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Editor’s Note: Dr Kurtis Budden has written a very well-researched and thorough article about the many issues surrounding Covid vaccinations. The team at the Canberra Declaration agree with his ethical conclusion that Covid vaccines should not be mandated. Having said that, we have doubts regarding vaccine efficacy and strong concerns about the vaccine safety record. The great need for the moment is to have an open and gracious debate about these matters. Dr Budden’s article will help that process.

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There is a lot of conflicting information about coronavirus vaccines. Here is an in-depth examination of various studies on the effectiveness of the vaccines, along with an analysis of the scriptural basis for considering vaccination, and whether it is a matter of conscience.

I haven’t written about COVID vaccines previously — it seemed that everything that could be said has been said. However, I’ve noticed an increase in several prominent opinions from believers on multiple sides of the political spectrum that I think are incomplete — not wrong, but incomplete.

I suspect I’m too late to the party and most people have a fully formed, unchangeable opinion about vaccines. However, I hope that I can help provide some clarity on how Christians may approach these vaccines.

This is not meant to address everything about COVID, including whether government responses and messaging have been appropriate or whether alternative treatments work. I may touch on some of these issues, but I don’t want them to distract from my focus on four specific questions:

• Do the vaccines work?
• Are the vaccines safe?
• Is taking/not taking the vaccine a commandment or matter of conscience?
• What should our response look like as a church?

This will require a LOT of words, but if you can stick with me, I hope it can help us to find a way for the church to exemplify the mutual love and unity that marks us as followers of Christ.

Part 1: Do the vaccines work?

Suspicion about the vaccines often references reports of lower efficacy against infection, case spikes in highly vaccinated countries, or large numbers of vaccinated individuals being hospitalised. Others point to studies that show similar viral load between vaccinated and unvaccinated to suggest that transmission is not reduced.

As I said earlier, it’s not that these reports don’t exist, or that the raw data is wrong or falsified. Rather, these reports don’t consider the full story and looking at them in isolation leads to incomplete conclusions. Proper context is needed on each point to properly interpret it.

Do the vaccines prevent infection?

The early evidence for protection against infection was excellent. As time went by, we noticed a concerning trend as the extent of protection decreased – down to 74% for Pfizer and 67% for AstraZeneca in the UK, while Pfizer was just 39% effective in Israel at one point.

At the same time, vaccines appear to be >80% effective in Canada. Unvaccinated people in Virginia have an infection rate 5.6 times higher than fully vaccinated people, similar to trends in America as a whole. This is slightly higher than the 2.5 fold increase for unvaccinated Indian healthcare workers and 1.7-1.9 fold increase in unvaccinated close contacts in the UK, most likely because these latter studies involved looking at participants in high-risk settings.

Does this conflicting data mean it can’t be trusted?

How can the evidence of vaccine efficacy suggest both high and low efficacy in different studies?

Some may be reflected in study design, as different study populations and conditions can cause variability in results. As one of many examples, unvaccinated people in America tend to be less worried about catching COVID and so may be more willing to engage in “risky” behaviours, artificially increasing their risk. However, in countries like Israel which had vaccine passports, there is likely a bias in the opposite direction as unvaccinated people are prevented from interacting in as many high-risk situations.

This is why the best studies are the randomised, double-blind, placebo-controlled trials, which account for these differences by randomly selecting participants from a pool of patients with well-defined characteristic.

Trials conducted in this manner showed VERY good vaccine effectiveness, but were conducted before the rise of the latest COVID variants hence why we need to rely on more population-level data and lab-based studies to keep monitoring effectiveness.

Of the studies above, I think the UK study (1.7-1.9 fold reduction in infections) is the best to look specifically at vaccine effectiveness, as it only investigated close contacts, minimising confounding variables such as behaviour.

The other major difference between studies showing high/low effectiveness is time, as multiple studies from America, Qatar, and the UK show that immunity against infection decreases over time.

This may be one of the reasons for better-than-expected outcomes for NSW in October – as our vaccinations were quite recent their effectiveness at preventing infections was at their peak during the worst of the outbreak.

Incomplete protection and waning immunity is not unique to COVID vaccines. Efficacy of whooping cough, hepatitis B, and influenza vaccines start ~80% according to some studies but wane over time. Influenza and COVID are both respiratory viruses, and the efficacy of influenza vaccines wanes at a rate of ~7% per month. This is comparable to the ~4%, ~8%, and the ~5% rate of waning observed for the Pfizer COVID vaccine.

Waning immunity doesn’t make the vaccines useless. For one, they still have SOME effect, even if it is lesser. For another, we may just need to optimise doses to get a more sustained effect (Hepatitis B requires 4 doses) or we might need annual doses to target new variants, as in the case of influenza. We need to acknowledge the limits of our current knowledge.

Most importantly, protection against infection is just one aspect of vaccine efficacy and we need to include an assessment of protection against severe disease and against transmission. This is especially true as, of these three measures of protection, preventing infection will be the most susceptible to waning and thus may not be the most appropriate measure of effectiveness (Appendix 3).

Do the vaccines prevent severe disease and death?

There is very compelling evidence that, even if a vaccinated person still contracts COVID, vaccines do offer protection against the severity of disease. Vaccinated individuals are less likely to develop symptomatic disease, including reduced risk of chronic symptoms (long-COVID). So even if they catch the disease, it has less impact on the vaccinated for both the short and long term.

When it comes to severe disease, multiple studies in the UK show much lower rates of hospitalisation and death in vaccinated patients, as do data from the USA (and again), Malaysia, France, Singapore, Qatar, and Israel, including some studies cited as evidence that vaccines have poor efficacy against infection.

According to some data, the unvaccinated are 11 times more likely to die from COVID, and we consistently see results that demonstrate effectiveness of >90% against hospitalisations.

Crucially, these findings hold true even after 6 months, and as far as I know there is little sign of them slowing down (except in the case of immunocompromised individuals). So even though there appears to be a waning protection against infection, the protection against disease is much more sustained, which again reflects the functioning of our immune system (See Appendix 3).

So why the high numbers of vaccinated hospitalisations and deaths in some countries?

Part of this is a feature of the waning protection against infection – even with protection against severe disease, more infections overall leads to more deaths. This is a limitation that needs to be acknowledged and considered for personal and public health policies.

There are also at least two other reasons that are less concerning – the base rate fallacy and Simpson’s paradox.

The first is easy to explain – we need to take into account the starting proportions or ‘base rate’ of a group. For example, if I had dice that rolled “6” once every six rolls you would say that was normal. If you knew they were 20-sided dice you would say that was much higher than expected because the “base rate” is 1 in 20.

The question is not whether the number is high or low but is it “disproportionate”. Similarly, even if the vaccines work, a highly vaccinated population will expect many hospitalisations/deaths in vaccinated people but at disproportionately low rates, which is what the studies cited previously show.

Simpson’s paradox is a little more complicated, but effectively it builds upon the base rate to look at different categories. The idea is that the “average” between two groups may appear similar even if there are real differences, because one subset of people is “biased” to a particular result and overrepresented in one of the groups.

For example, if I compared shopping bills from two hypothetical communities’ (100 people each) and they average $200 per week for a family, we might conclude they had a similar cost of living. However, if community A had twenty 4-person families and ten 2-person families (100 people, 30 families), while community B had ten 4-person families and thirty 2-person families (100 people; 40 families) it makes a difference.

	Community A		Community B
	Average cost	Number of families	Average cost	Number of families
Whole community	$200	30	$200	40
4-person families	$250	20	$300	10
2 person families	$100	10	$166.67	30

 

The cost of living in community B is higher for both 4 person families and 2 person families, but the average cost is the same because there are more 2-person families in community B.

How does this work with vaccine efficacy? Well, there is an excellent explainer here using data from Israel. The vaccine only looks ~67.5% effective (at the time of the article) because young people who are at lower risk of hospitalisation are less likely to be vaccinated. However, the vaccine is over 90% effective at preventing severe disease (hospitalisation) in most age groups.

The conclusion — the vaccines are very effective at preventing severe illness and death.

Do the vaccines reduce the spread of disease?

