Key Takeaways from Strategic Engagement of Religious Leaders in COVID-19 Vaccination Webinar
October 15, 2021
“Religious factors are the third most frequently cited reason for not getting vaccinated, and so the voice of the religious community is absolutely critical,” said Ellyn Ogden, MPH, USAID Coordinator for Polio Eradication and COVID-19 Vaccine Access in a webinar co-hosted by World Vision and CCIH on October 12, 2021.
The webinar, Strategic Engagement of Religious Leaders in COVID-19 Vaccination, brought together a panel with a wide array of experience and perspectives on how religious leader engagement affects vaccine acceptance or hesitancy and what we can do to leverage the influence of faith leaders.
In addition to Ellyn Ogden, speakers included Tom Davis, MPH, Global Sector Lead for Health & Nutrition, World Vision International; Sara Melillo, MPH, Global Health Consultant; and Reverend Dr. Fred Sheldon Mwesigwa, Bishop of the Ankole Diocese in the 13 million member Church of Uganda.
The panel was moderated by Susan Otchere, MSc, RN, Senior Director, Health-International Programs, World Vision US and included introductions from Mike Odera, Vice President for Resource Development, International Programs Groups, World Vision US and Doug Fountain, CCIH Executive Director.
Successful Faith Leader Engagement
In her presentation, Ellyn Ogden shared her experience in Nigeria engaging faith leaders to encourage uptake of the Polio vaccine. “It really became apparent that we needed to have a much more systematic approach [to engaging religious leaders],” she explained. “So we organized a religious leaders forum for Polio Eradication that was organized out of the office of the Sulton. Each person within the organization had a role or responsibility, there were training materials, consistent messaging, and set certain expectations. Bringing all of these people in again systematically made a huge difference that we were sending a common message from very high levels down to the very smallest communities throughout the country. This really was a turning point in building vaccine confidence where there had been great hesitancy.”
“Religious factors are the third most frequently cited reason for not getting vaccinated. And so the voice of the religious community is absolutely critical in making sure no matter which vaccine is being used, that there’s confidence that they know there’s a social norm that they’re part of; they’re serving their communities, and protecting not only themselves, but their loved ones.” -Ellyn Ogden, USAID
Barrier Analysis Uncovers Factors Driving COVID-19 Vaccine Acceptance or Refusal
There is substantial evidence that faith leaders have enormous influence in vaccine acceptance and refusal, and to encourage healthy behavior we need to understand the drivers behind this. “We really need to understand the drivers of that decision to get vaccinated with a COVID-19 vaccine by people of faith,” said Tom Davis, MPH, Global Sector Lead for Health & Nutrition, World Vision International. “And we need to know also why some faith leaders choose to promote COVID-19 vaccines amongst the religious communities that they serve, and others do not.”
Tom Davis shared the results of a Barrier Analysis that World Vision conducted in a number of regions, including Myanmar, Bangladesh, Africa, Europe and the US to discover the drivers of COVID-19 vaccine acceptance, and factors contributing to vaccine promotion by religious leaders. A Barrier Analysis, a technique Tom Davis developed in 1990, identifies the behavioral determinants associated with a particular behavior in order to develop more effective behavior change activities, and messages.
According to Tom, a key feature of the technique is to interview those doing a behavior or intending to do the behavior, the “doers,” and compare what they say with those who do not plan to do the behavior, “the non doers or non acceptors.” This allows the researchers to look for correlations between responses and the behavior so you can identify what is driving adoption of the behavior.
“In Myanmar, we found that vaccine acceptors were 2.8 times more likely to say that God approves of them getting a COVID-19 vaccine; they were 1.3 times more likely to say that they had a very high level of trust in COVID-19 vaccine information provided by religious leaders.” – Tom Davis, World Vision International
The COVID-19 Vaccination Barrier Analysis revealed that COVID-19 acceptors were much more likely to say that God approves of them getting the vaccine and that most of their community and faith leaders would want them to get a COVID vaccine. “In Myanmar, we found that vaccine acceptors were 2.8 times more likely to say that God approves of them getting a COVID-19 vaccine; they were 1.3 times more likely to say that they had a very high level of trust in COVID-19 vaccine information provided by religious leaders,” explained Tom.
