Knowledge and Attitudes Toward Covid-19 and Vaccines Among a New York Haredi-Orthodox Jewish Community

Abstract

The Covid-19 pandemic has exposed the difficulty of the US public health system to respond effectively to vulnerable subpopulations, causing disproportionate rates of morbidity and mortality. New York Haredi-Orthodox Jewish communities represent a group that have been heavily impacted by Covid-19. Little research has examined their experience or perceptions toward Covid-19 and vaccines. We conducted a cross-sectional, observational study to explore the experience of Covid-19 among Haredim. Paper surveys were self-administered between December 2020 and January 2021 in Haredi neighborhood pediatricians' offices in Brooklyn, New York. Of 102 respondents, 43% reported either a positive SARS-CoV-2 viral or antibody test. Participants trusted their physicians, Orthodox medical organizations, and rabbinic leaders for medical information. Knowledge of Covid-19 transmission and risk was good (69% answered ≥ 4/6 questions correctly). Only 12% of respondents would accept a Covid-19 vaccine, 41% were undecided and 47% were strongly hesitant. Independent predictors of strong vaccine hesitancy included believing natural infection to be better than vaccination for developing immunity (adjusted odds ratio [aOR] 4.28; 95% confidence interval [CI] 1.23-14.86), agreement that prior infection provides a path toward resuming communal life (aOR 4.10; 95% CI 1.22-13.77), and pandemic-related loss of trust in physicians (aOR 5.01; 95% CI 1.05-23.96). The primary disseminators of health information for self-protective religious communities should be stakeholders who understand these groups' unique health needs. In communities with significant Covid-19 experience, vaccination messaging may need to be tailored toward protecting infection-naïve individuals and boosting natural immunity against emerging variants.

COVID-19 Vaccine Hesitancy in the United States: A Systematic Review

“…Two studies report COVID-19 vaccine acceptance percentages in religious minorities in the US; an average willingness of 25% in Amish families of the Holmes County in Ohio ( 56 ) and 12% in Jewish Orthodox individuals in NY ( 30 ). Previous studies have shown that outbreaks of measles, rubella, and poliovirus have significantly affected the Amish community in Ohio, reflecting their lack of concern regarding the severity of the disease ( 81 ).…”

“…Other predictors of unwillingness included avoiding dependence on the government, while some conservative families were not convinced as the bishop did not levy importance to it ( 56 , 82 ). Local governments in Pennsylvania, Ohio, and Indiana have set up vaccination facilities at health departments to increase turnout ( 30 ). However, an effective approach to spreading COVID-19 vaccine awareness and destigmatizing it in the Amish community will have to be in conjunction with the church leadership, and the Old Order Amish families which were unaffected by the religious doctrine ( 82 ).…”

“…Regardless of the likelihood of contracting coronavirus, negative vaccine trends in Chasidish respondents in Brooklyn were observed ( 83 ). However, factors affecting their vaccination status; the belief that natural immunity was more beneficial, and the mistrust in physicians in the US, among other reasons put them on the priority list of strategizing distribution plans and approaches ( 30 ).…”

“…Of the 9 studies reported in this systematic review, vaccine acceptance is one of the highest (60–90%) in most studies. Nursing staff showed the least willingness to vaccination (<50%) in multiple surveys which were conducted as vaccines were rolled out ( 30 , 71 ). This results from the level of medical education in each group, and prospects about its long-term safety.…”

Localising Vaccination Services: Qualitative Insights on an Orthodox Jewish Collaboration with Public health during the UK coronavirus Vaccine Programme

“…Recent studies exploring uptake of SARS-CoV-2 vaccination among Orthodox and Haredi Jewish neighbourhoods in the US report lower likelihood of accepting vaccination and higher rates of hesitancy, and report that primary disseminators of vaccine information should be trusted stakeholders. 23 Considering how convenience and confidence affect use of vaccination services in this ethnic and religious minority, we examine the possibility of localising services in settings that are affected by outbreaks of vaccine-preventable disease. Emerging directly from the data analysis in our study, we define localising vaccination services as collaborating with community health organisations to deliver vaccines in ways that meet the situated (context-specific) needs and expectations of minority groups.…”