Why America’s white evangelicals shy away from covid jabs

AT FIRST SIGHT, the decision by America’s Food and Drug Administration to pause the roll-out of the covid-19 vaccine from Johnson & Johnson is a comparable setback to that in Europe over the Oxford-AstraZeneca jab. In both cases the worry is about whether there is a link with blood clots. And in both cases, such clots are extremely rare, meaning that in most circumstances not getting a shot is a far higher risk to health. Yet whereas in Europe the AstraZeneca blow came at a time when countries were struggling to supply vaccines, America is now awash with them.

So the main impact in America is less on supply than on people’s wariness about getting vaccinated at all. The country is close to delivering jabs to almost all who want them. Unfortunately, only seven in ten Americans are interested. To suppress the coronavirus effectively, 70% or more of the entire population must be vaccinated—a high bar, given that the vaccine is not administered to those under 16. Anything that reduces take-up makes such herd immunity even harder to attain.

One of the largest vaccine-wary groups are white evangelicals, or “born-again” Christians, who voted overwhelmingly for former President Donald Trump last year. They are obstinate in their doubts and about a quarter of America’s population. The country’s herd immunity may rest on their shoulders.

In February only 54% of white evangelicals said they were likely to get vaccinated or already were, according to polling by the Pew Research Centre. That compares with 64% of non-white evangelicals, 69% of Americans overall and 72% of white non-evangelicals. Vaccine hesitancy was also split along partisan lines: 83% of Democrats wanted the jab, but only 56% of Republicans did.

White evangelical Christians are not unique in their concern. African-Americans are also markedly hesitant. But white evangelicals are unusual in their obstinacy. Over time, all racial groups have become less hesitant, with blacks making the largest gains. In Pew’s survey 61% of African-Americans said in February that they had been or planned to get vaccinated (a 19-point improvement in just three months). But white evangelicals remain sceptical. According to Samuel Perry, a sociologist at the University of Oklahoma, 33% of white evangelicals said in October they would not get the vaccine. By February, the figure had budged by only one percentage point, to 32% (see chart).

Why the stubborn hesitancy? One reason may be that evangelicals overwhelmingly denounce abortion, and some are concerned about the jab’s connection with the practice. The vaccines currently distributed in America were developed and tested using cell lines from aborted fetal tissue. This has not stopped the Vatican from endorsing their use. But some evangelicals may believe the (false) idea that the vaccines use recently aborted fetuses or require continual abortions.

Another concern relates to the Bible. According to some interpretations, the Book of Revelation describes the end of days: a beast will force his mark on people. Some worry that the vaccine is this mark.

Evangelicals are more likely than non-evangelicals to worry about side effects from covid-19 and childhood vaccines, according to the Understanding America Study, a survey from the University of Southern California. They are also more likely to believe, wrongly, that covid-19 vaccines are not effective in preventing infection. And evangelicals tend to rely on media sources that feed their fears.

Politics plays a part, too. About 80% of white evangelicals voted for Mr Trump in 2020, compared with 34% of non-white evangelicals. Mr Trump at first suggested that covid-19 was not terribly serious—like a bad case of the flu, he said early in the pandemic. This may have reinforced his fans’ behaviour (though some of those same fans seem less inclined to follow his more recent advice to get jabbed).

A study in Nature, using data from 15m smartphones a day, found that people in Trump-voting counties did 14% less physical distancing than those in Democratic counties during the first wave of lockdowns, in March-May 2020. Partisanship was more strongly associated with physical distancing (or the lack of it) than other county-level factors, including population density, income, race and age.

Tackling all this is not simple. Typical strategies to combat vaccine hesitancy, such as educating sceptics and enlisting the support of trusted leaders, are less likely to be effective among white evangelicals. According to Ryan Burge, a pastor and political scientist at Eastern Illinois University, evangelical culture is individualistic and anti-authority. Evangelicals do not think the average person needs a mediator with God, like the pope for Catholics.

Church leaders such as Franklin Graham, son of the late Billy Graham, have urged their congregations to get vaccinated. Some political leaders have done so, too. Mr Trump encouraged vaccination at a big Republican shindig in February. But these statements have had little impact (and in some cases have caused a backlash). The lack of religious authority within the community allows conspiracy theories to flow unchecked, says Mr Burge.

This combination of religion, politics and misinformation has merged into a worrying cocktail. According to Mr Perry, white evangelicals fear religious and political persecution in America, despite there being no historical or current evidence for this. Some believe that the American government is conspiring against them (though the willingness to pause a vaccine for just six recorded blood-clot cases out of nearly 7m doses hardly suggests a state conspiring against its people).

“It’s ironic, since the United States has literally done things like that to minority populations but obviously never to evangelical Christians,” says Mr Perry. “They’ve never been the target of some kind of conspiracy to infect them with disease or to keep track of them, and yet there’s this fear that the government is out to get them.”

Giving it a shot

Persuading black Americans to take part in a vaccination drive organised by a government that has historically abused them has been more successful than reaching vaccine-hesitant white evangelicals. African-Americans have begun to trust the jab as they learn more about its safety and effectiveness, and see people in their communities get it. More progress is needed, but the gains are promising.

But how do you win over people with deep religious concerns and angst about plots against them, who feed on misinformation and refuse to trust even revered figures prepared to tell them the truth? A successful effort to reduce vaccine hesitancy among white evangelicals will need to tackle their specific anxieties without validating the conspiracy theories or stoking worries of a government takeover. It will take a tricky balance of empathy and frankness. And it won’t be any easier now that the pause in use of the Johnson & Johnson vaccine has sown fresh seeds of doubt. ■

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All our stories relating to the pandemic and the vaccines can be found on our coronavirus hub. You can also listen to The Jab, our new podcast on the race between injections and infections, and find trackers showing the global roll-out of vaccines, excess deaths by country and the virus’s spread across Europe and America.