the 1980s, originate in tissue from an aborted child.

Vaccines are not normally made using fetal tissue itself, but some vaccines are prepared in, or tested using, a cell-line originally developed from an aborted child,” explained Dr. Helen Watt, a Senior Research Fellow at the Oxford-based Anscombe Bioethics Centre, the main Catholic bioethics institution of the UK.

“Some COVID-19 vaccine candidates, like the Oxford Astra-Zeneca and Janssen/Johnson & Johnson vaccines appear to have used a fetal cell-line in all three areas: design, production and confirmatory testing. At the other end of the spectrum, some vaccine candidates such as CureVac have seemingly made no use of fetal cell-lines in either their design, their production or any test,” she told Crux.

“Some vaccines fall into an intermediate category such as Pfizer/BioNTech, Moderna, Novavax and Sanofi-Pasteur: They may be cell-free in production or prepared in non-fetal cells but confirmatory testing unfortunately seems to have included a test using a fetal cell-line,” Watt added.

The morally problematic origin of the cell lines used in research raises ethical questions for people seeking a COVID-19 vaccine.

“The question of whether we may or should refuse a morally contentious vaccine depends on the availability of alternatives, and the impact of any refusal in terms of health and welfare of ourselves and others. That includes considering the extent to which refusal is likely to change practice and/or influence the public or government to be sympathetic or otherwise to a pro-life view,” Watt said.

However, she said end users don’t have the same responsibility as those who chose to use a fetal cell-line in vaccine production, let alone those who originally created that cell-line, “but they do have some responsibility.”

“Catholics and others should certainly make an effort to choose the least problematic vaccine available to them, if they believe they have reason to be vaccinated,” Watt said.

What follows is Watt’s conversation with Crux.

Crux: As more vaccine results are coming out, people are becoming optimistic that the COVID can be defeated. However, several ethicists are warning about how some of them were developed. Can you give us an overview about the vaccines that are in the news?

Vaccines are not normally made using fetal tissue itself, but some vaccines are prepared in, or tested using, a cell-line originally developed from an aborted child. The sourcing of the original fetal tissue will have involved close complicity in the abortion itself, even if the cell-line created from that tissue has now been circulating in labs for decades.

Some COVID-19 vaccine candidates, like the Oxford Astra-Zeneca and Janssen/Johnson & Johnson vaccines appear to have used a fetal cell-line in all three areas: Design, production and confirmatory testing. At the other end of the spectrum, some vaccine candidates such as CureVac have seemingly made no use of fetal cell-lines in either their design, their production or any test.

Some vaccines fall into an intermediate category such as Pfizer/BioNTech, Moderna, Novavax and Sanofi-Pasteur: They may be cell-free in production or prepared in non-fetal cells but confirmatory testing unfortunately seems to have included a test using a fetal cell-line. And with some other vaccine candidates it is not clear whether such tests will take place in the future. It may in fact be possible to influence whether that happens by raising awareness of the issue with the pharmaceutical company.

What are the moral considerations for a person receiving a vaccine?

This is one among many examples of potentially benefiting from the past wrongdoing of other people. As with other cases of benefiting from past wrongdoing, we need to ask if we have a serious enough reason to justify any bad messages we give out by accepting the tainted benefit. Because of the risk of giving out such messages, we need to ask if there is a readily available alternative and how important it is for us to have the morally contentious vaccine, which will depend on our own personal circumstances. We may, for example, be caring for very vulnerable people, whether family members or people we look after in our work. The question of whether we may or should refuse a morally contentious vaccine depends on the availability of alternatives, and the impact of any refusal in terms of health and welfare of ourselves and others. That includes considering the extent to which refusal is likely to change practice and/or influence the public or government to be sympathetic or otherwise to a pro-life view.

Because there may be a multitude of vaccines available in the coming months, are Catholics obliged to seek one that was developed ethically? What considerations do “end users” need to make?

End users do not have the same responsibility as those who chose to use a fetal cell-line in vaccine production, let alone those who originally created that cell-line, but they do have some responsibility. Catholics and others should certainly make an effort to choose the least problematic vaccine available to them, if they believe they have reason to be vaccinated.

What about if a public health service chooses the “bad” vaccine over the “good” vaccine?

This problem already arises for existing vaccines for other conditions and those who can afford it have sometimes travelled for the vaccine or arranged for it to be imported and administered by a local health care provider. That won’t be possible for everyone and depending on their circumstances, some may well be justified in accepting a problematic vaccine, while making their views known to their health care system as Dignitas Personae [a 2008 Vatican document on bioethics] recommends.

Given the fact that many of the vaccines being developed for COVID didn’t use the problematic cell lines, should Catholics be more vigorous in pushing pharmaceutical companies into abandoning these problematic cell lines?

Catholics and other pro-life people should indeed be urging pharmaceutical companies to avoid problematic cell-lines. That includes companies currently developing vaccines who have not yet used a fetal cell-line in confirmatory testing but may do so in the future unless they are encouraged to stick to morally unproblematic tests. The problem goes beyond COVID vaccines to other vaccines, and we need to be proactive and positive about alternatives in the case of the many existing vaccines that made no use of fetal cells.

Follow Charles Collins on Twitter: @CharlesinRome