Perhaps this is the most controversial issue for vaccines because it is the main justification for mandates, or even just social pressure to be vaccinated. If vaccines just reduce the risk to yourself, it’s your choice. If vaccines affect the spread of disease, it carries broader implications.

The data here gets a little bit messy and technical, so I want to go through it slowly and with detail. There are studies supporting both arguments, but I will state from the outset that I think the studies that suggest it does reduce spread are MUCH better designed, more reliable, and more convincing (Note: I said REDUCE spread, not stop).

High case numbers in heavily vaccinated countries have prompted questions about whether the vaccines had any impact on transmission. One widely circulated study suggested no correlation between vaccination rates and new COVID cases, seeming to put the nail in the coffin.

However, this study was anything but conclusive. They only assessed transmission rates in a seven-day period. This is far too short to accurately measure transmission of a disease where we have good evidence that there is a seasonal component and for which we see waves peaks affecting different countries at different times.

Even in Australia, if I compared COVID cases in NSW and Victoria I could draw completely opposite conclusions about which state had fewer cases just based on the week that I chose to examine.

Additionally, it ignored other important factors which could contribute to differences between countries and counties– herd immunity from previous waves, testing rates, which variant was circulating, population density, other precautions/restrictions, etc.

Instead of comparing whole countries/counties over a very short window, a much better study looked at COVID patients and their close contacts. Here, the question is not just “how many cases are there”, but we’re specifically asking the question of “if I catch COVID, how likely am I to pass it on to a person I’m around”. By focusing on comparable populations, in comparable settings this focused study is a much better investigation of what the vaccines are doing.

This study found that people vaccinated with AstraZeneca and Pfizer were 35% and 65% less likely to infect close contacts, respectively, than unvaccinated people. However, it’s worth noting that this effect waned over time. So even though the two studies conflict, the better-designed and more reliable study shows that vaccination does reduce transmission.

Similarly, a recent study suggested that vaccinated people were just as likely to spread disease to household contacts as the unvaccinated. However, this study was very small and didn’t account for immunity from prior infection.

In a much larger study that accounted for prior infection (that is, a better and more reliable study, they found that someone without immunity was less likely to contract COVID in households with more immune family members – the more robust study showed that the vaccines helped reduce transmission.

We see this pattern repeat in mechanistic studies too. One early report stated that vaccinated COVID healthcare workers had 251 times higher viral load than unvaccinated counterparts making them more dangerous. However, vaccinated workers were infected with the Delta variant while the unvaccinated workers had previous, less infectious variant and thus direct comparisons could not be made.

Other studies found no difference in viral load between the vaccinated and unvaccinated when all patients were infected with the delta variant, but these studies were relatively small and didn’t correct for other factors such as age, BMI, or smoking history that can impact the differences vaccinated and unvaccinated groups. They also only really give us a snapshot of one point in time, rather than comparing what happens over the course of disease.

In contrast, a much larger study with a randomised cohort (better design that reduces the impact of confounding factors) suggested that vaccinated individuals did have lower viral load.

Part of this may relate to the time of sampling, as studies from Singapore and the UK found that even though initial viral loads are similar, they drop faster in vaccinated subjects making them non-infectious quicker, which also helps to reduce disease spread.

Additionally, the PCR tests used in most of these studies analyse genetic information. They are very accurate at telling us what we’re looking at but doesn’t tell us as much about its condition. As an analogy, if you found my DNA at a crime scene, you’d know I was there, but you couldn’t tell how healthy I was at the time.

Similarly, the viral load tells us if the virus is there and how much, but multiple studies have shown that even where viral load (by PCR) is similar, virus from vaccinated patients is less infectious. That is, even if there is the same number of virus particles, they are weaker and less transmissible.

Finally, the lower airways and lung are responsible for generating more and smaller aerosols. Viruses are typically enriched in these smaller aerosols which travel further and penetrate deeper into the recipient’s lung than larger aerosols, making them a greater danger of transmission.

Since moderate and severe COVID is associated with greater involvement of the lower respiratory tract, reducing disease severity through vaccination likely reduces the spread of infection. Given that most studies only investigate the upper airways (using nasal or oral swabs), this data is not being captured in the above studies but is a reasonable conclusion.

Overall, there are studies that say vaccines help reduce transmission, and studies that say that don’t. However, the former are much, MUCH stronger studies and have far fewer limitations.

The limitations don’t make the studies against vaccines reducing transmission useless, but it severely limits the strength of the conclusions that can be drawn. This was my original point – citing these studies is not “wrong”, but many times we are not using them correctly which leads to inappropriate conclusions.

Therefore, we should give far more credibility to the well-designed, controlled studies that provide compelling evidence that the vaccines do reduce spread of disease. Emphasis needs to be made that this is REDUCING spread, as it doesn’t stop it completely, but it does help and neglecting the good in the hope of the perfect would be unwise.

Summary: Do vaccines work?

• Vaccines are quite good at reducing risk of infection. This wanes over time, but still retains some protective effect.
• Vaccines are very good at reducing risk of severe disease/death. This is robust and preserved over time.
• Vaccines are very good at reducing the risk of transmission.
• Vaccines are not perfect in their effects, and do not prevent any of these things entirely.

Part 2: Are the vaccines safe?

What does safety mean?

A 2005 study estimated that aspirin (or similar drugs) cause 15.3 deaths per 100 000 people, while there is an estimated 1 death per 7.9 million commercial airline passengers.

Few of us would characterise aspirin or flying “unsafe”, nor would we hesitate to make good use of these activities even though the relative rewards (pain relief or quick travel) are low compared to the risk of dying.

My point here is not to compare these activities to COVID vaccines directly, but to highlight a couple of important points:

1. Nothing in life is free of risk. It’s important to keep everything in perspective. Our actions are basically saying “I am willing to accept this risk for the sake of this reward”. In the case of flying, “I am willing to accept a one in 7.9 million chance of dying for the sake of a quick, convenient journey”.
2. Avoiding risks has consequences. The consequences may be simple consequences of convenience (e.g. avoiding flying means the trip takes longer), or they may be consequences that actually increase risk (e.g. your risk of death from driving is much greater than from flying – avoiding one specific risk increased overall risk).
3. We’re not always the best at judging risks. Many factors determine our willingness to accept risks, including emotions, experiences, familiarity, level of trust, and whether the risk is voluntary or involuntary. Aspirin may feel safe because it’s familiar and we used it before, but that doesn’t change the ACTUAL risk.
4. Different people will have different risks and tolerances for those risks. Different medical conditions are associated with a greater risk of adverse event from aspirin, which will impact a patient’s decision whether to take it. One person may be comfortable flying while another feels unsafe, even though the actual risk is the same.
5. Even when unlikely, the consequences of a risk are real. The fact that aspirin and flying are incredibly safe comes as little comfort to those who have lost loved ones to either one.

Vaccine adverse events

With this understanding, we can look at vaccine safety in a bit more detail. Vaccine side-effects do happen and are real. There are families feeling the pain of this and may very well be regretting their decision. It’s a horrible situation, and I have nothing but compassion and sympathy for those families.

Nevertheless, despite these events (and without minimising them at all) I would conclude that the vaccines are safe for two reasons.

• Severe adverse events are rare.

Many people hesitant about the vaccines know people or have heard stories about those who had severe adverse reactions. I want to reiterate that these instances occur, and I do not want to diminish the pain of those people.

However, to add my own anecdotal story, I work in a building with >1500 employees and >97% are vaccinated. I do not know of a single severe adverse event.

More importantly, we can look at the data. In one study, the greatest risk after vaccination was lymphadenopathy (a non-severe symptom of swollen lymph nodes) at a rate of only 78 per 100 000 (0.078%).

More severe adverse events were even less likely, including myocarditis (3 per 100 000; 0.003%). Another study had an even lower estimate of only 1 per 100 000 (0.001%), although some people may have only received one dose of vaccine. Even in the highest risk group (young men), the risk of myocarditis was only 67 per million (6.7 per 100 000; 0.0067%).

To put this in perspective, the incidence of myocarditis globally in 2013 was estimated to be ~22 per 100 000 (0.022%), though that reports an annual rate and can’t be compared directly to the numbers from the above studies.

