When health leaders in the heart of the Dutch country of Pennsylvania began implementing a strategy to distribute COVID-19 vaccines, they knew it would be a tough sale with the Amish, who tend to be wary of preventative strikes and government intervention.
Initially, they published leaflets in agricultural supply stores and at auctions where the Amish sell handcrafted furniture and quilts. They sought advice from members of the deeply religious and conservative sect, who told them not to bother. And they have asked three newspapers widely read by the Amish to publish advertisements promoting the vaccine. Two were refused.
In May, two rural vaccination clinics opened at a fire station and a social services center, both locations known to the Amish in Lancaster County. During the first six weeks, 400 people showed up. Only 12 were Amish.
The invention of vaccination is far behind in many Amish communities in the United States following a wave of virus outbreaks that have swept through their churches and homes over the past year. In Holmes County in Ohio, home to the largest concentration of Amish in the nation, only 14% of the county’s general population is fully vaccinated.
While their religious beliefs do not prohibit them from taking vaccines, Amish are generally less likely to be vaccinated against preventable diseases such as measles and whooping cough. Although acceptance of vaccines varies by church district, the Amish are often based on family tradition and advice from church leaders, and a central part of their Christian faith is to accept the will of God in times of sickness or death.
Many think they don’t need the COVID-19 vaccine because they are already sick and believe their communities have gained band immunity, according to health care providers in Ohio, Pennsylvania and Indiana, home to nearly two-thirds. of the estimated 345,000 Amish in the United States
“That’s the No. 1 reason we feel,” said Alice Yoder, executive director of community health at Penn Medicine Lancaster General Health, a network of hospitals and clinics.
Experts say the low vaccination rates are a reflection of both the nature of the Amish and the general hesitation of vaccination found in many rural parts of the country.
Because many Amish work and shop alongside their neighbors and take them on as drivers, they feel skepticism, concerns about the side effects and misinformation surrounding the vaccine from the “English” world, or non-Amish, around them. to them even if they avoid most modern conventions.
“They don’t get that from the media. They don’t watch TV or read on the internet. They get it from their English neighbors,” said Donald Kraybill, a former Amish expert. “In many ways, they’re just reflecting rural America and the same attitudes.”
In one case, an anti-vaccine group took out a full-page newspaper ad showing a buggy smashed with the words “Vaccines can have unintended consequences.”
Public health officials who have been trying to fight the confusion and hesitation have put up announcements where the Amish travel on horseback and in buggies, have sent letters to the bishops and have offered to take the vaccines in the their homes and workplaces, all without much success.
“It’s not for lack of effort,” said Michael Derr, the county health commissioner in Holmes, Ohio. “But this thing is so politically charged.”
Some health clinics serving Amish are hesitant to push the issue for fear of distracting them by getting blood pressure checks and routine exams.
Derr said a local business and the organizers of a community event told the health department in Holmes County that he would no longer be welcome if he brought the vaccine.
Staff members at the Parish Medical Center, which serves the Amish and Mennonites in Lancaster County, Pennsylvania, encourage patients to get vaccinated, but many have little fear of the virus, said Allen Hoover, the administrator of the clinic.
“Most of them are listening and are respectful, but you can know before you finish that you have already decided,” he said.
The clinic, he said, sees almost no cases of the virus now after being treated with five a day last fall. “We suspect we’ve gained some sort of immunity. I know that’s under discussion, but I think that’s why we’re only seeing a spattering now,” Hoover said.
Relying on a possible herd immunity when little testing has been done among the Amish is risky, said Esther Chernak, director of the Center for Public Health and Communications at Drexel University in Philadelphia.
“It’s not a community that lives on an island, that doesn’t interact with other people,” he said. “They don’t have zero interaction with the outside world, so they’re always exposed.”
Also, how long someone remains immune after taking COVID-19 is not clear, and some experts advise being vaccinated because it carries a higher level of protection.
As many as 180 million Americans – 54% of the population – have received at least one dose of a COVID-19 vaccine. Experts say low vaccination rates could allow the virus to mutate and make a comeback.
During the early months of the pandemic, the Amish followed social separation guidelines and stopped meeting for church and funerals, said Steven Nolt, a scholar at the Young Center for Anabaptist and Pietist Studies at Elizabethtown College. in Pennsylvania.
But when non-Amish neighbors and local elected officials began pushing against state and federal mandates, they resumed meetings, he said. What followed was a wave of fires last summer, Nolt said.
Most say now that they already have the virus and don’t see the need for vaccinations, said Mark Raber, who is Amish and a member of a facility in Daviess County, Indiana, which has one of the highest vaccination rates. low of the state.
“As long as everything stays the same, I don’t plan to get it,” he said.
Changing those views will require building trusting relationships with the Amish, the Centers for Disease Control and Prevention said in a report looking at outbreaks in those communities last year.
What is not working, health care providers say, is bombarding the Amish with statistics and vaccine lotteries because of their general distrust and the rejection of government aid. The Amish do not accept Social Security benefits.
Trevor Thain, who owns Topeka Pharmacy in northern Indiana, where there are 25,000 Amish, has worked with the CDC to fill communication gaps in LaGrange County, where only 18% of all residents are vaccinated. completely.
Since the vaccine is available, they have immunized 4,200 people, perhaps just 20 of them Amish, he said.
A few weeks ago it put into circulation offering private appointments or dispensed doses in homes. Only a few Amish people responded, said Thain, even one who came up with a question: “Don’t tell my family.”