Factors Driving Faith Leaders to Promote Vaccination
What encourages faith leaders to promote COVID-19 vaccines? Like in many behavior studies, social norms matter, explained Tom. “Faith leaders who believe that about half of faith leaders are encouraging, or will soon encourage people to get a COVID-19 vaccine were much more likely to be doing so now,” he said. “In fact, they are about 1.8 times more likely to be promoting COVID-19 vaccines. Faith leaders who believe that most of their close family and friends would want them to encourage people if they get a vaccine, were also much more likely to be promoting COVID-19 vaccines, they were almost twice as likely.”
How do we ensure faith leaders have accurate information and are comfortable promoting the COVID-19 vaccination? Tom recommends:
Medical professionals reach out to faith leaders, discuss vaccines with them and encourage them to promote vaccination among their congregations.
Sermon guides can be very useful
Encouraging faith leaders to promote vaccines in community meetings
Using mass or social media, including WhatsApp groups, to encourage vaccination
Sharing videos of faith leaders (especially high level leaders) receiving the vaccine or encouraging the vaccine.
Four Country Deep Dives to Better Understand Vaccine Hesitancy and Identify Promising Practices to Increase Uptake
Sara shared findings from a deep dive into four countries: Ghana, Indonesia, Sierra Leone, and Uganda and factors driving vaccine acceptance or hesitancy. This deep dive was a follow-up to a global landscape analysis on faith engagement in immunization.
Key takeaways from the study:
Few major religious objections to COVID-19 vaccines were found in the four priority countries. There were pockets of minority religions in those countries that have publicly objected to COVID-19 vaccination.
Social media is playing a highly influential role in spreading COVID-19 vaccine misinformation.
Perceived divine will is an important determinant to vaccine acceptance among health workers in rural areas (Sierra Leone).
The inclusion or perception of inclusion of haram (forbidden) ingredients within COVID-19 vaccines or their components may influence uptake of COVID-19 vaccine among Muslim populations (Indonesia).
“I think the findings show that this is a call to action to engage and invest in local faith actors in highly religious countries to serve as central partners to Ministries of Health and global technical bodies in COVID-19 vaccination,” said Sara. “What we found in these four countries were few major religious objections to COVID-19 vaccination although there were packers of smaller minority religions that publicly objected. In general, the major religious faiths have been very supportive.”
The study revealed 15 promising practices which can be categorized into four areas for promoting and scaling up COVID-19 immunization.
Strengthen support for COVID-19 immunization, including addressing any religiously linked concerns on vaccination through theological and scientific analysis and sensitive dialogue.
Strengthen collaboration among local faith actors (LFA) and state and civil society actors on COVID-19 vaccination promotion and delivery.
Leverage faith-based infrastructure to increase acceptance, uptake, and delivery of COVID-19 vaccines.
Provide technical support and tools to LFAs to increase the effectiveness of their COVID-19 vaccine social mobilization and delivery efforts.
“I think the findings show that this is a call to action to engage and invest in local faith actors in highly religious countries to serve as central partners to Ministries of Health and global technical bodies in COVID-19 vaccination.” -Sara Melillo, Global Health Consultant
Faith Leader Shares First-Hand Experience
Reverend Dr. Fred Sheldon Mwesigwa, Bishop, Ankole Diocese of the 13-million-members Church of Uganda shared his experience and journey from COVID-19 vaccine hesitancy to acceptance and promotion. Bishop Mwesigwa explained that after his questions and concerns about the vaccine were answered, he “caught the fire” and has been widely promoting the vaccine.
He was selected by the Anglican Church in Uganda to identify myths and truths about COVID vaccination to help roll out communications through all dioceses and clergy, a process that has led him to consult many global experts and to share his views through social media, and printed and online media such as the Daily Monitor. The Bishop and the Church of Uganda are active on social media dispelling myths and sharing accurate information about the COVID-19 vaccine (see sample posts at the top of the article).
The Way Forward: It’s Going To Take All of Us to Increase Vaccine Acceptance
In conclusion, Ellyn Ogden emphasized the need to listen and make sure we understand where people are coming from, what their priorities are and that we understand their concerns. “I often feel that hesitancy and confidence are due to a lack of our ability to communicate as health professionals,” she said. “We can’t blame communities for having what could be very real concerns. So we have to do a better job of explaining ourselves and convincing people why this is important to them and their families. And it’s going to take all of us.”