Conscience and Vaccines: Lessons from Babylon 5 and COVID-19

1 A real-world example would involve Jehovah’s Witness parents whose child requires a blood transfusion (Gamble and Pruski Citation2020).

2 This point is previously stated by the boy’s father who states that ‘[t]here are more important things in life than the next breath’ circa 17:26 minutes, and is later reiterated by the boy’s mother when Dr Franklin states that ‘[t]he child deserves a chance at life’ and she replies ‘[y]es, but without a spirit it isn’t life at all. You know that’ circa 31:06 minutes.

3 Another dialogue also highlighted the issue of state interference in a pluralistic society: Ambassador Delenn: Matters of the soul are very private, very personal to us. We have suffered the interference of others in this area, and are thus, ourselves, forbidden to intervene in matters such as this./ Parent: You are refusing because of your beliefs? We thought the Minbari were the most intelligent of all races. We are only trying to save our child./ Ambassador Delenn: That is also what Dr Franklin believes he is doing. Whose belief is correct and how do we prove it? No. On this issue the Minbari cannot take sides - circa 22:42 minutes.

4 Similarly to the youth serum from the Wachowskis’ ‘Jupiter Ascending’.

5 Some might argue that foetal cell transplants, e.g. for Parkinson's disease (Lindvall Citation2015), involve a similarly ethically problematic practice.

6 There can also be objection against compulsory vaccination, but here I only consider objections to specific vaccines. However, this is an important topic to consider in the COVID-19 debate, (especially in light of restrictive COVID-19 measures such as radical limitations on freedom of movement), as is the issue of the extent to which parents versus the state should be making decisions on behalf of children (see e.g. Pruski and Gamble Citation2019, Gamble and Pruski Citation2020 for a general discussion on this issue).

7 This means that if vaccination passports (Hern Citation2021, Ada Lovelace Institute Citation2021, Brown et al. Citation2020, Lawrie Citation2021) were to become a common reality, they would potentially increase inequality, for those who already are more burdened by having a medical conditions (and in some countries are protected by anti-discriminatory laws) would also be discriminated against in respect to travel. This should be something considered by those arguing for compulsory vaccination and the penalisation of those who choose not to be vaccinated, for they often advocate for such compulsory vaccination exactly to protect these vulnerable groups (Savulescu Citation2021). Of course, the matter of vaccination passports is subject to a plethora of other arguments as well, e.g. those relating to the efficiency of the process (Kofler and Baylis Citation2020). When Kofler and Baylis (Citation2020) mention a ‘dystopian future’ in this context it also brings to mind Gattaca (Citation1998).

8 This contraindication usually exists because a given vaccine might not have been tested on a sufficient population of pregnant women to confirm its safety, rather than because it has been shown to be dangerous if administered during pregnancy. Some vaccinations are, on the other hand, encouraged during pregnancy.

9 For cases of vaccination related compensations see Looker and Kelly (Citation2011).

10 From an epistemological point of view, no medical professional can guarantee that a vaccination will have no adverse effect on a particular patient or that it will protect them effectively from the specified disease, the best they can do is give statistics on previously recorded effects (Flanagan-Klygis et al. Citation2005, Zimmerman Citation2006).

11 Even with respect to some COVID-19 vaccines there was debate ‘about pork or bovine gelatine used in some vaccines’ (Rachwani, Citation2020).

12 Though people can be vegan for religious reasons and at the core of the Catholic objection is a pro-life viewpoint that does not require a religious commitment.

13 Those holding strong pro-life views might object to such interventions as mentioned in footnote 5.

14 In Believers (circa 08:35 min.) Dr Franklin notes that ‘[y]ou never insult a patient’s beliefs! You work with them, you try to understand their concerns, you give them a reason to be on your side’, here the parents are already on the side of vaccination, one just has to address their concerns, and since they have most likely used vaccination before, these concerns should be realistic to address’.

15 See the earlier quoted dialogue between the Commander and Dr Franklin, and the parental replies to the doctor in footnote 2.

16 Additionally, there is no universally accepted denominator to balance the different goods of life (Finnis Citation2011).

17 This is also the case with respect to lockdown considerations (Pruski Citation2020).

18 Similarly, reproduction is not a value that trumps others for Catholics (as highlighted by their refusal of many assistive reproductive interventions) despite their reputation for having large families.

19 There are a lot vaccines that are predominantly or exclusively produced using cell lines derived from aborted human foetuses, e.g. the Rubella vaccine or the Hepatitis A vaccine (Treloar Citation2019).

20 Though van der Eb (Citation2001) is probably the best formal account of how this cell line came to be, Austriaco (Citation2020) notes that in private correspondence with the cell line’s creator, Professor Frank Graham stated that the exact origin of the foetal cells is unclear.

