Discussions of Book of Mormon issues and evidences, plus other topics related to The Church of Jesus Christ of Latter-day Saints.

Friday, October 15, 2021

Institutional Bullying and the Question of Religious Exemption from Vaccine Mandates

I received a call this week from a father with two children facing intimidation and bullying from the universities they are attending. As is common these days, those who have concerns about the COVID vaccine and are hesitant to be vaccinated are treated as second-class citizens, with corporations, universities, and other institutions treating them as second-class citizens if not pariahs to be ousted. At the two universities in question, the vaccine hesitant are easily identified and are pressured or bullied by other students and intimidated by the university. Sincere religious concerns do not count for much. 

Religious exemption requests are based on the idea enshrined in the Constitution that American citizens should have freedom to practice their religion. Of course, where the boundaries of those freedoms are is a complex and thorny issue. But an important aspect of that liberty is codified into law in Title VII of the Civil Rights Act of 1964, which prohibits discrimination of employees on the basis of religion. The Equal Employment Opportunity Commission requires employers to provide "reasonable accommodations" for the sincere religious beliefs of workers unless that would cause undue hardship. Similar principles have been put into state laws and are part of the official policies of many universities. See, for example, the Religious Accommodations Policy of the University of North Carolina

But what does this have to do with COVID? No major religious organization, as far as I know, has come out against COVID vaccination. The leaders of The Church of Jesus Christ of Latter-day Saints have encouraged us to protect ourselves and others by being vaccinated. (For the record, my wife and I are vaccinated and we think it's a good idea to get vaccinated, especially if they do not already have natural immunity and are in a high-risk category or closely associate with those at high risk.) So how can there be a sincere religious objection to the COVID vaccine? 

Two Possible Grounds for Religious Objections

The two university students in question have concerns about the use of fetal cells in the R&D and development that led to these new vaccines. The vaccines do not contain fetal cells, but fetal cells were used in the development and commercialization of the vaccines that are available in the US. Many people who share an opposition to unnecessary abortion and strongly believe in the sanctity of human life do not necessarily object to the use of modern fetal cell lines that have been cultured from fetal cells taken in the 1970s, especially when those fetal cells are not physically part of the product. But there are arguments both ways. I think we need to understand that a person can have a sincere concern about any new medical product that was invented or developed through the use of abortion, even if the abortion occurred long ago.  If aborted cells were an integral part of the development and introduction of a new product, I can see why it might be viewed as tainted and objectionable to use, or especially repugnant to take into one's body. 

As reported by the State of Michigan in their fact sheet on fetal cells and COVID vaccines (PDF), the “Johnson & Johnson (Janssen) COVID-19 vaccine used a fetal cell line to produce and manufacture their vaccine.” While the Pfizer and Moderna COVID-19 vaccine did not use a fetal cell line to manufacture their vaccine, “a fetal cell line was used in a very early phase to confirm efficacy prior to production and manufacturing.” All three vaccines are thus subject to potential religious concerns about the use of fetal cells for the development of a new drug.  

But fetal cell use is not the only reason a religious person might have a sincere religious concern about the COVID vaccines or any experimental drug or drug that has not had the normal years of long-term safety testing. As I discussed in my Sept. 10, 2021 post on the Emmy Award-winning singer, Victory Boyd, whose contract with the NFL was terminated when she refused vaccination on religious grounds, Ms. Boyd based her request for a religious exemption on the biblical concept of the sanctity of her body and the desire to not take potentially harmful (or not completely tested) substances into her body. Here is her statement:

“The Bible admonishes Christians to appreciate their bodies as being sacred and a temple of the Holy Spirit and to not participate in things that can defile the body or render the body dysfunctional.

“I am in prayer to make sure that the Lord guides me into the right decision concerning receiving an unproven injection with artificial properties that can potentially have a long-term effect on my reproductive health.

“If I want to take the vaccine, the decision will be between myself, my doctor, and my God. At this point, the Spirit of God is leading me to take a stand for freedom of choice.”

Sadly, the "my body, my choice" argument only seems to work if it's being used to justify destroying someone else's very vulnerable prenatal body. When it comes to actually protecting your own body from unwanted substances, many institutions insist that compliance is the only option with no effort at all to make reasonable accommodations for one's sincere concerns. But that doesn't mean a person with those concerns should be silenced, shamed, or booted from the company or university. Even if we disagree with the religious concerns, I think we need to stand with those who are asking for their religious views and rights to be respected.

