COVID-19 vaccines are still so scarce, health experts say this is not the time to be "shopping" — take whatever shot you can get.
But last week, Catholic leaders in Michigan released a letter calling the Johnson and Johnson vaccine — as well as AstraZeneca (which is not yet approved in the US) — "morally problematic." At issue: the use of fetal stem cells.
"The vaccines developed by Johnson & Johnson and AstraZeneca are more morally problematic, however," the letter, signed by Michigan's seven bishops including Archbishop of Detroit Allen H. Vigneron states.
The letter contends that while Pfizer and Moderna used the fetal lines in their "confirmatory testing" Johnson & Johnson used it in their "design, production, development, and confirmatory testing" making it more morally "problematic."
"This connection to the abortion is very remote," the letter says of the Pfizer and Moderna use of the cells, adding: "however, and it is important to keep in mind that there are varying levels of responsibility."
Still despite the warning, the leaders explained that if individuals have only the Johnson and Johnson option they should take it.
"If one does not have a choice of vaccine and a delay in immunization may bring about serious consequences for one’s health and the health of others, it would be permissible to accept the Johnson & Johnson or AstraZeneca vaccine," the letter states, noting that the same stance was taken by the church with the Rubella vaccine, which utilizes the same fetal tissue.
The chickenpox, hepatitis A and rabies vaccines also use the same fetal cell-lines.
"What we’re talking about is human cells that can be replicated, essentially in a petri dish, generation after generation," said Dr. Mark Casanova a Dallas-based physician and medical ethicist, explaining that two fetal cell lines were used for the Johnson & Johnson vaccine — as well as these other vaccines — originated in the Netherlands over four decades ago.
"We’re talking about two cell lines that are very old," he said. "It doesn’t dispute the fact of where they arose, but that is why stem cells are so important, they’re very durable."
Since the Johnson & Johnson vaccine is an adenovirus (or viral vector) shot, the stem cells are used to create this.
"Viruses need human cells for the cells to reproduce so we use these stem cell lines to accomplish that," said Casanova, noting that it is not fetal cells — but rather the virus they help to replicate — that is ultimately what is the vaccine.
"As the virus is then extracted and put into syringes, all those stem cells are filtered out, if you will, so that you’re not actually receiving any sort of stem cell, or human cell period, you’re only receiving the Johnson & Johnson vaccine which in that case is called a viral vector."
Johnson & Johnson reiterated this in a statement.
"Our vaccine contains no fetal tissue whatsoever," a spokesperson wrote. "We employ a technology platform using cells that were engineered and grown in labs from a single cell more than 30 years ago into a fully engineered cell line. This cell line enables us to rapidly manufacture hundreds of millions of single-shot COVID vaccines that can be transferred and stored without the need for deep freezing."
Still, it's the very use of this particular cell line, that the church believes needs attention.
"The Bishops are always concerned of course with their belief in the evil of abortions and subsequently how those abortions might develop with science," said Msgr. Gary Smetanka, of Our Lady Star of the Sea in Grosse Pointe Woods, stressing still that ultimately if people don't have a choice they should still get the Johnson & Johnson vaccine.
"The bottom line is, because of the health crisis that people should be vaccinated," he said. "If possible if you can choose to get Pfizer or Moderna, that would be the preferred option, but if not receiving the Johnson and Johnson vaccination would also be morally acceptable."
While the stem cells derived from the two fetal cells tend to garner a lot of attention and debate, Casanova points out that these are not the only stem lines that have raised ethical questions over the years.
He points in particular to the HeLa cell line, which was created from cervical cancer cells taken from a poor, black tobacco farmer Henrietta Lacks in 1951. The cell line, which has been used in the development of the polio vaccine, cloning, and gene mapping, has received heightened attention in recent years as it was publicized that Lacks, who died months after the cells were taken, was never told they were being taken.
"That’s another example of a cell line that has brought us the immense benefit of medicine and cancer therapies and what not but has its own moral questions," said Casanova. "What was the full disclosure to Ms. Lacks?"
It is his opinion that these conversations are important.
"The church, I think we can understand, is going to stand strong in their belief structure to say that abortion is wrong and things that derive from abortion is wrong," said Casanova. "They are also very pragmatic in the sense that they’re looking at the risk to humanity — a risk to all individuals, catholic or not — and their take-home message is: When the time comes that there are ample vaccines to choose from, certainly pick the vaccine that you’re more morally comfortable with, right now, the most important thing we need to accomplish is getting as many people immunized as quickly, effectively and efficiently as possible."
Johnson & Johnson said that the highest of biomedical ethical standards were maintained in their creation of the vaccine.
"In developing a COVID-19 vaccine, our goal has always been to save as many lives as possible. We’re proud to bring a single-shot vaccine to the world in record time and contribute to ending this pandemic," a spokesperson wrote, latter adding: "Some of the brightest minds from within our company and from across the global scientific community have worked for years to develop breakthrough treatments to some of the most devastating diseases facing humanity. As we do this, we hold ourselves to the highest biomedical ethical standards – even more so in the face of a pandemic."
This week President Biden announced the U.S. was ordering 100 million Johnson and Johnson vaccines. He says that by May one of the three vaccines will be available to every adult in the country.