As we live through the tragic consequences of the Covid-19 pandemic, it is useful to reflect on the current vaccination process and, in particular, the innovative contribution of Pope Francis’ teaching and action. Michael Rozier, a Jesuit professor of health management and policy, has reflected on the importance of commitment to health care and identified three significant areas: traditional health care practice; public health; and global health. We will follow this tripartite approach here.
Traditional health care practice
Throughout Christian history, beginning with Jesus, accompanying the sick and caring for them has been an integral part of the personal and ecclesial life of faith. Individual believers, confraternities, congregations, and countless women and men religious have made their mark in Christian history with their generosity in the service of those who are sick and in need of help. On every continent and in different ways Christianity has permitted and encouraged the development of hospices, hospitals and clinics, that is to say, of structures and institutions that serve the practice of health care. In this way, over the centuries, the relationship between healthcare professionals (doctors, nurses, technicians and administrators) and citizens has characterized and guided Christian involvement in promoting health.
However, when we look at other areas of health, it is more difficult to identify and recognize examples of how we have been involved in promoting other essential and no less important aspects of health promotion, including prevention, hygiene and public health at local, regional and state level, as well as global health. Promoting each of these additional aspects brings significant benefits to individual and collective health.
Preventing the onset of disease benefits the well-being of individuals, families and society as a whole. This is done, for example, with vaccinations and regular health checks (from mammograms to weight checks, from growth checks in children and adolescents to checks on blood sugar, lipid levels and blood pressure monitoring).
Promoting public health improves the quality of life in working environments by requiring compliance with regulations that protect workers’ conditions, as well as in educational settings and society as a whole. For example, thanks to regulations aimed at protecting public health, travelers can count on airbags in cars, seatbelts and, in the case of motorcyclists, protective helmets, all of which reduce the consequences of injuries in the event of accidents. The regular verification of the quality and freshness of food sold and consumed, the purification and ionization of water, the control of fine suspended particles and the quality of the air we breathe, the standards required in the case of vehicle emissions, the ban on smoking in public places and campaigns to limit smoking, the supervision of chemicals used in industry, agriculture and the home are some examples that show how important the protection and promotion of public health is and how it has positive repercussions on traditional health practice, to the benefit of citizens, health professionals and institutions (hospitals and clinics). One can therefore ask whether the Catholic tradition has become sufficiently involved in promoting public health and, if the answer is uncertain or negative, what needs to be done to ensure further involvement.
Recognizing the importance of public health and working to promote it have positive implications for individuals, for the health system and for society as a whole. Reflecting on health implies considering injustices, inequalities, leading to striving for greater social justice through concrete forms of solidarity, as the Church’s social doctrine teaches and reminds us.
Along with traditional health and public health, global health is the third approach to expand and complete our commitment. The Covid-19 pandemic shows how vulnerable humanity is and how much needs to be done to protect citizens. Global health depends on a combination of social and political factors that affect the quality of life of individuals and communities. In other words, how we live, how we build our cities, how we educate ourselves and work, how we cultivate the land and prepare food, how we monitor the outbreak of infectious diseases, how we deal with the non-infectious diseases that continue to spread around the world (e.g., the multiple types of cancer), how we reduce and strive to eliminate hunger and thirst in the world, and how we protect the most vulnerable from the devastating consequences of climate change on the planet. All of these point to both the urgency and complexity of efforts to promote global health. Health is a fragile, finite and shared good. Caring for one’s own health and for the health of others – of my neighbor and also of those living in other countries and continents, as well as for the health of the entire planet with its trees, rivers, mountains, oceans and atmosphere – is an urgent necessity that requires generous commitments at the systemic and structural level.
Health practice, public health and global health: there is no conflict between these three approaches; each aims to secure the good health of individuals, nations, humanity and the planet. With his prophetic voice and his focused and humble actions, Pope Francis is showing how it is possible to be at the service of the health of people, populations, all humanity and the planet.
