The Vaccination Question – Timothy Collins, MD

Published in The Angelus Magazine, Feb 2006
2915 Forest Avenue
Kansas City, MO  64109
Publisher:  Fr John Fullerton
Editor Fr. Kenneth Novak
Assistant Editor: Mr. James Vogel

The Vaccination Question

By Timothy P. Collins, MD

Letter From The Editor – The Angelus

Catholics are not aware of some of the moral dilemmas posed by the use of vaccines. Many Catholics are not even aware hat the most common vaccines were developed from the cell lines derived from babies aborted specifically for this purpose. For instance, the RA273 rubella vaccine required at least 47 separate abortions. Thankfully, the Vatican recently clarified the Church’s position on this issue, which has been debated for years. The entire document, issued by the Pontifical Academy for Life, is published here (see p.14ff – Angelus Magazine). (Note: Vatican statement linked on-line)

In this introductory article, Catholic pathologist Dr. Timothy Collins points out that vaccinations in principle are certainly for the common good of a population. However, a dilemma arises when three situations converge: 1) genuine need, 2) mandatory vaccinations for schools or travel, and 3) the fact that these vaccines are made from aborted fetuses. What is a Catholic to do? In America, at least, it is recognized that members of certain religions can claim conscientious objection status. Catholics, however, are generally not recognized as conscientious objectors because of a lack of clarity regarding the official Church position. The recent Vatican document (June 9,2005) is a welcome breath of fresh air from Rome.

Rome has clearly enunciated the principles: 1) the production of vaccines derived from aborted fetuses is condemned, 2) at least for now, under certain conditions, Catholics may use fetal cell line vaccines only when it is impossible to use vaccines derived from non-fetal cell lines, 3) the availability of and production of non-fetal cell line vaccines must be persistently and resolutely petitioned for by Catholics, 4) Catholics have the duty to make known their objections to appropriate government agencies (i.e., in the US, the Department of Health & Human Services, the Center for Disease Control and Prevention, and the Food and Drug Administration, for which The Angelus has published contact information on p.30) as well as to the drug manufacturers themselves (contact information provided on p.30)

This Angelus is not meant to give anyone an easy conscience regarding medical choices. Slicing out baby parts or sucking out baby brains in the development of human vaccines-in some cases while the aborted baby was still alive-is sick. Rome has weighed-in late in the game and so Catholics have been forced to play a desperate game of catch-up. The directives of the Pontifical Academy for Life must be followed as a moral obligation. Failing the prayerful and powerful leverage the Pontifical Academy asks Catholics to apply, we face a proliferation of human technology manufacturing platforms, the catastrophe of moral coercion injected into every aspect of medical treatment, and the specter of “rule by insurance companies.”

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The Vaccination Question

By Timothy P. Collins, MD

Catholics ought to be aware of the moral problems associated with specific vaccines, as well as some looming problems regarding trends in vaccine manufacture. This is not an obscure topic, and it is of relevance to every Catholic, not just parents. Given all of the opinions floating around regarding vaccinations, I would like to make a couple of clarifications up front.

First, I accept the usefulness of mass vaccinations in general. After sanitation measures such as flush toilets and monitored water supplies, mass vaccination campaigns targeted at specific serious infectious diseases of high endemnicity (prevalence) have done more to improve overall population health and well-being than any other single measure.¹ Secondly, I accept, in principle, the authority of a government to impose regulations regarding mass vaccination. Vaccination programs rely, in part, on the so-called “herd effect” in order to be efficacious, meaning that, in order to decrease a disease within the population, a large percentage of the population (90% is a nice working number) needs to be immunized against the disease. The herd effect functions in addition to the individual protection the vaccinated person obtains against the illness. Notice that, in theory, 10% (more or less) of a population can remain unimmunized and remain free from the disease; this is because the disease in a highly vaccinated population is kept at such a low level that the rare unvaccinated individual rarely (or never) encounters it. Thus, in a highly vaccinated population, the rare individual who is unvaccinated is literally reaping the benefits of the 90% who did undergo vaccination. Also note that if the unimmunized proportion of the population should increase-say, to 20% or more, then the disease can reappear.

Most of the diseases we immunize against are still out there. They’re invisible to us because we live in a highly vaccinated population, but they’re still out there, waiting for the opportunity to come back in. If a disease is serious enough to warrant a significant public health risk as well as being a risk for an individual-and most of the illnesses we vaccinate against fall into this category-then it is, I believe, a proper role of government to regulate regarding mass vaccinations as part of the state’s general interest in the health and well-being of its population.² Although there may be some controversy regarding whether this or that specific vaccination should be required, in general these are technical questions best resolved by the epidemiologists and infectious disease researchers. The exception comes when a government requires an immoral vaccine, a topic we will examine later.

