Elsevier

Vaccine

Volume 22, Issues 31–32, 22 October 2004, Pages 4238-4244
Vaccine

Ethical analyses of vaccines grown in human cell strains derived from abortion: arguments and Internet search

https://doi.org/10.1016/j.vaccine.2004.04.034Get rights and content

Abstract

The fact that certain vaccines are grown in cell strains derived decades ago from an aborted fetus is a concern for some. To understand such concerns, a standardized search identified internet sites discussing vaccines and abortion. Ethical concerns raised include autonomy, conscience, coherence, and immoral material complicity. Two strategies to analyse moral complicity show that vaccination is ethical: the abortions were past events separated in time, agency, and purpose from vaccine production. Rubella disease during pregnancy results in many miscarriages and malformations. Altruism, the burden of rubella disease, and protection by herd immunity argue for widespread vaccination although autonomous decisions and personal conscience should be respected.

Introduction

Patient acceptance of vaccines can be threatened by perceptions about safety and ethics; in fact, a national survey of parents found that 19% thought vaccines are not proven safe prior to use in the US [1]. In Colorado, the percentage of philosophical exemptions to immunization increased from 1.02 to 1.87% from 1987 to 1998 [2]. The frequency of exemptors from vaccination in a county is associated with the incidence rate of measles and pertussis cases among the vaccinated [2]. Thus, refusals for vaccination, though relatively uncommon, are rising in some places for multiple reasons, including ethical concerns.

The Internet has the potential to influence perceptions about vaccines because of its global reach and volume of use. In fact, it is estimated that two-thirds of US adults use the Internet and of these 80% use it to access health information [3], [4]. Studies have identified a number of web sites in which various claims against vaccination are made; in particular, one study found that 32% raised the issue of a link to abortion [5], [6], [7]. However, to our knowledge and based on a December 4, 2003 MEDLINE search, no study has analysed the ethical arguments on the issue of vaccines and abortion raised by these web sites.

The issue of vaccines and abortion is worth addressing for three reasons: (1) it affects the acceptance of vaccines by some patients/parents and thereby could affect immunization rates and disease incidence; (2) the ethical issue of moral complicity with evil is a serious charge with historic ethical implications; and (3) planning for new vaccines may be altered by political lobbying or efforts in financial markets related to this issue. For example, two groups claim to have brought this issue to the attention of the shareholders of one large vaccine manufacturer [8].

The importance of the issue of moral complicity with evil can be made with an extreme historical example. Nazi physicians executed Jewish prisoners at Auschwitz for the explicit purpose of developing a skull collection for a University; other specimen collections were also obtained from euthanasia victims [9], [10]. These collections were used for research and teaching purposes in German medical schools until international pressure forced several German universities to remove all specimens from Nazi victims [10]. The ethical concerns were the potential for legitimization of atrocities by the scientific discoveries made on the specimens, even though the researchers were not necessarily participants in any atrocities themselves [10], and respectful treatment of human remains. Of course, this is an extreme example; yet, the Holocaust is the comparison made on some web sites about the use of vaccines grown in human cell strains derived from an abortion [11], [12], [13].

Two human cell strains in which vaccines are grown were developed from fibroblasts from lung tissue from two abortions: the Wistar Institute (WI)-38 line in 1961 and the Medical Research Council (MRC)-5 strain in 1966 [14]. These cell strains do not require new abortions to continue their use. Rubella vaccine virus is grown in the WI-38 line. A number of vaccines are grown in the MRC-5 line including varicella vaccine, hepatitis A vaccines, one poliovirus vaccine (i.e., Poliovax® but not others), and one rabies vaccine (i.e., human diploid cell vaccine, e.g., Imovax®, but not other rabies vaccine types).

Another issue is derivation of the virus used in certain rubella vaccines. The RA27/3 strain of rubella virus used in the current US vaccine was isolated from an aborted fetus infected with rubella in early 1965 [15]. The RA27/3 strain is the most widely used in the world because of its consistent immunogenicity, high efficacy, and low side effect rates.

Section snippets

Web search methodology

In order to better understand the concerns about vaccines and abortion, a web search was conducted. Web pages were identified using Copernic Agent Basic v6.11 (Copernic Technologies Inc., Saine-Foy, Quebec) which is an Internet search program designed to simultaneously submit searches on numerous engines. The world-wide search was conducted using the terms “vaccine” and “abortion”; vaccine was chosen because it is much more likely to result in sites critical of vaccination than is

Web site design analyses

Of the 15 sites, 9 provided information on how to legally avoid vaccination and 4 discussed reporting adverse reactions. Of these 15 sites, 8 solicited contributions and 6 offered materials for purchase (one of these was by a link to a retailer who shared sales receipts with the initial site). Two-fifths (6 of 15) linked to sites critical of vaccination whereas 2 linked to sites supporting vaccination (however, one of these linked mostly to sites critical of vaccination). Several (3) had

Literature review

To my knowledge, only three articles involving formal searches of web sites that are critical of vaccinations have been published; all are descriptive [5], [6], [7]. Another article analyses the use of scientific literature citations on such sites and reports multiple inaccuracies [24]. However, to my knowledge and a December 4, 2003 MEDLINE search, no study has described and analysed the ethical arguments raised on these web sites on the issue of vaccines and abortion. Two recent articles in

Acknowledgments

Stephanie Cleary and Judith Troy for assistance with the web search.

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