By Stan Chu Ilo
“Father, do you think I need to go to confession?” With this startling question, a devout Catholic called me aside after a Sunday celebration of the Eucharist wanting to know if she was sinning by refusing to be vaccinated. “I don’t agree with Pope Francis on vaccination”, she began, “Do you realize that today, October 1, the Covid-19 mandate on all Vatican workers takes effect.” Then came the question: “Am I sinning because I refused to get vaccinated?”
I have never viewed my priestly service or scholarship as a calling to be a zealous guardian of other people’s conscience. Therefore, while I did not want to judge this devout Catholic, I however, made the same appeal to her that Pope Francis has continuously made: that getting the COVID-19 vaccine is both an act of love and a moral obligation for the common good. If the previous statement is true, then there is the need for a moral evaluation of the refusal of some people to get the vaccine. By rejecting to make this ‘act of love’ and failing in charity, could the anti-vaxxers be sinning against God and their neighbors? Do anti-vaxxers who get the virus and infect others who then die from the disease share a moral responsibility in causing such deaths? To what extent are anti-vaxxers responsible for spreading this disease, prolonging the pandemic, and over-burdening not only the healthcare system, but other aspects of the local and global economy? These are some of the important ethical considerations for me in this essay.
In 2014 the WHO’s Strategic Advisory Group of Experts (SAGE) report from the Working Group on Vaccine Hesitancy defined vaccine hesitancy as, “delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence.” In its 2019 report, the World Health Organization identified vaccine hesitancy as one of the ten major threats to global health. According to the WHO, vaccine is one of the most cost-effective ways of avoiding disease, preventing 2-3 million deaths a year and a further 1.5 million could be avoided if global coverage of vaccinations improved. By taking the vaccine where it is available, people are helping to reduce and prevent the spread of disease, promoting individual health, and improving population health and wellbeing.
My Catholic parishioner—a self-professed anti-vaxxer—identified herself with the anti-abortion, pro-life group in the parish who were preparing to march to some of the abortion clinics in the Chicago area in October, the respect life month. It struck me that she did not see her refusal to get a vaccination as being anti-life. If I could stretch this argument a little further then, when pro-lifers refuse the vaccine on the ground of pro-choice, they indirectly validate the reasoning of pro-choice abortion proponents, that is, one has the right to choose what to do with one’s body. Beyond the search for a moral equivalence on the ethics of ‘pro-choice’ is the need for some moral clarifications on the devastating consequences of the choice of those who refuse to be vaccinated against Covid-19.
I must admit that there are many reasons why people refuse to be vaccinated. I am concerned here with those anti-vaxxers who refuse to receive the vaccine on the grounds of their right to choose and a claim to individual moral autonomy in an unqualified way. This will exclude those who for health reasons or for moral reasons refuse to receive the vaccine, but are open to gaining more moral insight and knowledge to guide their conscience in its search for moral clarity. I am thinking particularly of those who object to vaccination based on their objection to the fact that some Covid vaccines were developed through the use of fetal cell lines that were grown in laboratories from cells taken from aborted fetuses in the 1970s and 1980s. For this group of people, there is a need to continue to educate them and give them more information to help them form their conscience in a way that leads them to making a choice that promotes the common good by protecting their lives and that of their neighbors, communities, and the entire world. We all do not arrive at a moral insight in the same manner and through the same route.
Furthermore, there are those, particularly African Americans, for instance, whose rejection of vaccines is based on the unfortunate “dangerous, involuntary, and nontherapeutic medical experimentation” like the Tuskegee Syphilis study in 1970s. Harriet Washington documents how many Blacks and the poor who were tacit features of these studies, “were given experimental vaccines known to have unacceptably high lethality, were enrolled in experiments without their consent or knowledge, were subjected to surreptitious surgical and medical procedures while unconscious, injected with toxic substances, deliberately monitored rather than treated for deadly ailments, excluded from lifesaving treatments, or secretly farmed for sear or tissues that were used to perfect technologies such as infectious-diseases tests.”
