Pulling back the curtain on religious and cultural resistance to vaccines

By Tara Haelle

Vaccine hesitancy and refusal are not binary concepts. They are both part of a continuum of vaccine acceptance that encompasses “a range of attitudes, beliefs, emotional orientations, ideologies, and health-seeking behaviors,” as one paper describes it.

Similarly, the individuals and social groups that share these beliefs, attitudes, and feelings are diverse and motivated by many different factors. It’s important when writing about vaccines and particularly vaccine hesitancy to avoid the temptation to think of vaccine-hesitant individuals or groups as a monolith. 

This article provides an overview of personal, social, and environmental determinants of vaccine hesitancy. But nuances exist even within these determinants. This study, for example, explored the roots of anti-vaccine beliefs among over 5,300 participants in two dozen countries and found those with strong opposition to vaccines were more likely to have one or more of four major psychological factors: 

• They showed high levels of conspiratorial thinking.
• They had particularly low tolerance for what they perceived as curbs on their freedoms.
• They felt strong disgust regarding blood and/or needles.
• Their worldviews strongly leaned toward an emphasis on the individual and on social hierarchies.

That particular study found little association between anti-vaccine attitudes and demographics or education level. However, it was published in 2018—there have been shifts in associations between vaccine hesitancy and demographics since then—and defined demographics fairly broadly since it was conducted across 24 countries. 

On a micro scale, researchers have identified common demographic patterns or groupings with vaccine hesitancy. For example, the 2025 measles outbreak began in a tight-knit Mennonite community in West Texas. Mennonites’ faith falls under the umbrella of Anabaptist churches, and Anabaptist beliefs do not include specific tenets that oppose vaccination, their somewhat insular social circle in this region contributed to shared attitudes about vaccines independent of their faith’s teachings.

Below is a non-exhaustive list of several communities that have a higher than average level of vaccine hesitancy for various reasons. However, journalists should be cautious not to generalize from these groups, which serve as examples of some patterns but do not apply to all members of those groups.

Further, this list is only a small sampling of large and small subcultures, demographics, and communities who may have higher-than-average levels of vaccine hesitancy. Many other groups, including hyper-specific subcommunities, may represent pockets of vaccine hesitancy, just as other communities that fall within these groups may have high immunizations rates and vaccine confidence.

Certain Christian communities

The spectrum of attitudes toward vaccines within the many denominations of Christianity is vast, as this article nicely summarizes. Often, the opposition to vaccines within some of these communities has less to do with the literal teachings of their faith and more to do with the intersection of their faith and political views. In the U.S., for example, conservative and/or evangelical Christianity has been linked to greater vaccine resistance. 

This resistance can sometimes be specific only to certain vaccines too. For example, Christian nationalists tend to have higher rates of vaccine refusal and are particularly resistant toward COVID-19 vaccines. More resistance has also been documented against the HPV vaccine in some communities because of its association with a disease that is primarily sexually transmitted. 

An example of the diverse reasons some Christian groups may oppose vaccines are summarized in this document submitted by Christians to the Oregon state legislature. These arguments may not represent concerns of all Christians about vaccines but provide representative viewpoints journalists may want to be aware of.

Some groups of Orthodox Jews

Judaism as a whole tends to strongly support vaccination, even relying on scripture to endorse it, but some ultra-Orthodox communities have high levels of vaccine hesitancy and refusal both in Israel and in the U.S. That has led to disproportionate numbers of measles cases in U.S. and outbreaks in Israel. These beliefs are explored here, here, and especially in this systematic review. This NPR article discusses how Israel overcame some of this opposition with COVID-19 vaccines.

Other religions 

Islam overall is also largely supportive of vaccination, as is Sharia law, but some Muslim subcommunities, such as this rural Thai community, can develop hesitancy for various reasons. 

Despite the availability of religious exemptions to vaccine mandates in many states, it’s not clear that any major organized religion opposes vaccination itself on principle. Even among Christian Scientists, who often prioritize faith healing over medical interventions, do not have doctrine opposing vaccination and leave the decision up to individual members. Rather, religion-based opposition to vaccines usually results from concerns about ingredients in certain vaccines, such as use of cow products for Hindus or pork products for Muslims, or belief in the body as a sacred temple which should not receive “unnatural” chemicals or animal tissues. This paper describes five “types” of religious objections to vaccines. Multiple religious authorities have issued statements on these concerns. Still, religious and philosophical opposition to vaccination is complex, as discussed here and here.