Similarly, at the height of concern about the AstraZeneca vaccinae and blood clotting, rates were reported as high as 14.9 per million (1.49 per 100 000; 0.00149%), compared to an annual rate in the general population of around 1 in 1000 (0.1%).

In an incredibly large study of 10 million participants, there was no increased risk of 18/19 severe adverse events monitored compared to unvaccinated counterparts. Some were even lower risk in the vaccinated group, and only myocarditis/pericarditis was observed at a mildly higher rate (1.39 cases in vaccinated for every 1 in unvaccinated group).

None of these rates of severe adverse events should be considered high. While severe adverse events are serious, we rarely base our decision making on “worst case scenario”. More typically, we base it on “risk-reward” and I would argue that these vaccines pass that test.

Again, none of this is meant to minimise the real pain of people and families affected by adverse effects of vaccines. The point is that most of us would engage in far riskier activities willingly, and often with far less benefits than the vaccines provide.

Crucially, the rarity of these cases feeds into the second reason why I would consider these vaccines safe.

• Practically every risk associated with the vaccines is worse for COVID infection.

One argument against certain COVID measures is “why should we be afraid of a disease over 99% of people survive”? I certainly have some sympathy for that argument for many aspects of the COVID response.

However, it doesn’t really make sense in the context of vaccines because the same argument can be made for vaccines – “why should we be afraid of a vaccine that over 99.99% of people survive?”

Consider this study of the Pfizer vaccine from Israel. It estimated the absolute risk of myocarditis at 3 per 100 000. Not common, but also not zero. However, the risk of myocarditis after catching COVID was 11 per 100 000 – nearly 4 times greater.

The same trends were seen for kidney injury, arrythmia, deep-vein thrombosis, intracranial haemorrhage, myocardial infarction, pericarditis, and pulmonary embolism. Only herpes zoster infection (shingles) and lymphadenopathy (swelling of lymph nodes) were higher risk in the vaccinated, both of which are comparatively mild side effects.

The same patterns are evident for neurological adverse events and blood clotting. Given that the vaccines reduce the risk of symptoms and severe disease, the vaccines represent a safer option than risking COVID infection.

Avoiding one form of risk is not avoiding all risk. In the case of COVID vaccines, avoiding the risk of an adverse event exposes us to a greater risk of those same dangers if (or when) we contract the infection. Just because the risk of infection feels familiar because we’ve been sick before, doesn’t mean it is actually less risky – we are often poor judges of risk.

Even if we were to calculate the individual risk difference of one adverse event is worth avoiding the vaccine, I’d suggest that the cumulative effect is even more substantial. That is, we might justify the risk myocarditis after infection to avoid vaccination, but I do not think we could justify the risk of myocarditis, and pericarditis, and pulmonary embolism and… so on.

I strongly argue that, in a risk-reward calculation, the slight increase in risk an adverse event from a vaccine is more than offset by the dramatic reduction in risk of severe COVID symptoms that the vaccine provides for the vast majority of people who take them.

What about VAERS?

People will often point to the Vaccine Adverse Event Reporting System (VAERS) in the USA or the Therapeutic Goods Administration vaccine safety monitoring and reporting data in Australia.

The argument against vaccine safety is phrased as “there are X number of deaths reported” or “there are more reports for these vaccines than any others”. However, such concerns are generally overwrought by exaggerations of what the data means and how it is collected.

For one thing, reporting to VAERS is voluntary. Some point out that this can lead to undercounting of adverse events, a fact acknowledged by the CDC. However, it is a mistake to assume that all adverse events are underreported equally.

People may not bother to report a fever, but few would fail to report a hospitalisation or death of a loved one. In fact, healthcare workers administering COVID vaccines are required by law to report serious adverse events.

Similarly, consider the changes in information over the last few years. I have studied Biomedical Science, been vaccinated for overseas travels, vaccinated my child, and been involved in medical research for years. I knew there was post-market surveillance of vaccines/medicine but it was only during COVID that I learnt of this voluntary reporting system.

I suspect I am not alone. How much of the “higher reports” are due to increased knowledge of the database? Is the underreporting factor lessened due to improved participation? This is especially true given that, in Australia, people who are vaccinated are sent a survey to monitor adverse events and this does not happen for other vaccines.

Moreover, high numbers alone need to be put into context. For example, the CDC reports ~4 billion doses of ALL vaccines administered between 2006 and 2019, or ~308 million per year. In the USA, there have been more than 520 million doses of COVID vaccines given since the vaccines were approved, or ~480 million per year.

You may argue about the wisdom of vaccinating so many so quickly, but the fact remains that 55% more COVID vaccines are being given annually than ALL other vaccines combined. That is going to skew report numbers higher.

This skewing to a higher number of adverse events is also more likely when we consider who is getting vaccinated. Most of our vaccines (apart from annual flu shots or boosters) are given in childhood. COVID vaccines have had greater uptake in the elderly and middle aged. Compared to children, these people are much more likely to NATURALLY suffer from serious health problems, including death.

Why is this important? Because the VAERS and TGA both track adverse events AFTER vaccination, not caused by. These reports are investigated to determine causality, but it can’t be assumed immediately.

As an analogy, if I followed a million people who ate toast for breakfast and 10 people died from heart attacks in a month, should I conclude toast caused heart attacks? Or should I look more closely at the data to determine what is happening? The same holds for vaccines.

Now, for an article where I’ve tried to be data-heavy, you may notice this section is quite light on hard facts and is mostly speculative explanations. So let’s try to explore some of this data looking at the most serious adverse event — death.

Sample study — VAERS deaths

In the USA there were reported 10 688 deaths after 496 million doses of vaccine, a rate of 0.0022% of people receiving at least one dose (at time of writing data only updated to 20/12/21). To reiterate, the “FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS, even if it’s unclear whether the vaccine was the cause”, so we can be fairly confident that this is not a dramatic undercounting.

Already, the death rate is nearly 10 times lower than that of the LEAST susceptible people infected with COVID (younger women), further strengthening the argument that vaccines are safer than the alternative.

However, even this calculation is assuming that every single death is directly caused by the vaccine, but that may not be the case. To account for the ‘natural’ death rate, we can compare to earlier statistics.

For example, in 2019 there were 715.2 deaths per 100 000 people in the US population, or approximately 1.96 deaths per 100 000 people per day. Based on these numbers, we’d expect that of the 247 million people receiving COVID vaccines (at time of writing) we would see approximately 4841 deaths per day just by chance.

I don’t have access to the timing of every single one of those COVID deaths, but this means that if every single death occurred within 3 days of vaccination, we’d consider those numbers statistically “normal”.

Most studies reporting on adverse events in vaccines use at least a 21-day window, a far greater span of time and clearly indicating that the vaccines aren’t associated with a greater risk of death compared to the “normal” population.

You see the same pattern if you do the calculations based upon the TGA reported deaths in Australia from vaccines compared to all-cause mortality in 2019. The raw data of deaths can be confronting, but the numbers are not abnormally high compared to the general population and in no way indicate that COVID vaccines are causing death.

In fact, people receiving COVID vaccines were less likely to die from non-COVID causes than those who didn’t. This doesn’t mean that the vaccines protected against non-COVID disease (the data wasn’t corrected for other factors that might contribute), but there is no evidence of a non-COVID uptick in deaths among the vaccinated.

What about long-term side effects?

Some people are concerned about long-term side effects. If the vaccines were only developed in 2020, we can’t possibly know what impact they will have in 10-15 years.

