Ben Kasstan is a medical anthropologist based at the University of Bristol (UK) and Hebrew University of Jerusalem. His research explores the points where religion, health, and state meet, and he has a long-term interest in parental decisions surrounding vaccination. His recent monograph, Making Bodies Kosher, explores how religiously Orthodox Jews navigate health care in Britain.
With public (health) hope pinned on vaccination as a possible exit strategy from the coronavirus pandemic, much discussion has focused on issues of uptake among ethnic and religious minorities. Attempts to promote “faith” in the coronavirus vaccination program have circulated in British and global media. Salisbury Cathedral was repurposed as a pillar of the largest mass vaccination program in British history. An elderly Shoah survivor received his vaccine from a military officer, with the rolling of his sleeve revealing an Auschwitz number, accompanied by a quote: “and I will redeem you with an outstretched arm” (Exodus 6:6).
Vaccine advocates have been quick to assert that the vaccines have been endorsed by religious leaders, and they do not contain any pork—a reference for the benefit of Muslims and Jews. While I do not dispute these attempts to promote vaccination among ethnic and religious minorities, I question the implicit ways that religion is essentialized and generalized in public (health) debates surrounding vaccination. In what follows, I argue that the endorsement of vaccines by religious authorities does not really reflect the full and diverse reality of vaccine decision-making among ethnic and religious minorities.
What Do We Mean by Religious Beliefs and Opposition?
Since 2013, I have been exploring the vaccine decisions of religiously Orthodox Jewish parents in Britain and Jerusalem. Lower-level vaccination coverage among Jewish neighborhoods in London, New York, and Jerusalem has led to persistent outbreaks of measles. In 2018, cases of measles emerged in Orthodox Jewish neighborhoods in New York and were attributed to unvaccinated travelers arriving from Israel, which led to the United States and Israel experiencing the highest cases of measles in a quarter century. So, the current debates and dilemmas around the coronavirus vaccination among ethnic and religious minorities have deeper roots that need to be explored by academic researchers and public health bodies alike.
Vaccines are neither explicitly endorsed nor forbidden under Jewish law (halakha), but they are widely interpreted as permissible, if not mandated, as a way to fulfill the commandment of pikuach nefesh—meaning the preservation and protection of life. Chief Rabbi of the United Kingdom Ephraim Mirvis, who represents the Orthodox stream of Judaism, decreed that it was a “religious imperative” to accept the coronavirus vaccine. But is his position shared by religious devotees?
Chief Rabbi of the United Kingdom Ephraim Mirvis decreed that it was a 'religious imperative' to accept the coronavirus vaccine. But is his position shared by religious devotees?
In my research with Orthodox and Haredi Jews in Manchester and Jerusalem, I found that parents generally did not view vaccination as a “religious issue” that would require the intervention or advice of religious authorities. This was the case among parents who accepted vaccinations and among parents who felt that a rabbi would attempt to sway their decision towards vaccination—or if they perceived rabbis as uncritically accepting the information presented by health care professionals. To quote one parent, “even if a rabbi said ‘you have to vaccinate,’ we wouldn’t.”
Often parental concerns were rooted in claims of vaccine non-safety, risk, and trust in public health institutions. While Andrew Wakefield’s claims of causal links between the MMR vaccine and autism have long been refuted, I found that parents held lingering concerns. In the words of one parent, “Parents are cautious around vaccination, and aren’t up to date with recent research that shows the MMR is safe, well, supposed to be safe.” Such concerns are not specific to religiously Orthodox Jewish parents, but what is different is how concerns of safety become voiced as a religious prerogative and right to not vaccinate. In the words of one mother in Jerusalem, vaccines were “siqun hayim” (a danger to life).
Such concerns are not specific to religiously Orthodox Jewish parents, but what is different is how concerns of safety become voiced as a religious prerogative and right to not vaccinate.
The legacy of the MMR is crucial to consider in the coronavirus vaccination program, especially amidst controversial plans (in extraordinary circumstances) to allow "mixing and matching" vaccines—before any clinical trials have been completed to confirm efficacy or safety. If parents and people do not feel safety is considered to be the absolute priority by the government, then a dilemma of protection will arise (to vaccinate or not), which will compound the issues of mistrust among ethnic and religious minorities that public health services are attempting to address.
“Vaccines Are a Safe Path to Freedom” and the Art of Deception
In Britain, Piers Corbyn (the brother of Jeremy Corbyn, former leader of the British Labour Party) was arrested for circulating newspapers purporting to be the Evening Standard— featuring an illustration of Auschwitz-Birkenau. “Vaccines are a safe path to freedom,” was written on the camp gates, in place of “work sets you free,” a discursive reference to the systematic deception that led millions of Jews to their deaths during the Shoah. The material was circulated to areas in London that are home to large ethnic and religious minorities, and at a time of increased public health and government debate about mistrust towards the new coronavirus vaccine program and lower-level uptake among minorities. Yet, were Corbyn’s antics unique? And how are Shoah comparisons perceived?
My research has explored how non-vaccination activists tailor their messages to ethnic and religious minorities by drawing on entrenched historical, social, and religious concerns. I found that non-vaccination activists, often based in the United States, have been promoting their cause internationally and targeting religiously Orthodox Jewish parents in Jerusalem. Their claims of vaccine non-safety not only circulate but also “convert” and undergo a transformation of ideas and rationales to be made relevant.
Non-vaccination advocacy then acts like a virus, mutating in form and exploiting the fears of ethnic and religious minorities.
Historical events such as the Shoah, Nazi experiments, and state deception are mobilized in this tailoring of non-vaccination rhetoric. This discourse becomes assimilated and projected, to quote one Polish child survivor of the Shoah, “we can’t fall into being too obedient to authority.” Vaccination is presented as a general theological issue in these global-local encounters, and opposition is engendered as a form of moral regulation (especially regarding vaccines that are cultured on human-cell lines). In so doing, activists attempt to promote non-vaccination as a religious right. Non-vaccination advocacy then acts like a virus, mutating in form and exploiting the fears of ethnic and religious minorities.
Promoting “faith” in vaccination will require more than the endorsement of religious authorities. The tendency to reduce the concerns of religiously Orthodox parents to issues of pork or religious law overlooks the fact that their decisions are often informed in the same ways as parents in the broader population. With the possibility that vaccination will be a long-term project, public health services must produce consistent and coherent guidance to counterbalance the strategies of non-vaccination activists. Parental concerns of safety must be addressed transparently and “with an outstretched arm.”