Far-right political adherents 

Multiple studies have documented the relationship between political ideology and attitudes toward vaccination, particularly the link between far-right belief systems and opposition to COVID-19 vaccination in Europe and the U.S. Some of this association intersects with an overlapping belief in conspiracy theories as part of a political ideology and/or with distrust in the government, pharmaceutical companies, the scientific establishment, and/or health care system.

African-American/Black communities

Several studies have documented higher rates of vaccine hesitancy in Black communities in the U.S. and Canada. Much of this can be traced to a history of medical mistrust based on medical racism, a history of medical abuses against Black Americans, and current inequities in the health care system. One study has found effective approaches for addressing this hesitancy include “education, multidimensional approaches, and healthcare provider recommendations.”

Native American, Alaskan Native, First Peoples and other Indigenous communities 

While logistical and access barriers are a major reason for lower immunization rates among indigenous groups, many other individual-, organizational-, community-, and social-level determinants play a role too, including contributors to vaccine hesitancy. That hesitancy can arise from historical trauma, distrust of the government, lack of reliable information sources, misconceptions, racial discrimination experiences, and inconvenience of getting vaccinated. 

Addressing concerns in specific communities

Several strategies have evidence for increasing vaccine confidence, but all of these must start with understanding the root cause of a particular communities’ hesitancy and concerns. Once the root cause is understood, these interventions can address those concerns with vaccine communication that is “evidence-based, context-specific and culturally appropriate and tailored to the individual’s position on the vaccine hesitancy continuum.”

• Provider recommendations have consistently been found to be among the strongest factors that influence people’s decisions to vaccinate, but providers (outside of pediatricians, who have these conversations daily) may be hesitant to broach the topic if they fear resistance or potential harm to the patient-provider relationship. They often need more tools and strategies for vaccine conversations and training in effective techniques, such as motivational interviewing. 
• Education with trusted messengers, members of the community who already have the trust and credibility to be heard by their fellow members, are effective. Examples of trusted messengers within the Orthodox Jewish community include this New York Times op ed by a Hasidic yeshiva graduate, this Jewish organization, and these Orthodox nurses’ statement. Education can also take the form of countering misinformation and disinformation, particularly within word-of-mouth communities and on social media platforms favored by that community.  
• Community engagement, ideally with trusted messengers and/or “vaccine champions” (see here and here), can be helpful in the form of listening sessions, health fairs, vaccination clinics, education sessions, and similar activities in places that are familiar and comfortable for that community. For example, the Somali community in Minnesota has had historically higher rates of vaccine hesitancy following anti-vaccine talks from disinformation influencers such as Andrew Wakefield, the author of the discredited Lancet study that sparked autism concerns. However, the state health department has partnered with Somali organizations, trusted messengers, and providers to make strides in improving Somali-American vaccine confidence and uptake.
• Both positive and negative coercive techniques, such as mandates, financial penalties, financial incentives, and other incentives, have mixed results depending on the community, context, and causes for hesitancy.

Quick tips for journalists covering vaccine hesitancy within local communities

• Become familiar with the specific community you are reporting on and listen closely to their concerns. Be cautious not to inadvertently make assumptions about how many in the community are hesitant toward vaccines, why they are hesitant, which vaccines they may have concerns about, and what interventions would be effective. Avoid ascribing beliefs or attitudes to this community that exist in other communities, including ones with similar demographics. The large Somali community of Minnesota, for example, may substantially differ from Somalis in Columbus, Ohio, or Seattle. 
• Identify trusted messengers and key community leaders and influencers who can share representative views of the community, including opposing or varying perspectives within the community. Ask questions to learn about the range of beliefs, attitudes, fears, concerns, and effective strategies in this particular community. 
• Ask questions that uncover the root concerns of vaccine hesitancy so that you can include key cultural context in your story, ensuring that audiences recognize the underlying contributors to the community’s concerns. 
• When identifying expert sources, invest time in finding providers and public health officials who are specifically from the community and/or who work closely with members of the community and who understand what messaging is effective.  
• Avoid framing in stories that implies shame or blame toward communities with hesitancy. Pay close attention to language that may carry patronizing or condescending connotations, and avoid fear-based messaging, including in anecdotes. 
• If possible, seek a trusted person in your newsroom or social network who is a member of or is familiar with that community and can provide a sensitivity read of your piece to look for inadvertently culturally insensitive phrasing. 
• When possible, use a solutions-based framing that includes discussion of what strategies are effective and evidence-based in this community, buttressed by research and by experts with education-based knowledge and lived experience. 

Tara Haelle is a freelance science/health journalist based in Dallas. She is author of Vaccine Investigation: The History and Science of Vaccines, and has covered vaccines for 15 years at National Geographic, Scientific American, The New York Times, and over a dozen other publications.