Why Are Some Americans Vaccine-Hesitant? A New Book Says It’s Their Religion.
Vaccines have been a source of tension in recent years. This tension has only increased since Robert F. Kennedy Jr., a notable vaccine skeptic, was appointed by President Donald Trump as the Secretary of Health and Human Services and changed the vaccine schedules for children.
A few years ago, disagreements regarding the COVID-19 vaccines became a marker of political identity. Much of the conversation about why some people are hesitant to be vaccinated has centered around misinformation. However, recent research has suggested that being vaccine-hesitant is related to issues like community, purity and corruption — concepts associated with religion.
In her book, “Unvaccinated Under God: Religion and Vaccine Hesitancy in Modern America,” religious studies scholar Kira Ganga Kieffer discusses how the concepts people use to study religion (ranging from conversion, testimony and purity) can be used to study the vaccine hesitancy movement.
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Kieffer does this by guiding the reader through a history of the vaccine hesitancy movement from the 1980s to current events. In her book, the author also shows how the vaccine hesitancy movement became bound up with religious liberty activists in trying to preserve their rights.
Religion Unplugged interviewed Kieffer over Zoom about her new book and how it relates to current events. She discussed how the tools of religious studies can help people understand vaccine hesitancy, the Make America Healthy Again movement, and how the vaccine hesitancy movement became intertwined with religious liberty activism.
This interview has been edited for clarity and conciseness.
Religion Unplugged: Your book is over the religious component of the anti-vaxxer movement. Why is this important to write about?
Kieffer: The book is taking a new approach to studying the behaviors and attitudes known as vaccine hesitancy, colloquially known as anti-vaxxer movement. My training in religious studies gave me the ability to recognize religious themes and styles of discourse. And so I took this religious studies approach of seeing religion in places that maybe most people don't see it because it's not in a traditional institution or coming from a pastor or the pope or recognized religious official, nor from scripture or doctrine, but in extremely religious stylings and vibes.
People described as anti-vaxxers in the media were talking about their feelings about vaccines, but also about the perceived damaging effects of vaccines that they were worried about or that they reported having seen in their own experience or that of their child. So that’s where I came into it from a religious studies perspective. I read everything there was to read on vaccine hesitancy and on the history of vaccines from a cultural perspective and historical perspective in the United States. I didn't see any discussion of vaccine hesitant folks in religious frameworks. And so I was bringing that in to add a new dimension to the ways that public health professionals and scholars and then sociologists and historians have talked about vaccine hesitancy.
RU: You talk about bringing the religious understanding into vaccine hesitancy. In the book, you talk about conversion narratives, testimonies and concepts of purity; things that are commonly discussed in religious studies. Elaborate on how those things relate to vaccine hesitancy.
Kieffer: Some vaccine-hesitant people talk about their reasons for being hesitant fall into a few different categories that are related to the frameworks for being an evangelical Christian, frameworks for alternative spirituality, self-help and natural health participants or followers. I saw on the evangelical Christian side of things, people who weren't necessarily identifying themselves as evangelical Christians, but in the 1980s, evangelical Christianity was huge. I mean, it's still huge, but hugely dominant in public discourses and politics and on TV with televangelists speaking about conversion from a state of not knowing to a state of knowing, a state of being unsaved to a state of being saved.
I started seeing that people who were claiming that their child, in particular in the 1980s, were harmed by a particular vaccine, the DPT or diptheria pertussis tetanus vaccine said things similar to, “I didn't know that this vaccine could hurt my child, and now I do know that a vaccine could hurt my child. That is life-changing information. … I’m in a new group, I got a new perspective.”
And it's a very classic conversion narrative, but people hadn't really talked about this as a conversion narrative experience in that language. So I was identifying that type of speech, which is extremely popular, but also extremely moving, extremely motivating and emotional and meaningful to add a dimension to our understanding of what vaccine hesitancy is all about and how it is, in my view, an expression of religious impulses, which are to protect children and to protect what is seen to be pure, what is seen to be sacred, to maintain that sacredness if you are in a position to, especially for, in this case, parent or mothers who were particularly the main drivers of vaccine hesitancy in the 1980s, the 1990s, the 2000s.
