More Catholic bishops weighed in Wednesday on the morality of coronavirus vaccines, offering at times conflicting guidance to the nation’s 50 million Catholics. Some have urged them to take any available vaccine, while others said they should avoid the newly approved Johnson & Johnson shot because it was made using abortion-derived cells. One bishop said the vaccine was “morally compromised and forbidden.”

The Vatican first sought to counsel Catholics about the coronavirus vaccines in December, when its Congregation for the Doctrine of the Faith declared it “morally acceptable” to take ones that relied on cell lines from aborted fetuses in their research and production “when ethically irreproachable Covid-19 vaccines are not available.”

Pope Francis has since taken the Pfizer vaccine, and last month the governor of Vatican City said employees who don’t take a vaccine could be sanctioned or fired.

In assessing the morality of the vaccines, Catholic teaching considers factors including how extensive and direct are any connections to an abortion, the urgency of the pandemic and the potential to improve the common good.

When testing whether their vaccines work, both Pfizer and Moderna used fetal cell lines derived from fetal tissue taken from elective abortions in the 1970s and 1980s, according to James Lawler, an infectious-disease specialist at Nebraska Medicine. They did not use the lines during the development or production phases, so they are not inside the injection, Lawler said. In creating its vaccine, Johnson & Johnson used cells that are descended from tissue taken from a 1985 elective abortion.

That distinction was enough to prompt the Archdiocese of New Orleans on Friday to single out the Johnson & Johnson vaccine, saying it is “morally compromised as it uses the abortion-derived cell line in development and production of the vaccine as well as the testing.” However, the archdiocese’s statement said, the decision to receive a vaccine is “one of individual conscience in consultation with one’s healthcare provider … we advise that if the Moderna or Pfizer vaccine is available, Catholics should choose to receive either of those vaccines rather than” the Johnson & Johnson one.

Over the weekend, the Food and Drug Administration authorized the Johnson & Johnson shot for emergency use. Then, on Tuesday, the U.S. Conference of Catholic Bishops — which represents hundreds of active and retired bishops — also said Catholics should avoid taking the Johnson & Johnson coronavirus vaccine if possible and choose alternatives from Pfizer or Moderna.

That was followed by much more unequivocal guidance from the Diocese of Bismarck, N.D., which issued an unsigned statement that said the Johnson & Johnson vaccine “is morally compromised and therefore unacceptable for any Catholic physician or health care worker to dispense and for any Catholic to receive due to its direct connection to the intrinsically evil act of abortion.”

On Wednesday, San Diego Bishop Robert McElroy wrote that the world is complicated and Catholic moral teaching is complex and nuanced. However, “on the concrete moral and pastoral question of receiving” the three FDA-approved coronavirus vaccines, “I want to make clear to the Catholic communities of San Diego and Imperial Counties that in the current pandemic moment, with limited vaccine options available to achieve healing for our nation and our world, it is entirely morally legitimate to receive any of these four vaccines, and to recognize, as Pope Francis has noted, that in receiving them we are truly showing love for our neighbor and our God.”

The conflicting statements about issues of life, death and morality come as Americans in many parts of the country are already trying to navigate a confusing and frustrating process for procuring a shot.

As some houses of worship host vaccination centers, some worry that the range of advice from Catholic officials could affect distribution efforts and drive people away from the single-dose vaccine just as health officials are urging Americans to take whichever doses are available.

“If you go to a place and you have J&J, and that’s the one that’s available now, I would take it,” Anthony S. Fauci, the nation’s top infectious-disease expert, said on NBC’s “Meet the Press.” “I think people need to get vaccinated as quickly and as expeditiously as possible.”

Johnson & Johnson's coronavirus vaccine was distributed from a Louisville shipping center on Mar. 1, two days after the FDA authorized it for emergency use. (The Washington Post)

The competing statements from Catholic officials mark the latest iteration of a long-standing debate in the church over accepting vaccines and treatments that are in any way connected to the use of fetal tissue.

In 2005, under Pope Benedict, the Pontifical Academy for Life conducted a study that concluded vaccines created using the cell lines derived from abortions are morally permissible, the National Catholic Register reported that year. Vaccines for chickenpox, hepatitis, polio, rabies, rubella, measles and mumps all used such lines. Drug companies and researchers should denounce as evil the abortions that made possible the fetal cell lines and try to find alternative ways, but doctors and patients who use the vaccines, when no alternative is available, “carry out a form of very remote ... cooperation, and thus very mild” in “the original act of abortion,” according to the Pontifical Academy for Life.

The Vatican’s December statement offered lengthy debate about what it sees as moral issues at play. It emphasized that the normal Catholic mandate not to participate with “passive” cooperation in abortion is not obligatory considering the spread of the virus is “grave.” It also framed getting vaccinated as a moral cause, though it must be voluntary, the Congregation wrote.

The U.S. bishops’ statement Tuesday said: “Given the world-wide suffering that this pandemic is causing, we affirm again that being vaccinated can be an act of charity that serves the common good.”

Fetal tissue from abortions has been essential to scientific research for decades. Researchers have used it to help find treatments for a wide range of illnesses, including Ebola and cancer. It has also been crucial for studying the immune system.

The treatment President Donald Trump received when he contracted the coronavirus was tested using fetal cells. Trump endorsed its use, despite suspending federal funding for similar scientific research in 2019.

The Johnson & Johnson vaccine offers a strategic advantage to a vaccine rollout as demand continues to outweigh supply. Not only does the one-shot dose allow for quicker and more widespread inoculations, but it can also be stored in a regular refrigerator for months.