Finally, this is not a paper about vaccine safety. Vaccine safety is a tremendously important topic, and if questions regarding a vaccine or a component of a vaccine come up, they should be rigorously investigated. But my point is this: in general, the vaccination is far, far safer than the disease it is preventing, ^//public health requirements involve such a trade off: individual inconvenience (and, possibly, individual risk, however slight) vs. overallpopulation benefit. Which brings us to the dawn of vaccination.

A Brief History of Vaccination

Edward Jenner (1749-1823) was an English physician who, after serving in Her Majesty’s Army out in the Empire, returned to the country life in Gloucestershire in western England.³ He was a quiet and observant man, and knew the “old wives’ tale” that milkmaids didn’t get smallpox. Now, smallpox is an illness that few of us living on the planet today have any experience with. Throughout history, however, it was one of the greatest scourges known, along with other infectious diseases we never see today in the West like polio (“the scourge of summer”), yellow fever, and malaria. “Leprosy” in Holy Scripture is a generic ancient term for pretty much any serious infectious disease with skin manifestations, including real, verifiable leprosy, but including smallpox as well. Smallpox has been responsible for more military deaths throughout history than cannon, gun, or sword combined, and has been known as a bioterror weapon since the earliest times. The clothes or bedding of the infected person can transmit the disease, and infected linen and even bodies of those who died of smallpox were not infrequently catapulted into the opposing camp; as late as the French and Indian War, the British utilized this ancient technique. Throughout history, smallpox was as common as heart disease or cancer today, and frequentlyfatal. If you didn’t die of smallpox you were left with disfiguring scars. However, you were immune for life.

A form of immunization already existed in Jenner’s time. Lady Mary Wortley Montagu, wife of the British Ambassador to Turkey, brought to England in 1721 the “Eastern technique,” where the contents of a smallpox pustule from an infected person were rubbed into the vein of a healthy person. If the person survived the infection resulting from the inoculation, he was immune for life. Though the person could also die from the inoculation, he had much less chance of dying than if he contracted the disease naturally. It was this technique that General George Washington used to inoculate the troops at Valley Forge: although he himself had contracted (and survived) smallpox as a child, he was quite aware of its military significance, in part from his experiences during the French and Indian War. Although he was immune, his wife Martha was not, and she volunteered to stand at the head of the line that freezing winter and receive the first inoculation. Thus mass vaccination of the US Army was born.

Cowpox (vaccinia, from the Latin vaca, cow) was a disease that cows got, usually manifesting itself by blisters on their udders and teats; milkmaids not infrequently got the blisters themselves. Cowpox blisters on milkmaid hands were not fatal to the milkmaids, nor did it make them very ill. They had the local blistering skin reaction which healed, and then they were immune to cowpox. Jenner knew the old wives’ tale about milkmaids not getting smallpox, and he also observed firsthand, during a smallpox epidemic in 1788, that milkmaids who had previously had cowpox blisters on their hands didn’t get smallpox. He also knew that cowpox in milkmaids was a mild illness with only the few blisters where the milkmaids had milked the affected cows. So, in 1796 he tested his hypothesis that exposure to cowpox could protect against smallpox. He took some pus from the cowpox blisters of a milkmaid named Sarah, who had gotten them after milking an infected cow named Blossom. He injected the pus into an 8-year-old boy named James Phipps, repeating the injections over the course of several days. He then inoculated young Phipps with smallpox. Phipps did not get sick. This may seem like a radical method to us today, but for young Phipps (and, presumably, his parents) it was a calculated risk. He figured he had a better chance of dying of smallpox than from Jenner’s hypothesis.

