Vaccine Hesitancy Among Orthodox Jewish Communities
Blima Marcus, DNP, RN, ANP-BC, OCN, works with cancer patients in primarily ultra-Orthodox Jewish communities in New York City. Like other vulnerable communities, her patient population is targeted by well-funded antivaccine organizations that know how to strengthen mistrust that may already be inherent in the population, she said.
Dr Marcus outlined 3 main concerns expressed by Orthodox Jewish patients:
- What is in the COVID-19 vaccine?
- Is the vaccine toxic?
- Does the vaccine actually work?
“Some people try to fit narratives that resonate better with them, such as wondering if COVID death numbers are real or if they are somehow inflated and whether patients died from COVID or with COVID?,” said Dr Marcus, who is a nurse practitioner in ambulatory oncology as well as adjunct professor at Hunter College-Bellevue School of Nursing, City University of New York. She saw similar concerns during the measles outbreak among Orthodox Jewish communities in New York and New Jersey that started in October 2018.
In response to distrust stemming from initially confusing messages on mask wearing, Dr Marcus tells patients that this is one of the first times in history where we are watching science evolve “and it is messy.” As new evidence emerges, the CDC has had to backtrack and change recommendations. “When the [initial] recommendation was made not to mask, that was before we knew that asymptomatic transmission occurred. There was a delay in learning,” she said.
She emphasized the importance of having people from within the community become advocates or vaccine ambassadors. These trusted advocates can endorse scientific information when educating community members. Dr Marcus also is founder of the Engaging in Medical Education with Sensitivity (EMES) initiative.
Dr Marcus also uses cautious optimism to encourage vaccination in her oncology patients, many of whom “have isolated for over a year now refusing to leave their homes except for coming into the clinic for chemotherapy and appointments. They are the ones I’m giving messages of future hope of getting to a place where they can see their grandchildren and where they can feel less afraid.” Most of her oncology patients have received the vaccine, she said.
“The fatality rate [from COVID-19] for cancer patients is close to 20% to 25%, so definitely get the vaccine,” she said.
Fighting the Infodemic on Social Media
Misinformation on Twitter, Instagram, and Facebook continues to be a pronounced barrier to COVID-19 vaccination uptake. Nurses, who are often seen as trusted sources of information, can play a key role in arming the public with evidence-based facts and helping patients overcome vaccine hesitancy, the presenters said.
“Allowing lie after lie without breaking in and saying, ‘Hold off, this is false. And here’s a good resource you can read,’ is very important for the lurkers who may be reading along, but have not been yet given a rebuttal,” Dr. Marcus said. She suggests offering scientific information in a respectful response to help battle misinformation online.
However, Dr Marcus also knows when to cut her losses. “It is so important to keep that respect and step back when you feel you can no longer engage in good faith and be useful to the conversation,” she said.
Centers for Disease Control and Prevention. Vaccines and immunizations: training and education resources. Accessed March 12, 2021. www.cdc.gov/vaccines/covid-19/training-education-resources.html