True to Tradition? A Qualitative Study of Clergy Attitudes toward Vaccine Advocacy
Joshua Williams, MD, Assistant Professor of Pediatrics / General Pediatrician, University of Colorado School of Medicine / Denver Health Medical Center
Background: Vaccination is one of the most important health advances in history. Traditionally, clergy have been influential vaccination advocates, promoting the public health practice or even vaccinating others. It is unclear if clergy today believe vaccine advocacy should remain in the past or ground the medicine of the future.
Objective: To explore clergy attitudes toward vaccine advocacy.
Methods: We conducted qualitative interviews of clergy from multiple faith traditions in Colorado and North Carolina, according to grounded theory methodology. We used a semi-structured interview guide, recorded and transcribed interviews, and analyzed transcripts using constant comparison. We developed codes iteratively, resolved disagreements by consensus, identified themes, and constructed a theory.
Results: We reached thematic saturation after 16 clergy interviews (1 Buddhist, 3 Catholic, 2 Jewish, 1 Hindu, 1 Islamic, 7 Protestant, 1 Unity). Most clergy were middle-aged (median 50.5 years), men (13/16), white (12/16), parents (11/16), and head pastors or equivalent (11/16). Analyses yielded six themes.
1. Vaccination Attitudes: Nearly all clergy had positive views of vaccines, although many had questions about vaccine efficacy and safety. A few clergy had neutral views, and one actively resisted vaccines.
2. Congregational Vaccination Needs: Most clergy perceived their congregations to be pro-vaccine without vaccine-related needs, although a few reported receiving requests to discuss vaccines or have access to specific vaccines at religious gatherings (e.g. yearly influenza vaccine after mass once each year).
3. Public Health Climate: Nearly all clergy cited news reports about measles outbreaks, which increased their perceived responsibility to address vaccines. Clergy also described prevailing societal norms of individualism and decreasing mutual responsibility that increased their perceived responsibility to act.
4. Perceived Responsibility to Address Vaccines: Most clergy reported they had never thought of addressing vaccines or felt little perceived responsibility to do so. Yet, these same clergy described a conditional responsibility in which confidence in vaccines’ benefits, negative congregational vaccination attitudes, or public health crises could increase their sense of responsibility to an actionable threshold.
5. Comfort Addressing Vaccines: Clergy described feeling comfortable with the idea of addressing spiritual matters related to vaccination (e.g. protecting one’s neighbors) but were uncomfortable with the idea of discussing medical topics. Nearly all clergy desired the expertise of medical professionals to do so.
6. Reported Vaccination Actions: Over half of clergy reported promoting vaccines in individual, congregational, or community contexts. None reported speaking against them. Clergy who promoted vaccines described being convinced of their benefits, responding to congregational needs and recent disease outbreaks, and feeling comfortable speaking about them.
Discussion: True to tradition, most clergy reported being open to vaccine advocacy, and over half of clergy described promoting vaccines in various contexts. In an era of increasing vaccine skepticism requiring novel public health partnerships, clergy may ground the medicine of the future as influential vaccination advocates. Religious physicians and allied health professionals could cue clergy to action by answering clergy questions about vaccines, asking clergy to address them in their congregations, raising awareness of recent disease outbreaks, and partnering with clergy to discuss medical topics.
Objective: To explore clergy attitudes toward vaccine advocacy.
Methods: We conducted qualitative interviews of clergy from multiple faith traditions in Colorado and North Carolina, according to grounded theory methodology. We used a semi-structured interview guide, recorded and transcribed interviews, and analyzed transcripts using constant comparison. We developed codes iteratively, resolved disagreements by consensus, identified themes, and constructed a theory.
Results: We reached thematic saturation after 16 clergy interviews (1 Buddhist, 3 Catholic, 2 Jewish, 1 Hindu, 1 Islamic, 7 Protestant, 1 Unity). Most clergy were middle-aged (median 50.5 years), men (13/16), white (12/16), parents (11/16), and head pastors or equivalent (11/16). Analyses yielded six themes.
1. Vaccination Attitudes: Nearly all clergy had positive views of vaccines, although many had questions about vaccine efficacy and safety. A few clergy had neutral views, and one actively resisted vaccines.
2. Congregational Vaccination Needs: Most clergy perceived their congregations to be pro-vaccine without vaccine-related needs, although a few reported receiving requests to discuss vaccines or have access to specific vaccines at religious gatherings (e.g. yearly influenza vaccine after mass once each year).
3. Public Health Climate: Nearly all clergy cited news reports about measles outbreaks, which increased their perceived responsibility to address vaccines. Clergy also described prevailing societal norms of individualism and decreasing mutual responsibility that increased their perceived responsibility to act.
4. Perceived Responsibility to Address Vaccines: Most clergy reported they had never thought of addressing vaccines or felt little perceived responsibility to do so. Yet, these same clergy described a conditional responsibility in which confidence in vaccines’ benefits, negative congregational vaccination attitudes, or public health crises could increase their sense of responsibility to an actionable threshold.
5. Comfort Addressing Vaccines: Clergy described feeling comfortable with the idea of addressing spiritual matters related to vaccination (e.g. protecting one’s neighbors) but were uncomfortable with the idea of discussing medical topics. Nearly all clergy desired the expertise of medical professionals to do so.
6. Reported Vaccination Actions: Over half of clergy reported promoting vaccines in individual, congregational, or community contexts. None reported speaking against them. Clergy who promoted vaccines described being convinced of their benefits, responding to congregational needs and recent disease outbreaks, and feeling comfortable speaking about them.
Discussion: True to tradition, most clergy reported being open to vaccine advocacy, and over half of clergy described promoting vaccines in various contexts. In an era of increasing vaccine skepticism requiring novel public health partnerships, clergy may ground the medicine of the future as influential vaccination advocates. Religious physicians and allied health professionals could cue clergy to action by answering clergy questions about vaccines, asking clergy to address them in their congregations, raising awareness of recent disease outbreaks, and partnering with clergy to discuss medical topics.