Initially there was resistance to Jenner’s discovery. However, the clear-cut success in Jenner’s method in preventing smallpox overcame opposition, and by 1840 the British government had banned any method other than Jenner’s vaccinia inoculation in dealing with the disease. The last case of naturally occurring smallpox was in Somalia in 1977, and in 1980 the World Health Organization (an arm of the United Nations) declared smallpox officially eradicated from the planet. Vaccination in the US was discontinued in 1971, except in the military, where it continued until 1990.⁴   Edward Jenner gave his discovery to the world for free. He did not patent it, never made any money on it, and lived the rest of his life before going to his judgment as a quiet country doctor

The Question of Vaccinating Children

If you look at the package insert of the MMR® II (Merck)⁵ vaccine your child was immunized with during his routine pediatric appointment, you will find that it is actually a combination of three vaccines: measles vaccine, mumps vaccine, and rubella (German measles) vaccine. The manufacturer did this so that your child gets three immunizations in one shot. There are other combination vaccines out there besides MMR* II, but we’ll stick with this one for now. Reading the package insert, you find that all three vaccines consist of live, attenuated strains of the viruses in question, for all three illnesses are caused by viruses of the same name: measles virus, mumps virus, and rubella virus. The names of specific viral strains used suggests a colorful history (if you are inclined to medical history): the measles vaccine uses the Enders’ attenuated Edmonston strain, and is grown in chick embryo cell cultures. The mumps vaccine is the Jeryl Lynn (B level) strain, also grown in chick embryo cell cultures.

What is a chick embryo cell culture and why is it necessary? Unlike bacteria, which are complete, unicellular organisms which can be grown in “nutrient broths”-soups, essentially, made up to the liking of the bacteria in question-viruses are “incomplete organisms.” They consist of only genetic material, DNA or RNA, encased in a protein coat. Although they have their genetic identity, they lack the cellular machinery to reproduce themselves, the cellular machinery that bacteria and all living cells more complicated than bacteria, up to and including ourselves, possess. So, a virus cannot, in general,⁶ grow and eventually reproduce itself by simply being “fed” the way a bacteria or a baby can. They need to usurp the machinery of some cell. And that’s exactly what they do: the virus attaches itself to the wall or membrane of a cell (different viruses have preferences for different kinds of cells, just as different bacteria have preferences for different nutrient broths, and my children have preference for peanut butter and jelly to the exclusion of everything else) and literally injects its own genetic material into the cell. That genetic material usurps the cell’s machinery to manufacture copies of itself, and, when the number of virus copies gets large enough, they pop the cell like an overblown balloon and the now liberated virus particles float around to latch on to another cell and start the whole process again. Thus, viruses, unlike bacteria, must be grown in cell cultures. The Enders’ attenuated Edmonston strain of measles virus and the Jeryl Lynn (B level) strain of mumps virus like chick embryo cell cultures, which are essentially self-replicating lines of cells grown in petri dishes, and which were originally derived from chick embryos.

Reading further in the MMR® II package insert, you find that the rubella attenuated viral strain is a strain called “RA 27/3,” and it is grown in a cell culture called “WI-38 human diploid lung fibroblasts.” If you look at the package insert for the varicella (chickenpox) vaccine your child received, you find that this product also used the “WI-38 human diploid cell culture” as well as another human diploid cell culture, “MRC-5,” to grow the virus used in the vaccine. The moral issue is as follows: the WI-38 and MRC-5 human diploid cell lines used for viral culture in the rubella and varicella vaccines, as well as the RA 27/3 rubella viral strain which is the virus cultured for the rubella vaccine, are derived from babies aborted decades ago.

A detailed and annotated history of the abortions related to the development of these lines is available in Debra L. Vinnedge’s document, “Aborted Fetal Cell Lines and the Catholic Family,” available at the Children of God for Life website.⁷ Briefly, in the early 1960’s, attempts were being made to develop human cell lines for, among other things, vaccine viral culture media. Researchers at the Wistar Institute in Philadelphia, Merck Research Institute, and the Karolinska Institute in Stockholm, Sweden, collaborated in the project. The researchers were specifically looking for parents with no medical problems, as they wanted their cell lines to be untainted by genetic illnesses. Thus, the ideal prospective fetus was the one to be aborted for “social” reasons, usually given as “too many children.” It took the researchers 37 attempts, representing 20 Swedish abortions, to develop a cell line which grew. The line which did finally grow, the Jflth attempt, was designated WJstar institute 38: WI-38 (see sidebar on p.6). In addition to a viable cell culture line, the researchers also needed a strain of the rubella virus which had been shown to successfully cross the placenta and infect an unborn child. And now, we need a slight digression into the reason for rubella vaccination.