Pope Francis and vaccinations against Covid-19
From the very beginning of the pandemic, the pope recognized the need for integrated and global responses to deal with what humanity was experiencing. In multiple instances in national and international ecclesial and political settings, he has called for recognition of the global dimension of the pandemic and, faithful to the biblical, Gospel-based Catholic magisterial experience, has called for special care for the poorest, those with fewer social, political, financial and health resources. Francis has reaffirmed and supported the generous and heroic commitment of so many healthcare professionals at the service of their patients in the many medical facilities across various continents. At the same time, he has been attentive to what concerns the health of populations and the complexity of improving global health.
The pope asked that research for a vaccine be supported and facilitated in order to obtain effective vaccines while controlling the spread of the infection with the necessary public health measures (hygiene, protective masks, social distancing, quarantine for infected persons, targeted reduction of free movement and of the various social activities: educational, work and recreational). In addition to demanding availability and access for all to the necessary diagnostic tests, Francis has not ceased to demand that vaccines, after the necessary scientific verification of their efficacy and safety, be made available to all, everywhere, without patent constraints and, once again, with a preferential option for the poorest and neediest.
To promote vaccination globally, thus showing his commitment to promoting the health of all humanity, the pope appeals to the characteristic element of the Christian life: love. For Francis, “being vaccinated, with vaccines authorized by the competent authorities, is an act of love. And contributing to ensure the majority of people are vaccinated is an act of love, love for oneself, love for family and friends, love for all peoples. […] Vaccination is a simple but profound way of promoting the common good and caring for one another, especially the most vulnerable.” 
Love is always inclusive and all-embracing, as the Gospel commandment reminds us. Vaccination is an act of love for oneself and for others, especially for the benefit of the weakest, whose health is more fragile because of pre-existing diseases or conditions or because of age or occupation. Furthermore, every act of love depends on the love of God, given freely, forever and unconditionally, to everyone everywhere. Finally, every act of love makes us capable of loving, of living out God’s love here and now, in our daily life in its ordinariness. From the beginning of his pontificate, Francis has continually exhorted us to live our reality as disciples, enlightened, inspired, nourished and strengthened by God’s love, which we experience in multiple ways in Jesus, in the Church and in the world, thanks to the Spirit and his countless gifts.
In doing so, the pope encouraged and inspired scientists, health workers, leaders, national and international organizations, and people of good will around the world who are urging people to get vaccinated and working to make vaccination possible everywhere. Global vaccination is proceeding at different rates: in the global North at a faster pace, and in the South at a slower pace. The causes of this difference are multiple and include the availability of vaccines, distribution strategies, the presence and efficiency of health structures, information processes, involving local communities, as well as the authorities who need to responsibly put themselves at the service of citizens, ecclesial communities and the various religious denominations present in the territory.
Addressing the issue of global vaccination, the Holy Father has called for this procedural outreach to be respectful and to take place in the context of the growth of a local health culture: “Knowledge must be shared, expertise must be shared, science must be pooled. Science, I say, not just the products of science which, if offered on their own, remain band-aids that can dress the wound but not cure it in depth. This applies to vaccines, for example. There is an urgent need to help countries that have fewer of them, but this must be done with far-sighted plans, not just motivated by the haste of wealthy nations to become safer. Remedies must be distributed with dignity, not as alms on a pitiful scale. To truly do good, we need to promote science and its integral implementation: understanding the contexts, identifying treatment, nurturing the healthcare culture.”
Undoubtedly, trust in scientific research and medical practices in general, and vaccination in particular, has and continues to play an important role, affecting individuals and communities. Anyone who has suffered as a result of scientific research projects or health practices – for example, in the case of ethnic, racial, cultural, religious and linguistic minorities – will rightly be alert to and critically examine what is being proposed, including the case of Covid-19 vaccination. However, in ways that continue to surprise, and even scandalize, there is now worldwide resistance, even aggressive and violent resistance, to the vaccines now available and to the possibility of being vaccinated, and thus protecting oneself against the infection caused by Covid-19 or, if one contracts the infection, of having reduced symptoms.
