Religious Beliefs and COVID Vaccine Hesitancy in San Pedro De Macoris, Dominican Republic

Background and Purpose: Religious views concerning vaccines and medical treatment exist within a constellation of socio-cultural views surrounding trust, autonomy, and risk of contracting a disease. Currently, with the emergence of a global pandemic, resource limited communities struggle with how to make sense of emergent health care (COVID vaccines). As immigrant communities turn to their religious leaders for guidance, more research is needed in how religious leaders shape attitudes and behaviors of their congregations with regards to vaccine hesitancy.

This project aims to assess the extent to which the relationship between immigration, sociocultural factors, religious beliefs impact vaccine hesitancy. This study drew from surveys and interviews in and near the sugarcane plantations (bateyes) of San Pedro de Macoris in the Dominican Republic which has a predominant Haitian immigrant population.

Methods: This data was collected in March of 2022. 12 in-depth, semi structured interviews were conducted with religious leaders (protestant, evangelical, voodoo) lasting from 45 minutes to 2 hours; and 151 surveys with Haitian residents of the San Pedro de Macoris bateyes. The religious leaders (ages 38-94, 3 women, 4 men) were recruited through a partnership with the local university. The residents of the bateyes were recruited by local physicians (participants: 20% Catholic, 42% Protestant; Female 63%). Qualitative interviews elicited participants’ life narrative from the onset of the COVID pandemic and their roles as religious leaders managing their congregations beliefs and vaccine hesitancy during COVID. Qualitative interviews were transcribed verbatim in Spanish and analyzed in Spanish using MaxQDA software, guided by the principles of grounded theory and using an inductive approach to qualitative analysis. Quantitative surveys which looked at vaccine rates, religion, leadership, and beliefs, were distributed to patients attending the health clinic in 3 bateyes over 3 days.

Findings: Data analysis reveals that although there were high levels of vaccine adherence among the immigrant population there remained suspicion/concern about vaccines, and religious leaders noted that they engaged multiple strategies to manage their congregations’ fears and hesitancy. Religious leaders managed strategies to integrate faith leadership with technology, fundamentalist Biblical references/framing, and governmental/medical policies. Leaders noted that governmental mandates influenced more integrated immigrants, but belief systems had to be managed. Notably, religious leaders struggled with managing fundamentalist beliefs (“faith in the Bible”) with scientific beliefs (“faith in the science”).

Conclusions and Implications: Although there was a high rate of vaccine adherence in the Dominican Republic due to government mandates, there remains unforeseen outcomes regarding beliefs and vaccine adherence among immigrant populations. Immigrants, who already must manage varying levels of integration from acceptance to xenophobic policies, often rely on religious beliefs and leaders for guidance in managing the unknown. Government health policies and emergent medical interventions (COVID vaccines) must attend to belief systems, in this case organized religion and religious leaders for guidance on working with and gaining the trust of their population. Growing suspicion, lack of information, and unchallenged fundamentalist beliefs may threaten the future stability of emergent care.