The mistrust generated by this long history of the fetishization, and objectification of Black bodies will take a lot of time, effort and transparency to rebuild. It is a big stain on the collective conscience of humanity. Thus, the mistrust of Western medicine and vaccines by people whose bodies have been so brutalized and whose lives have been constantly instrumentalized will continue to be a driver of anti-vaccination mentality among this particular group until some of the barriers have been removed. This effort at rebuilding trust in public health will include the sincere commitment to addressing the persistent health inequities faced by Black and Brown communities in the U.S and by addressing the commercial and social determinants of health that created the co-morbidities that have turned Covid-19 into another layer of suffering and death upon other preventable and modifiable causes of ill health, diseases, and death for Black and Brown people and the poor throughout the world.
It must be stated, however, that anti-vaccination must be critically read as part and parcel of the social construction of unequal power differentials among people; the knowledge gap generated by how public health information and practice have been deployed to serve the interests of the population along the binaries of the poor and the rich, the North and the South. We must also take into consideration the suspicions generated by the exploitation of the health care system in many places by Big Pharma through what has been described as ‘toxic psychiatry’ (Peter Breggin) characterized by over medication, manipulation of people’s mind to seek medical intervention or to take drugs which they don’t actually need. For some, vaccine education is seen as a continuation of this manipulation by Big Pharma.
According to a recent NY Times special report, “An overwhelming majority of Americans who have died in recent months, a period in which the country has offered broad access to shots, were unvaccinated.” Even though, the CDC has not kept data of the number of unvaccinated people who have died from COVID-19, the CDC’s study released in September shows that after Delta became the dominant variant, unvaccinated people were more than 10 times as likely to die of the virus as the vaccinated were. Unvaccinated people are more than likely to expose others to infection as well, while overwhelming the public health care services.
My contention here is that a consistent pro-life ethic must include a choice to be pro-vaccination. Given the severity and possibility of death when infected, I argue that being pro-vaccination is the most logical way of being pro-life in our times; and being anti-vaccination means that one has chosen to be pro-death, and anti-life. I am of course referring mainly to those countries who have access to the vaccines. The sinful and tragic situation faced by people in Africa who have no access to the vaccines makes the moral culpability of those who are refusing to be vaccinated and those who are spreading vaccine misinformation more egregious.
According to the data released by the WHO in September, the urgent global goal of vaccinating the most vulnerable 10% of every country’s population against COVID-19 by the end of September, 2021 was not reached in most of Africa. Forty-two of Africa’s 54 nations—nearly 80% failed to meet this target. Over 143 million doses have been received in Africa in total and 39 million people—around 3% of Africa’s population—are fully vaccinated. In comparison, 52% of people are fully vaccinated in the United States of America and 57% in the European Union. Whereas President Biden is floating the idea of paying Americans to get vaccinated, millions of people in Africa do not have access to vaccines or life-saving therapies for treating Covid-19 patients. There is no single Catholic hospital in my home country Nigeria which has a ventilator.
One must, therefore, introduce the religious language of sin and evil as a new category for capturing the gravity of the anti-vaccination choices, the spreading of conspiracy theories against vaccination, and misinformation that the religious right has circulated as spiritual currency for mortgaging the souls of the most vulnerable and gullible of our society. As an African priest and humanitarian who is daily confronted with the destructive impact of the pandemic on the African poor, some of whom are refusing the life-saving vaccines against Covid-19 because of some of the misinformation coming from the conservative right Christian movement in America, I ask myself what kind of God supports this destructive and deceptive message to the world’s poor?
According to Afrobarometer’s nationally representative surveys in five West African countries (Benin, Liberia, Niger, Senegal, and Togo) on the average, only four in 10 people say they would be likely to try to get vaccinated, including just one in three Liberians and one in five Senegalese. Most say they do not trust their government to ensure that the vaccines are safe. The deficit of trust seems to be recurrent in other studies, for instance, the African CDC in their study discovered that hesitancy could be attributed to doubts about the safety and efficacy of the vaccines and misinformation about COVID- 19, such as that it is not real, does not pose a serious threat, or can be cured by safer alternative treatments.
