How to talk about vaccines with someone who is Muslim, when you aren’t Muslim
The Basics
Islam professes beliefs articulated in its Holy Book, the Qur'ān (i.e., Koran), and through the teachings and example of the Prophet Muhammad (570-632 CE). Muhammad, the last messenger of Allāh (the God, in Arabic), descends from Abraham (Ibrahim) through his son Ishmael.
Note: This content is intended to provide basic religious context to support pharmacist-patient conversations. Religious beliefs are often complex and nuanced. Space does not allow an exhaustive consideration here. Read on to learn more, to enable you to have respectful conversations or ask respectful questions. Encourage patients to discuss personal religious concerns in greater depth than you can with their faith leaders.
Support for Vaccination Within Islam
Islam espouses a principle of preventing harm (izalat al dharar yuzaal) and a principle of serving public interest (maslahat al-ummah or al-masalih al-mursala), each of which favor vaccination against serious diseases. The Qur'ān uses the concept of wiqaya in multiple situations to refer to taking preventive action (e.g., against hell fire, punishment, greed, bad acts, harm, heat). Scholars conclude that prevention is one of the laws of Allāh, with obvious application to preventive medicine.
The Qur'ān and tradition forbid consumption of several animals outright (e.g., “the flesh of swine”), while other animals are permitted (halal) or forbidden (haram) based on conditions of how they died or were slaughtered. Gelatin made from porcine products is forbidden as food. Gelatin made from other halal animals (e.g., cattle, fish) is acceptable as food. Another guiding principle comes from the prophetic statement of Muhammad: “God has not made things that are unlawful for you to consume to be your medicine.”
Regarding COVID-19 vaccines, none contain components of porcine origin. Saudi Arabia required COVID-19 vaccination for pilgrims seeking to attend the Hajj to Mecca in 2021 (the year 1442 per the Hijri calendar).
Scholars have called polio vaccination obligatory (wajib) due to the seriousness of the disease and because the benefits of vaccination far outweigh its risks. Muslims are interested in issues of vaccine safety because vaccination should not lead to side effects of the same magnitude as the disease. When an action (such as vaccination) could harm a small number of people while also benefiting a far greater number of others, one must compare harm and benefit. In such cases, the good lies in accepting the small harm to obtain a greater benefit.
One can have complete trust in Allāh (tawakkul) while also accepting vaccination. The Islamic principle is to have active reliance on Allāh, rather than passively accepting one’s fate in a helpless manner. Prevention (wiqayat) does not involve claiming to know the future or the unseen (ghaib) nor trying to reverse destiny (qadar). One can anticipate risk of future infection for which preventive measures can be taken. Muhammed is quoted as saying, “Tie your camel and then trust in Allāh,” meaning to make reasonable efforts to achieve what is in your interests.
Muslims may express concern over vaccines manufactured using cell lines (e.g., MRC5, WI38) with remote links to specific fetuses aborted several decades ago. This is the situation with adenovirus-vector COVID-19 vaccines (e.g., from Janssen, no longer distributed in the United States) that use HEK293 or PER.C6 cell lines. Messenger RNA in vaccines produced by Pfizer-BioNTech and Moderna are chemically synthesized, not grown in cell culture, but their developers used assays at early stages of vaccine formulation to confirm protein configurations, an even more remote involvement with cell lines of fetal origin.
Critically, these abortions were not conducted for the purpose of harvesting the cells that were transformed into these cell lines. This lack of intention is key in breaking a complicity link that could otherwise make vaccination unacceptable. No additional abortions are needed to sustain vaccine manufacture. The cell lines are not the final product, and no human cells are present in the final vaccine formulations.
Maybe Your Religious Patient’s Vaccine Concerns Don’t Really Involve Religion
As you interact with people who express concerns about vaccination, listen to the words they use. Are they expressing a concern along religious or theological lines? Or are they commenting about safety or matters related to clinical trials or the approval process?
You may wish to ask questions or offer comments related to how contagious diseases spread, how vaccines are tested, or the components used in vaccines. People who decline vaccination may benefit from encouragement not to act as a vector enabling COVID-19 viruses to spread to others. Each unvaccinated person adds to the vulnerability of a household or group.
Additional details and primary literature are cited in: Grabenstein JD. What the world’s religions teach, applied to vaccines and immune globulins. Vaccine. 2013;31(16):2011-2023. doi:10.1016/j.vaccine.2013.02.026
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