ASTANA – Religious reasons were found to be relatively weakly linked to vaccine refusal in Kazakhstan. Public distrust in the healthcare system plays a much larger role, according to the preliminary results of a new World Health Organization (WHO) research presented on June 26 in Astana.
Photo credit: Batyrzhan Berdenuly, a secretary of the Council of Scholars at the SAMK, and Archpriest Anatoly Izmerov. Photo credit: Maral Nuridin/WHO Kazakhstan
The study of attitudes towards vaccines among religious communities comprised 27 focus groups with 227 participants across four locations: Almaty, Astana, Atyrau, and Turkistan. The final results of the study are expected to be presented within the next two months.
Contrary to the widespread belief that religion negatively influences vaccination, the survey found that confidence in vaccines is more closely tied to healthcare workers and trust in the medical system, said Sahil Warsi, a consultant at the WHO Regional Office for Europe and lead scientist of the study.
“The people who are not vaccinating often appear religious. But it’s important to note that across these almost 230 people, almost no health workers, no parents, or administrators felt that the reasons for not vaccinating were grounded purely in religion. Only two people mentioned that the reason that a parent gave them was religious, that it was haram,” Warsi said.
Two common factors were identified among parents who refuse to vaccinate their children: personal or secondhand negative experiences with vaccination and exposure to emotionally charged and persuasive misinformation.
“We’ve all lived through the pandemic exposure to incorrect information. But what’s important is not just that they receive misinformation. It is misinformation that is emotional, and because it is emotional, it is convincing. So it might be somebody who sees a video online of a mother who is crying and saying, ‘Had I only known, I would never have vaccinated.’ And as we all know with social media, the algorithm will show you more of whatever you’re looking at,” Warsi said.
The research found that distrust in vaccines or the healthcare system in general is also a common factor contributing to the refusal to vaccinate.
Parents’ distrust stems from a fear of the negative consequences of vaccination, such as developmental delays, disability, and death; gaps in medical literacy and a lack of understanding of how vaccination works; and a feeling that the healthcare system workers do not care about children and do not take an individual approach to providing care.
According to Warsi, many people are concerned by the belief that no one can offer absolute assurance that what they see in alarming videos, such as claims that one in every 100 children dies from vaccination, won’t happen to their own child.
“When you talk to such parents, it is clear that there is not an understanding of how vaccination works, there’s not an understanding of how medicine works on the body. In this case, the statement that nobody can give me a 100% guarantee is also related to another distrust of the system, which is a feeling that parents will be left alone, and that the system does not care about my child. It does not have an individual approach to my child,” Warsi said.
The overarching pressure to meet specific vaccination indicators for healthcare workers creates an additional barrier to building trust with patients and effectively communicating the benefits and safety of vaccines.
“It puts a lot of pressure on a health worker in the moment of communication, whether that is the appointment, whether face-to-face with a parent, whether that’s when they invite them to seminars, or whether that’s if they go to their home to visit them. This pressure then means that they are focused primarily on convincing a parent when a parent might instead only want them to hear, or a parent might be in a place where information doesn’t matter,” Warsi explained.
“What matters for them is that maybe they need time. They don’t want to be talked to about this right now. This moment where health workers are trying to explain to parents, they’re trying to convince them they’re giving it 200% of their professional experience, and they see again and again that the parents shut down, the parents don’t respond,” he said.
Ultimately, such situations affect the morale of health workers, and it can lead to a resignation that nothing can be done with religious people or people who are against vaccines.
“What our research shows is that the reasons for vaccination themselves are not religious, and across the board, the reasons why people are not vaccinating are really connected to distrust. They’re connected to a real fear. And these things are emotional,” Warsi said.
Recent statistics on vaccination in Kazakhstan
According to Zhannat Nusipova, a representative of the Scientific and Practical Center for Sanitary and Epidemiological Expertise and Monitoring at the Ministry of Health, the number of vaccine refusals has increased 6.2 times over the last decade. While there were 8,383 refusals in 2015, the number had increased to 51,726 by the end of 2024.
“In recent years, there has been a worldwide increase in the refusal of preventive vaccinations, and refusals are among the top 10 global threats to human health. Kazakhstan has also seen an increase in hesitancy towards vaccination, which leads to a decrease in immunization coverage and, as a result, increases the risk of outbreaks of controllable infectious diseases,” Nusipova said.
“Refusal on religious grounds is also common in our country, ranking second after personal beliefs [61.73%] and accounting for 18%,” she added.
The main types of vaccine hesitancy rooted in religious beliefs include a reliance on Divine will, reflecting a form of passive fatalism that sees vaccines as unnecessary. It also includes moral objections, where certain vaccines are viewed as unethical due to how they are produced or their perceived effects, concerns about ingredients believed to defile the body, and the belief that vaccination is part of a conspiracy targeting a specific religious group.
Response of religious community leaders
Batyrzhan Berdenuly, a secretary of the Council of Scholars at the Spiritual Administration of Muslims of Kazakhstan, said that a common misconception that religious people are opposed to vaccination still prevails.
Although the traditional Islamic community supports vaccination, Berdenuly noted that minority or non-traditional religious groups tend to be more likely to be sceptical.
“Vaccination is not prohibited in Islam. However, if the vaccine contains something that is forbidden or impure, which is prohibited by Sharia, then we encourage the use of an alternative vaccine. If that is not available, then in case of necessity, Sharia allows the use of that product. Why? Because human health is important in Islam. Human life is important in our religion,” Berdenuly said.
“We’re not medical experts; we speak from a Sharia perspective. The issue is that even doctors often can’t give clear answers. When asked about the composition of vaccines, many doctors and nurses struggle to explain it properly,” he added.
According to Anatoly Izmerov, archpriest and chairman of the Society of Orthodox Doctors of Kazakhstan, Christianity is not opposed to vaccination.
“In fact, as a representative of the SAMK said, there is no religious reason in Islam, and I also declare that there is no religious reason in Christianity not to seek medical help and not to take medicine. And vaccination is also a kind of medicine,” Izmerov said.