What Afrobarometer’s report fails to note is the destructive conspiracy theories being transmitted from the U.S to Africa. Whereas, I do not wish to infantilize our continent as having no agency of its own and being merely a victim, we cannot deny the digital divide and the strong hold that information from outside Africa has on Africans. With the bold title, “Right Wing Churches in America could Kill Millions in Africa with Anti-Vaccine Conspiracies”, CJ Werleman writes of the harm these anti-vaccine movements in the U.S are causing to some Christians in Africa, when he writes, “But persuading right-wing Christians will not only save tens or hundreds of thousands of Americans from avoidable death, but also potentially millions of people in Africa, Asia and South America—anywhere else within reach of the right-wing American televangelists with their deceptive message, “Jesus was not vaccinated.” Americans who refuse to take the vaccine based on these conspiracies, who later become sick, have a better chance of survival than most Africans because of the presence of different anti-covid therapies and treatments in the U.S that are non-existent in Africa.
Given this challenging reality, one way to confront this rising tide is to demonstrate to those Christians, who refuse to get vaccinated and who spread false information about vaccines, the sinfulness of their actions and why they need to be converted. Sin is as the Patristics called it ‘conversioadcreaturam’, that is, clinging to created things, enslavement to the self, and to the pride of self, to the forgetfulness of the good of the other. Sin is a form of idol worship—that false self, ideologies, doctrines, false imaginaries to which one gives one’s soul and freedom. Sin is often referred to as contemptusdei—contempt of God because of the idolatrous end of sinful actions. Any deliberate act freely chosen by me that lacks charity and as a result harms me, other people or creation in any way, is a sin because it is opposed to God’s will. The moral reasoning of the common good is central to all ethical considerations with regard to autonomous human exercise of freewill, because it specifies the ultimate goal and human responsibility of every human act. Freedom is indeed a burden because it comes with responsibility. In this light then, in the face of a pandemic that has done so much harm to our world; killed more than 700,000 fellow Americans, and 4.5 million people worldwide, the rejection of the life-saving means provided through human ingenuity, must be considered a grave sin.
In the light of the foregoing, I will argue that those who refuse to take the vaccine without any just cause, other than a claim to the autonomy of the individual and right to choose, act out of selfish interests and fail in their moral responsibility. Their failure to apply their freedom responsibly in promoting the common good in these trying times is contributing to prolonging the life span of this virus, harming the healthcare sector, and endangering the collective health of many people. Refusing to be vaccinated without a just cause, other than an appeal to the right to choose or based on conspiracy theories, is both a failure in the love of self and in the love of one’s neighbors. Anyone who through a fault of his or her own, refuses to get the vaccine, contracts the disease and dies or infects another who later dies or suffers permanent bodily injury or becomes a Covid long hauler, in the light of this moral reasoning, has committed a grave sin against God.
It is important to introduce the religious language of sin from the Christian tradition in order to motivate particularly, people of faith and faith leaders to engage with their communities in persuading “individuals to change their habits and behaviors” or to use a more spiritual term to embrace the path of conversion; to change their mind by receiving the vaccine where it is available. This goal of changing habits and behaviors was adopted by the WHO as fundamental to a renewed vaccine education seen as “a lynchpin of public health success.” In Lesotho, for instance, faith leaders under the aegis of the Lesotho Christian Council have teamed up with the Ministry of Health in spreading the message of “faith in the vaccine”, while combating misconception, myths, misinformation, and conspiracy theories both from within the country and outside the country.
Reflecting on the gravity of refusing the vaccine, its sinful burden, and its terrible consequences for one’s eternal salvation, hopefully, should motivate some Christians like my parishioner, to change their minds and get vaccinated as their contribution to the common good and to a healthier and more hopeful world that can conquer the greatest plague ever to confront human beings.