21 As such, the Catholic Bishops' Conference of England and Wales’ statement seems to correctly interpret the licitness of the Catholic faithful’s use of a COVID-19 vaccine developed from such cells, but ignores to exhort the faithful to lobby the government to provide what the Catholic Church would regard as ethical alternatives to such vaccines (Moth Citation2020). The American Catholic Bishops’ statement does state that the faithful should avoid using a vaccine produced using such cells (i.e. AstraZeneca) if an alternative is available that e.g. only used such cells in testing (i.e. Pfizer and Moderna vaccines; United States Conference of Catholic Bishops Citation2020).

22 Though as in Believers, the Church’s stance is also based on metaphysical assumptions about the personhood of the embryo from which the HEK293 cell line was developed.

23 Nevertheless, the public might have been more appreciative of the gravity of the matter if the kidney was not obtained from a foetus but e.g. from a political prisoner, or if the process of producing the cell line involved killing a born child, for the Catholic Church views the use of HEK293 as violating such same dignity (Congregation for the Doctrine of the Faith Citation2008).

24 See e.g. Brennan (Citation2020) – a Protestant demonstrating a firmer stance. Indeed, it could be argued that unless such a firmer stance is taken, objections to the use of cell lines such as HEK293 will not be taken seriously.

25 It was rather unfortunate that while the Pfizer-BioNTech vaccine was advertised as safe and tested, soon after its roll-out guidance had to be changed because two healthcare workers had an allergic reaction after its administration (Lovett Citation2020). There have also been some concerns regarding this vaccine’s safety due to deaths reported among the elderly who have received it in Norway (Conifer Citation2021), though the link between these deaths and the vaccine has been dismissed (Taraldsen Citation2021). Similarly, the Oxford/AstraZeneca vaccine has been investigated with respect to links with disseminated intravascular coagulation, resulting in some changes in how that vaccine was offered to certain age groups and the term ’vaccine induced thrombosis and thrombocytopenia’ coming about (European Medicines Agency Citation2021, Triggle Citation2021, British Society for Haematology Citation2021). Issues surrounding blood clots were also brought to the public attention in relation to the Johnson & Johnson vaccine in the USA (BBC Citation2021).These incidents highlight both the precaution needed in how a vaccine’s safety is advertised when it is made available through an expedited approval route, but also that due vigilance is beening taken to continue the safety monitoring of the vaccines. Moreover, one needs to remember that the world-wide scale of these blood clot events (even if they were all due to the vaccines, which they might not have been) would still be magnitudes lower than the 10400 deaths that were likely averted in England alone due to vaccinations between December 2020 and March 2021 (Public Health England Citation2021).

26 The swine flu Pandremix vaccine was associated with a rise of narcolepsy that resulted in victim compensation being paid in the UK (Narcolepsy UK Citation2020). In 1976 a controversy resulted from Ford’s vaccination programme where compensations were made to those who developed Guillain-Barre syndrome following their vaccination (Fisher Citation2020). The Centers for Disease Control and Prevention notes that '[s]tudies suggest that it is more likely that a person will get GBS after getting the flu than after vaccination' (CDC Citation2020).

27 There should not be any suspicion in how quickly these vaccines have been developed as this is largely due to scientific progress and efficient management of the development and testing processes, rather than due to rushed work (Davis Citation2020). On the other hand, changing the vaccination schedule (Neville and Mancini Citation2020) did raise some criticism regarding the evidence basis behind this (Lintern Citation2021, Iacobucci and Mahase Citation2021). These criticisms did seem to be warranted and the data on single dose effectiveness might perhaps not have been as accurate as was thought originally (Beaumont Citation2021).

28 Though, to reiterate the point, this is largely how the Catholic Church views the development of the HEK293 cell line and other cell lines developed from samples taken from aborted foetuses.

29 Of course, some will wish to highlight the huge public impact of contagious disease outbreaks and their impact on other people’s lives. This issue is not the subject of this manuscript, but it is worth noting that we do not force patients to undergo treatments that will in the long run be most efficient for the economy, nor do we make it compulsory for HIV patients to take medication so as to reduce the chances of them accidentally passing on the virus to others.

30 See Rodger (Citation2021) for a discussion of the relevant U.K. laws and guidance in relation to a parallel issue of the use of animal-derived components in medical products, and how this relates toissues of informed consent and respect for autonomy.

31 E.g. the Welsh Government website explicitly states that patients do not have a choice as to which COVID-19 vaccine they can receive (GOV.Wales Citation2021).

32 There is generally little discussion on how to address fears surrounding vaccination in a constructive way, as opposed to about how to enforce higher vaccination uptake (Berry et al. Citation2017, Black and Rappuoli Citation2010, Larson et al. Citation2011).