Immunization is the most successful public health intervention after clean water. It has led to large reductions in the burden of disease associated with vaccine preventable diseases, and in the case of smallpox, complete disease eradication. Decreasing inequalities in vaccination is one of the objectives of the World Health Organization’s Immunization Agenda 2030 strategy.
Vaccine coverage for routine childhood immunization in Israel is generally high, with some variation among the different ethnic and religious groups that comprise Israeli society. The Ultra-orthodox Jewish population comprises approximately 14% of Israel’s population. Over the years this segment of the population has been disproportionately affected by outbreaks of vaccine preventable diseases, most recently measles, partly due to reports of lower vaccination coverage compared with other groups in Israel. Lower vaccine coverage in this group has largely been attributed to barriers to accessing healthcare services rather than religious beliefs. The COVID-19 outbreak is also disproportionately affecting The Ultra-Orthodox community in Israel, in which over a third of cases were reported in early October 2020.
The Ultra-Orthodox community in Israel is not homogenous and presents regional variability in terms of health beliefs and religious leadership. In Tzfat (Safed), Northern Israel, a proportion of the ultra-orthodox community combines an ultra-orthodox lifestyle with beliefs in a “natural” or “holistic” lifestyle. There are concerns that this lifestyle is increasingly incorporating hesitancy towards vaccination or anti-vaccination sentiment, although this has not been formally described, Nevertheless since the onset of the COVID 19 pandemic, anti-vaccination material (which also expresses skepticism towards COVID-19, ) specifically targeting the ultra-orthodox community has been seen around Tsfat (see above). Its impact on the current childhood immunisation programme, as well as a potential COVID-19 vaccination programme, is unknown.
This project aims to better understand the current status of vaccination as well as knowledge, beliefs, attitudes and practice of this community towards vaccination (including both existing routine childhood vaccine and a potential COVID-19 vaccines and to use the information collected as a basis to design, implement and evaluate an intervention to improve vaccine coverage among the Ultra-orthodox Jewish community in Tsfat.
Specifically the successful PhD candidate will collect information from existing data, literature and key stakeholders as a basis to design, implement and evaluate an intervention using the World Health Organization's “Tailoring Immunization programmes” framework as well as its Immunization inequity guidance. The European Office of the World health Organization will provide technical support to this project. It is anticipated that the resulting intervention will be relevant to other communities across Israel as well as globally.