What Can Islamic Ethics Say About Our Vaccine Distribution Plan?
By Adam Beddawi, MPAC Policy Analyst
Last week, the Department of Defense (DOD) unveiled their vaccine distribution plan. It will be implemented through funding allotments in the relief bill which recently passed through the Congress. The most pertinent details in the plan regard who will receive the vaccine and through which entities can the DOD most effectively receive and administer the vaccine. This piece will explore an under-discussed aspect of the vaccine distribution which is no less important for the American Muslim population: the compatibility of the COVID-19 vaccine distribution plan and Islamic ethics.
The most pertinent details in this consideration regard public trust as well as the extent to which current distribution protocols comport with Islamic notions of harm prevention and social responsibility.
The first point was already a source of contention prior to the COVID-19 epidemic. Last year, the World Health Organization (WHO) identified “vaccine hesitancy” as a leading threat to global health, citing low vaccination rates in countries where confusions persisted over whether vaccines were acceptable under Islamic law. At issue is the inclusion of gelatin as an ingredient in many vaccines. Similar concerns persist in affluent U.S. suburbs, though to a lesser extent. In response to these confusions, some drug companies began producing halal vaccines, while other contingents of Islamic scholars persuaded their constituents to consider the Islamic principle of “transformation,” which would permit a forbidden product in the case where it is fundamentally changed, in this case from pork to gelatin. For what it is worth, spokespeople for Pfizer, Moderna and AstraZeneca have confirmed their vaccines do not contain pork products.
However, these vaccines have already been allotted to countries with preexisting deals with the development companies and supranational organizations presiding over distribution. This brings us to the more complicated consideration of the United States’ vaccine distribution plan, titled Operation Warp Speed (OWS), which appears as follows.
OWS comprises a partnership between private firms and federal agencies such as the Department of Health and Human Services (HHS) — including the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Biomedical Advanced Research and Development Authority (BARDA) — and the Department of Defense (DoD).
OWS is a distribution plan which operationalizes the decisions made by the Advisory Committee on Immunization Practices (ACIP), a 15-member body chosen by HHS Secretary Alex Azar. Secretary Azar recently became the subject of an investigation opened up by House Majority Whip James Clyburn (D-SC), who is the Chairman of the House Select Subcommittee on the Coronavirus Crisis. Rep. Clyburn is concerned that Azar suppressed CDC reports on the coronavirus in an effort to achieve “herd immunity”.
The ACIP members, however, are a group of respected professionals and field experts who have recommended the following distribution schedule:
- Phase 1a — recipients include health care personnel and long-term care facility residents
- Phase 1b — recipients include persons aged ≥75 years and non–health care frontline essential workers
- Phase 1c — recipients include persons aged 65–74 years, persons aged 16–64 years with high-risk medical conditions, and essential workers not included in Phase 1b.
- Phase 2 — recipients include all other persons aged ≥16 years not already recommended for vaccination in Phases 1a, 1b, or 1c.
They have already sketched out a set of ethical principles to guide distribution in the event that vaccine supply is limited. Those principles include: maximize benefits (“promote public health) and minimize harms (“death and severe illness”); mitigate health inequities (“reduce health disparities in the burden of COVID-19 disease and death”); promote justice (“remove unfair, unjust, and avoidable barriers to COVID-19 vaccination”); promote transparency (“allow and seek public participation in the creation and review of the decision processes”).
Similarly, the Islamic ethical tradition abides by a focus on and appraisal of actions believed to be “good”, those which God obligates Muslims, and those which lead to Paradise. However, the practical application of these foundational commitments is far from a settled matter among Muslims. This is due to the the present-day decentralization of Islamic religious authority as well as Islam’s long-standing promotion of ethical pluralism. Even still, a budding literature on Islamic bioethics outlines several insights that may be of use for medical ethicists and the American population more broadly, whom the OWS explicitly identifies as participants in “the creation and review of the decision processes.” Imam al-Ghazali sketched out the Islamic consideration of actions in the specific public interest (maṣlaḥah) as a combination of those which accrue benefit and avoid harm. More specifically, they are those actions that conform to the preservation of religion, life, the intellect, lineage, and property, as well as anything which safeguards and guarantees those five principles or removes harms and corruptions of those principles.
As a general principle in the shari’ah, Muslims living as minorities in any country are bound by the law of the land in which they live. No consideration of Islamic ethics supersedes the American political and juridical coda. However, as part of the broader fabric of American pluralism, Islam can check the actions and decisions of the OWS with respect to the higher objectives or aims of Islamic law (maqāṣid), in order to “determine the overall correctness and value of the decision,” or look to Islamic legal principles (qawāʿid) and controls (ḍawābiṭ) as “instruments to guide one’s precision and accuracy in reaching a conclusion.” The general methodology by which Islamic jurists determine the rightness or wrongness of an action (uṣūl al-fiqh), include tactics like differentiation (furūq), preponderization (tarjīḥ), and the consideration of public interest (maṣlaḥah).
Practical application of these methodologies need not justify a revolutionary practice. In fact, even the reformist trajectory of Islamic ethico-juridical thought focuses on “betterment and purification” of society. The idea being that no man can ultimately ascertain divine law, but that collective and focused deliberation over vaccine distribution can ultimately better and purify society.
To this point, the early success of the distribution plan does not account for several key indicators of societal well-being. For one, there is no mention of the connection between vaccine hesitancy and the persistent inequities which exist between and among many Americans. Importantly, vaccine skepticism between Black and African-Americans is intimately connected with the history of American iniquity and exploitation. The DOD has no plan to convince Americans to trust the vaccine, though there is a decentralized effort to swing “willing skeptics” or to publicly vaccinate public servants. On this point, the Islamic ethical tradition can constructively intervene on the vaccine distribution plan in order to reaffirm the public trust that has eroded over the course of this long and difficult year. This may ultimately mean the platforming of a diverse array of Americans who can explain how their choice to take the vaccine (or not) is grounded in their belief system. Such deliberation is central to the redevelopment of a public square which has dissipated over the course of the lockdown.
A more important question to consider is whether the vaccine distribution plan advances the preservation of life universally. If so, then the plan can be a valid devotional law under the Islamic ethical consideration. More importantly, for the purposes of an American audience: the deepening inequality in this country caused by the pandemic necessitates a plan that ensures the universal preservation of life. A diverse array of voices goes a long way toward the betterment and purification of society, but so too would the reallocation of resources back toward those hundreds of thousands of small businesses who closed over the course of lockdown or those whose families were split apart or irrevocably altered during the pandemic.