As Latter-day Saints with our own health code, we are taught to have concerns about taking harmful substances into our body. Tobacco, alcohol, and harmful drugs are on the list. But what about drugs where the safety status has not been fully resolved due to the lack of long-term studies on such issues as reproductive health or cancer? The two students in question both wish to be parents one day and have sincere concerns about the long-term impact of the vaccines on reproductive health. What is the impact on pregnancy or on fetal development or mutations? What we know so far from extensive safety testing in the past 18 months is that the vaccines are safe. But no matter how awesome your short-term testing is, no matter how close your rats and mice are to humans, there are some human health issues that cannot be fully settled with one or two years of testing. Most vaccines go through 10 to 15 years of development and testing before being rolled out for widespread use. There is a sincere reason why someone might feel short-term testing is not enough time to take a substance that could affect them for the rest of their life. It's a reasonable basis for a religious exemption and a reasonable basis for a scientific objection. I'm not saying we have to agree with it or that the argument is compelling, but it is a position that a reasonable person can take. 

There may be further grounds for religious exemption requests besides the two considered here, but please understand that those having religious objections may have more than one basis for their concerns. 

As healthy young people with very little risk to COVID, both of these students wonder why they should be compelled to take a substance into their bodies that may bring genuine risk (though risk that at the moment seems quite rare) yet offers very little benefit for them while in their youth. Given their health and age, having COVID is very unlikely to send them to the hospital to use up limited resources for others. Their vaccinated peers have very little to fear from them if the vaccines are effective. Compelling them to take a medication that may bring risk but offers little benefit seems unfair. Giving them time to wait for long-term safety results doesn't seem unreasonable. 

Aspirin, Tylenol, Ex-Lax and the Hypocrisy Test

One of the children of the father who called me had already expressed the desire for a religious exemption to the university, which apparently claims that it will make reasonable accommodations to sincere religious belief. In response, the university provided an intimidating form to "test" the sincerity of that belief by giving a long list of popular over-the-counter products that allegedly also have used fetal cells. The form requires students seeking a religious exemption to vow that they do not and will not use such products.

The hypocrisy test apparently was developed at the healthcare company, Conway Medical, per Tristates Public Radio, WIUM. Here's their form (click to enlarge):


The same list is now being used in many parts of the country, including at some universities. This hypocrisy test, in my opinion, might not really be based on a good-faith desire to confirm the sincerity of a student's religious views, for it feels like it is intended to intimidate students and mock their belief. It's a little like saying, "Oh, you refuse to drink alcohol due to religious beliefs? According to science, you're a hypocrite.  We've seen you drinking orange juice and eating bananas, both of which can contain around 0.2% ethanol. We've seen you eating hamburgers with baked buns known to have over 1% ethanol. It's amazing you can even walk straight right now. You obviously don't have a sincere religious belief against alcohol. Now drink up!" 

This alcohol-related mocking is only a little like the mockery of the university's hypocrisy test, because my alcohol hypocrisy test is actually much more logical. Alcohol occurs naturally in many foods, enough so that parents perhaps really should be cautious about giving young children lots of fruit juice. See Eva Gorgus, Maike Hittinger, and Dieter Schrenk, "Estimates of Ethanol Exposure in Children from Food not Labeled as Alcohol-Containing," Journal of Analytical Toxicology, vol. 40, no. 7 (Sept. 2016): 537–542. But there's still a significant difference between most alcohol-rich foods and the alcohol content of beer, wine, or liquor. 

Importantly, whether my religious acceptance of the Word of Wisdom's prohibition of alcohol is logical or scientific does not determine the sincerity of my religious belief. My religious beliefs related to what I eat or drink is based on revelation and to some degree religious tradition in interpreting that revelation. I personally avoid low-alcohol beer, even if its alcohol content might actually be less than that of my favorite fresh-baked bread. Our response to the Word of Wisdom may seem illogical or contradictory when explored by secular observers. But guess what? It's religion. It's a matter of faith and sometimes a matter of tradition. It's not supposed to make perfect sense to outside secular observers. Religion of all kinds abounds with elements that require faith and may seem contradictory, superstitious, or unreasonable to outsiders, especially those looking for reasons to criticize. Whether it's the nature of the Trinity or the refusal to eat cheeseburgers based on an interpretation of a verse in the Torah, there are things that are puzzling to those outside the believer's faith. Whether a student has taken Tylenol is not a fair gauge of the sincerity of religious belief.

