VATICAN CITY (CNS) -- The Vatican's doctrinal office said that when alternative vaccines are not available, it is morally acceptable to receive COVID-19 vaccines developed or tested using cell lines originating from aborted fetuses.

However, "the licit use of such vaccines does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted fetuses," said the Congregation for the Doctrine of the Faith.

"Both pharmaceutical companies and governmental health agencies are therefore encouraged to produce, approve, distribute and offer ethically acceptable vaccines that do not create problems of conscience for either health care providers or the people to be vaccinated," it added in a note published Dec. 21.

The note "on the morality of using some anti-COVID-19 vaccines" had been reviewed by Pope Francis Dec. 17 and he ordered its publication, the doctrinal office said.

As vaccines against the novel coronavirus that causes COVID-19 are being distributed in some parts of the world, the doctrinal office said it has been receiving requests for guidance regarding the use of vaccines which, "in the course of research and production, employed cell lines drawn from tissue obtained from two abortions that occurred in the last century.”

The "diverse and sometimes conflicting pronouncements in the mass media by bishops, Catholic associations, and experts have raised questions about the morality of the use of these vaccines," the congregation said.

Even though there are already some notes and instructions by the doctrinal office and the Pontifical Academy for Life regarding vaccines prepared from such cell lines, it said, "this congregation desires to offer some indications for clarification of this matter.”

The Catholic Church teaches that there are differing degrees of responsibility of cooperation with evil. That means that the responsibility of those who make the decision to use cell lines of illicit origin is not the same as those "who have no voice in such a decision," the doctrinal office said, quoting from its 2008 instruction, "Dignitas Personae.”

"When ethically irreproachable COVID-19 vaccines are not available -- e.g. in countries where vaccines without ethical problems are not made available to physicians and patients or where their distribution is more difficult due to special storage and transport conditions or when various types of vaccines are distributed in the same country but health authorities do not allow citizens to choose the vaccine with which to be inoculated -- it is morally acceptable to receive COVID-19 vaccines that have used cell lines from aborted fetuses in their research and production process," the doctrinal congregation wrote in the new note.

Using these vaccines is morally licit when the "passive material cooperation" with the evil of an abortion "from which these cell lines originate is, on the part of those making use of the resulting vaccines, remote.”

"The moral duty to avoid such passive material cooperation is not obligatory if there is a grave danger, such as the otherwise uncontainable spread of a serious pathological agent -- in this case, the pandemic spread of the SARS-CoV-2 virus that causes COVID-19," it said.

Therefore, in such a case, "all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion," it said.

However, the doctrinal congregation emphasized that "the morally licit use of these types of vaccines, in the particular conditions that make it so, does not in itself constitute a legitimation, even indirect, of the practice of abortion, and necessarily assumes the opposition to this practice by those who make use of these vaccines.”

The congregation repeated the Vatican's call on pharmaceutical companies and governmental agencies to produce, approve and distribute ethically acceptable vaccines, that is, without using morally compromised cell lines at all.

The doctrinal office also said that "vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”

From an ethical point of view, "the morality of vaccination depends not only on the duty to protect one's own health, but also on the duty to pursue the common good," it added.

If there are no other means to stop or prevent an epidemic, the congregation said, "the common good may recommend vaccination, especially to protect the weakest and most exposed.”

Those who wish, for "reasons of conscience," to refuse vaccines produced with cell lines from aborted fetuses, "must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission" of the virus.

They must avoid putting at risk the health of those who cannot be vaccinated for medical or other reasons and who are the most vulnerable, it said.

Lastly, the congregation said it is "a moral imperative for the pharmaceutical industry, governments and international organizations to ensure that vaccines, which are effective and safe from a medical point of view, as well as ethically acceptable, are also accessible to the poorest countries in a manner that is not costly for them.”

Otherwise, this lack of access would become yet another sign of discrimination and injustice "that condemns poor countries to continue living in health, economic and social poverty.”

Maryland’s Catholic bishops in a Dec. 12, 2020 letter strongly encouraged Catholics to receive the COVID-19 vaccines, which on Dec. 14 began being administered to frontline health care workers across the nation and will next be administered to residents of long-term care facilities.

“A Catholic can in good conscience receive these COVID-19 vaccines. Moreover, given the grave risk of harm to others, we strongly encourage the faithful to receive a vaccine against COVID, unless medically indicated otherwise,” the bishops said. They added, “It is vitally important that the most vulnerable among us and those who are from communities that have been disproportionately impacted by COVID receive the vaccine swiftly.”

As the vaccines began to be administered, the United States had passed a grim milestone, with more than 300,000 Americans dying from the coronavirus so far this year and more than 16 million people being infected by it. The Washington Post reported that the United States is experiencing a daily average of 200,000 new cases of coronavirus and almost 2,500 deaths.

The Catholic bishops serving Maryland who signed the letter included Washington Cardinal Wilton Gregory, who leads the Archdiocese of Washington that includes the nation’s capital and the five Maryland surrounding counties; Baltimore Archbishop William Lori, who leads the Archdiocese of Baltimore which includes that city and nine Maryland counties; and Bishop W. Francis Malooly, who leads the Diocese of Wilmington that encompasses the state of Delaware and Maryland’s Eastern Shore.

The letter was issued by the Maryland Catholic Conference, the public policy arm of the Catholic dioceses serving Maryland, and it was also signed by the auxiliary bishops of Washington and Baltimore.

Maryland’s Catholic bishops said they looked with hope at the development of effective and life-saving vaccines and added,  “We are heartened by the quick progress to date and look forward to working with federal, state and local government leaders to promote widespread vaccination against COVID-19 in the interests of protecting public health and human life.”

The bishops noted that some have raised questions about the source of the vaccines, and to provide clarity for the ethical and moral status of the vaccines, they quoted a recent communication from the chairmen of the United States Conference of Catholic Bishops’ pro-life and doctrine committees, which noted that “neither the Pfizer nor the Moderna vaccine involved the use of cell lines that originated in fetal tissue taken from the body of an aborted baby at any level of design, development, or production.”

The bishops did point out that, “They are not completely free from any connection to abortion, however, as both Pfizer and Moderna made use of a tainted cell line for one of the confirmatory lab tests of their products. There is thus a connection, but it is relatively remote.” Then Maryland’s bishops noted that the Holy See has addressed the use of tainted vaccines, and the USCCB chairmen wrote that following that guidance, “at the level of the recipient, it is morally permissible to accept vaccination when there are no alternatives and there is a serious risk to health.” 

At that point in the letter, Maryland’s Catholic bishops said, “Therefore, a Catholic can in good conscience receive these COVID-19 vaccines.”

The bishops also emphasized that it “is imperative that pharmaceutical companies be urged to develop vaccines that fully respect the dignity of the human person at all stages.”