This is absolutely a true statement, and a concern that needs to be taken seriously. However, I would argue that the balance of risk weighs in favour of being vaccinated for several reasons:

• As stated above, all the evidence we currently have suggests the risks from COVID infection outweigh the risks from the vaccine for every serious side-effect. It is reasonable to suspect this is true for long-term side effects also.
• We’re gradually getting longer term data which appears to confirm that the greatest risk of adverse events is immediately after vaccine, not with extended long-term effects. The longest I’ve found published is 6 months, but others are ongoing and have seen no compelling reason to publish their results early (bearing in mind that many of these studies will be from researchers like myself who have no financial incentive to hide data if it was inconvenient).
• History suggests that few vaccines are removed from the market after approval, and the majority of these are because they are replaced with better products or eradication of the disease, not because of safety. A review of 57 vaccines over a 20 year period found only one was removed for safety reasons, and this was done almost immediately (i.e. not for long-term effects.
• More generally, in a study of 72 countries, only 133 drugs were withdrawn for safety concerns in the 20 year period from 1990 to 2010. This is hardly a common occurrence and one that suggests the balance would suggest long-term side effects are unlikely, particularly as long-term side effects from vaccination appear to be even rarer than from conventional medications. To the best of my knowledge, no vaccines have ever been withdrawn due to long-term safety concerns that are only discovered years later.

What about antibody-dependent enhancement?

The concept of antibody-dependent enhancement (ADE) is that the antibodies produced by the body can facilitate either easier entry to the cells (more infection) or excessive immune responses (more severe disease). This was a legitimate concern when developing the vaccines, but I don’t think it should be a major concern for us now.

If ADE was occurring currently, it should be evident in a disproportionate number of vaccinated people in hospital. As I outlined earlier, there is no evidence that these vaccines are causing increased risk of infection, or more severe disease. In fact, we see the opposite – the vaccinated are less likely to be infected and develop less severe disease.

People may be concerned about developing ADE against future variants. I don’t believe this should preclude us from getting the vaccine though, as this is seeking to minimize a hypothetical, possible risk in the future at the expense of minimising a real, present risk.

Furthermore, ADE can be observed in COVID-19 patients even if they aren’t vaccinated, so avoiding a vaccine does not eliminate this risk entirely. You’ll still be exposed to a similar risk of ADE in the future with this hypothetical new variant, so why not protect yourself from the current variant anyway?

Again, I would weigh the balance of evidence to say that taking a COVID vaccine is the safer option.

Do the vaccines cause an increase in variants?

The rationale for this concern is that the vaccines lead to a highly specific immune response against the infection. A vaccinated person quickly eliminates the “original” strain the vaccine was developed to target, but it allows new variants to escape.

Over time, this would lead to the more dangerous variant becoming dominant. While this reasoning may seem logical, it rests upon some assumptions that are not consistent with what we’re observing.

For a start, it assumes that the new variants are equally likely to arise in both vaccinated and unvaccinated populations. However, new variants appear due to mutations occurring during viral replication. More replication, more mutations, more likelihood of a new variant.

As I outlined above, vaccinated individuals are less likely to transmit the virus and have less internal viral replication as they clear the virus quicker. This is why highly vaccinated populations have FEWER, not more mutations.

Second, this assumes that natural immunity will be more effective at neutralising new variants than vaccine-induced immunity. However, the existing variants of concern for immune evasion (beta, omicron) are capable of evading both natural- and vaccine-induced immunity. This suggests that there is little, if any, gain to avoiding the vaccines for the sake of inducing a broader immune response.

Indeed, there is increasing evidence that the most versatile immune response is obtained through either mixing vaccines or through hybrid immunity (previous infection + vaccination), as we develop a capacity to respond to multiple different stimuli.

Finally, I need to re-iterate the point – avoiding vaccines to protect against variants is creating a greater current risk in the hopes of avoiding a future hypothetical risk.

We have the capacity to protect ourselves and others against the current variants. It seems reckless to refuse that protection for the sake of avoiding a variant that MIGHT appear later.

Reaching herd immunity through infection alone will lead to a greater number of deaths, hospitalisations and long-term consequences than doing so through vaccination because the vaccines reduce the risk of all of those compared to catching COVID.

Summary — are vaccines safe?

Overall, with the current state of our knowledge, I would draw the following conclusions about the currently approved vaccines:

• The risk of serious side effects in the short term is very, very low.
• The risk of long-term side effects (including antibody-dependent enhancement) is also low, though it will still be some time before we can say that definitively.
• Vaccination is highly unlikely to cause any increase in the development of new variants or more severe disease.
• For any serious side-effect of the vaccine (real or potential), the risk is much, much greater for infection.

Therefore, I conclude that the vaccines should be considered safe and the prudent decision, in most cases, would be to get vaccinated.

Part 3: Should we treat vaccination as a command from Christ?

The science of vaccines is not actually my main purpose in writing this article. My concern is much more about what scripture says and how this should inform our interactions as believers.

However, it is helpful to have some understanding of what vaccines do since their impacts will relate to how we understand them in the light of scripture. Summarising the science as briefly as possible, I conclude that the vaccines are effective and safe, but not perfect in either regard.

Some readers may disagree about exactly how safe and how effective, or whether the risks outweigh the rewards, but I hope this wording is broad (and accurate) enough that we can all approach this next section with at least some degree of agreement.

Commands and conscience

Vaccines are not mentioned in scripture directly, but we can still draw one of three possible conclusions (as we do for many other issues):

• Based upon the general principles and commands of God, we MUST get vaccinated
• Based upon the general principles and commands of God, we MUST NOT get vaccinated
• Vaccination is neither commanded nor forbidden. This does not mean it is never right/wrong to be vaccinated, or there is never a better/worse decision. Rather, it is an issue of an individual’s wisdom and/or conscience to determine based upon the general biblical principles and commands of God.

I’m going to make the argument for point (3) –  that, based upon scripture, the church should treat vaccination as an issue of conscience (1 Cor 8:1-13; 1 Cor 10:14-33; Rom 14:1-23).

Essentially, this would mean that vaccines are a good thing that is both permissible and beneficial. If your conscience permits you, you should take them. However, if your conscience does not permit, you do not sin by not taking the vaccine (and in fact, if your conscience condemns you, don’t take it).

In either case, that decision MUST be based on our understanding God’s commandments, principles, and Spirit-led direction for our life. Whether we take it or not, our motivation should not be primarily dictated by other motivations (social acceptance, fear, compulsion, etc).

Finally, though we may disagree with each other’s decision, as Christians we should seek to love and accommodate one another without creating unnecessary division.

Reasons to get vaccinated

Given what the science shows us about vaccines, I think there are good and godly reasons why Christians should be vaccinated, if their conscience permits. I don’t mean that you MUST be vaccinated, but rather that this should be our default position in the absence of a compelling issue of conscience.

For example, caring for our own physical health is important, exemplified in the command that we “Love the Lord your God with all your…strength”, and general principles such as “our bodies are temples of the Holy Spirit” and that we should be good stewards of what God has given us.

Additionally, we are also commanded to “Love your neighbour as yourself” and, biblically, we know that “[love] always protects”. Paul also sets an example that he wanted to avoid being a burden to others.

I would humbly suggest that reducing transmission, reducing the length of our infectious period, and reducing our chances of taking up hospital resources is ONE WAY we can fulfill these commandments.

If the balance of evidence suggests that the vaccines are likely to protect me from harm, I would consider it prudent, wise and good for Christians to participate.

So, doesn’t that mean scripture commands us to get vaccinated?

I wanted to emphasise that vaccination is ONE way to honour God with our bodies and love our neighbour. I do not believe it is THE way to do these things. If it were THE way, then we would be right to say we are commanded to be vaccinated.

Furthermore, if being vaccinated were commanded, then even the real, but rare, risks of serious side effects would not absolve us of our responsibility. Our commands from Christ are to be willing to lay down our lives for our friends, and that love “bears all things”. We do not neglect His commands for the sake for physical health or comfort, so we could not disobey out of concerns for safety.

However, before we start poking at the specks in the eyes of our unvaccinated brothers and sisters, we should consider our own logs.

For example, let us make a VERY rough spectrum of what we can do to reduce our chances of catching/transmitting COVID, at one end we say

• “do nothing”

and at the other end of the spectrum, we say:

• “Have 3 doses of a vaccine (mixing varieties). Wear an N95 mask, surgical mask, face shield, AND surgical gown at all times (changing regularly). Wash hands every 15 minutes and disinfect every surface/object you go near. Never, ever leave the house except in the gravest emergency. Never have anyone enter your house. Never engage in any social interaction or any unnecessary activity around people.

In between those two would be different levels of protection, depending how much detail you want to break things down into. My question is – what biblical reason would we have to draw the line for what is/isn’t a sin?

