"If a rabbi did say 'you have to vaccinate,' we wouldn't": Unveiling the secular logics of religious exemption and opposition to vaccination.

Maintaining 'faith' in vaccination has emerged as a public health challenge amidst outbreaks of preventable disease among religious minorities and rising claims to 'exemption' from vaccine mandates. Outbreaks of measles and coronavirus have been particularly acute among Orthodox Jewish neighbourhoods in North America, Europe and Israel, yet no comparative studies have been conducted to discern the shared and situated influences on vaccine decision-making. This paper synthesises qualitative research into vaccine decision-making among Orthodox Jews in the United Kingdom and Israel during the 2014-15 and 2018-19 measles epidemics, and 2020-21 coronavirus pandemic. The methods integrate 66 semi-structured informal interviews conducted with parents, formal and informal healthcare practitioners, and religious leaders, as well as analysis of tailored non-vaccination advocacy events and literature. The paper argues that the discourse of 'religious' exemption and opposition to vaccination obscures the diverse practices and philosophies that inform vaccine decisions, and how religious law and leaders form a contingent influence. Rather than viewing religion as the primary framework through which vaccine decisions are made, Orthodox Jewish parents were more concerned with safety, trust and choice in similar ways to 'secular' logics of non-vaccination. Yet, religious frameworks were mobilised, and at times politicised, to suit medico-legal discourse of 'exemption' from coercive or mandatory vaccine policies. By conceptualising tensions around protection as 'political immunities,' the paper offers a model to inform social science understandings of how health, law and religion intersect in contemporary vaccine opposition.