Catholic Medical Quarterly Volume 72(1) February 2022

A Pragmatic and Philosophical discussion of vaccine mandates and the wider issues of COVID-19 and the Church

“For consent to immunisation to the[sic] valid, it must be given freely, voluntarily and without coercion by an appropriately informed person who has the mental capacity to consent to the administration of the vaccines in question.” The Green Book, June 2021

  • A covid-19 vaccine mandate for the entire healthcare workforce appears to be an unnecessary and unjust intervention
  • Currently available SARS-CoV-2 vaccines are clearly not sterilising i.e. patients can still become infected, and transmit that infection onto other individuals.
  • Most vaccine drives still use psychological ‘nudges’ based on the belief that receiving the vaccine protects others.
  • Even if the vaccine was sterilising, coercing (via likely loss of income) or compelling an individ-ual to receive a vaccine is unjust.
  • Individuals have an inherent right to consent and make what may be considered to be bad decisions about their care (cf free will)
  • The risk/benefit ratio for covid vaccine markedly changes based on various individual factors. Fit and healthy individuals less than 30 years of age are very unlikely to derive significant individual benefit from the vaccine, which in turn will increase the relative risk of significant vaccine induced adverse events.
  •  It is clear that mRNA vaccines are causing an increased incidence of myocarditis and pericarditis in younger adults and adolescents, especially males (Patone et al 2021). An individual in these groups may come to a reasonable conclusion that the covid-19 vaccine risk outweighs the benefit to themselves.
  •  Clinical trials of these vaccines only end in 2023, thus anyone receiving a vaccine basically enrolls in the largest phase 3 trial ever known.
  •  As a result they are not subject to the norms of safety, and potential compensation if serious adverse effects occur. (Although it is fair to say these events appear to thankfully be rare).
  •  All currently available SARS-CoV-2 vaccines have some link to aborted foetal cell lines (via testing in the case of Moderna and Pfizer)
  •  It is reasonable for a Catholic individual to be unwilling to accept the vaccine based on the link to these cell lines.
  •  The Church has stated that the gravity of the pandemic situation allows one to licitly receive these vaccines for the greater good. Does this change on the individuals paerception of the risk from contracting the virus?
  • The vaccine mandate is being applied to health-care students with equal force to the workforce (Medical Schools Council, 2021). Students have already been told that fitness to practice procedures or forced withdrawals will occur if they do not consent to vaccination. As a result individuals are being asked to consent to an unlicensed treatment which provides little benefit to themselves or others.
  • Immunity from previous infection appears to play no role in discussions regarding vaccine mandates in the UK at present. A basic under-standing of immunology leads us to believe that infection will confer some degree of immunity on the individual. Recent studies appear to show that previous infection with SARS-CoV-2 may generate a wider ranging and longer last-ing immune response than is achieved with vaccines (Gazit et al 2021, Kojima and Klausner 2022). Vaccinating previously infected individ-uals is of questionable benefit and may increase the risk of adverse events.
  • Psychological ‘nudges’ have been used through-out the pandemic to increase compliance with Government directives. Mandatory vaccination is quite possibly the most obvious example of a ‘nudge’.
  • The Public have never been consulted on whether or not they consent to being ‘nudged’ in this manner. (Cf Sidley et al, 2021)
  • Many interventions have been made in the best interests of the elderly and vulnerable (e.g. closure of care homes). I am unaware of how often the elderly and vulnerable have been consulted regarding whether they want this to happen.
  • The Church has instituted new norms of Mass in the pandemic. As the celebration of the Holy Eucharist is a sacrament, it should inherently be an outward sign of inward grace. The most obvious outward sign currently in the Church is to be greeted with face masks and hand sanitisers, neither is conducive to prayer or the lifting of one’s spirit. As a parent of young children I am finding it increasingly difficult to rationalise why I am subjecting them to such a sterile and risk averse environment.
  • The fundamental goal of the Catholic Church is the sanctification of souls in this life in order to join with God in heaven in the next. If we truly believe in eternal life we should not be overly afraid of disease. I think the Church needs to adjust its perception of the virus otherwise it risks becoming irrelevant. Clearly mitigations may be made but we should be mindful of the message these interventions send to the members of the Church and the wider population.

References

Dr Jonathan D Berry PhD, MPharm, PGDipClin-Pharm, PGCHE, FHEA

Jonathan is an academic pharmacist, husband and father of three young children. He has received two doses of the Pfizer vaccine and thinks that is quite enough for now. His wife is a nurse who declined the vaccine during pregnancy (after receiving one dose prior) due to limited safety data. He is also the son of an 84 year old mother who declined any covid vaccine based on a conscientious objection. The mother tested positive on a lateral flow for SARS-CoV-2 recently and spent a week away from the world with mild coryzal symptoms and thankfully nothing worse.