COVID Vaccination Challenges: Ethical Imperatives and Local Realities
Webinar, February 24, 2021

Webinar Summary

Overview

Lessons from the lived, ongoing experiences of religious communities can contribute to national and global COVID-19 vaccination campaigns, with applications ranging from the very global to the very local. New demands for cooperation and partnerships highlight the complex relationships between governments and religious communities. These involve shared and divergent concerns about ethical and practical aspects of equitable vaccine allocation and access, mechanisms to meet urgent logistical challenges, communications about needs and process, and addressing doubts and fears.

A February 24 event on COVID Vaccination Challenges: Ethical Imperatives and Local Realities centered on faith engagement in the ongoing vaccination rollout, featuring three specific perspectives: Mohamed Elsanousi provided insight as part of a U.S. nationwide interreligious coalition focusing on the COVID-19 vaccination campaign; Sister Sharon Eubank, leader of Latter-day Saint Charities, linked responses in the western United States to global humanitarian operations; and Berkley Center Senior Research Fellow Rev. Gerard McGlone, S.J., explored the experience of Georgetown’s Jesuit community and considered broader mental health challenges linked to the COVID-19 emergencies.

This event was co-sponsored by the Berkley Center for Religion, Peace, and World Affairs at Georgetown University; G20 Interfaith Forum; International Center for Law and Religion Studies at Brigham Young University; Fondazione per le Scienze Religiose, Giovanni XXIII; World Faiths Development Dialogue (WFDD); and the Joint Learning Initiative on Faith and Local Communities.

Sidebar: This webinar was the eleventh in a series of public conversations focused on faith engagement in the COVID-19 crisis and response, organized by the Religious Responses to COVID-19 project. A video recording is available on the Berkley Center website.

 

 

Key Takeaways

 

  • Unique aspects of the COVID-19 vaccination effort—such as its urgency, novel vaccine, and global reach—demand sharp focus on both ethical and practical aspects. All engage religious actors, both in theory and in practice. Each aspect has both global and local dimensions, including diversity in both local ethical priorities and practicalities of local implementation.  
  • Rapid and focused U.S. vaccination campaigns need to avoid reinforcing “vaccine nationalism,” always proactively shaping U.S. messaging in ways that can readily be adapted globally.
  • The new U.S. interreligious coalition, Faith4Vaccines, highlights potential links between practical engagement and effectiveness in addressing the challenges of reaching vulnerable and often skeptical communities.
  • Lessons from positive experiences—for example, the vaccination success of Cherokee and Navajo communities in the United States—can be adapted to other national and global contexts.
  • Challenges of vaccine hesitancy, including poor information and distrust of health systems, have global relevance, underscoring potential ways religious communities can contribute to solutions.
  • Arguments that science and faith clash or are incompatible are false and damaging. While small religious communities deny scientific learning, large majorities accept scientific evidence as entirely consistent with religious beliefs.
  • COVID-19 vaccination campaigns involve stages where initial competition for access is followed by persuasion of those who hesitate. Focus on vulnerable communities at all stages is a central ethical concern.
  • Fears and distrust must be addressed primarily at very local levels.

 

 

Pull quote: “No one is safe until we all are safe. Until all segments of society, worldwide, are safe and well, with most vaccinated, the danger of COVID-19 will persist.”

 

 

Participant Interventions: Key Trends and Concerns

 

Katherine Marshall, Berkley Center and WFDD (moderator)

The rapid development of COVID-19 vaccines—a miracle of science, partnership, and cooperation—now presents unique and unprecedented challenges of implementation. These call for new forms of leadership by global institutions, including the G20, and by local authorities, as well as within communities and by individuals. Three ethical and practical issues demand attention and thoughtful engagement between public health and religious authorities:

(a) The moral catastrophe (Dr. Tedros Adhanom Ghebreyesus, WHO) of the imbalance between wealthy countries with access to vaccines, notably the United States, and other countries. Some 130 poorer countries have no vaccine supplies, no vaccinations in progress, and the prospect of long delays before vaccines reach them. The clear moral obligation is to ensure that the most vulnerable communities have priority, notwithstanding pressures on any country to care for its citizens. Imbalances are evident both locally and internationally.

(b) Logistical challenges have practical and ethical dimensions: to manufacture, test, price, and deliver vaccines; ensure that they go to the right people; track side effects; cease fire in armed conflicts to allow vaccination; and so on. This demands extraordinary leadership and cooperation among sectors. The complex ongoing experience in the United States suggests many lessons.

(c) People need positive persuasion and reassurance that vaccination is the right thing to do, and trusted religious leaders are critical messengers. They can also address high levels of resistance and hesitation, linked to history, fears, inadequacies of health delivery systems, and deliberate misinformation.  