Further, the university's hypocrisy test is actually deceptive and unreasonable. It is deceptive because nearly all of the products on the list were developed and marketed without the use of fetal cells, often long before fetal cells were even available for testing. Aspirin, which was first marketed by Bayer in 1899 but has a history that goes much further back in time. Ex-Lax was first produced in 1906. Tums was introduced to the market in 1928 but employs compounds known to be safe long before that. Preparation H dates to around 1935. Ibuprofen was discovered in 1961. Now that aspirin is on the market, if some lab or manufacturer decides to test it with fetal cells, I don't need to reject aspirin if my religious belief and conscience leads me to reject products that relied on abortion for their development and commercialization. Products that were developed and commercialized independent of an aborted child are what some people object to. Taking an existing product that did not rely on the cells of an aborted fetus for its development and commercialization and then later testing it with fetal cells may be unfortunate, but need not require the believer to reject that product.

If some lab decides to test the safety of lettuce using fetal cells, that would be unfortunate, but it does not turn pro-lifers objecting to fetal cell use in vaccines into hypocrites if they are caught eating salad. Lettuce salad, like most of the products on the hypocrisy test list, was an established product long before fetal cells were available for testing.

A Better Sincerity Test

If the universities really want to know if these students have sincere objections to the vaccines based on pro-life views or the Word of Wisdom or some other matter of faith and conscience, the right gauge is not whether or not they have ever used aspirin, Tylenol, Ex-Lax, etc., or consumed fresh-baked bread or orange juice. The hypocrisy test is great as a secular tool to belittle the beliefs of others, but if you want to know how sincere those students are, a better tool might be to simply observe what they have been doing already. In spite of being publicly shamed as vaccine hesitant rebels, facing sustained harassment from fellow students motivated by statements and policies from the university without respect for the medical privacy and personal beliefs of the students, these students continue to maintain their position and to implore the university for the right to control what is taken into their bodies and to avoid an injection of a substance that, unlike aspirin or Tylenol, relied on the cells of an aborted fetus for its very existence (i.e., its development and commercialization). Being willing to face that kind of pressure and discrimination and now to risk being expelled from the university for their beliefs seems like an indicator of sincerity, even if we don't share or agree with the position they take. 

The "Scientific Exemption": It's Not Just Religion We Need to Respect

For the two university students in question, the objection to the vaccine is not just based on religious concerns, though I think they should be respected in spite of my not fully agreeing with them. Besides the religious concerns, there is also a scientific or health-based objection, and they may be including a request for a "scientific exemption" in their requests to the university. 
 
Their concern is that they are young, healthy people with almost zero risk from COVID. The decision to receive the vaccination makes a long-lasting change in their bodies and while the evidence so far points to a high level of safety, there are significant unanswered questions. A particular concern is about long-term impact on their reproductive health. These concerns are swiftly dismissed by advocated of vaccine mandates based on "extensive" testing in the past 18 months or so. But have we really had enough time to understand the effect on the human reproductive system and on children born to those who have received the vaccine? Do we understand the long-term effect on cancer? How can we have solid answers in such a short time?
 
If concerns about reproductive issues have been fully assessed already, why did the NIH just award five institutions grants “to explore potential links between COVID-19 vaccination and menstrual change”? See the NIH post, "COVID-19 Vaccines and the Menstrual CycleNIH encourages researchers to investigate reported changes in menstruation after COVID-19 vaccination." Here there are enough concerns that have been raised for the NIH to launch a study related to reproductive health.  Note that these grants in no way suggest there are any reasons to believe that the vaccine might have any adverse impact on fertility or on children born to vaccinated parents, and I personally don't know of any data suggesting the least real concern so far. But if understanding the effect on menstruation requires more time and money, could their be other aspects of reproductive health that will require even more time? Ditto for the long-term effect on cancer or other ailments.  It is not unscientific to ask questions about such effects and to seek more data before taking injections that can impact my body for decades to come with effects that are not yet clear.  I may not agree, but a person can have sound scientific reasons for at least wanting more data before committing to vaccination. There is a reasonable basis for a good-faith request for a "scientific exemption" from the vaccine mandate based on the principle of stewardship over one's body, back to "my body, my choice."

Finally, Let's Not Forget Natural Immunity

One of the most puzzling things about the vaccine mandates sweeping this country is the uniform neglect of natural immunity. Why should those who have already had COVID need to be vaccinated as a condition of employment or continuing at a university?