More specifically, if you advocate that being vaccinated is a commandment imperative for Christians, what other ‘risky’ behaviours are acceptable? Wherever you draw the line, why is THIS standard exactly the right amount to not be sinful, but any less is?

Are we sinning by taking Astra Zeneca, which has a more rapid waning of protection? If people previously infected or vaccinated must get boosted to develop more robust and/or sustained immunity, does that not apply to the type of vaccine also?

Even though it is not currently approved in Australia, should a doctor in Australia be mixing different types of vaccines to give better protection? After all, we should disobey civil authorities if it means obedience to God?

If I rushed to take my vaccine early in 2021, was that sinful because my protection had waned by the time we had a major outbreak? Conversely, if I go to get a booster shot am I failing to love my neighbour, since there’s a real concern that wealthy countries seeking booster shots are reducing first dose access to developing nations.

If I am vaccinated but go to a concert or a wedding, I am a greater risk to those around me than an unvaccinated person staying at home. Why is the former acceptable but the latter not? Surely your “right” to go enjoy music or celebrate a marriage is not more important than my health?

If I wear a surgical mask, am I more sinful than someone wearing an N95 but less sinful than someone wearing a cloth mask? What if I choose to dine indoors at a restaurant instead of outdoors? If I order food delivered, am I sinful for creating a risk of infection for the person who delivers to me?

Those speaking loudly or singing are more likely to spread viral particles, so are we sinning when we sing? If so, how does that square with our command to sing to God with gratitude in our hearts?

What about non-COVID examples? Certain contraceptives can reduce immune responses to viral infection. Are women who take these sinning by increasing their risk of transmission?

Do we need to repent for all those times that we left the house when we had a runny nose, knowingly exposing other people to our germs (even if they are less threatening than COVID)?

Is it sinful for a believer to not be an organ donor since this is beneficial to others and comes at no cost to the person? Air pollution accounts for ~3000 deaths annually in Australia and there are over 1000 deaths from traffic accidents — do you sin whenever you drive your car by increasing risk to others?

Cooking with gas can increase the risk of developing or exacerbating asthma, and poor diet is the leading contributor to early death globally. Did I sin by cooking bacon and eggs for my family on a gas stove?

If the argument is that the risk of COVID is greater than these examples, what is the exact cut-off for when “risk” becomes “sin”? Do we have a rationale for that?

If the argument is that doing all of this is too difficult to uphold, that can’t be justified based upon the same verses that would suggest we can’t avoid godly commands simply based on issues of practicality or risk to ourselves.

If we argue that the inconvenience of these measures outweighs their benefit, we’re saying our convenience trumps the safety of others based only on our subjective idea of what is “enough”.

If there is a clear biblical reason to draw a distinction between these examples and vaccination, then I cannot find it. If our standard is that it is not just unwise but wrong to be unvaccinated, then we need to either accept that we are just as wicked, repent and change our behaviour, or else we need some explanation for why our behaviour is not sinful.

Are you suggesting that we all need to start doing these things?

To be clear — I think there are reasonable objections to these points and examples. As I said, I believe vaccination is an issue of conscience and of wisdom, and I would include these examples in that same category.

The point of my examples was to prompt us to consider whether there is a biblical justification to elevate vaccines to a higher moral level, and whether we have a right to pass judgement based on someone else’s decision.

Most of us would consider that even though the examples I cited above may increase risk to others, a prudent use of godly resources may, at times, creates risks without being inherently sinful.

Being a good steward means using our resources well, and that may include sacrificing some beneficial actions for the sake of a higher purpose. Rather than being sinful, such risks are a consequence of living in a fallen world. Could we extend the same grace to those who choose not to be vaccinated?

If these examples (and vaccines) are all examples of practicing godly wisdom in obedience, and are a matter of conscience, then we need not condemn those who decide differently and instead choose to bear with one another in love.

Are there any similar examples in scripture of activities that risk the safety of others?

As a word of caution — we do need to be careful drawing conclusions from the comparisons I made above, based exclusively on our own feelings about what is and isn’t “too extreme”. Our standard must be based upon what God reveals in scripture, not what we interpret as being acceptable.

Fortunately, there are references which I believe support my position:

• At the Council of Jerusalem, the apostles resolved that they would not burden the Gentiles with the Jewish law. This included measures of quarantine against the sick, and unlike other commandments, these are not reiterated in the New Testament. (though most of us would acknowledge that these are wise and good measures to have in place for managing disease).
• In fact, Jesus regularly violated these restrictions to demonstrate that His Kingdom had power over life and death, and He did so without sinning (though we need to acknowledge the special circumstances of His role as Messiah and the miraculous healing that accompanied it).
• Jesus failed to wash before some meals, which can increase the risk of infections. To be clear, the criticisms levelled against Jesus were concerns about his failure to follow man-made traditions and not hygiene, so we should not over-interpret this. However, He could have washed Himself anyway and still addressed their hypocrisy, and therefore the unhygienic act was not sinful.
• Jesus delayed his healings of Jairus’ daughter and Lazarus. While this did not cause physical harm, it was a deliberate choice that led to emotional “harm” for those who loved these people.
• Ezra appears to unilaterally (or at least, only with a small group of leaders) decide that the people returning to Jerusalem do not need a protective escort, thereby exposing them to greater danger on their journey.
• Both King Amaziah and Gideon were instructed by God to reduce the size of their armies which, by all human reckoning, put their remaining men at greater risk.

I’m not claiming that these examples suggest we should not get vaccinated, or that they are widely applicable to every situation. Often they were specific instructions from God under the direction of the Holy Spirit, but given to specific people, at specific times, for a specific purpose. I also acknowledge that they aren’t direct comparisons to vaccines.

Rather, I suggest that these examples indicate that in SOME circumstances people can be obedient to God while doing things that are irrational and seemingly put others at risk. Such circumstances are not binding on all believers but are rather an example of a Spirit-led obedience even when the decision appears unwise.

Therefore, I argue that those who choose not to be vaccinated are not necessarily sinful and we should be very, VERY careful to mark someone else’s decision as sinful for fear of creating an unnecessary burden for other believers.

Reasons why Christians may not get vaccinated

Just because it is an issue of conscience does not mean that all decisions on the matter are acceptable —  we can still be motivated by sinful intent. Nor does it mean that we MUST neglect prudent decisions meant to keep ourselves and others safe.

Rather, it should mean that our reasons for not following prudent caution (such as I would argue in the case of vaccines) should be more than just ‘I don’t want to”. Whatever we choose, acting with wisdom should be founded on acting in faith, with a good conscience, and directed towards our ultimate purpose of glorifying God.

I can’t speak to what may lead a specific individual to avoid vaccination, but it will be helpful to outline some of the possible reasons why a faithful Christian may reject vaccination below. I’ll also explain why these issues don’t particularly prick my conscience, since it’s helpful for people to understand my perspective.

I’ve already stated that I believe the prudent decision in most cases would be to consider the vaccines safe, and it is wise to make our decisions based on this evidence.

However, for individuals, this may not be the case. It is important that we not minimise the severe side effects when they occur. For a very small proportion of individuals, the consequences of choosing to take the vaccine have been severe and they may have fared better to take their chances without it.

Both wisdom and discernment are listed as gifts of the Spirit, and there are several examples in scripture where the logical, prudent choice was not the same choice that God desired for that specific individual.

Paul going to Jerusalem, being kept from some ministries before going to Macedonia, refusing to escape prison and appealing to Caesar were not logical, but they were right. Sending singers ahead of the army was not logical for Jehoshaphat, but it was correct.

So even as the vaccines are safe in general, we should also leave room that godly discernment may lead some believers to the conclusion that it is not safe FOR THEM. Otherwise, we’re effectively asking them to take a risk for themselves to protect us against a potential risk if they catch COVID.

In fact, I would argue that our acceptance of recommendations for vaccine safety suggests we all implicitly acknowledge this in some capacity.

For example, Australia’s own guidelines for exemptions acknowledge that, at least temporarily, the risks to an individual may outweigh the need to be vaccinated in the interest of public safety.