And then on the alternative spirituality front, we see a lot of discourses in the 1990s, the 2000s as wellness culture starts to build, alternative health culture starts to build, and interest in alternative spirituality that's not Christian, but is focused on individual experiences, is focused on purifying the body, making sure that the body is a sacred vessel is something that you have control over. It is the medium through which you have your spiritual experiences and where you derive a lot of meaning from. So what you put in really matters. That is something that starts coming through in the 1990s and 2000s, when you see reports of mothers in particular saying, I think my child was harmed by … the MMR vaccine, the measles-mumps rubella vaccine. And so we're really talking about stories of alleged harms from a vaccine, but then being framed in religious terms and religious frameworks that are very common to our popular culture.
Frantz: You use these religious concepts in your book to push back against the idea that it's only misinformation that's driving vaccine hesitancy, so would you expand on that?
Kieffer: I hope the book will push back on what I think are reductive arguments about vaccine-hesitant people, namely, those that say that vaccine-hesitant or anti-vax people are ignorant, are victims of misinformation and are unable … to find reasonable, correct or scientifically valid information. And, there are people who just have a mistrust of doctors or scientists and are therefore uneducated on why vaccines are good. We have seen many attempts to educate or provide scientific literacy or medical literacy around the benefits of vaccines and the very, very few possibilities of adverse reactions or side effects. And that doesn't really move the needle on people who are vaccine-hesitant, saying, “Oh, OK, I didn’t realize that. Thanks for letting me know. I'm going to get vaccinated now.”
We don't see that kind of uptick in vaccine acceptance amongst vaccine-hesitant people just based on educational public health outreach. So what else is there? What else can we understand? It's not just about scientific illiteracy; it's about something that means a lot more to people. I wanted to use new language to describe this whole movement and set of different perspectives because I wanted to illustrate to people who are not in that culture that the same way that we try not to judge people's religious beliefs. … Maybe we should try and have more of an open mind to understand what's going on in people's communities and in people's own minds about vaccines that has to do with things that are much more meaningful than just statistics or even more meaningful than a possible or even likely reduction of the possibility of getting a disease like measles or mumps.
Frantz: Another person who's featured a bit in your book, Robert F. Kennedy Jr., often uses the language of MAHA, but also bodily purity, healthy food and changing the vaccine schedules for children based on his beliefs on vaccines. Do you see him in the MAHA movement as a continuation of the narrative you're telling in your book?
Kieffer: I would say it’s certainly an expansion on it, yes. And if you go back to RFK Jr.’s own origin story into this movement of vaccine hesitancy, which vastly predated his MAHA movement, it was kind of his own conversion to this idea that there could be toxins in vaccines that could cause children irreparable harm that he hears from a mother who comes to him, basically beats down his door and says, “Please listen to my story.”
Over the course of this back half of his career, getting very in deep on this idea of the body as an environment unto itself that can be polluted the way that you can't see pollution outside for the most part until it's really, really bad, but that's why you need to have regulations in order to prevent companies from putting chemicals and bad things into rivers.
Same idea. He takes the same idea and applies it to bodily health, and he's following along with the growth of wellness culture. He just keeps at it though with this vaccine concern. I think he's truly a believer in this, and I think that he just has expanded his views to honestly include a lot more alternative medical understandings of what is and is not good for people. And it just happens that his views are extremely counter to the biomedical establishment, and that’s why he's constantly running up against it. And he's also trying to prove that he's right, but he can't exactly.
And it’s absolutely an expansion of the vaccine hesitancy movement just into a much broader arena of what health is. I read him as wanting to regulate. We see him wanting to regulate vaccine schedules. We see him wanting to regulate toxic chemicals. And on both of those fronts, he's getting hindered for very different reasons. And then it builds into this whole embattlement narrative.
Frantz: Talk about the role religious liberty and bodily autonomy play in the vaccine hesitancy narrative.
Kieffer: That's an important piece of this whole movement because it represents an intersection of different interest groups coming together at a certain point right prior to verging into the MAGA movement. So that then becomes also the MAHA movement in a way. So here's at least two streams of people that are coming together on this. So the first is if you even go back all the way to the 1980s, the first chapter of my book with the DPT controversy, the people who got together trying with the primary goal was fix the vaccine(s). Their secondary, but also super important goal was to allow parents to opt out of vaccination if they feel uncertain about it, if they feel like it's just not safe for their child.