The repeated interventions by the pope as well as by authoritative ecclesial, social, cultural, political and scientific voices do not seem to be able to promote a completely positive reception of available vaccines, as well as to invite a critical reflection on the positions taken. Too often, disinformation campaigns and false information seduce us into thinking that we are experiencing a global conspiracy, that Covid does not exist, that vaccines introduce computer chips into our bodies. Families in which some members are vaccinated and others have no intention of vaccinating are not uncommon, with individuals citing various reasons, creating divisions and separations and making dialogue and critical reflection difficult. In these situations, health and what can protect it seem to have become a personal, subjective and individual good, which is threatened by what aims to promote global health. It seems that individuals worry about their own health – and only about their own – autonomously and independently, as if their health did not depend on the health of others and of the entire planet.
In addition, the search for truth, for prudent and wise decisions, together with self-critical reflection and careful examination of information sources no longer seem in many cases to be shared values. Regretfully, it is observed that those who try to live these values are attacked verbally on social media and even physically. Finally, in many cases health is politicized. Thus protecting and promoting the health of individuals, of populations, and of the most vulnerable, indeed humanity as a whole is reduced to a partisan choice, informed by party strategies, confusing health choices with approaches proposed by ideologically motivated parties or pressure groups.
Global health as a common good
In the ecclesial sphere, calling for the production and availability of vaccines capable of stimulating the immune defenses of citizens in order to achieve worldwide immunity does not imply superficiality or lack of attention to consider and deal with possible ethical problems associated with the production of vaccines. With clarity and competence, the Congregation for the Doctrine of the Faith has repeatedly reaffirmed the theological-moral approach previously developed with regard to the production and administration of vaccines. In particular, it has helped to reflect on the ways in which some vaccines had been tested in laboratories, with the intention of reassuring the scrupulous, the doubters and the skeptics in the Catholic Church and in wider society. Unfortunately, on a global level, this has not been enough.
In the present social, cultural, political and ecclesial context, it is necessary to reflect on how global health can be promoted by re-establishing a serious, respectful, informed and civil dialogue. Obviously, authentic dialogue implies generous, shared and benevolent listening, enabling us to seek the truth together in a rigorous and demanding way, verifying what we consider to be our own truth. The Gospel, by reminding us that truth is a person – Jesus Christ – makes us understand that no one can control or possess it. For the Gospel, the only access to truth is relational, interacting with Jesus, living a dynamic of encounter, discovery and conversion in our incarnate reality.
The social doctrine of the Church affirms the importance of dialogue and, through it, fostering the commitment of every person of good will to achieve the common good in inclusive ways and with a preference for the weakest, the frailest, the poorest and the most vulnerable. Moreover, for Francis, “underlying the principle of the common good is respect for the human person as such, endowed with basic and inalienable rights ordered to his or her integral development. It has also to do with the overall welfare of society and the development of a variety of intermediate groups, applying the principle of subsidiarity. […] Finally, the common good calls for social peace, the stability and security provided by a certain order which cannot be achieved without particular concern for distributive justice; whenever this is violated, violence always ensues. Society as a whole, and the state in particular, are obliged to defend and promote the common good” (LS 157).
Global health is an emblematic example of the “universal common good,” for humanity and for the planet. Following the example of the pope and his “concern for integral human development” (FT 276), many seek to remain in an attitude which welcomes and listens to those who do not recognize the vaccines against Covid-19 as a means – limited, like any means – to protect and promote health together as a common good of humanity. One hopes that it is possible to seek together and promote what serves the good of all.