 

Sharon Eubank, LDS Charities

Pull quote: “Whatever your network is, make some bridges and connections to others, so that we can grow those concentric circles and be more powerful.” — Sharon Eubank, LDS Charities

While vaccination challenges have common dimensions, micro-local responses differ widely. Trusted faith leaders can persuade and encourage people in many situations. Examples of effective leadership include the personal examples of Pope Francis and Pope Emeritus Benedict being vaccinated and their forthright addressing of concerns about stem cells in vaccine manufacture, which provide theological resonance and justification linking personal health and the health of others.

An online video posted by LDS President Russell Nelson, a cardiac surgeon, stressed: “I’m a man of science and I’m a man of faith, and those things blend in this worldwide pandemic.” The patriarch of the Ethiopian Orthodox Church also showed leadership in supporting testing and treatment to combat HIV as spiritually acceptable. Modern leaders need to underscore that all are people of science and faith to various degrees, and we must blend science and faith as we respond. When faith communities acknowledge that their faith in God and their trust in the scientific miracle of vaccination are compatible, common efforts are possible: Faith and science blend, and they are complementary.

Reaching vulnerable communities everywhere and bridging unacceptable gulfs between rich and poor countries and communities for vaccine access are priorities. Acknowledging that the U.S. experience is mixed is necessary, notably serious gaps in reaching out to prisons, immigrant communities, and Native American nations, which have struggled to receive needed supplies, food, and vaccines. Addressing resistance to vaccination demands efforts to understand why people resist. There are positive examples to build on, notably lessons from local leaders empowered to make decisions that make sense for local circumstances.

 

Mohamed Elsanousi, Network of Religious and Traditional Peacemakers, Faith4Vaccines

 

Pull quote: “This will take all of us to address the issues. That is why we created the Faiths4Vaccines initiative. Everybody is welcome, from any denomination, any religious group, and non-religious groups also. All add value that can be replicated to this table.” — Mohamed Elsanousi, Network of Religious and Traditional Peacemakers

 

A whole-of-society approach involving new and innovative mechanisms is essential to meet the COVID-19 challenge. Religious leaders across the United States are recognizing opportunities to leverage interfaith and interreligious collaboration to address issues that affect every community, with an interfaith collaboration to leverage vaccine distribution and trust-building that draws from previous national and global interfaith collaboration.

Interfaith communities can have large impact in support of community-based initiatives, especially in times of crisis, and interfaith collaboration can support equitable vaccine distribution. National religious leaders—including, but not limited to, representatives from the National Council of Churches, Islamic Medical Association of North America, Union for Reformed Judaism, National African American Clergy Network, National Latino Evangelical Coalition, National Association of Evangelicals, Catholic Charities, and Network of Religious and Traditional Peacemakers—have formed the Faiths4Vaccines initiative. It addresses four key objectives:

(a) Increasing vaccine trust and acceptance among religious and minority communities. Faith leaders, including women and youth, can encourage trust and acceptance of vaccines, particularly among communities with histories of mistreatment by health care systems: Black, Latino, Native American, Alaska Native, and other marginalized communities have faced health care inequity and discrimination, contributing to distrust in the vaccine.

(b) Identify and utilize houses of worship as new and innovative venues for vaccine distribution. Nearby and familiar, these sites are well positioned in communities to address specific concerns about vaccine distribution. Mega sites—stadiums, for example—may be difficult to travel to and are not conducive to decentralized community-based approaches. Using local and trusted sites can make the vaccine experience convenient and comfortable. Some state and county health departments are already working with religious institutions and houses of worship.

(c) Advocating and advancing equitable vaccine distribution, notably among marginalized and minority communities. Community leaders can serve as trusted messengers to dissuade hesitancy, and interfaith networks can help ensure that community members have equal opportunities to receive the vaccine, regardless of faith affiliation, racial background, or socioeconomic status.

(d) Amplifying interreligious service to support the common good. Interreligious approaches offer high added value and opportunities for community reconciliation at a time of national polarization and division.

The Faiths4Vaccines initiative can serve as a model for other nations to build interfaith coalitions to support vaccine distribution and combat hesitancy. Colleagues in Finland and Kenya are looking to the model, adjusted to fit local contexts. The fortunate position of the United States must be kept in mind. UN Secretary General Guterres, addressing the UN Security Council on February 17, highlighted inequitable access to COVID-19 vaccines, with only 10 countries administering 75% of all COVID-19 vaccines; in most countries, COVID-19 vaccinations are a luxury. Communities affected by conflict and insecurity are at particular risk of being left behind.