While I am vaccinated and think it's a good idea for most people, I also recognize the scientifically demonstrated principle of natural immunity and feel that those who have already lived through COVID should be given recognition for their natural antibodies. There should also be recognition that adverse reactions, though typically mild, are more likely for those that have already had COVID and is something that might reasonably be weighed in a person's personal decision about vaccination.

A few days ago, I met a young mom who was required by her employer to get the vaccine in spite of having had COVID. She objected and asked for an exemption based on already having antibodies. Request denied. So she buckled. For her, the adverse reaction to the vaccine was much worse than COVID. COVID was like having a cold for her, but the vaccine caused intense pain and fatigue that kept her ill for about a week. Unfortunately, even after a month she said feels she's only 75% back to normal. 

Meanwhile, a close friend of that woman had COVID and struggled with the complication of myocarditis. Now he's been forced by his employer to receive the vaccination, even though it is known that young men like him may be at some risk of myocarditis from the vaccine (again, the vaccines are generally safe and I still encourage vaccination, but also encourage respect for individual concerns). He's asked for an exemption based on medical risk and the fact that he already has natural antibodies. Request denied, even though his doctor is on his side (so I was told, but maybe she had the story wrong). He's deeply worried about his health and does not want the vaccination, but may have to leave his high-paying job in the financial industry. Shouldn't there be respect for people's health and for their concerns? Shouldn't there be reasonable accommodations for reasonable health-based and scientific objections, as well as religious objections? Concerns about myocarditis, especially in males, are not based on mere rumors and fake news, but are leading Europe to take significant steps. See the Oct. 8, 2021 CNBC report, "Nordic countries are restricting the use of Moderna’s Covid vaccine. Here’s why," and the earlier July 9, 2021 Reuters story, "EU finds potential link between heart inflammation and mRNA COVID shots." These concerns are generally minor and don't affect everyone, but they can affect some. The CDC is also aware of some reports of myocarditis, but still encourages vaccination. But we must not forget that there are always risks with any drug, and these need to be weighed against the benefits.

There are plenty of good reasons to be vaccinated, and I'm glad (so far, anyway) that I've been vaccinated. But may we have enough compassion and respect for others to recognize that there are genuine religious and scientific concerns that some may have. Today there is popular pressure to shame such individuals, some of whom are likely in our own wards or branches, families, workplaces, or schools. 

May we express our humanity and our tolerance of diversity by standing for their freedom to choose, for their rights to have their religious views reasonably accommodated and their scientific objections to be considered. May we stand against the unreasonable and hateful condemnation of the unvaccinated and sweeping one-size-fits-all vaccine mandates that may be genuinely unnecessary for many. May we resist the manipulative paranoia and fear that is causing some of us vaccinated people to dread and despise those who have sincere reasons for not wanting the vaccination at this time. And may we help keep them from being fired or expelled from universities, especially those who are in critical areas related to health care, law enforcement, manufacturing, and numerous other fields already suffering from a shortage of talent. Reasonable accommodation and kindness is surely the most reasonable thing we can be doing with those who have sincere concerns about these new vaccines.

UPDATE, Oct. 21, 2021: The social argument for vaccine mandates needs more discussion and more science. It's repeated without question as an article of faith, often without consideration of data and the existence of other means of mitigating risks. Those wishing to not be pressured into letting others make decisions about one's body and one's health care may be on even stronger grounds in light of the latest relevant scientific report:  S. V. Subramanian and Akhil Kumar, "Increases in COVID-19 are unrelated to levels of vaccination across 68 countries and 2947 counties in the United States," European Journal of Epidemiology (Sept. 30, 2021), https://doi.org/10.1007/s10654-021-00808-7. Analysis of extensive data suggests that high levels of vaccination aren't effective in slowing the spread of the virus. The benefit is the reduced risk to the vaccinated. This seems to greatly weaken the "social good" argument that requires people to "give up their 'precious' freedoms" and let some corporate or political bureaucrat dictate what medical treatment they receive instead of making their own decision. I'm pro-vaccine, but also pro-freedom. There are cases where the social good argument may be compelling, but the data does not seem to come close to supporting that in this case. If vaccination does not greatly reduce the spread of the infection, what's the basis for vaccine mandates and shaming the unvaccinated? It's time we engage in conversation on this topic.