Science in the service of global health
During the Covid-19 pandemic, Pope Francis’ commitment to the service of global health also prompts reflection on how to evaluate the role of science, pointing out when and how it can be at the service of the common good. In this regard, in the recent magisterium we note another circumstance in which a pontiff reflected on scientific progress in the service of humanity and global health and considered it an act of love. On August 29, 2000, Pope John Paul II, addressing the participants at the 18th International Congress of the Transplantation Society, affirmed that “every organ transplant has its source in a decision of great ethical value: ‘the decision to offer without reward a part of one’s own body for the health and well-being of another person.’ Here precisely lies the nobility of the gesture, a gesture which is a genuine act of love. It is not just a matter of giving away something that belongs to us but of giving something of ourselves.”
Moreover, in the same speech, John Paul II showed how a prudent reception of specific contributions of science is possible in situations where they are not in accord with an anthropological vision that manifests respect for human dignity. In considering the evaluation offered by neurology concerning the “complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and the brain stem). This is then considered the sign that the individual organism has lost its integrative capacity.” John Paul II specifies that “with regard to the parameters used today for ascertaining death – whether the ‘encephalic’ signs or the more traditional cardio-respiratory signs – the Church does not make technical decisions. She limits herself to the Gospel duty of comparing the data offered by medical science with the Christian understanding of the person, bringing out the similarities and the possible conflicts capable of endangering respect for human dignity. Here it can be said that the criterion adopted in more recent times for ascertaining the fact of death, namely, the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology.”
We can add that in the current pandemic, in the light of the global social situation, as well as on anthropological criteria, Pope Francis manifests a welcoming and constructive approach to science, making use of the richness of the Church’s social doctrine. Thus he shows that the contribution of scientific research in the field of health – which has made it possible to develop safe, effective vaccines with minimal and identifiable undesirable effects, tested clinically in an extensive and rigorous way – can be at the service of health as a common and global good. In this way the pope articulates a moral perspective that, in addition to being anthropological, is also social, at the service of the common good of all humanity. Thus, both anthropological criteria and those inspired by Catholic social morality indicate fruitful and ethically significant ways of discerning and acting in the service of humanity, both in the case of healthcare practice and in the sphere of public and global health.
DOI: La Civiltà Cattolica, En. Ed. Vol. 5, no.12 art. 8, 1221: 10.32009/22072446.1121.8
. See M. Rozier, “Religion and Public Health: Moral Tradition as Both Problem and Solution”, in Journal of Religion and Health 56 (2017/3) 1052-1063; Id., “When Populations Become the Patient”, in Health Progress 98 (2017/1) 5-8; Id., “Collective Action on Determinants of Health: A Catholic Contribution”, in Health Progress 100 (2019/5) 5-8; Id, “A Catholic Contribution to Global Public Health”, in Annals of Global Health 86 (2020/1) 1-5; Id., “Global Public Health and Catholic Insights: Collaboration on Enduring Challenges”, in P. J. Landrigan – A. Vicini (eds), Ethical Challenges in Global Public Health: Climate Change, Pollution, and the Health of the Poor, Eugene, OR, Wipf & Stock, 2021, 63-74.
. Cf. M. Rozier, “A Catholic Contribution to Global Public Health”, op. cit.
. A specific example can help us. In the United States, one of Boston’s hospitals, the Boston Medical Center with its 514 beds, is a “safety-net” hospital, whose mission is to provide health care to people regardless of their insurance status or ability to pay. Thus this healthcare facility serves all citizens, especially those most in need. In reflecting on the services offered to patients, the health care staff realized that most of the costs incurred by the hospital were for emergency medical services. In particular, homeless individuals and families repeatedly used the emergency department for necessary treatment. It turned out that lack of stable housing increases the risk of health problems and burdens the entire healthcare system. Through dedicated funding and local partnerships, Boston Medical Center has taken action to reduce housing instability and homelessness. In 2017, the hospital invested 6.5 million in housing, creating housing for individuals and families in need. In doing so, it promoted the well-being and health of a substantial number of individuals and families in need, making work and school engagement possible and reducing the number of emergency room visits of those citizens. See www.bmc.org/mission/social-determinants-health/housing-security
. “In the present condition of global society, where injustices abound and growing numbers of people are deprived of basic human rights and considered expendable, the principle of the common good immediately becomes, logically and inevitably, a summons to solidarity and a preferential option for the poorest of our brothers and sisters” (Francis, Laudato Si’ [LS], No. 158).
