I have been thinking about, writing about, speaking about and teaching about SARS-CoV2 and Covid19 before the virus was even named, the pandemic was declared or US government had called for a national emergency and shut down. I am a pediatric infectious diseases physician by training and a former researcher in a cellular and molecular biology laboratory. I have advised the board of my local mosque against a Umrah trip in March 2020 before the Saudi government shut down the lesser pilgrimage and advised for the closing of the mosque for the obligatory prayers due to my belief that prayer in congregation during this pandemic caused by a respiratory virus would be putting lives in harm’s way. I have used my social media accounts to educate my Muslim community and the community at large about the dangers of Covid19 and how to protect ourselves because I believe in the hadeeth of the Prophet Muhammad – peace be upon him – regarding the parable of the ship.
I spent the end of February pushing back on public health protocols to get my patients tested when the protocols only involved testing those with a travel history or an epidemiologic tie to a known infected person because having worked at the hospital where the second American patient was admitted with Covid19, I knew that the virus was already in the community. I took care of one of the first American pediatric patients with MIS-C (multisystem inflammatory syndrome in children) in early April before the entity was even named by the CDC in mid-May and then spent the next month teaching pediatricians about it. I spent most of November preparing a lecture on 13 vaccine candidates that were expected down the pipeline including Pfizer, Moderna, Johnson and Johnson and Astra Zenece, reading every study published on the topic.
On December 18, 2020, I was invited to be one of the first Americans to get vaccinated with the Pfizer vaccine. I prayed the istikharah prayer and moved forward. At that time, the US had been nearing the milestone of half a million dead from Covid19 and there were reports of 10% of infected patients becoming long-haulers. Long haulers are patients who were infected with Covid19 but continued to suffer from symptoms such as shortness of breath, brain fog, fatigue, dizziness and others many months after the acute infection. What was not known in December 2020 and continues to be unknown today is why SARS-CoV2 ravages the bodies of some young previously healthy people, not just the elderly, or obese or those with underlying cardiopulmonary issues.
I spent most of December and January 2021 educating people about the vaccines, reassuring and encouraging everyone around me to get vaccinated because as an infectious diseases expert, I believed and continue to believe that this is the only current, most effective way we emerge from this pandemic. And now as the CDC warns about the fourth wave of infections washing over the United States, I have become more emphatic than I have ever been about our actual obligation to get vaccinated. I am not talking about permissibility anymore; I am talking about obligation.
If there are no contraindications specified by your physician to get vaccinated, it is my belief that as Muslims, we are obligated to get vaccinated just as I believe it is our obligation to wear a mask, wash our hands frequently and practice social distancing during this pandemic. Our religion teaches us to rely on the opinion of experts. In the Qur’an, God – Exalted Be He – proclaims that we should “…ask the people endowed with knowledge…” if we do not know [16:43]. All the experts in this arena, scientists, infectious diseases physicians and epidemiologists, are saying the same thing: please get vaccinated and do it now. Anyone who is recommending waiting, taking our time in the vaccination process or shopping around for a vaccine clearly does not have a deep understanding of epidemiology, evolution or virology.
In an infectious diseases pandemic led by an RNA virus, time is of the essence. Achieving a high level of immunity across the human population is necessary to prevent or at least mitigate the chances of more lethal mutant variants emerging. That is why it is a race against time. As more people become immune, the virus “knows” it needs to evolve or it will become extinct.
Some have argued against the use of the Johnson and Johnson vaccine that has been recently approved in the US because it is cultured in a genetically modified retinal cell line obtained from an aborted fetus. The technology of producing vaccines using human cell lines from an aborted fetus is not new or isolated to the Johnson and Johnson Covid19 vaccine (nor the Astra Zeneca one which is also cultured in an aborted fetal cell line). In fact, this technology has been used in producing some MMR (measles, mumps, rubella), shingles and varicella vaccines. It is important to note, that these cell lines were isolated from an already aborted fetus and that the fetus was not aborted for the purpose of vaccine development. These cell lines were isolated decades ago and continue to be used today. The vaccine contents are purified from the cell culture material meaning that it is highly unlikely any human genetic material remains in the final vaccine product. That being said, Muslims know that in times of necessity, consuming even prohibited food becomes permissible. And in terms of the pandemic, the time of necessity was yesterday. We don’t have the luxury of time to wait until the opportunity to take a vaccine of our choice. If given the opportunity to get vaccinated, I urge all my co-religionists to take any of the three vaccines available in the US today, Pfirzer, Moderna or Johnson and Johnson, even if that opportunity comes in Ramadan because the vaccines are intra-muscular with no nutritional value to invalidate the fast.
In the beginning of the pandemic, as a participant of a Whatsapp chat consisting of Muslim women who attend my local mosque, I had made a comment about the need to adhere to the public health guidelines that were being put out and a woman who didn’t know who I was or what I did for a living told me to “chill out because we are all going to die at some point” to which I replied “I am not afraid to die as we know that every soul will experience death. But I am afraid to face Allah – subhanahu wa ta’ala – knowing that ignoring guidelines put out by my public health department made me contagious to a high-risk individual who ultimately contracted and died of Covid because of my actions.” And the same would be true if that were to happen because of my inaction.
Dr. Nour Akhras is an infectious disease specialist.