Religion and the refusal of the vaccine are linked. We have to talk about it.



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As cases of measles have increased in the US and Europe this year, there has been a lot of talk about what is causing the outbreaks. Among the most discussed issues: distrust of the medical establishment, populist politics that fuels vaccine doubt, and the dissemination of disinformation in social media.

Of course, there is more to the story – and great global research published Wednesday by the Wellcome Trust, a UK non-profit health research organization, helps to clarify what is happening. Researchers asked 140,000 people aged 15 and over in more than 140 countries about their views on religion, science and health, including their attitudes toward vaccines.

They found that people in higher income countries were among the least confident in vaccine safety – particularly in North America and Europe. Meanwhile, vaccine confidence was highest in countries where preventable diseases still spread, such as Bangladesh and Rwanda. Thus, the more people are the victims of outbreaks, and the more distant the memory of diseases such as whooping cough and measles, the greater the likelihood of avoiding vaccines.

"It's in richer countries where we no longer see the terrible impact that these preventable diseases can have, that people are more reticent," said Seth Berkley, CEO of Gavi, the Vaccine Alliance. "That reticence is a luxury we can hardly afford."

The research also unveiled something that links some of the communities where outbreaks have spread lately, and it's not that easy to talk about it: religious belief.

North America was the only high-income region where people who follow a religion were far more likely to say they are on the side of this belief system about science whenever disagreements arise. This finding was driven mainly by the US, where measles has been spreading among religious communities in states that have allowed exemptions from religious vaccines.

Religious concern about vaccines is "a big problem," said Paul Offit, a vaccine researcher who did not participate in the study. "We are reduced to 15 states that have philosophical exemptions for vaccines and we have 45 states that have religious exemptions, because the minute someone says," This is my faith, "we respect that in this country.

We are now living in a time when families once again need to be afraid of measles – a nearly eliminated disease – because many people have chosen not to receive the virus and the status of America as a country that has eliminated measles is threatened. If we do not address all the factors behind the vaccine's refusal, this public health crisis will not improve, Wellcome Trust director Jeremy Farrar said.

"There are immensely important lessons to be learned about bringing in religious groups that may be skeptical or can really question the value of science," he added. "But without them, you can see outbreaks [of vaccine-preventable diseases] will continue to happen. "

With few exceptions, vaccine doubt has no religious basis

After Edward Jenner developed the first immunization in 1796, he faced a reaction from members of the clergy who argued that the vaccination was against "God's will." Since then, religious concerns about vaccines have persisted in many parts of the world.

No major religion opposes vaccines – but members of various religious groups have in some cases provided religious justifications for refusing the vaccine, or have used their authority to keep people away from immunization. Some religious groups have also been targeted for vaccine misinformation.

In a 2013 academic paper examining outbreaks of religion and vaccines, a Merck researcher found more than 60 outbreak reports in religious communities. He also noted that, with the exception of Christian scientists, there are "few canonical bases for the decline of immunization" in the world's major religions. Instead, "religious reasons for refusing vaccination actually reflect concerns about vaccine safety or personal beliefs among a social network of people organized around a community of faith."

This is mainly how outbreaks in religious communities happened in the USA. In New York, the epicenter of the largest US measles outbreak in recent history, the Orthodox Jewish community was the hardest hit. It is also where anti-vaccine activists made inroads, based on rabbinical authority to spread misinformation about autism and vaccines. (For the record, most rabbis support vaccines.)

Another major outbreak of measles in 2014 happened in an Amish community in Ohio: it was triggered by a missionary who brought the virus back from a trip to the Philippines and spread it to its unvaccinated community, many of whom opted for vaccines because of concerns of security .

In both cases, vaccine doubt has had little to do with religion – but close-knit religious communities have helped to make it viral, prompting people to turn down vaccines and cause disease spread.

In Washington, home to another major measles outbreak this year, some Christian patients have opted for the measles, mumps, and rubella vaccine because of concern that it was derived from cells originally obtained from an elective abortion in the 1960s. Catholics in Kentucky have avoided the chicken pox vaccine for the same reason. (According to the National Catholic Bioethics Center, the use of these vaccines is justified because the "public health risk, if one chooses not to vaccinate, overcomes the legitimate concern about the origins of the vaccine.")

Meanwhile, lobbying efforts by Christian scientists, who have openly discouraged vaccination, have helped pass exemptions of religious vaccines that are now law in most US states.

Religious concerns about vaccines are a global problem

The problem of dissemination of vaccine doubt in religious communities appears in several countries. Only three countries – Pakistan, Afghanistan and Nigeria – have been unable to stop transmission of polio, a virus that has been almost eliminated through vaccines. In these countries, Muslim fundamentalist leaders have sometimes convinced people that polio eradication is "an American maneuver to sterilize Muslim populations," or "that vaccination is an attempt to avoid Allah's will," according to an analysis.

In Indonesia, a "fatwa vaccine" has been issued by Islamic leaders against the measles and rubella vaccine because, according to them, it is not halal and contains traces of products derived from swine. (Islam forbids the consumption of pork and, according to Science, the pig products of the vaccine include gelatin derived from the skin of pigs.) This concern helped the vaccination rate to plummet and the effect spread to neighboring Thailand , stimulating a measles outbreak.

To be clear, millions of Muslims around the world receive vaccines without objection. But outbreaks of preventable diseases in Muslim-majority countries have gone far enough for governments to pass fines on parents who refuse to vaccinate their children – as Australia and some European countries are doing.

North America is the only high-income region where religious people are much more likely to support religious teachings about science.

Wellcome's new research is replete with insight into people's beliefs in science, medicine, and vaccines. Most notably, it has been found that 79% "somehow" or "strongly agree" that vaccines are safe. That is certainly a majority – but there are also a dangerous number of people who do not trust vaccines.

"Broader doubts" about vaccine safety were more common in certain regions. For example, several higher-income regions were among the least certain on vaccine safety: "Only about 72% of people in North America and 73% in Northern Europe & # 39; that the vaccines are safe and the number is only 59%. in Western Europe and 50% in Eastern Europe. "

The report also helps explain the conflicts that may arise between science and religious belief. Among the findings:

  • In people who reported a religious affiliation, 55 percent said they would agree to their religious teachings in a disagreement between science and their religion.
  • The proportion was even higher – 64% – for people who have a religious affiliation and say that religion is an important part of their daily lives.
  • The highest percentage of people who say science disagrees with their religious teachings is based in the US and southern Europe (59%).
  • North America was the only high-income region where people who follow a religion are "substantially more likely" to say they believe in their religious teachings about science when disagreements arise. "This finding is driven predominantly by the US, where people who have a religion are almost twice as likely to believe in their religious teachings (60%) as in science (32%) in cases of disagreement."

Saad Omer, director of the Yale Institute for Global Health, who was not involved in the research, noted that strongly linked groups that are not affiliated with any religion also had major outbreaks, although "there is substantial data to support that it is primarily religious communities."

"Public health can not ignore the potential of working with religious leaders," he added. "Even if the issue is not religion itself, religion is a form of organization for communities to unite, and that means that public health has the opportunity to intervene and work with them. [these] communities. "

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