Rubella is a mild illness in children. Like measles and chickenpox, the child who gets German measles usually has a short, mild illness and then recovers, and also has lifelong immunity against re-infection. However, rubella is highly contagious, and can be devastating to a fetus in utero. The reason rubella is a public health issue is because if a pregnant mother who is unimmunized (either by vaccination or by natural immunity) is exposed to a child with rubella, the mother will get the disease. In turn, the virus can cross the placenta and infect the child. Congenital rubella syndrome (CRS), the constellation of defects associated with congenital rubella infection, can be mild, but can also be devastatingly severe. CRS of some level of severity results from up to 85% of maternal infections which occur in the first trimester, but the frequency of CRS drops dramatically by the eighth week. If the mother is infected after the 20th week, the incidence of CRS is zero.⁸ The reason, then, to vaccinate the child is not primarily to protect the child, although this is a useful secondary effect. The reason is to prevent the transmission of the disease from an infected child through a pregnant mother to her unborn child. You vaccinate your child against rubella to protect someone else’s unborn child.

Since not all rubella virus infections result in CRS, a strain which had been shown to successfully cross the placenta and infect an unborn child was necessary for the vaccine. For many years the medical establishment recommended abortion if an unimmunized, pregnant mother was exposed to rubella for fear of CRS (this is no longer the case), and during a rubella outbreak in Pennsylvania in 1964, pregnant mothers who had no rubella immunity underwent abortions. Organs from 26 of these aborted babies underwent culture looking for the virus. Only with the 27th was the virus grown successfully; this strain was then successfully cultured in WI-38, and designated RA 27/3 for Rubella Abortus number 27, 3rd tissue explant. Thus it is the RA 27/3 rubella viral strain, grown in WI-38 human diploid cell culture, which is the basis of the current vaccine in use in the United States today. Vinnedge estimates that some 47 elective abortions were involved in the development of this product: 19 from the failed WI cell lines, one for WI-38 itself, and 27 to find the viral strain. Several years later the Medical Research Council of England used similar techniques to develop the MRC-5 human cell line.

In addition to rubella and varicella, other vaccines in use which depend on human cell lines are hepatitis A (MRC-5) and rabies (MRC-5.) The polio vaccine currently in use in the US uses multiple strains of poliovirus grown in monkey kidney cultures; however, there is another polio vaccine using MRC-5 cultures which is licensed, but not yet distributed, in the US. The smallpox vaccine (currently in use only in selected members of the armed forces) uses the traditional New York Board of Health vaccinia strain, which was prepared in calf lymph and stored as a freeze-dried product decades ago. However, a second generation smallpox vaccine using both MRC-5 and a new human cell line, PER C6, is under development. It is to this new cell line, PER C6, that we will now turn our attention.

Human Technology Manufacturing Platforms

In 1985, an abortion was performed in France on an 18-week female fetus. The unborn child’s parents were healthy, and there was no family history of medical problems; the abortion was performed solely because “the woman wanted to get rid of the fetus.”⁹ The woman and her unborn child met the criteria that the researchers from the University of Leiden were seeking: no medical problems. This is because they were looking for sources of material to develop cell lines specifically for pharmaceutical manufacturing of vaccines and other biotherapeutics. The abortion was performed, cells were procured from the aborted child’s retina, frozen, and ten years later thawed for development as the PER C6 line. The researcher from University of Leiden who oversaw the project noted in his discussion of the line’s development,

“[a]nd then the pharmaceutical industry standard. I realize this sounds a bit commercial, but PER C6 were (sic) made for that particular purpose. Also, as far as I know, more than 50 different companies have taken license for PER C6.” ¹⁰

The PER C6 cell line has been expanded onto a commercial scale by the Dutch biotechnology company Crucell NV as one of the company’s two “broadly applicable human technology platforms”¹¹ for developingpharmaceuticals.

PER C6, according to Crucell NV, will be used as a manufacturing system on which a wide range of biopharmaceuticals can be developed and manufactured, such as vaccines, antibodies, therapeutic proteins and gene therapy products.¹²

PER C6 human cell line will soon be used in the production of the US influenza vaccine as it was shown to be an efficient system for propagating both influenza A and influenza B in 2001.¹³ On April 1, 2005, Sanofi-Aventis Group [the third largest pharmaceutical conglomerate in the world-Ed] announced that it had been awarded a $97 million contract by the US Health and Human Services Department “to speed production process for new cell culture influenza vaccines in the US.”¹⁴

Of interest, the same press release noted, in the “about cell-culture technology” section, that the two main advantages of human cell culture over the conventional influenza viral culture medium of chicken eggs is that 1) the cell culture technique decreases the start up time for a new viral culture from four weeks to three, and 2) it eliminates the need for all those eggs. Unstated, but equally true, is that PER C6 is licensed. Chicken eggs are not. And there’s a lot of doses of influenza vaccine waiting to be manufactured.

