JAKARTA, Indonesia (AP) – In October, Indonesian diplomats and Muslim clerics got off a plane in China. While the diplomats were there to finalize deals to ensure that millions of doses reach Indonesian citizens, the clergy had a very different concern: whether the COVID-19 vaccine was allowed for use under Islamic law.
As companies race to develop a COVID-19 vaccine and countries rush to secure doses, questions about the use of pork products – banned by some religious groups – have raised concerns about the possibility of disrupted immunization campaigns.
Pork-derived gelatin is widely used as a stabilizer to ensure vaccines remain safe and effective during storage and transport. Some companies have been developing pork-free vaccines for years: Swiss pharmaceutical company Novartis has produced a pork-free meningitis vaccine, while Saudi and Malaysia-based AJ Pharma is currently working on its own vaccine.
But the demand, the existing supply chains, the cost and shorter shelf life of vaccines that don’t contain swine gelatin means that the ingredient will likely be used in most vaccines for years to come, said Dr. Salman Waqar, general secretary of British Islamic Medical. Association.
Spokesmen for Pfizer, Moderna and AstraZeneca have said that pork products are not part of their COVID-19 vaccines. But limited supply and pre-existing multi-million dollar deals with other companies means some countries with large Muslim populations, such as Indonesia, will receive vaccines that are not yet certified as gelatin-free.
This poses a dilemma for religious communities, including Orthodox Jews and Muslims, where the consumption of pork products is considered to be religiously unclean, and how the ban is applied to medicines, he said.
“There is disagreement among Islamic scholars as to whether to allow something like pork gelatin to undergo a rigorous chemical transformation,” Waqar said. “Is that still considered religiously impure to believe?”
The majority of previous debates about the use of pork gelatin in vaccines has been that it is allowed under Islamic law because there would be “greater harm” if the vaccines were not used, said Dr. Harunor Rashid, an associate professor at the University. from Sydney. .
There is a similar assessment by a wide consensus of religious leaders in the Orthodox Jewish community.
“Under Jewish law, prohibiting eating pork or using pork is prohibited only if it is a natural way to eat it,” said Rabbi David Stav, president of Tzohar, a rabbinic organization in Israel.
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 are divergent views on the issue – some with serious health implications for Indonesia, which has the largest Muslim population in the world, some 225 million.
In 2018, the Indonesian Ulema Council, the Islamic administrative body that issues certifications that a product is halal, or permitted under Islamic law, stated that the measles and rubella vaccines were ‘haram’ or illegal because of the gelatin. Religious and community leaders began urging parents not to vaccinate their children.
“Measles cases then increased, giving Indonesia the third highest measles rate in the world,” said Rachel Howard, director of the research partnership of the healthcare market research group.
Later, a decree was issued by the Islamic administrative body saying it was permissible to receive the vaccine, but cultural taboos still led to persistently low vaccination coverage, Howard said.
“Our studies have found that some Muslims in Indonesia feel uncomfortable accepting vaccinations containing these ingredients,” she said, even as the Muslim authority issues guidelines stating 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 Muslim parents have enacted stricter laws, requiring parents to vaccinate their children, otherwise they will face fines and imprisonment. In Pakistan, where confidence in vaccines has declined Parents have been imprisoned for religious and political reasons because they refuse to vaccinate their children against polio.
But as hesitation about vaccines and misinformation spreads around the world, including in religious communities, Rashid said community involvement is “absolutely necessary.”
“It could be disastrous,” he said without strong community involvement from governments and health professionals.
In Indonesia, the government has already said it will involve the Islamic administrative body in the procurement and certification process of COVID-19 vaccines.
“Public communication about halal status, price, quality and distribution must be properly prepared,” Indonesian President Joko Widodo said in October.
While in China in the fall, Indonesian clergy inspected China’s Sinovac Biotech facilities and there are also clinical trials with about 1,620 volunteers in Indonesia for the company’s vaccine. The government has announced several COVID-19 vaccine purchasing agreements with the company for a total of millions of doses.
Sinovac Biotech, as well as Chinese companies Sinopharm and CanSino Biologics – all of which have COVID-19 vaccines in late-stage clinical trials and selling deals selling millions of doses around the world – did not respond to Associated Press requests for ingredient information .
In China, none of the COVID-19 vaccines have received final market approval, but more than 1 million health professionals and others at high risk of infection have received vaccines under permission for emergency use. The companies have yet to disclose how effective the vaccines are or possible side effects.
Pakistan is late in clinical trials with the CanSino Biologics vaccine. 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 working to control the virus as numbers continue to rise, Waqar said the government’s efforts to reassure Indonesians will be key to a successful immunization campaign, as COVID-19 vaccines are approved for use.
But, he said, companies producing the vaccines should also be part of such a community outreach.
“The more transparent they are, the more open and honest they are about their product, the more likely there are communities out there who trust the product and can have informed discussions about what they want to do,” he said.
“Because it is ultimately the choice of individuals.”
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Associated Press authors Edna Tarigan in Jakarta, Indonesia, and Ilan Ben Zion in Jerusalem contributed to this report.
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The Associated Press’s Health and Science Department is supported by the Howard Hughes Medical Institute’s Science Education Department. The AP is solely responsible for all content.