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JAKARTA, Indonesia (AP) – In October, Indonesian diplomats and Muslim clergymen stepped off a plane in China. While the diplomats were there to do deals to ensure millions of doses reached Indonesian citizens, the clergy had a very different concern: whether the COVID-19 vaccine could be allowed under Islamic law.
As companies battle to develop a COVID-19 vaccine and countries scramble for doses, questions about the use of pork products that have been banned by some religious groups have raised concerns about the possibility of disrupted vaccination campaigns.
Pork gelatin is widely used as a stabilizer to ensure vaccines remain safe and effective during storage and transportation. Some companies have worked for years to develop pork-free vaccines: the Swiss pharmaceutical company Novartis has made a vaccine against pork without meningitis, while AJ Pharma from Saudi and Malaysia is currently working on its own vaccine.
However, the demand, existing supply chains, cost, and shorter shelf life of vaccines that don’t contain pig gelatin mean the ingredient is likely to be used in most vaccines for years, said Dr. Salman Waqar, Secretary General of the British Islamic Medical Association.
Pfizer, Moderna and AstraZeneca spokesmen have stated that pork products are not part of their COVID-19 vaccines. Due to the limited supply and multi-million dollar business with other companies already in existence, some countries with large Muslim populations such as Indonesia are receiving vaccines that have not yet been certified as gelatin-free.
This poses a dilemma for religious groups, including Orthodox Jews and Muslims, who view the consumption of pork products as religiously impure and how the ban is applied to medicine, he said.
“There is disagreement among Islamic scholars over whether to take something like pork gelatin and subject it to severe chemical transformation,” Waqar said. “Is that still considered religiously impure to you?”
The majority consensus from previous debates on the use of porcine gelatin in vaccines is that Islamic law allows it to do so because “greater harm” would be done if the vaccines were not used, said Dr. Harunor Rashid, Associate Professor at the University of Sydney.
There is a similar assessment of a broad consensus among religious leaders in the Orthodox Jewish community.
“Under Jewish law, the ban on eating pork or using pork is prohibited only 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 by mouth (eaten),” then “there is no ban and no problem, especially if we are worried about disease,” he said.
However, opinions differed on the issue – some with serious health implications for Indonesia, which has the world’s largest Muslim population at 225 million.
In 2018, the Indonesian Ulema Council, the Muslim clergy authority, issued certificates that a product is halal or permitted under Islamic law, that the measles and rubella vaccines were “haram” or illegal because of the gelatin. Religious and community leaders urged parents not to allow their children to be vaccinated.
“As a result, measles cases increased, making Indonesia the third highest measles rate in the world,” said Rachel Howard, director of Research Healthhip in healthcare.
Later, the Muslim clergy issued a decree permitting the vaccine to be obtained, but cultural taboos still resulted in continued low vaccination rates, Howard said.
“Our studies have shown that some Muslims in Indonesia are uncomfortable with accepting vaccinations containing these ingredients,” she said, even when the Muslim authorities issue guidelines that they are allowed.
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 passed so that parents must vaccinate their children or face fines and prison sentences. In Pakistan, where confidence in vaccines has declined for religious and political reasons, parents have been detained for refusing to vaccinate their children against polio.
Given mounting hesitation and misinformation about vaccines around the world, including in religious communities, Rashid said community engagement was “absolutely necessary”.
“It could be catastrophic,” he said, if governments and health workers don’t get heavily involved in the community.
In Indonesia, the government has already announced that it will involve the Muslim office in the procurement and certification process for COVID-19 vaccines.
“Public communication regarding Halal status, price, quality and distribution must be well prepared,” said Indonesian President Joko Widodo in October.
Indonesian clergy inspected China’s Sinovac biotech facilities while in China in the fall. Clinical trials for the company’s vaccine are currently ongoing in Indonesia with around 1,620 volunteers. The government has announced several COVID-19 vaccine procurement deals with the company totaling millions of doses.
Sinovac Biotech, as well as Chinese companies Sinopharm and CanSino Biologics, all of which have COVID-19 vaccines in late clinical trials and sell millions of doses worldwide, did not respond to Associated Press requests for ingredient information.
In China, none of the COVID-19 vaccines have received final marketing authorization, but more than 1 million healthcare workers and others at high risk of infection have received emergency vaccines. Companies have yet to disclose how effective the vaccines are or what side effects they may experience.
Pakistan is in late-stage clinical trials with the CanSino Biologics vaccine. Bangladesh had previously reached 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 health care workers in Indonesia remain largely active in containing the virus as the number continues to rise, government efforts to reassure Indonesians will be key to a successful vaccination campaign as COVID-19 vaccines target Use are permitted.
However, companies that manufacture the vaccines must also be part of such public relations.
“The more transparent they are, the more open and honest they are about their product, the more likely it is that 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 it is ultimately the individual’s choice.”