 

Rev. Gerard McGlone, S.J., Berkley Center

Pull quote: “We   must address the   enormous inequality that is happening, both in vaccinations, but also in the ways in which we value women and we value children that the crisis has revealed. When we address them, we will be working for the common good.” — Rev. Gerard McGlone, S.J., Berkley Center

Data shows overwhelming psychological issues that individuals are confronting during the pandemic. The United States is commemorating 500,000 U.S. deaths from COVID-19, which can help people to deal with our losses. This is an ethical imperative. Lighting a candle to remember those we have lost is profoundly important for our spiritual and psychological health and well-being. In every faith tradition, that is the core of how we begin to enter this experience with sanctity and with a sense of safety.

Focusing continually on the most vulnerable, at the forefront of both global and local thinking, is vital. Early data from vulnerable populations in the United States and globally highlight that women or children are suffering the most. Faith leaders who are women need to be part and parcel of the response. We learned during the HIV/AIDS epidemic in parts of Africa, for example, the vital roles of family and community support in a person’s well-being. With a goal of reinforcing existing cultures of  safety and safeguarding, protecting children and women then becomes the broader focus of a culture of accountability and responsibility.

Living in a Jesuit house with 45 other Jesuit priests highlights the shifting emotional tempo and focus, with well-controlled fears shaping relationships—the essence of both global and local society—in complex ways. Religious leaders at every level need to model how to be advocates for vaccine distribution that is equitable and fair and favors the underprivileged and those with troubled historical and contemporary relationships to the medical community.

The best psychological tool is to stay in the fears—never to dismiss, however unintentionally, the other individual. Effective leaders model a positive response. Cardinal Wilton Daniel Gregory, for example, has grieved publicly—praying nationally, taking the vaccine, and visiting vulnerable communities. Ethically, this must be our first concern. Likewise, realities of exclusion of underprivileged countries and people find expression right in the neighborhoods of Washington, DC, even in the house where I live. The Gospel of the Christian tradition is that the first shall be last and the last shall be first.

 

Questions and Exchange

 

Trust and vaccine confidence and hesitancy

 

The national and global crisis reflects and is accentuated by an erosion of trust in most institutions. While trust in religious leaders is weaker than it once was, it remains a strong asset to build on in addressing vaccine access, as well as fears and distrust, among vulnerable communities. An example is undocumented populations, where different fears and uncertainties may be interlinked, with fear of being deported contributing to reluctance to be vaccinated. Religious communities can help to rebuild trust while addressing underlying issues at stake.  

 

Fears linked to the Tuskegee history

 

The unethical Tuskegee medical experiments and other examples are cited often and reflect histories that explain some current fears and distrust. However, many do not fear that something like Tuskegee will happen again, even if that is their stated reason; bigger fears and distrust arise because today vulnerable populations are not treated with dignity and respect by the medical establishment.

Vulnerability, authority, and trust

In ensuring that vulnerable people and communities are vaccinated, issues to address include disparities that block vaccine access, such as digital divides; scrambles by the more advantaged to have vaccine access; and disproportionate hesitation and distrust of public authorities. People separated from their natural community—including people in prison, undocumented people, refugees and new migrants, and children separated from caregivers—often lack a community of trust.

Complex questions turn on the relationship between free will and trust, as governments around the world, to varying degrees, compel people around public health requirements. Compelling people can erode trust, so giving people and communities as much self-determination as possible is critical. Faith communities should focus on vulnerable people who are physically separated from their sources of faith and trust. They should work as citizens to balance the need to protect    everybody and people’s abilities to choose, as scriptures teach us. (Sharon Eubank)

Scapegoating, discrimination, and pandemics

We could predict from history that during times of pandemics, uncertainty, and pain, discrimination and scapegoating of certain communities and even conflict will rise. Distrust, spread of misinformation, and social tensions erode social cohesion and contribute to social and political fragility. Despite calls for global ceasefires, conflicts still rage. Prejudices may worsen, fueled by fear.

Positive experience in Native American communities

The Cherokee and Navajo nations have traditionally had quite low vaccine acceptance rates, but some recent surveys show rates for COVID-19 vaccination as high as 75% (significantly higher than U.S. willingness to be vaccinated overall). These communities have separate health care systems, and many people believe in traditional medicine alone.

For the Cherokee Nation, one explanation is that the community was jolted by deaths of respected elders. They therefore put fluent Cherokee-speaking elders first in line for vaccines, to protect a cultural treasure and thus to help preserve the cultural heritage. As a result, acceptance rates along the Cherokee Nation increased sharply. Experience was similar in the Navajo Nation, where medicine men were the first wave of the inoculation, even if they were not in the officially sanctioned age group. Tribal leaders answered questions over the radio and held town hall meetings twice a week. Navajo doctors worked with people, speaking Navajo, and answered questions about the vaccine. The medicine men’s association certified the vaccine, and traditional farmer cooperatives worked with members.  