Few of us would consider someone sinful for applying for such an exemption, but if that is the case is there a precise level of risk at which it becomes “sinful”? How should we define that risk?

When AstraZeneca was the only vaccine available in Australia we did not consider it sinful for those with a history of blood clots to not be vaccinated. Even though the vaccines were still safer than infection and had all the benefits of “loving your neighbour”, we acknowledged that these individuals could weigh their own risks.

Or take the case of some countries that have restricted access to certain vaccines in certain demographics. Several European countries paused the rollout of Moderna vaccines in young people but permitted Pfizer due to concerns over myocarditis, even though the risk of Moderna is only marginally greater than that of Pfizer and both remain low in terms of absolute risk.

It seems strange to suggest that avoiding one vaccine is justified but avoiding the other is completely irrational, especially when the pause included women who have a lower risk of myocarditis than men. I know that if one vaccine is dangerous then alternatives are available, and my point is not to suggest these pauses were either right or wrong.

Rather, if we are willing to grant people an exception in certain circumstances based on a certain level of risk then vaccination CANNOT be a command of God. If we can grant godly discretion to those with one level of risk, should we not also be willing to grant godly discretion to others, even when we disagree?

Concerns about use of fetal cell lines

The specifics of this issue are often muddled. No vaccine contains “parts of aborted fetuses”, and no vaccine requires aborted foetuses to be produced.

Rather, as part of either their production or testing, some vaccines use cell lines such as HEK293. Cells were taken from an aborted fetus and were isolated, modified, and then grown in a lab. Such cell lines are considered “immortalised”, meaning that they will grow continuously and do not require additional sources to replace them. All the cells used today have been grown in a lab from that one original fetus in 1973.

We don’t know the reason why this abortion happened, but this wasn’t a woman who got pregnant just so she could donate her unborn child to science. The decision to get an abortion was unrelated to the donation of the tissues.

Now, how should Christians react to this news, particularly if we are pro-life on the issue of abortion? Suggesting that we should avoid vaccines because they rely on tissues once obtained from an abortion certainly has some scriptural support.

We don’t participate in evil that good may come, and we should have nothing to do with fruitless deeds of darkness. We should not have fellowship with darkness or have anything in common with wickedness, and in some way, we may feel that our participation in using these vaccines would be doing so.

On the other hand, examples of Esther, Daniel, Ezra, and Nehemiah, to name a few, demonstrate that God’s people can use resources from ungodly men, often obtained in ungodly ways, to accomplish godly purpose.

This was not a matter of sinning to do the work of God, but rather about not letting the sins of others halt the work of God who “works all things for the good of those who love Him”. Christians can, with wisdom, discern ways to honour God in the midst of evil without endorsing it. However, this may not be true in all cases and sometimes our conscience may prevent us from doing so.

I believe we, as Christians, should abhor abortion and actively oppose it (while loving mothers who feel this is their only option). However, I would not consider the use of these cells in this vaccine to be an endorsement of abortion or “participating in evil”. Since the abortion has already happened, we are not contributing to further sin by using these vaccines.

Therefore, I conclude this is an issue of conscience. Much like meat sacrificed to idols, as believers we can use vaccines as a gift of God, acknowledging that the initial abortion was a case of man intending it for harm and God using it for good. Yet if your conscience is not clear and you feel uncomfortable, do not participate and do not feel judged for doing so.

Some may, quite sensibly, object that many medications use foetal cells in their testing and development, so holding such a standard would exclude all of those. I have two replies:

• In issues of conscience, we are told that we need not ask questions for fear of going against our conscience in ignorance. Ignorance is not an excuse for disobeying God’s commands but since issues of conscience are not commanded, we do not sin by acting without knowing. The issue is not “can we find a way to conflict with my conscience”, but rather “how does my conscience convict me in this action based on what I know.” So we don’t go searching for a list of medications to find out which ones can/can’t be taken, but we do need to make sure our conscience is clear for the ones we do know.
• There is value in distinguishing between new developments and established medications. That is, my use/disuse of a medication will have little impact for something developed many years ago, with established use and for which there are few comparable medications. For COVID vaccines, the companies producing these could choose which cell lines were used and established their new vaccine in any format they wished. My choice to use, for example, the Novavax vaccine which does not use foetal cell lines has the capacity to send a message to companies that “I do not endorse this form of research, and if there is an alternative, I will use that”. It is a VERY small stance but one that may help to dissuade from other uses of foetal tissues which are more urgent for the current pro-life movement.

Now as someone who is staunchly pro-life, I wrestled with the consideration of whether to get vaccinated or wait for Novavax to be approved. I decided my conscience was clear when I compared abortion/fetal tissue donation to murder/organ donation.

If someone was murdered, I would not hesitate to accept either an organ donation for transplant or medical research. It does not mean the cause of their death was moral or sinless, and accepting that some good has come out of their death doesn’t mean I participated in that sin.

Similarly, the abortion of the fetus was going to happen regardless of whether it was used for research. That does not necessarily make the abortion sinless (though we do not know the mother’s reason for seeking it) or condone the choice, but it means that my decision did not cost that child its life.

If a new abortion was required each time the vaccines were developed or produced, I would not take them since that would be, to me, participating in evil. But my conscience is clear when I consider that this one child has been able to bless billions of people through decades of medical research in spite of, not because of, their horrific early death.

Therefore, when the COVID outbreak occurred in Australia I decided that the benefit of protecting myself and others by taking the AstraZeneca vaccine as soon as possible was greater than the benefit of “sending a message” by waiting for Novavax. This reasoning may not reassure you, but it is possible for both of us to be honouring God in our wisdom and conscience.

Concerns about methods and government

Submission to governmental authorities is an important part of the Christian walk, but at the same time, there are limits to the authority and the roles of government.

For example, Jesus draws a distinction between what is God’s and what is Caesar’s. Authorities are meant to ensure that we have an ability to live peaceful and quiet lives in all godliness and holiness, by punishing those who do wrong and commending those who do right.

Daniel, his friends, and Peter and John all confirm that resisting ungodly government is both acceptable and right. Even though his own obedience was not conditioned upon it, Paul spoke up to appeal against a punishment from one civil authority since it violated a higher civil law.

Nor is this principle only limited to what is done by governments, but also how it is done and with what motive.

None of these examples directly relate to vaccines and we need to be cautious about drawing direct parallels from historical models of government to our own, especially Old Testament theocracies.

However, it is clear biblically that:

• There are limits placed upon government authority.
• God is concerned with what, how and why something is done (including by governments).
• Believers are authorised (and sometimes commanded) to oppose governmental authorities who are doing wrong.
• Submission to authority does not mean we cannot criticise where it is wrong, or that we are not permitted to appeal against what we consider an unjust ruling through appropriate channels.

Now I’m going to be cautious about approaching our own government authorities in Australia. I believe some things they have done are good, and some are bad. Some may have been good with bad motives or bad with good motives.

Regardless, there are elements of governmental response to COVID that can indicate areas of concern, at the very least based upon the message they send and how that might shape future interactions.

For example, I would argue that governments should preserve our freedoms, but some of the language during COVID has talked about freedoms being granted by governments and given as a reward. The latter suggests that our freedoms don’t exist without government and government can take them away for whatever reason they deem worthy.

As NSW was removing most restrictions there were suggestions that not requiring masks was at odds with recommending masks. I would argue that the idea that what is good and recommended must be mandated by government is not an appropriate scope of government.

Finally, the suggestion that things like in-person schooling and corporate worship of the church are “non-essential” can have significant impact on decisions about these in the future.

These ideas did not begin with COVID, and they won’t go away once COVID is over. I’ll also freely acknowledge that a lot of these concerns could probably be resolved (or at least lessened) by better messaging from the government. In many cases, we’ve been just as guilty of the poor messaging on these issues ourselves.

If you don’t find these examples concerning, perhaps consider some others that might use a similar logic. Some speculate population control may be required to tackle climate change in the future – would we accept a limit on the number of children permitted for the sake of the public good?

More immediately, Victoria legislation that (as admitted by government lawyers) will make it illegal to pray for a same-sex attracted person to help them refrain from living out their desires, even with their permission. This holds implications for the church.

