How pastors can respond to vaccine hesitancy

In a recent congressional hearing, Sen. Raphael Warnock, an ordained Baptist pastor, described himself as a Matthew 25 kind of guy regarding government policies. Warnock explained that he was guided by the words of Jesus, “Just as you did not do it to one of the least of these, you did not do it to me.”

Warnock then posed a series of questions to Julie Margetta Morgan, president of The Century Foundation. Guided by Matthew 25:31-46, they came down to this: How did current policies comport with gospel warrants in this passage?

The practice of Christians applying “Scripture warrants” to public problems is useful, up to a point. Given the wide array of problematic circumstances to which they might be called into service, such application can be taken in almost any direction. This is especially true at points where science, religion and law intersect, as when vaccines for children are concerned.

Science and medicine provide definite answers about vaccines. All vaccines currently in use have proven efficacy and benefits for populations in general and most individuals in particular. The specific vaccines and administration schedules recommended by the American Academy of Pediatrics are safe and backed by science, confirmed by data and experience.

The altered schedule for the measles, mumps and rubella vaccine put forward in an August executive order is not driven by science nor are other recent efforts undertaken by the Centers for Disease Control and Prevention but stopped by a federal judge.

Clinicians are able to identify anyone who should avoid vaccines or alter their administration schedules precisely because of peer-reviewed scientific data and the highly trained people who curate it. In such cases, vaccine exemptions based on identified risks are appropriate.

Unfortunately, any given individual’s response cannot be predicted, beyond those of persons with known risk factors. This means some uncertainty exists in the calculus of science in general and medicine in particular for populations as a whole. It also means public health depends on evidence about how populations fare once individual outcomes are aggregated.

When serious, low-incidence side effects occur, support for sufferers is paramount. That said, the chief “side effect” of every vaccine is risk reduction against the disease it is designed to prevent. Recipients and their neighbors benefit simultaneously — a result that aligns with Old and New Testament warrants focused on mutual care.

But what happens when science and medicine do not match the personal or individual preferences grounded in someone’s religious beliefs?

For Christians, the matter should be simple. No major denomination prohibits vaccine adherence. Even Christian Science respects conscience around vaccines. Subsets in Christian communities of all sizes, however, invoke conscience to skirt vaccine-science recommendations.

This is where matters become fraught. Informed conscience differs from assertional conscience — a conscience ready to assert its position based on an inherent sense of the rightness of its feelings or views on some matter. Cherry-picked Scripture warrants that align with established personal beliefs lie at the heart of religion-justified vaccine hesitancy, at least among many Christians.

Specifically, Christians who emphasize individualism over community — the church as the rock of individual salvation over the church as the body of Christ — often cite different, sometimes conflicting warrants. This “all Scripture is equal and flat” approach short-circuits agreement. A historical parallel is the Civil War. Both sides invoked Scripture in arguments about slavery.

Today, whether one identifies with a particular theological camp or eschews labels and simply wants to pick and choose beliefs for oneself, identity- or adjective-driven choices shape attitudes toward science and medicine, including the matter of vaccines and public health. When noncompliance decisions are attributed to “conscience,” then conscience becomes problematic. Diseases — for which vaccines have been and will be developed — respond to individual immunity, not identity-driven beliefs. The dictates of conscience are irrelevant in this circumstance.

That some religious beliefs, as well as federal and state laws, could oppose proven and science-backed medical guidance aimed at public health may seem counterintuitive. Yet that is where we find ourselves today.

In the United States, parties adjudicate difference by law, which comes from the Constitution. The Constitution defines collective and individual rights, responsibilities and liberties. The First Amendment of the Constitution protects religion without defining it. The 14th Amendment guarantees due process. No amendments address science, medicine or public health. Individual states can make laws that differ among themselves while still adhering to the Constitution. Laws passed by Congress stand unless the judiciary rules otherwise. Though at odds with science, medical data and experience, a law may stand.

Interactions among these factors play out in vaccine mandates, exemptions and public health impacts. As of this writing, 46 states and the District of Columbia recognize religious exemptions from school and daycare vaccine requirements. Coupled with federal government changes to vaccine recommendations, these exemptions ignore science, medicine and public health. Individual liberty is privileged over collective well-being. Witness measles’ resurgence in the last year. Once on the brink of eradication, this most vaccine-responsive disease is returning with deadly results.

Confusion created by messaging at the federal level as well as state exemptions feed growing levels of vaccine hesitancy. In combination with freedom of association, movement and the like, these become probable disease vector components. In this manner, public health is undermined. The health, rights and well-being of others stand as collateral damage. And children suffer from adult decisions.

How, then, can one “pastor through” religion-based vaccine hesitancy? There is no single answer, but a layered response may help.

Judgment and condemnation are counterproductive options. So is silence. Asserting facts may harden hesitancy. Folks who do their own vaccine research may succumb to the Dunning-Krueger effect — greater certainty resting on more inaccurate facts.

A positive approach is best. Involving physicians in conversation with congregational thought leaders may help balance discussion of biopsychosocial factors in a religious teachings’ context. Emphasis on community stakes at play and common-good narratives may help.

Teaching Luke 6:31, “Do to others as you would have them do to you,” and highlighting children and applicable Scripture warrants — like Luke 10:25-37 — to reinforce love of God, neighbor and self as one may also hold persuasive power. But above all, emphasizing that what we do only for ourselves divides us from others is vital. Such division is never pleasing or acceptable to God.