Pfizer, Moderna and AstraZeneca all confirm that pork produce is not part of their Covid-19 vaccines.
While companies race to develop a Covid-19 vaccine and countries scramble to secure doses, questions about the use of pork products, which are prohibited by some religious groups, raised concerns about the possibility of disrupted vaccination campaigns.
Pork-derived gelatin is commonly used as a stabilizer to ensure that vaccines remain safe and effective throughout storage and transport.
Several companies have been developing pork-free vaccines for years.
The Swiss pharmaceutical company Novartis has produced a pork-free meningitis vaccine, while the Saudi and Malaysia-based AJ Pharma is currently working on its own vaccine.
Yet demand, existing supply chains, cost and the shorter shelf life of vaccines that do not contain pork gelatin mean the ingredient will likely be used in a majority of vaccines for years to come, Dr. Salman Waqar, secretary general of the British Islamic Medical Association, said in a statement.
Spokespeople for Pfizer, Moderna and AstraZeneca have said that pork products are not an ingredient in their Covid-19 vaccines.
However, limited supply and million-dollar contracts already in place with other companies mean that some countries with large Muslim populations, such as Indonesia, will receive vaccines that are not yet certified gelatin-free.
This presents a dilemma for religious communities, including Orthodox Jews and Muslims, where eating pork products is considered religiously impure, and how the ban will apply to medicine, he said.
“There is a difference of opinion among Islamic scholars about taking something like pork gelatin and subjecting it to a rigorous chemical transformation,” Waqar stated.
“Is it still considered religiously impure if you ingest it?”
💉 Updated advice to Muslim communities on Pfizer/BioNTech #CovidVaccine issued after consulting Muslim health care professionals, Islamic scholars & Muslim umbrella bodies from across the UK. Please see this thread for those supporting the statement
— British IMA (@BritishIMA) December 14, 2020
Injection vs. ingestion
Majority consensus from past debates over the use of porcine gelatin in vaccines is that it is permissible under Islamic law because “greater harm” would result if vaccines were not used, according to Dr. Harunor Rashid, an associate professor at the University of Sydney.
It gives a similar assessment from a broad consensus of religious leaders in the Orthodox Jewish community as well.
“According to Jewish law, the prohibition against eating or using pork is only if it is a natural way to eat it,” Rabbi David Stav, chairman of Tzohar, a rabbinical organization in Israel, was quoted as saying.
If “[it is]injected into the body, not (eaten) by mouth,” then there is “no prohibition and no problem, especially if we are concerned about disease,” he said.
Yet there were dissenting opinions on the issue – some with serious health implications for Indonesia, which at about 225 million has the world’s largest Muslim population.
Our Research and Development team are dispelling some myths surrounding the COVID vaccine trials. Hear @AngusSturrock asking Professor Dinesh Saralaya about the vaccine being Halal. To get involved in the research or for more info https://t.co/FPSHCqsBBj https://t.co/zBjwKjLJkG
— BDCFT NHS (@BDCFT) November 19, 2020
During 2018, Indonesia’s Ulema Council, the Muslim clerical body that issues certificates that a product is halal or permissible under Islamic law, stated that measles and rubella vaccines are “haram,” or unlawful, due to the gelatin they contain.
Religion and community leaders began urging parents not to have their children vaccinated.
“As a result, measles cases skyrocketed, making Indonesia the third-highest measles rate in the world,” according to Rachel Howard, director of the public health market research group Research Partnership.
Later a decree was issued by the Muslim clerical body that stated it was permissible to receive the vaccine, yet cultural taboos still led to persistently low vaccination rates, Howard said.
“Our studies have shown that some Muslims in Indonesia are uncomfortable accepting vaccines with these ingredients,” even when the Muslim authority issues guidelines saying they are allowed, she noted.
Stricter laws for parents
The 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, requiring parents to have their children vaccinated or face fines and jail time.
In Pakistan, where trust in vaccines has waned for religious and political reasons, parents have been jailed for refusing to have their children vaccinated against polio.
But with increasing vaccine hesitancy and misinformation spreading around the globe, including in religious communities, Rashid said community engagement is “absolutely necessary.”
“It could be catastrophic” if there was not a strong commitment from governments and health workers, he said.
Just finished a great conversation with Muslim health leaders. They asked me to share that vaccines are Halal! Go to https://t.co/shaHrgN2YB & find out where you can get your flu vaccine today, and get your questions answered so you can get the #COVID19 vaccine with confidence! pic.twitter.com/3FDo9UyMjw
— U.S. Surgeon General (@Surgeon_General) November 23, 2020
Clerical body inspections.
Already in Indonesia, the government has said it will involve the Muslim clerical body in the procurement and certification process of the Covid-19 vaccine.
“Public communication about halal status, price, quality and distribution must be well prepared,” Indonesian President Joko Widodo stated in October.
While in China in the fall, Indonesian clerics inspected Sinovac Biotech’s facilities in China, and clinical trials involving some 1,620 volunteers for the company’s vaccine are also underway in Indonesia.
Government officials have announced several contracts with the company to procure millions of doses of Covid-19 vaccine.
Similarly, Sinovac Biotech and Chinese companies Sinopharm and CanSino Biologics – all of which have Covid-19 vaccines in late-stage clinical trials and contracts to sell millions of doses around the world – did not respond to Associated Press requests for information about the ingredients.
In China, none of the Covid-19 vaccines have received final marketing approval, but more than 1 million health care workers and others deemed at high risk of infection have received the vaccine with emergency approval.
The companies have not yet disclosed how effective the vaccines are or what side effects they might have.
CanSino Biologics’ vaccine is in late-stage clinical trials in Pakistan.
Bangladesh previously had an agreement with Sinovac Biotech to conduct clinical trials in the country, but the trials have been delayed due to a funding dispute.
Both countries have some of the largest Muslim populations in the world.
While health workers on the ground in Indonesia are still largely concerned with containing the virus as numbers continue to rise, Waqar said government efforts to reassure Indonesians will be key to a successful vaccination campaign as the Covid-19 vaccines are approved for use.
But the companies that manufacture the vaccines also need to participate in the public relations effort.
“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 are able to have informed discussions about what they want to do,” he said.
“Because ultimately, it’s the individual’s decision.”