Abstract
Religious minority affiliation or status can play a very important role in influencing people's access to vaccines as well as their willingness to undergo vaccination. Many studies focus on class, ethnicity and geographic location when examining how social inequalities impact vaccination programmes. However, religious marginality is often overlooked. Here we explore how being situated on the margins, on account of religious affiliation, shapes experiences of vaccine access and uptake. The issues addressed are important for COVID-19 vaccination roll out, but also contain lessons for all vaccination programmes and many other preventative health measures. In this brief, we present key considerations for addressing differentials in access to and willingness to undergo vaccinations that are linked to religious minority status, experiences, authorities or doctrine. We explain why the study and awareness of religious marginality is crucial for the success of vaccination programmes broadly and specifically as they apply to COVID-19 vaccination. We also explore ways in which religious marginality intersects with other identity markers to influence individual and community access to vaccines. Finally, we examine vaccine hesitancy in relation to religious minorities and outline approaches to community health engagement that are socio-religiously sensitive, as well as practical, to enhance vaccination confidence.
Highlights
Data regarding the proportions of populations who have benefited from vaccinations must be disaggregated by religion and where possible according to denominational belonging
Historic and systemic inequalities can put members of these communities at a higher risk of infection as well as creating mistrust between authorities and minorities. This mistrust of health services and the pandemic response in general has been amplified by higher COVID-19 infection rates among minorities
Over-crowding associated with large family sizes and economic deprivation enabled the speedy transmission of COVID-19, more so than among Jews living in non-Haredi neighbourhoods with very different socio-economic profiles
Summary
Create or reinforce broad-based partnerships between health providers, religious and lay leaders from within a religious minority community that are perceived by that community to be legitimate and authoritative This is key to successful outreach and building trust. For religious minorities who are isolated, linguistically distinct or socio-economically excluded, tailored outreach communication methods are needed. These may include working with religious leaders but not necessarily be exclusive to them. Avoid a one-size-fits-all approach to partnerships with religious minorities and recognise the heterogeneity of religious minorities and their needs The terms of these partnerships must be tailored to address the intersection of religious and socio-economic factors to address vaccine hesitancy in a community. Making welfare benefits conditional upon vaccination may raise ethical issues of penalising the socio-economically excluded members of religious minorities - not the economically privileged who are shielded from any economic impact
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