Another biotechnology company, Vaxin, based in Birmingham, Alabama, announced a license agreement with Crucell NV on September 13, 2004, to use the PER C6 cell line to develop vaccines against influenza, anthrax, respiratory syncytial virus (RSV), and other unspecified diseases.¹⁵

The Aeras Global TB Vaccine Foundation of Bethesda, Maryland, contracted with Crucell NV for $2.9 million to develop a new tuberculosis vaccine using PER C6 to replace the old BCG TB vaccine (not used in the United States).¹⁶

The PER C6 cell line is being used in the development of Merck’s HIV-1 vaccine.¹⁷

The PER C6 cell line is being used to develop Sanofi-Pasteur’s avian influenza vaccine, and will enter clinical trials in Norway in the spring of 2006.¹⁸ It is possible that a government could require universal inoculation with an avian influenza vaccine.

At this point, it is reasonable to ask what the Church’s position is concerning all of the above. To date, the only Vatican statement on the subject is a study from the Pontifical Academy for Life, an arm of the Congregation for the Doctrine of the Faith, dated June 9, 2005, entitled, “Moral Reflections on Vaccines Prepared from Cells Derived from Human Foetuses.”¹⁹ It was attached to a cover letter addressed to the Executive Director of Children of God for Life, Mrs. Debra Vinnedge. The purpose of the study was “to clarify the liceity of vaccinating children with vaccines prepared using cell lines derived from aborted human foetuses.”²⁰

In addition, the study “regarded in particular” Mrs. Vinnedge’s question concerning “the right of parents of these children to oppose such a vaccination when made at school, mandated by law.”²¹ Before rendering an answer to Mrs. Vinnedge’s questions, the document first developed the notion of levels of “cooperation” with evil. For those who, like me, are theologically naive, we’ll review them, too.

How Close Is Close: The Notion of “Cooperation”

The first fundamental distinction is between formal and material cooperation. In formal cooperation, one shares the intent of committing the evil. In other words, one agrees with the evil act. Thus, whether the personwas the abortionist who actually aborted the baby 40 years ago whose cells became WI-38, or simply a contemporary parent whose child is to be immunized against rubella but also agrees with the abortion, such formal cooperation is never licit.

In material cooperation, one shares the act, but not the intent. In other words, one is somehow associated with the act, but disagrees with the intent. Both formal and material cooperation have different levels of “closeness” (as illustrated briefly above) but we’ll confine the rest of this discussion to material cooperation. Material cooperation may be either immediate or mediate. In immediate cooperation, one cooperates directly in the act. In mediate cooperation, one doesn’t participate directly, but performs some indirect function, such as providing instruments or products which support the occurrence of the act. Cooperation can also be divided intoproximate (either spatially, temporally, or conceptually) or remote.

• Immediate material cooperation is always proximate. It has to be proximate, because one is directly participating in the act. When the evil is a grave matter, such as participation in abortion, immediate material cooperation is always illicit?² Thus, in the abortions performed decades ago in developing the WI-38 and RA 27/3 lines, one would conclude that the participation of the Wistar and Merck researchers who collaborated with the Swedish abortionists at the Karolinska Institute to procure the tissue were immoral because they were proximate, regardless of whether they “personally agreed” with the abortions or not. Further, the document specifically and repeatedly draws attention to those involved in “the preparation, distribution, and marketing of vaccines produced as a result of the use of biological material whose origin is connected with cells coming from foetuses voluntarily aborted,” noting that such activity is, “as a matter of principle, morally illicit.”²³

If the activity of the Merck and Wistar researchers was illicit-and I do not see how it could not have been-it is even more true of the activities of the researchers at the University of Leiden who developed PER C6, Crucell NV [the company developing and marketing this human technology manufacturing platform (see sidebar on p.8)-Ed.\, as well as those 50 or more companies licensing this “platform.” It would also seem to be true of the US Department of Health and Human Services which has, as noted above, provided at least $97 million of US taxpayer money to support, specifically, the PER C6-based influenza vaccine program being developed by Crucell NV and Merck.

• Mediate material cooperation may be proximate or remote. Since the nature of the cooperation is not direct but indirect, it may be somewhat distant in terms of time, space, or circumstance. A further distinction is drawn between active (positive) cooperation with evil, and negative (passive) cooperation. The distinction here is between doing something involved with the act versus sitting back and allowing it to happen when one has a definite moral duty to impede the evil in question. Passive cooperation, like active cooperation, can be formal or material, immediate or mediate, proximate or remote.

