In October, Indonesian diplomats and Muslim clerics alighted from a plane in China. While diplomats were there to finalize deals to ensure millions of doses reach Indonesian citizens, clerics had a very different concern: whether the COVID-19 vaccine was allowed for use under Islamic law.
As companies rush to develop a COVID-19 vaccine and countries scramble for doses, questions about the use of pork products – banned by some religious groups – have raised concerns about the possibility of interrupting vaccination campaigns.
Gelatin of porcine origin has been widely used as a stabilizer to ensure that vaccines remain safe and effective during storage and transport. Some companies have worked for years to develop vaccines without pigs: Swiss pharmaceutical company Novartis has produced a vaccine against meningitis without pigs, while AJ Pharma, based in Arabia and Malaysia, is currently working on one of theirs.
But the demand, existing supply chains, cost, and shorter shelf life of vaccines that do not contain porcine gelatin mean the ingredient will likely continue to be used in the majority of vaccines for years to come, the Dr Salman Waqar, Secretary General of British Islamic Medical. Association.
Spokesmen for Pfizer, Moderna and AstraZeneca said pork products were not part of their COVID-19 vaccines. But the limited supply and pre-existing multi-million dollar deals with other companies mean some countries with large Muslim populations, such as Indonesia, will receive vaccines that have yet to be certified gelatin-free. .
This poses a dilemma for religious communities, including Orthodox Jews and Muslims, where the consumption of pork products is considered religiously unclean, and how the ban is applied to medicine, he said. .
“There is a difference of opinion among Islamic scholars as to whether you take something like pork gelatin and put it through a rigorous chemical transformation,” Waqar said. “Is it still considered unclean religious for you?”
The majority consensus in past debates over the use of pork gelatin in vaccines is that it is permitted under Islamic law, as “greater evil” would occur if vaccines were not used, said Dr Harunor Rashid, Associate Professor at the University of Sydney. .
There is a similar assessment by a broad consensus of religious leaders in the Orthodox Jewish community.
“Under Jewish law, a ban on eating pork or using pork is only prohibited if it is a natural way to eat it,” said Rabbi David Stav, chairman of Tzohar, a rabbinical organization in Israel.
If “it is injected into the body, not (eaten) by mouth,” then there is “no ban and no problem, especially when we are concerned about diseases,” he said. .
Still, there have been divergent views on the issue – some with serious health consequences for Indonesia, which has the world’s largest Muslim population, some 225 million.
In 2018, the Indonesian Ulema Council, the Muslim religious body that issues certifications that a product is halal, or authorized under Islamic law, decreed that measles and rubella vaccines were “haram” or illegal, because of gelatin. Religious and community leaders have started urging parents not to let their children get immunized.
“Measles cases then increased, giving Indonesia the third highest measles rate in the world,” said Rachel Howard, director of the Healthcare Research Partnership market research group.
An executive order was later issued by the Muslim religious body saying it was permissible to receive the vaccine, but cultural taboos have always led to consistently low vaccination rates, Howard said.
“Our studies have shown that some Muslims in Indonesia feel uncomfortable accepting vaccines containing these ingredients,” even when Muslim authorities issue guidelines saying they are allowed, she said.
Governments have taken steps to address the problem. In Malaysia, where the halal status of vaccines has been identified as the biggest problem among Muslim parents, stricter laws have been enacted so that parents must vaccinate their children or face fines and prison terms. In Pakistan, where confidence in vaccines has waned for religious and political reasons, parents have been jailed for refusing to immunize their children against polio.
But with growing hesitation over vaccines and misinformation spreading around the world, including in religious communities, Rashid said community engagement was “absolutely necessary.”
“It could be disastrous” if there is not strong community engagement from governments and healthcare workers, he said.
In Indonesia, the government has already announced that it will include the Muslim religious body in the process of purchasing and certifying COVID-19 vaccines.
“Public communication regarding halal status, price, quality and distribution must be well prepared,” Indonesian President Joko Widodo said in October.
While in China in the fall, Indonesian clerics inspected the Chinese facilities of Sinovac Biotech, and clinical trials involving some 1,620 volunteers are also underway in Indonesia for the company’s vaccine. The government has announced several COVID-19 vaccine purchase agreements with the company totaling millions of doses.
Sinovac Biotech, along with Chinese companies Sinopharm and CanSino Biologics – all of which have COVID-19 vaccines in advanced clinical trials and offers to sell millions of doses globally – have not responded to requests for ingredient information from Associated Press.
In China, none of the COVID-19 vaccines have received final marketing approval, but more than a million health workers and others deemed at high risk of infection have received vaccines under emergency use authorization. The companies have not yet revealed the effectiveness of the vaccines or possible side effects.
Pakistan is at an advanced stage of clinical trials for the CanSino Biologics vaccine. Bangladesh previously had an agreement with Sinovac Biotech to conduct clinical trials in the country, but the trials were delayed due to a funding dispute. Both countries have some of the largest Muslim populations in the world.
While Indonesian field health workers are still largely engaged in efforts to contain the virus as numbers continue to rise, Waqar said the government’s efforts to reassure Indonesians would be key to a successful vaccination campaign because COVID-19 vaccines are approved for use.
But, he said, the companies producing the vaccines must also be part of this community outreach.
“The more transparent they are, the more open and honest they are about their product, the more likely there are communities that have confidence in the product and will be able to have informed discussions about what they want.” want to do, ”he said.
“Because at the end of the day, it’s the choice of individuals.”
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