. For reflections on Pope Francis’ thinking about health care practice, see T. A. Salzman – M. G. Lawler, Pope Francis and the Transformation of Health Care Ethics, Washington, DC, Georgetown University Press, 2021; C. Kaveny, “Pope Francis and Catholic Healthcare Ethics”, in Theological Studies 80 (2019/1) 186-201.
. Cf. Francis, General Audience, August 19, 2020; Id., Address to the Members of the “Banco farmaceutico” Foundation, September 19, 2020; Id., Message to the Participants in the Plenary Assembly of the Pontifical Academy of Sciences, October 7, 2020; Id., Message for the 54th World Day of Peace 2021, No. 1; Id., Message “Urbi et Orbi”, Christmas 2020; Id., Address to the Members of the Diplomatic Corps Accredited to the Holy See, February 8, 2021; Id., Apostolic Journey to Iraq (March 5-8, 2021): Meeting with Authorities, Civil Society and the Diplomatic Corps, March 5, 2021; Id., Message “Urbi et Orbi,” Easter 2021; Id., Videomessage on the occasion of the 75th Session of the General Assembly of the United Nations, September 25, 2020. All these documents can be found at www.vatican.va.
. Id., Videomessage to the Peoples on the Covid-19 Vaccination Campaign, August 18, 2021.
. Cf. Matt 22:37-40.
 . Francis, Audience to the Members of the Biomedical University Foundation of the University Campus Bio-Medico of Rome, October 18, 2021.
. Cf. C. Fino, “Les vaccins: questions éthiques”, in Revue d’éthique et de théologie morale 311 (2021/3) 61-71.
. Cf. Congregation for the Doctrine of the Faith, Note on the Morality of the Use of Certain Covid-19 Vaccines (2020), at
https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20201221_nota-vaccini-anticovid_en.html /. Cf. also Vatican Covid-19 Commission – Pontifical Academy for Life, Vaccine for All: 20 Points for a More Just and Healthy World (2020), in
https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2020/12/29/0697/01628.html/; C. Casalone, “Vaccines: Making Responsible Decisions”, in Civ. Catt. En March 2021: https://www.laciviltacattolica.com/vaccines-making-responsible-decisions/ For earlier documents, see Congregation for the Doctrine of the Faith, Instruction “Dignitas Personae”: on Some Questions of Bioethics (2008), Nos. 34-35, at
https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html/; Pontifical Academy for Life, Note about the Use of Vaccines (2017), at https://www.academyforlife.va/content/pav/en/the-academy/activity-academy/note-vaccini.html
. Cf. John 14:6: “I am the way, the truth and the life.”
. “ It follows from this ever closer interdependence, which is gradually being extended to the whole world, that the common good – that is, the sum total of those conditions of social life which enable both groups and individual members to attain their own perfection more fully and more rapidly – is today increasingly becoming universal, involving rights and duties which concern the whole human race” (Gaudium et Spes, No. 26). See also D. Hollenbach, The Common Good and Christian Ethics, New York, Cambridge University Press, 2002.
. John XXIII, Mater et Magistra (1961), No. 57; Francis, Fratelli Tutti (FT) (2020), No. 260.
. Pope Francis reminds us that the climate is also a common good: cf. LS 23.
. John Paul II, Address to the 18th International Congress of the Transplantation Society (August 29, 2000), No. 3. Italics in the original. About the quotation, cf. Id., Address to Participants at a Congress on Organ Transplant (June 20, 1991), No. 3.
. Id., Address to the 18th International Congress of the Transplantation Society, op. cit., No. 5. Italics in the original.
. Ibid. Italics in the original.