So how does all this apply to the vaccine question? The Vatican paper identified three categories of people in this matter: 1) those who make the vaccines, 2) those who market and distribute them, and 3) those who use them. We’ve already touched on the first two categories; these activities the document condemned as morally illicit “as a matter of principle.” The reason for this is because “…preparation, distribution, and marketing… could contribute in encouraging the performance of other voluntary abortions, with the purpose of the production of such vaccines.”²⁴ It is, of course, precisely this that we see happening with the PER C6 endeavor. The paper notes that within the production-distribution-marketing chain, there are varying levels of responsibility, but the cooperation is “more intense” on the part of those authorities, for example the Department of Health and HumanServices, that accept the use of the vaccines.

The document then takes up the issue of those who use the vaccines. The parents who use the vaccines, as well as the physicians who administer them, assuming they are not in formal cooperation with the abortion (i.e.,they don’t agree with it), “carry out a form of very remote mediate material cooperation…in the performance of the original act of abortion.”²⁵ The document continues,

… “[I[n this situation, the aspect of passive cooperation is that which stands out most. It is up to the faithful…to oppose, even by making an objection of conscience, the ever more widespread attacks against life….From this point of view, the use of vaccines whose production is connected with procured abortion constitutes at least a mediate remote passive material cooperation to the abortion, and an immediate passive material cooperation with regard to their marketing.^“26

“Therefore,” the paper continues, “…fathers of families…should oppose by all means…the vaccines which do not yet have morally acceptable alternatives.”  Note is made here of the use of the word “yet.” Although not specifically stated, the authors seem to believe that the use of human cell lines is dying out, and that these vaccines will soon be replaced with something less “morally tainted” [i.e., non-fetal cell lines-Ed.] We will touch on this further down below.

Regarding those vaccines which have no alternatives, the paper notes that “it is right to abstain from using these vaccines if it can be done without causing children, and indirectly the population as a whole, to undergo significant risks to their health.” If there are significant risks, the paper continues, they may be used on a “temporary basis.” “The moral reason is that the duty to avoid passive material cooperation is not obligatory if there is grave inconvenience.”²⁷

In conclusion, the Vatican paper condemns the production, marketing, and distribution of the vaccines. It also condemns those public policy officials who implement their use. It supports those parents who make “an objection of conscience,” up to and including abstention from use (“…it is right to abstain from using these vaccines”) assuming it can be done without “significant risk.” However, it doesn’t condemn those parents who vaccinate, given the level of moral coercion which exists.

Moral Coercion and Significant Risk

The Vatican paper attempts to address the dilemma parents face. Parents have a sure and certain moral obligation to promote the health and well-being of their children, and vaccination, in general, is part of that parental responsibility. However, the vaccines which utilize these human cell lines derived from aborted babies are immoral. Their manufacture and distribution is morally illicit “as a matter of principle.” Using the vaccines represents cooperation with the evil of the original abortion, even if in a remote and passive way. Thus the recommendation that parents make “an objection of conscience,” up to, and including, abstention from use.

Except, the paper says, when “significant risk” exists in refusing to use them. This is not an insignificant caveat. Although there are no federal laws concerning vaccination, all states require proof of immunization against the “usual childhood diseases”-which include rubella and varicella (i.e., chickenpox)-prior to entry into public or private school, day care, and, increasingly, organizations such as the YMCA or Boy Scouts. Most states have conscientious-objector clauses allowing parents to opt out, though the Catholic Church has not heretofore been recognized by most authorities as one of the organizations allowing refusal on the basis of conscience. Thus, without a doubt, there is legal coercion of Catholic parents, and this was the issue which prompted the Children of God for Life letter to the Vatican: Catholic parents were being told they couldn’t opt out because the Catholic Church didn’t support their refusal. Unfortunately, the Vatican letter may be a little too nuanced to settle this issue, as the opposing (and occasionally acrimonious) interpretations of the letter in the Catholic press have shown. Some interpret it as official Vatican support of parental refusal, others interpret it as official Vatican denial of parental right of refusal. The crucial phrase seems to be, “significant risk.”