Pandemics in pandemics, a tsunami of parallel problems

Rates of suicide off the scale highlight the extraordinary mental health and loneliness effects of the COVID-19 crises. This tsunami is just beginning; we can predict that what has been hidden in the pandemic will come at us in enormous numbers. With predictability there’s control, so it is important that we gather resources now, both mental health experts in faith traditions and members of the faith community who can speak to fears and mental health issues. This is the pandemic within the pandemic-like a tsunami:

“We are at the beginning of hearing the waves and seeing that the water going out, thus anticipating that we’re going to see a flood of mental health issues that the world has not seen before.” (Rev. Gerard McGlone, S.J.)

Collaboration and partnerships

Efficiencies of scale are important to reach global but also local vaccination targets. That means working with experienced partners who have knowledge and established processes, like UNICEF, GAVI, and the World Health Organization. All are bound, ethically, to work with the most vulnerable first and as stakeholders. Religious communities can help hold them accountable, with networks of grassroots faith-based organizations.

“We can work together. We are two hands of the same body…We have the opportunity to activate people who haven’t been active before…We can give women, for example, an opportunity to have expertise and voice in their communities that they may not always have exercised in the past. And youth can drive communities. That is where opportunities lie.” (Sharon Eubank)

Whose voices are heard, what information or misinformation is spread?

Many local and regional religious institutions spread powerful and positive messages and counter misinformation, but still remain in the shadows. Social media and the viral spread of information accentuates the tendency to highlight excitement and drama, rather than the steady and gritty kinds of work that so many organizations are doing and their positive roles and spirit of hope.   Telling positive stories and effective communication are important priorities.

Messages and stories

“A source of consolation that eased my own fears over receiving the vaccine was talking to those who had received it: What were the side effects? Every person has a different story, and those stories need to be told. These witnesses and faith communities need to be tapped, speaking to others, especially those on the margins of society.  It’s important to go back to the experience of refugees and migrants, and have individuals in those cohorts and in those populations experience the vaccine first hand. In those areas rumor and innuendo and threats spread like wildfires. But you can also spread the wildfire of wellness and protection that can be equally powerful. The old adage notes that ‘Anger is as much a contagion as hope, and fear is as much a contagion as happiness and full healing.’ We need the positive momentum. Let’s not let the vagaries and horrible tragedies that we see determine the full extent of our response.” (Rev. Gerard McGlone, S.J.)

 

Conclusions and Next Steps

 

Some positive trends in faith-inspired and religious interventions in the COVID-19 vaccination rollout include:

 

  • Economies of scale developed through ethically and practically driven partnerships.
  • Local initiatives and approaches geared to local situations, especially to assuage fears in vulnerable communities.
  • Trusted community leaders leading discussions, where listening and hearing permeates the approach.
  • Witness of a leader who was skeptical about vaccination but changed their view.
  • Acknowledging legitimate reasons for distrust and doubts, including weaknesses in health delivery systems that fail to treat people with full respect.
  • Positive initiatives building on broad partnerships, including the business community.
  • Deliberately engaging women and young people as advocates and witnesses.
  • Drawing on experience in combatting religious resistance to polio vaccination in Nigeria and Pakistan.
  • Voices of reason speaking loudly to counter misinformation or disinformation surrounding COVID-19 vaccination.

We hear often that a crisis can bring out the best in humanity, the better angels, as people recognize that they are facing common challenges. They can see the humanity and the stories of others. But we also know that crises can bring out the worst in humanity; when people are afraid, they may become a mob and thrash out at others. As we struggle with perhaps the greatest moral challenge humanity has ever faced, the best of religion and the best of development need to be a real guide to the common good.

Back Matter

Participants

 

Dr. Mohamed Elsanousi is the executive director of the Network for Religious and Traditional Peacemakers, a global network that builds bridges between grassroots peacemakers and global players to work towards sustainable peace.

Sharon Eubank is director of Latter-day Saint Charities, the humanitarian organization of the Church of Jesus Christ of Latter-day Saints. Eubank is also the first counselor in the general presidency of the Relief Society, the church’s organization for its six million female members ages 18 and over.

Katherine Marshall is a senior fellow at the Berkley Center for Religion, Peace, and World Affairs at Georgetown University. She helped to create and now serves as the executive director of the World Faiths Development Dialogue.

 

Rev. Gerard J. McGlone, S.J., Ph.D., is a senior research fellow at the Berkley Center for Religion, Peace, and World Affairs at Georgetown University. Most recently, he was the associate director for protection of minors for the Conference of Major Superiors of Men.

About this Brief

 

This event summary highlights contributions to a virtual meeting on “COVID Vaccination Challenges: Ethical Imperatives and Local Realities,” held on February 24, 2021. The event featured health experts and development leaders, who reflected on faith engagement in COVID-19 vaccination.

+ Berkley Center/JLI/WFDD language

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