JAKARTA, Indonesia (AP) – In October, Indonesian Muslim diplomats and clergy boarded a plane in China. While diplomats were there to finalize agreements to ensure millions of doses reached Indonesian citizens, clerics had a very different concern: whether the COVID-19 vaccine was allowed for use under Islamic law.
As companies compete to develop a vaccine against COVID-19 and countries soar to get doses, questions about the use of pork products – banned by some religious groups – have raised concerns about the possibility of altering vaccination campaigns.
Pig-derived gelatin has been widely used as a stabilizer to ensure that vaccines are safe and effective during storage and transportation. Some companies have worked for years to develop pig-free vaccines: the Swiss pharmaceutical company Novartis has produced a pig-free meningitis vaccine, while AJ Pharma, based in Saudi Arabia and Malaysia, is currently working with its own.
But demand, existing supply chains, the cost and shorter lifespan of vaccines that do not contain swine gelatin mean the ingredient is likely to continue to be used in most vaccines for years, the doctor said. Salman Waqar, general secretary of the British Islamic Medical Association.
Spokesmen for Pfizer, Moderna and AstraZeneca have said the pork products are not part of their COVID-19 vaccines. But the limited supply and pre-existing offers worth millions of dollars with other companies mean that some countries with a large Muslim population, such as Indonesia, receive vaccines that have not yet been certified as having no gelatin.
This presents a dilemma for religious communities, including Orthodox Jews and Muslims, where the consumption of pork products is considered religiously unclean and how the ban applies to medicine, he said.
“There is a difference of opinion among Islamic scholars about whether to take something like pork gelatin and make it undergo a rigorous chemical transformation,” Waqar said. “Is this still considered religiously unclean to you?”
The majority consensus in past debates about the use of pork gelatin in vaccines is that it is allowed under Islamic law, as there would be “greater harm” 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 or using pork is only forbidden when it comes to a natural way of eating it,” said Rabbi David Stav, president of Tzohar, a rabbinical organization in Israel. .
If it is “injected into the body, it is not (eaten) by the mouth,” there is “no prohibition or problem, especially when we are concerned about disease,” he said.
Still, there have been dissenting 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 Ulema Council of Indonesia, the Muslim clerical body that issues certifications according to which a product is halal or is allowed under Islamic law, decreed that measles and rubella vaccines were “haram” or illegal because of the gelatin. Religious and community leaders began urging parents not to allow their children to be vaccinated.
“Measles cases subsequently increased, giving Indonesia the third highest measles rate in the world,” said Rachel Howard, director of the healthcare research market research group Research Partnership.
Subsequently, the Muslim clerical body issued a decree saying it was allowed to receive the vaccine, but cultural taboos still led to low rates of continued vaccination, Howard said.
“Our studies have found that some Muslims in Indonesia feel uncomfortable accepting vaccines that contain these ingredients,” even when the Muslim authority issues guidelines saying they are allowed, he said.
Governments have taken steps to address the problem. In Malaysia, where the halal status of vaccines has been identified as the main problem among Muslim parents, stricter laws have been enacted so that parents must vaccinate their children or face fines and imprisonment. In Pakistan, where confidence in the vaccine has been reduced for religious and political reasons, the parents have been imprisoned to refuse to vaccinate their children against polio.
But with the growing vaccine hesitation and misinformation spreading around the world, including religious communities, Rashid said community engagement is “absolutely necessary.”
“It could be disastrous” if there is no strong community commitment from governments and health workers, he said.
In Indonesia, the government has already said it will include the Muslim clerical body in the process of acquiring and certifying COVID-19 vaccines.
“Public communication on state, price, quality and halal distribution needs to be well prepared,” Indonesian President Joko Widodo said in October.
While in China in the fall, Indonesian clergy inspected Sinovac Biotech’s facilities in China and are also conducting clinical trials with 1,620 volunteers in Indonesia for the company’s vaccine. The government has announced several bids to acquire COVID-19 vaccines 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 end-stage clinical trials and sell millions of doses worldwide, did not respond to requests from the Associated Press. ingredient information.
In China, none of the COVID-19 vaccines have received final market approval, but more than one million health workers and others who have been considered at high risk of infection have received vaccines under emergency use permission. Companies have not yet revealed the effectiveness of the vaccines or the possible side effects.
Pakistan is conducting final-stage clinical trials of the CanSino Biologics vaccine. Bangladesh previously had an agreement with Sinovac Biotech to conduct clinical trials in the country, but trials have been delayed due to a funding dispute. Both countries have some of the largest Muslim populations in the world.
While field health workers in Indonesia continue to work heavily on efforts to contain the virus as figures continue to rise, Waqar said government efforts to reassure Indonesians will be key to a successful vaccination campaign, as COVID-19 vaccines will be approved.
But, he said, vaccine-producing companies should also be part of this community outreach.
“The more transparent they are, the more open and honest about their product, the more likely they are to have communities that have confidence in the product and can have informed discussions about what they want to do,” he said.
“Because, ultimately, it’s the people’s choice.”
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Associated Press writers Edna Tarigan in Jakarta, Indonesia, and Ilan Ben Zion in Jerusalem contributed to this report.
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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.