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      “If a rabbi did say ‘you have to vaccinate,’ we wouldn't”: Unveiling the secular logics of religious exemption and opposition to vaccination

      Social Science & Medicine
      Elsevier BV

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          Abstract

          <p class="first" id="d9684005e111">Maintaining ‘faith’ in vaccination has emerged as a public health challenge amidst outbreaks of preventable disease among religious minorities and rising claims to ‘exemption’ from vaccine mandates. Outbreaks of measles and coronavirus have been particularly acute among Orthodox Jewish neighbourhoods in North America, Europe and Israel, yet no comparative studies have been conducted to discern the shared and situated influences on vaccine decision-making. </p><p id="d9684005e113">This paper synthesises qualitative research into vaccine decision-making among Orthodox Jews in the United Kingdom and Israel during the 2014–15 and 2018-19 measles epidemics, and 2020–21 coronavirus pandemic. The methods integrate 66 semi-structured informal interviews conducted with parents, formal and informal healthcare practitioners, and religious leaders, as well as analysis of tailored non-vaccination advocacy events and literature. </p><p id="d9684005e115">The paper argues that the discourse of ‘religious’ exemption and opposition to vaccination obscures the diverse practices and philosophies that inform vaccine decisions, and how religious law and leaders form a contingent influence. Rather than viewing religion as the primary framework through which vaccine decisions are made, Orthodox Jewish parents were more concerned with safety, trust and choice in similar ways to ‘secular’ logics of non-vaccination. Yet, religious frameworks were mobilised, and at times politicised, to suit medico-legal discourse of ‘exemption’ from coercive or mandatory vaccine policies. By conceptualising tensions around protection as ‘political immunities,’ the paper offers a model to inform social science understandings of how health, law and religion intersect in contemporary vaccine opposition. </p>

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          Grounded theory research: Procedures, canons, and evaluative criteria

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            Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

            Summary Background There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. Methods In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Findings Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. Interpretation To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. Funding European Commission, Wellcome, and Engineering and Physical Sciences Research Council.
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              Grounded Theory Research: Procedures, Canons and Evaluative Criteria

              Using grounded theory as an example, this paper examines three methodological questions that are generally applicable to all qualitative methods. How should the usual scientific canons be reinterpreted for qualitative research? How should researchers report the procedures and canons used in their research? What evaluative criteria should be used in judging the research products? The basic argument we propose is that the criteria should be adapted to fit the procedures of the method. We demonstrate how we have done this with grounded theory and suggest criteria for evaluating studies done in this mode. We suggest that other qualitative researchers might be similarly specific about their procedures and evaluative criteria.
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                Author and article information

                Contributors
                Journal
                Social Science & Medicine
                Social Science & Medicine
                Elsevier BV
                02779536
                July 2021
                July 2021
                : 280
                : 114052
                Article
                10.1016/j.socscimed.2021.114052
                8d914395-6907-4f3f-97c8-3f914b0afeaa
                © 2021

                https://www.elsevier.com/tdm/userlicense/1.0/

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