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When health care leaders in the heart of the Dutch country of Pennsylvania began to develop a COVID-19 distribution strategy vaccines, they knew it would be a tough sell with the Amish, who tend to be wary of preemptive fire and government intervention.
At first, they displayed flyers at farm supply stores and at auctions where the Amish sold handmade furniture and quilts. They sought advice from members of the deeply religious and conservative sect, who told them not to be arrogant. And they asked three widely read Amish newspapers to run ads promoting the vaccine. Two refused.
By May, two rural vaccination clinics had opened at a fire station and a social service center, both familiar locations to the Amish in Lancaster County. In the first six weeks, 400 people showed up. Only 12 were Amish.
The vaccination campaign is lagging far behind in many Amish communities across the United States following a wave of virus outbreaks that has swept through their churches and homes over the past year. In Holmes County, Ohio, home to the largest concentration of Amish in the country, only 14% of the county’s total population is fully vaccinated.
Although their religious beliefs do not prohibit them from getting vaccinated, the Amish are generally less likely to be vaccinated against preventable diseases such as measles and pertussis. Although acceptance of the vaccine varies by church district, the Amish often rely on family tradition and the guidance of church leaders, and an essential part of their Christian faith is to accept the will. of God in case of illness or death.
Many believe they don’t need the COVID-19 vaccine now because they’ve already fallen ill and believe their communities have achieved herd immunity, according to health care suppliers in Ohio, Pennsylvania and Indiana, home to nearly two-thirds of the estimated 345,000 Amish in the United States
“It’s the # 1 reason we hear,” said Alice Yoder, director of community health at Lancaster General Health, a network of hospitals and clinics.
Experts say the low vaccination rates reflect both the nature of the Amish and the general reluctance to vaccinate that is found in many rural parts of the country.
Because many Amish people work and shop alongside their neighbors and hire them as drivers, they hear the skepticism, concerns about side effects and misinformation surrounding the vaccine from the “English” or non-Amish world around them, even if they avoid the most modern conveniences.
“They don’t get that from the media. They don’t watch TV or read it on the Internet. They get it from their English neighbors, ”said Donald Kraybill, a great scholar of the Amish. “In many ways, they just reflect rural America and the same attitudes.”
In one case, an anti-vaccine group released a full-page newspaper ad showing a broken buggy with the words “Vaccines can have unintended consequences.”
Public health officials trying to tackle the confusion and reluctance put up notice boards where the Amish travel on horseback and buggy, sent letters to bishops, and offered to bring the vaccines to their homes and workplaces, all without much success.
“It’s not due to a lack of effort,” said Michael Derr, health commissioner for Holmes County, Ohio. “But this thing is so politically charged.”
Some health clinics that serve the Amish are reluctant to push the issue for fear of stepping them away from routine blood pressure checks and exams.
A local business and the organizers of a community event told the Holmes County Health Department that he would no longer be welcome if he brought them the vaccine, Derr said.
Staff at Parochial Medical Center, which serves Amish and Mennonites in Lancaster County, Pennsylvania, encourage patients to get vaccinated, but many have little fear of the virus, clinic administrator Allen Hoover said. .
“Most of them listen and are respectful, but you can tell before they’re done that they’ve already made up their minds,” he said.
The clinic, he said, sees virtually no cases of the virus now after treating up to five a day last fall. “I suspect we have acquired some sort of immunity. I know it’s up for debate, but I think that’s why we’re only seeing splashing right now, ”Hoover said.
Relying on possible herd immunity when little testing has taken place among the Amish is risky, said Esther Chernak, director of the Center for Public Health Readiness and Communication at Drexel University in Philadelphia.
“It is not a community living on an island, which does not interact with other people,” she said. “They have no interaction with the outside world, so they are always exposed.”
Additionally, it is unclear how long a person remains immune after contracting COVID-19, and many experts advise getting the vaccine because it provides a higher level of protection.
Nearly 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.
In the first few months of the pandemic, the Amish followed social distancing guidelines and stopped congregating for church and funerals, said Steven Nolt, a researcher at the Young Center for Anabaptist and Pietist Studies at Elizabethtown College in Pennsylvania.
But when non-Amish neighbors and locally elected officials began to push back on state and federal mandates, they resumed the rallies, he said. What followed was a wave of epidemics last summer, Nolt said.
Most now say they’ve had the virus before and don’t see a need for a vaccine, said Mark Raber, who is Amish and a member of a colony in Daviess County, Indiana, who has the one of the lowest vaccination rates in the state.
“As long as everything stays the same, I don’t think I’ll have 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 on epidemics in those communities last year.
What won’t work, health care providers say, is bombarding the Amish with statistics and vaccine lotteries due to their general mistrust and rejection of government aid. The Amish do not accept Social Security benefits.
Trevor Thain, owner of Topeka Pharmacy in northern Indiana, where there are 25,000 Amish people, worked with the CDC to address communication gaps in LaGrange County, where only 18% of all residents are fully vaccinated.
Since the vaccine became available, they have vaccinated 4,200 people, perhaps just 20 of them Amish, he said.
A few weeks ago, he distributed flyers offering private meetings or doses distributed inside homes. Only a few Amish responded, Thain said, including one who came with a request, “Don’t tell my family.
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