Making a Covid-19 vaccine morally contentious is an own goal

Unlike the epidemiological trajectory of most viral diseases, in the case of Covid-19 the passing of time seems to highlight how little we know about the pathogen, rather than generating an increase in knowledge. As governments’ flailing efforts at containment of the infection have produced mixed but mainly poor outcomes, hopes of relief from the crisis have increasingly focused on the race to produce an effective vaccine.

Here, too, there have been many discouraging messages disseminated by researchers. The complexity of the virus, the requirement to develop a vaccine that attacks it on various fronts, the paramount need to guarantee safety in its eventual administration, present a daunting challenge. True, there have been claims of various “breakthroughs”, some of them undoubted achievements, but the Holy Grail of a safe, effective prophylactic against this lethal pathogen remains elusive and, for the immediate future, largely speculative. Nevertheless, the quest for the Grail goes on apace and on an unprecedented scale.

Globally, there are currently 164 prospective vaccines in development, 139 of them still in preclinical trials, not yet tested on humans, and 25 undergoing human testing. The British government has already signed agreements to purchase large quantities of four different vaccines in development: 100 million doses of the vaccine produced by Oxford University and AstraZeneca; 30 million shots from BioNTech and Pfizer; 60 million from Valneva; and 60 million doses from GSK and Sanofi. In this way, the government has secured coverage for the entire UK population from some of the most promising vaccines in development. It will now keep its fingers crossed for a breakthrough.

But the intractable problems being experienced in research laboratories are not the only issues worrying epidemiologists and some governments. There are also questions surrounding the public reception of any vaccine that may ultimately be developed. Since the goal is to produce an effect as close as possible to the “herd immunity” that was so extravagantly touted in Britain at the beginning of the epidemic – estimated at 95 per cent immunisation of the population – health authorities are anxious to maximise the number of people vaccinated; in that ambition they have already, in some respects, shot themselves in the foot.

In the current state of play, the vaccine being developed by Oxford and AstraZeneca is widely regarded as the front runner. However, there are ethical concerns regarding that research which could impact its public reception. This vaccine is being developed using the cell-line HEK 293, created from tissue taken from the kidney of an aborted baby. To people with pro-life beliefs this is an unacceptable abuse of human life and dignity; they regard abortion morally as murder, even though it is not so legally. In moral terms, to benefit from a vaccine that is a by-product of an abortion would make them accessories after the fact to murder.

Dr Anthony McCarthy, an ethicist at the Society for the Protection of Unborn Children, was quoted as saying: “Even those not opposed to all abortion may well have serious and substantial moral concerns over practices which seem to treat opportunistically the remains of an aborted unborn child. Society needs to respect the consciences of its members who uphold the inviolability of human life from conception and who do not wish to be involved in anything they may see as complicit with the unjust taking of such life.”

The AstraZeneca project is not the only vaccine open to this objection. Researchers at the American-based pro-life Charlotte Lozier Institute have published a list examining more than 20 of the leading vaccine projects and identified four others using morally compromised cells, including the University of Pittsburgh, also employing the HEK 293 cell-line. They simultaneously identified a much larger number of ethically uncontroversial projects. Why is there this difference of approach?

Andrea Gambotto, a University of Pittsburgh researcher, was quoted as claiming cell-lines from aborted babies were more useful: “Cultured [non-human] animal cells can produce the same proteins, but they would be decorated with different sugar molecules, which – in the case of vaccines – runs the risk of failing to evoke a robust and specific immune response.”

Other scientists do not share that view, as evidenced by 60 ethically uncontroversial projects known to be under way. No layman (and probably few virologists) can make an authoritative judgement on the issue; but the ethical case is clear – no scientific advantage can justify morally repugnant research.

What are the practical consequences of this controversy? In Britain, they will probably be relatively minor since there are likely to be ethically irreproachable vaccines also available. For example, the US-German developed BioNTech-Pfizer vaccine, of which the UK government has already ordered 30 million doses, is ethically uncontroversial. Where the outcome is likely to be problematic is in the United States.

Some observers believe Oxford-AstraZeneca could become the lead vaccine marketed in the Covid-stricken United States. That, however, could provoke an unprecedented level of vaccine rejection in America, due to the convergence of several factors. The pro-life movement is enormous in the United States, where opinion polls record a majority now opposed to at least some forms of abortion. Already the US Conference of Catholic Bishops has written to the Food and Drug Administration (FDA), saying “we all want a vaccine, we realise that’s important for our public health, but we also want a vaccine that has no ethical problems in the way it’s developed”.

The Catholic Church’s opposition to the vaccine is specific: it is not based on generalised anti-vaccination sentiments. But America is also home to a vociferous movement of “anti-vaxxers” whose influence has grown over the past two decades. Early this year a Gallup poll showed the number of Americans who feel strongly that parents should have their children vaccinated has fallen to 84 per cent – down by 10 per cent since 2001. It also showed that only 45 per cent of Americans believe vaccines do not cause autism in children.

If an American public resentful of the economic and employment consequences of anti-Covid restrictions and increasingly contemptuous of experts, further augmented by anti-vaxxers and more focused pro-lifers, were to reject a controversial vaccine, that would amount to a perfect storm in which ambitions to create herd immunity – requiring a 95 per cent vaccination uptake according to the WHO – would evaporate. That, in turn, would have implications for the global containment of Covid-19.

We have been here before. The MMR controversy, when parents feared to have their children given the triple measles-mumps-rubella vaccine, was a similar situation. The establishment media raged against Andrew Wakefield and his subsequently discredited autism claims, but failed to take a critical look at the flaws on the establishment side. There was no controversy attaching to single injections against each of these diseases, but the NHS refused to allay parental fears by offering that solution.

The excuse was that it would expose children to the danger of contracting those illnesses during the intervals between vaccinations. Would that danger have exceeded the consequences of the resultant plunge to a 79 per cent uptake of MMR vaccination by 2003? Cost was also cited. Would supplying single vaccines have been more expensive than the return of endemic measles transmission to Britain and this country being stripped by the WHO of its measles-free status last year? Why, when the precautionary principle was so ardently invoked in the cause of opposing climate change, was it rejected as a reassurance to worried parents?

The reality is that for government and the healthcare elites the MMR vaccine became a virility symbol, a totem of superiority over “populism”. The same mentality can be detected in health secretary Matt Hancock’s remarks relating to MMR last September: “We need to be bold and I will not rule out action so that every child is properly protected.” Health issues are likely to become prominent in the growing international confrontation between elites and dissident citizens.

If the marketing of a Covid-19 vaccine is impeded by its repudiation on ethical grounds by a proportion of the population, especially in America, that will demonstrate the consequences, in the current climate, of experts ignoring the moral concerns of others when making ethically significant decisions.