“Significant risk” is not easily defined. Consider chickenpox. Chickenpox is a mild illness in which natural infection confers lifelong immunity (which the vaccination does not do), and for these reasons, as well as other reasons, at least one developed nation (England) has opted against population-wide chickenpox vaccination. Thus, if even medical and public health professionals can’t agree, it’s not too much of a stretch to argue that there’s no significant risk to your child if you don’t immunize him. Rubella, on the other hand, is a bit more complicated. Remember, the primary reason for rubella vaccination is not to protect your child, but to protect someone else’s unborn child. In the United States today, the endemic level of rubella is quite low, and it is arguable that there is little risk to anyone else if your child is unimmunized. However, if the fraction of the US population not immunized against rubella were to increase, then rubella (and congenital rubella syndrome) will reappear. Further, rubella remains quite common in other parts of the world, and an unimmunized American child traveling overseas could certainly contract the illness, and spread it to an unimmunized mother. Thus, withholding a rubella vaccination from your child is a bit more complicated in terms of potential risk.

Finally, consider polio, a devastating disease. Like rubella, polio currently is not present in the US in measurable degree. Again, like rubella, this is due to the high levels of vaccine-mediated immunity within the population. The current polio vaccine poses no moral problems, as no human cell lines are involved in its manufacture. However, as noted previously, a new vaccine utilizing the MRC-5 human cell line has already been licensed by the FDA, and is awaiting distribution. If the pattern established with the rubella and other vaccines is followed, the new vaccine will replace, not supplement, the current vaccine and then, like rubella and varicella, there will beno choice for the parent besides either vaccinating with the immoral vaccine, or not vaccinating against this devastating disease. Polio DOES carry significant risk for one’s child, and this is MORAL COERCION.[And what about the spreading avian influenza?- Ed.]

A second dilemma with the Vatican document is that it may not adequately address the reality which exists. As noted above, the letter uses phrases such as “vaccines for which there are not yet acceptable alternatives,” and “temporary basis,” suggesting that the authors may believe this to be a situation which is transitory and self-correcting, as well as being confined to a relatively small group of parents and no one else. Though not stated in the letter, one gets the impression that the authors might believe that the vaccine manufacturers were unaware of the origin of these cell lines, but now that they know, they will take steps to correct things.

Nothing could be further from the truth. If, dear reader, you take nothing else away from this article, please take this: we are at the dawn, not the sunset, of human technology manufacturing platforms. The day is upon us where this sort of moral problem will be injected into virtually every aspect of medicine.

In considering this looming moral catastrophe, the following is worth considering: the use of human cell lines derived from aborted babies to manufacture vaccines (or anything else) is not conceptually different from the use of cell lines derived from the embryonic stem cells. The only difference is a practical one: medical therapies from cell lines from aborted babies are already in widespread use; those from embryonic stem cells are still hypothetical. But in both cases you have an unborn child being disassembled for useful parts. The Church appears to be heading in the direction that any use of products from embryonic stem cells is immoral because their origin is immoral. I am unable to discern a difference between products derived from aborted babies and products from embryonic stem cells. But I also know, on a personal level, the moral coercion regarding vaccines. I am a parent. I fully understand that the parents’ clear and certain responsibility is to provide for the welfare of their children. I do not criticize those parents who have struggled with this issue, and decided to vaccinate their children. I take this problem very seriously.

The simple fact is that this is not a problem which a handful of parents can solve, and it is unjust for the Catholic Church to put the weight of responsibility on them. This is something the Vatican and the bishops should weigh in on, clearly, repeatedly, and unambiguously. The only thing that can oppose this gathering cloud of evil is international, Vatican-led opposition. Very soon, the problem will no longer be confined to a handful of parents agonizing over whether they cooperate with evil when they vaccinate their children against chickenpox. It will be a moral dilemma which entangles virtually everyone. The Church will have to address it in the manner itdeserves, sooner rather than later. CJ3

Timothy P. Collins, MD is a Catholic Pathologist from Chesapeake, Virginia.  He is a graduate of Georgetown University School of Medicine and is Board Certified in Anatomic and Clinical Pathology, as well as being a Fellow of the College of American Pathologists. 

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Foot Notes

1. This is not to say that all vaccines currently in use should be used. There is controversy within the medical community regarding some specific vaccines such as varicella (chickenpox). We will touch on this a bit later in the paper. However, in my view these are technical-/.e., medical and public health-problems, rather than moral problems

² Again, I am speaking in generalities. I do not intend to say that the government should be mandating all of the vaccines which are currently mandated. As a point of interest, there are actually no federal laws regard­ing vaccination; all laws are at the state or local level.