They wanted what they called “informed consent”, meaning doctors should tell them about all the risks, and then a parent can choose, have a choice in whether they're going to vaccinate their child or not. And so that is really all about bodily autonomy.
They just are mostly focused on parental rights over their individual child. And the only way to do that legally is to obtain a religious exemption that's already on the books. Those are available in nearly every state at the time up until recently.
So that continues to be the main avenue for people who want to truly refuse a vaccine, mostly for their children.
And then you've got, at the same time, evangelical Christians in particular, white evangelical Christians whose culture war battles over all sorts of culture war issues keep on resulting in them feeling embattled because they feel like they're losing and that the culture overall is becoming too liberal, too permissive.
The way that they have learned to fight starting in the 2000s, the Tea Party, the 2010s, is to appeal to religious freedom law, their First Amendment rights, to stake a claim and say, “Hey, we don't agree with how this culture is going and we want to be able to do what we want to do “whether that be regarding gay marriage, whether that be regarding hosting the 10 Commandments in a public school, all sorts of different fronts in those wars.”
And so, they’re feeling embattled. By the 2010s, people are refusing vaccines at a higher rate and public health officials see that more people are using religious exemptions to abstain from vaccines.
Public health officials think of it as a legal loophole, and in a few states, they move to get rid of religious exemptions. It really upsets the vaccine-hesitant community that religious exemptions are under threat from a legal perspective, that their bodily autonomy option is being taken away from a legal perspective. And the mainstream white Christian conservatives are also very interested in anything having to do with religious freedom because they want religious freedom laws to be strong, because that's their primary avenue for fighting what they see as overly liberal cultural norms.
So, they see parents who are upset about the loss of religious exemption laws, and they kind of form a coalition between the two groups that were been totally different. And they see that they have some things in common right around the time that Trump is really getting going with his political career, and he also sees that. So you've got a coalition of people who can agree on some things, which is that we want to make sure that people are free to do whatever it is they want to do with their own body and their children’s bodies.
Frantz: In terms of your own views on religious liberty and bodily autonomy, did those evolve or change throughout the course of writing this book?
Kieffer: What I’ve come to see is that the history of having religious exemptions as the only non-medical way to abstain from a vaccine, and that's also in the book, it predates the period of the book because it goes back to the ‘60s and ‘70s. But I think that I can see how problematic it is and how problematic it's become to remove the only kind of opt-out clause from mandatory vaccines in terms of trying to maintain or even build trust between people who are hesitant and people who are interested in preserving public health.
In the short term, if our goal is to increase vaccination rates, removing the legal option for religious exemptions makes sense, and it's working, Connecticut being a good case in point for that, which is where I live. But in the long term, I don't think it will be helpful. I don't think it will help build trust. It's more punitive towards the people who are struggling to get on board with the public health agenda, and it doesn't build trust between the two groups.
Frantz: How would you build that trust?
Kieffer: I think that there can be a lot of trust built when people acknowledge and fully understand where another person is coming from. And I think that is hard to change culture, but the way forward in most things is to be empathetic with people with whom you don't agree and figure out if you can understand where they're coming from and if you can find some common ground. And it's also, I think, the way to try and build trust between a very dominant system of medicine, biomedicine being the dominant form of medicine in our culture, and people who struggle to feel seen.
And I guess I would also note that in one of the chapters in my book on flu shot hesitancy, we see a different type of hesitancy amongst racial minority groups, especially Black Americans who feel a lot of mistrust towards the medical establishment because of systemic racism, both history of medical racism, but also very clearly ongoing experiences of medical racism or racism within healthcare contexts.
Public health officials and the mainstream media have all tried hard to understand or at least get into some of that empathetic space around the role of race and racial injustice in many people of color's distrust or mistrust or angst about using traditional medical care. I see that as a place where things are moving forward in a more positive direction. And when we go back to the numbers, we can see that the empathetic approach broadly helped people of color choose to get the COVID vaccine when lots of other vaccine-hesitant people chose not to get it. And I think one set of people felt seen, the other group did not.
Kenneth E. Frantz is a freelance writer who has written for ReligionUnplugged, Sojourners, Real Clear Religion and Religion and Politics.