Or what about government surveillance and violations of privacy under arguments of protecting public safety? Might they concern us?

I’m not saying that that we’re facing imminent threat from these examples. I don’t think government sanctioned evil is breathing down our necks unless we’re all marching in the street today.

I do not think that these concerns I have are a ‘line in the sand’ that must be held, lest Australia fall into a tyranny tomorrow. I don’t think COVID vaccines are going to be the make tyrants out of otherwise good politicians.

My argument is that COVID has brought concerns about the proper scope of government to the national attention in a particular way. These concerns are always present, but right now there are a lot more people thinking about them than usual.

IF there are parties that have evil intent in Australian politics, then part of their planning will include “how much can I get away with before people push back”? In such a case, might universal acceptance of COVID restrictions and mandates without question suggest it might be more than we think?

Is there ANY politician from the Greens, or Labour, or Liberals, or One Nation, or any other party that you might look at complete, unconditional compliance on issues of COVID and think that it might justify their own policies that some consider a violation of rights?

As one American commentator expressed:

“Everything you go along with for “public safety” when you’re comfortable with their definition empowers and emboldens them to take action when the definition of “public safety” drifts to something you aren’t comfortable with.”

This does not mean we MUST resist vaccination because of government overreach (if you believe there is some). I’m saying there are government actions which people may have reasonable concerns about, some people may be more perceptive about the implications of these than others.

If we believe that it is prudent, wise and loving to be vaccinated then we should have a VERY compelling reason to suggest that resisting vaccination should be our recourse against such overreach.

This is especially true considering that it is possible to be vaccinated and still speak against inappropriate actions from the government through other methods. Protests, legal challenges, contacting or supporting politicians, choosing to spend money at “pro-freedom” businesses – all of these are ways that we could object to specific issues without changing our stance on vaccination.

However, it is possible that you are unsettled and the only reason you would get vaccinated is because of government coercion that you believe is inappropriate. In that circumstance you MAY feel compelled to take a firmer stand against this imposition and avoid vaccination.

I suggest that this falls under the issue of conscience, and in some ways can be considered an act of love. Even if the danger is not physical illness, for many people their stance is still motivated by a desire to protect others.

I acknowledge that my perception of what is inappropriate (not just regarding COVID) may be wrong and others who see no danger are right. I am also conscious of the fact that I may be too complacent, and I should be listening to those who see a graver danger than I do. Some of you will think I am fearmongering, and some will think I’m underreacting. Probably at least one of you is right, which is why I would suggest that we extend grace to one another.

A Word of Caution – Issues of Conscience are not all equal

I want to make very clear that issues of conscience do not mean “do whatever you feel like”, but rather “do whatever God lays on your heart”.

Getting the vaccine or resisting vaccination because your “political tribe” has done that is not responding to conscience. It is allowing someone other than God to dictate your actions. It may not always be sinful, but it is not being obedient.

Additionally, the passages on conscience (1 Cor 8:1-13; 1 Cor 10:14-33; Rom 14:1-23) don’t just refer to two opinions, they refer to “stronger” and “weaker” believers. This will be controversial, and please, please, PLEASE know that I say this without any judgement – I suggest that choosing to be vaccinated is more in line with the position of “stronger” believers in scripture.

I’m not saying this because it was my choice. I say this because the “stronger” believers, according to God through the writings of Paul, are those who can willingly enjoy those things which are not forbidden and use them to give glory and thanks to God. The “weaker” believers are those who abstain from those things to give glory and thanks to God.

Importantly, both are seeking God’s glory and we don’t pass judgement on either group. However, the wording suggests that as we mature in our faith we should become more comfortable with being part of the stronger group on issues of conscience.

With this in mind, I might humbly suggest that our default response as believers should be to get vaccinated as a wise, prudent decision and a way to love our neighbours. We should not be trying to come up with a reason to avoid vaccination or be seeking to drive our conscience in that direction. Rather, we should desire to be “stronger” and partake of these vaccines unless our conscience convicts us.

Summary — Are vaccines commanded, forbidden or a conscience issue?

Given the scriptures I have referenced above, I would suggest that the church treat vaccination as a conscience issue. I believe it is a good thing that can (and should) be joyfully participated in for the good of ourselves and our neighbours.

But if your conscience does not permit you to do so, you should not participate. You should not feel condemnation from yourself or from other believers.

This does not mean we cannot discuss the issue and attempt to persuade one another, or that we should not seek a deeper understanding and a maturing of our conscience. However, it does mean that we do not let it divide us and destroy unity in the church.

Part 4: Considerations and applications for the church

If vaccination is a conscience issue, then how should we respond and interact as individuals and the church?

Be grounded in truth.

Truth and honesty are essential components of our faith. Meaningless speculations are not helpful unless we have evidence. That means looking for accurate information and interpretations, not just those that confirm our opinions.

It means acknowledging the limitations of our knowledge, admitting the flaws in our reasoning, and taking seriously the concerns of others. Whether you support or oppose vaccines, make sure you do so with truth. If we make an error, admit it and correct your opinion if needed.

It also means being honest about our reasons. If you feel like you’re being led through discernment, have no fear saying so. You don’t need to justify it by appealing to obscure (or incorrect) data points that are far from conclusive. If you are willing to be vaccinated but have concerns about the government response, you should be willing to say so even if it doesn’t “fit the picture”. In both instances, your honesty creates opportunities for fellowship with believers or witness to non-believers.

Speak the truth. Vaccines may be an issue of conscience, but spreading falsehood is not. Whichever way you choose, it is still possible to be walking in sin — not because of your choice but because of deceit. Winning an argument is not more important than honouring God with integrity and truth.

Be careful in our accusations

The bible is full of examples of Christians who initially disagreed seeking clarification before rebuke. Where someone does wrong, especially an authority such as a church elder, we should be certain before we pass judgement and we should seek to resolve the issue with a few people before we make a big deal publicly.

Unsubstantiated accusations against one another are not helpful. Unless I can justify it from scripture, accusing others of “ignoring the Holy Spirit” or “being a sheep” is not helpful. I can’t accuse them of being “ignorant” or “corrupt” or “lying” unless I have evidence that is the case.

It is possible to be wrong without lying. It is possible to be cautious without being fearful. It is possible to agree with the government without being a government shill. It’s possible to disagree with the government without being a far-right terrorist.

It is possible to be willingly vaccinated and not want government overreach. It’s possible to be unvaccinated and still care about the health of others.

It’s not helpful to accuse the unvaccinated of being selfish if they have sincere concerns about safety. It’s not helpful to accuse the vaccinated of pitting “science” against “God”, since listening to science is not the opposite of listening to God.

This doesn’t mean we can’t point out where there may be problems with someone’s position, or that there aren’t some people with bad intentions in the debate. But we should consider the implications of our words and extend grace to those who disagree with us as much as possible.

Treat one another with respect and love.

The way we should approach matters of conscience is to say “if what I [do] causes my brother or sister to fall into sin, I will never [do it] again, so that I will not cause them to fall”.

Furthermore, “The one who [gets vaccinated] must not treat with contempt the one who does not, and the one who does not [get vaccinated] must not judge the one who does, for God has accepted them”.

It’s not just about tolerating one another’s opinion. We’re told to “Love one another with brotherly affection. Outdo one another in showing honour”.

So ask how you can love your unvaccinated friend maximally? How can you love your vaccinated friend maximally? How can you outdo them in your genuine care and compassion for their concerns, not just your own?

We are grounded in our love of Christ, not separated by our vaccine status and we should be far more concerned about our own conduct than others. If both the vaccinated and unvaccinated are acting according to good conscience we can love one another without judgement and with genuine affection.

Don’t be driven by fear

We are told we should not have a spirit of fear or timidity. Our lives are to be marked by the peace of God, not anxiety since we can cast our anxieties on Him.

Now neither prudence nor discernment leading us to make our decision are the same as fear, and I’m not saying that concern about danger makes your decision wrong. But we’re explicitly told not to worry, meaning it is wrong for us to be driven by fear whether that fear drives us to impose vaccines on the hesitant or to avoid vaccines.

