Vaccines and vitriol: an anthropological commentary on vaccine hesitancy, decision-making and interventionism among religious minorities.

Abstract

This commentary addresses the issue of vaccine hesitancy and decision-making among religious minority groups in high-income country settings. Recent measles outbreaks have been attributed to lower-level vaccination coverage among religious minorities, which has inspired targeted as well as wholesale public health interventions and legislation in a range of jurisdictions. The commentary takes the case of self-protective ethnic and religious minority groups, especially Haredi or 'ultra-Orthodox' Jews in the United Kingdom, to address two key aims. First, this commentary flags how damaging representations of religious minorities in recent measles outbreaks can be avoided by better understanding inner processes of vaccine decision-making and acceptance, which can, in turn, help to address hesitancy sustainably and trustfully. Second, the commentary advocates for addressing vaccine hesitancy as part of a broader re-visioning of public health relations with minority groups. This commentary calls on public health services to improve confidence in childhood vaccinations rather than resorting to compulsory (and coercive) vaccination policies in order to address lower-level vaccination coverage. The commentary signposts how essential it is to carefully navigate relationships with minority groups amidst the new forms of public health preparedness that will emerge from the 2020 Coronavirus pandemic (COVID-19).