 ³ Historical background developed from the following sources: “Edward Jenner and the Discovery of Vaccination.” Patrick Scott, Thomas Cooper Library, University of South Carolina, at www.sc.edu/library/spcoll/ nathist/jenner.html: “Edward Jenner” at History Learning Site, A History of Medicine, at www.historylearningsite.co.uk: and Wikipedia On Line Encyclopedia, “Vaccination” at www.wikipedia.org

 ⁴ The only remaining reservoirs of smallpox virus are at the CDC and in the Institute for Virology in the former Soviet Union. All of the smallpox once present in the former Soviet Union can no longer be accounted for, which, in part, underlies the fears concerning smallpox as a terror weapon. Since smallpox immunizations were discontinued worldwide decades ago, and since vaccination-produced immunity wanes, the world is, for practical purposes, unimmunized, and even more susceptible to a devas­tating smallpox outbreak than back in Jenner’s day, when that part of the population that survived into adulthood frequently had natural immunity. While deployed as a medical officer aboard a US Navy warship in the Persian Gulf during Operations Enduring Freedom and Iraqi Freedom, I was intimately involved with the deployment and program development for shipboard smallpox and anthrax vaccination of the Marines and sailors aboard the ships of Amphibious Squadron 2, my parent unit. This was the first time smallpox vaccinations had been administered since 1990, and the crews of entire ships had never been immunized. There were signifi­cant technical and logistical problems associated with this and we had to develop numerous techniques to address the issues. Nevertheless, we administered over 17,000 doses of these two vaccines with no significant problems. Yes, I was vaccinated as well.

 5. Package insert, MMR® II, Merck & Co., 1999. This insert, as well as most of the inserts for vaccines used in the United States, are available in PDF format at: Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W504 1, Baltimore, MD 21205; www.vaccinesafety.edu.

6.There are exceptions to this, but I’m painting with a broad brush, not giving a talk in microbiology.

7. Debra L. Vinnedge, “Aborted Fetal Cell Lines and the Catholic Family: A Moral and Historical Perspective,” Children of God for Life (Dec. 2004) cogforlife.org.

8. Maxcy-Rosenau-Last, Public Health and Preventive Medicine, 14th ed., ed. by R.B. Wallace (Appleton & Lange, 1998). See “Rubella,” pp.95ff.

9. This section is developed from the transcriptions of the US PDA Center for Biologies Evaluation and Research, Vaccines and Related Biologi­cal Products Advisory Committee Meeting, Wednesday, May 16, 2001, pp.77ff.,www.fda.gov/ohrms/dockets/ac/01/transcripts/3750tl 01 .pdf. In addition to pp,77ff, see also pp.91-95.

¹⁰ Ibid, p.95 (my emphasis). The researcher narrating this portion of the transcript is Dr. Alex van der Eb of the University of Leiden, The Netherlands. Dr. van der Eb also disclosed at the “Disclosure” section of the transcript that he has received consulting fees from Crucell NV (the company sponsoring the development of the PER C6 line) for “scientific advice” on human cell lines.

11. “Crucell’s PER C6 Cell-Line Used in Merck’s HIV-1 Vaccines Research Program,” United Business Media PR Newswire (April 3, 2001) www.prnewswire.com (my emphasis).

12. Ibid., see section “About Crucell” (my emphasis).

13. M.G. Pau et al., “The Human Cell Line PER C6 Provides a New Manu­facturing System for the Production of Influenza Vaccines,” Vaccine, 19(17-19), March 21, 2001, 2716-21.

14. “Sanofi-Pasteur Awarded $97 Million HHS Contract to Accelerate Cell-culture Pandemic Influenza Vaccine Development,” Sanofi- Aventis “Press Room” Year 2005, www.en.Sanofi–aventis.com.

15.“Crucell NV and Vaxin Announce PER C6 Licensing Agreement” (Sept. 13 2004) Birmingham, www.vaxin.com.

16. “Aeras Partners with Crucell NV to Develop TB Vaccine,” Press Release (March 24, 2004), University of Leiden, The Netherlands, www.aeras. org News and Events.

17. United Business Media, op. cit.

18. “High-Volume Avian Influenza Vaccine a Step Closer,” in PharmaTechnologist.com (Oct. 14, 2005).

19. “Moral Reflections On Vaccines Prepared From Cells Derived From Aborted Human Fetuses,” Letter dated June 9, 2005. The entire text is available at multiple sites, including the National Catholic Bioethics Center “News and Events” section (www.ncbcenter.org ) and Children of God for Life website, cogforlife.org/vaticanresponse.pdf

20. Ibid., cover letter to Debra Vinnedge

21 Ibid.

22 Ibid., p. 5

23 Ibid.

24. Ibid.

25. Ibid. (emphasis in the original).

26. Ibid (emphasis in the original).

27. Ibid., p.6 (emphasis in the original)

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