I would not dare to accuse another of their motives in making their decision, and I reiterate that I’m not trying to conflate prudence or discernment with fear. Rather, I would urge honest reflection on what is driving our decision, to see if we are motivated more by fear or by obedience.

Consider what your actions reflect.

Our call, as Christians, is to be Christ’s witnesses, to be salt of the earth and light of the world, and to make disciples. Physical protection or political victories are good things, but they are not our primary goal as the church.

So before you make your decision, consider whether your resistance to vaccines will create a stumbling stone for a non-believer who doesn’t understand your reasons, but only sees you risking their safety and failing to love your neighbour.

Consider how they might perceive your act as an unloving lack of care for their physical health, even as that’s not your intent. Consider that they may see you as unwise, or anti-science, or negligent and uncaring and that perception may impact their view on the whole church. Whether they are right or not is irrelevant if there is now an additional barrier to their salvation.

In the same way, before you treat unvaccinated people with disrespect or hesitate to meet with them, consider that your ambivalence to their concerns, social life and freedoms may also be a stumbling stone to like-minded unbelievers. Consider that your complaints may be seen as unloving scorn, and perhaps suggest to unbelievers that the church is as cruel and vindictive as we are accused of being.

Consider that if you demand that they be vaccinated you may be creating an unnecessary burden that God has not commanded. Consider that, even if your choice is a good thing, making that demand of others for your own safety may be sending a message that Christians fear death rather than that we are “not afraid of those that can kill the body”.

This is not to say that you let others dictate what your conscience tells you to do – we obey God, not men. It doesn’t mean that we change our opinions just based on what we think other people want, or what their opinion of us is.

And I’m certainly not saying that either position can’t be used for God. Unvaccinated people have an opportunity to witness by explaining the role of the Spirit in discernment. Vaccinated people have an opportunity to explain why their love for God and others leads them to meet every Sunday with unvaccinated people that the world fears. Both have an opportunity to proclaim that they care for others but do not fear their physical death because of the promised eternal salvation.

We are called to look not to our own interests, but to the interests of others, and consider that everything is permissible, but not everything is beneficial. Our goal is ALWAYS the proclamation of the good news of Jesus Christ — that He died for our sins and was resurrected to bring us new life so that we need not fear death.

For all our decisions, including our approach to vaccinations, we should consider how we may become all things to all men so that we may win some.

Conclusion

Vaccines are an issue of conscience for the church. Based on the science and biblical principles, I encourage all believers to joyfully receive the vaccines if their conscience permits. If it does not, then do not get vaccinated and I will still welcome you with open arms.

This is an opportunity for the church.  In the middle of the pandemic we, vaccinated and unvaccinated, are willingly giving up our rights, safety, concerns, and hesitancies to love one another.

We are giving up our fear and bending over backwards to make each other feel heard, valued, and respected. We are doing everything we can to be united and worship our God together, regardless of what other differences we have.

And then we are taking that attitude out into the world to love the people of our community.

What a witness that can be.

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Appendix 1: Omicron

I’ve been working on this article for a long time, and the arrival of the latest omicron variant occurred just as I was finishing. The data on this is still in the early stages and I don’t think it would be valuable to try to re-write half the article to address it with the preliminary data we have.

With that said, it’s likely to be a burning question for some readers. So for those who feel I’ve earned their trust enough to be interested in how I would interpret the early data:

• The omicron variant is more infective than earlier variants but seems to be less severe. While this is good at an individual level, from a public health perspective this still has a lot of potential to cause excess burden and overwhelm the healthcare system.
• The omicron variant is very good at evading existing immunity to cause infection. This appears true for both vaccines and prior infection, though hybrid immunity (infection + vaccine) is more robust.
• Boosters also appear to improve protection but would likely have more benefit from modified vaccines that specifically target this variant.
• There is still good protection against severe disease from vaccines (and likely natural immunity also). This is good evidence that transmission is likely still reduced, but not eliminated completely.
• COVID therapies are also generally still effective, though some will likely be impacted.

I can’t stress enough that this is VERY speculative and could well turn out to be completely wrong. As time goes by data on this will become clearer, so definitely take those interpretations with a grain of salt. As it stands though, I don’t think this substantially changes the conclusions of the article.

Appendix 2: Natural immunity

I don’t discuss natural immunity too much in the article, because it’s not particularly relevant to the questions I’m trying to answer.

To explain, natural immunity is real and is perhaps even more effective than being vaccinated. However, there is significant variability in how well people develop it and the process of acquiring natural immunity requires catching the virus, which is the very thing that we are trying to avoid.

Most importantly, hybrid immunity, developed by being vaccinated either before or after infection, leads to even better immunity so there is still a benefit to being vaccinated regardless.

Therefore, whether a person has/doesn’t have natural immunity may well factor into their personal decision to be vaccinated and should inform a government’s assessment of how much “immunity” is in the population.

However, it doesn’t answer the question of whether vaccines work, are safe, are biblically commanded, or how it affects our response as Christians. Regardless of if we have natural immunity, we’re still faced with the same conscience issue.

Appendix 3: Why do the vaccines wane more against infection than against severe disease?

A very simplistic view of the immune system in the lungs, in the order it is encountered by the invading virus, looks something like this:

1. Initial barrier – Made up of the mucus layer and cilia that prevent penetration and remove foreign objects, as well as the epithelial cells that forms a physical barrier. Most of this barrier is non-specific (i.e. just prevents anything getting in) although the mucus layer does contain antibodies that may target specific viruses.
2. Innate immune system – an extra level of non-specific protection. Cells like macrophages and neutrophils just target anything “foreign” and can also produce different molecules that improve general “defence”.
3. Adaptive immune system – Once the innate immune system detects a virus it activates the adaptive immune system, including B cells and T cells. B cells produce antibodies that both improve the initial barrier (step 1), innate immune effectiveness (step 2), and target the virus directly. T cells also ramp up responses from the innate immune system (2) and can target virus-infected cells directly.
4. Memory cells developed – once the threat is eliminated the innate and adaptive immune system returns to “standby mode” since our body tends not to waste too much energy and excessive immune responses are harmful. However, a subset of cells is kept as memory cells that can rapidly ramp up the adaptive immune system next time the virus is encountered.

How does this relate to waning immunity? Well, a person becomes ‘infected’ if the virus overcomes the initial barrier (1). At this point, it enters our cells and begins replicating. With more replication, damage occurs through either virus-induced cell death or excessive immune responses.

So to stop infection, we need to have a really strong initial barrier (1), but to prevent severe disease, we just need to prevent too much replication of the virus. Therefore, if we have good innate (2) and adaptive (3) responses we can prevent severe disease.

The process of both infection (natural immunity) and vaccination takes us through all 4 stages of that immune response to leave us with some good antibodies in our mucus layer (preventing infection) and memory cells that are ready to respond next time we encounter the virus.

Over time, we gradually lose those antibodies preventing infection since we shut down the adaptive response after the infection was over. This makes us more susceptible to infection.

However, we still have those memory cells, so the lag between the virus overcoming the initial barrier (1) and our body activating adaptive immunity (3) is a much, much shorter window. So, there is less virus replicating, it does not penetrate as deep into our tissues, and we clear it much faster, which prevents severe disease.

Long story short — our body can only devote so much energy to keeping a virus out, but we can much more readily prepare to get rid of it once it gets here and the vaccines help with that.

This also explains why we see less of a waning effect for vaccines against other pathogens. Bacteria, since they don’t replicate inside epithelial cells, need to establish a niche near the surface of the initial barrier or even break down the barrier to cause a sustained infection. This means, our body has more time to activate that adaptive immune response before we end up with an infection.

A similar principle applies to viruses affecting internal organs, such as hepatitis, which have a greater length of time between the first encounter with the immune system and the establishment of infection. In contrast, the influenza vaccine, which also targets a respiratory virus, wanes at roughly similar rates to the COVID vaccine.

Author’s note: I’ve used COVID to describe both the disease and the virus for simpler reading. Technically, SARS-CoV-2 is the virus and COVID-19 is the disease caused by it.

Thank you to Mitchell Skipsey for your invaluable input.

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