Promoting Childhood Vaccinations
Within the Ukrainian and Eastern Orthodox Community of Spartanburg, SC
Engaging the Ukrainian Eastern Orthodox community on vaccinations requires a deep and respectful understanding of the Church's teachings on health, science, and personal responsibility. Public health messaging that fails to acknowledge this religious framework will be less effective. The goal of this section is to demonstrate that a commitment to public health through vaccination is not in conflict with Orthodox Christian faith but can be understood as a profound expression of it. By validating the community's core values while gently correcting misinformation, a foundation of trust can be established.
The Eastern Orthodox Church has a long and consistent history of viewing legitimate science and medicine as compatible with faith. The foundational Orthodox Christian belief is that human life and well-being are precious gifts from God, who is the ultimate source of all life and healing. Within this framework, the Church perceives the work of medical professionals as a "God-given art". When used appropriately, medicine serves God's purpose of restoring health and alleviating suffering. Therefore, for most Orthodox Christians, there is "no essential contradiction" between turning to modern medicine for physical healing and seeking the spiritual resources of the faith for the healing of the soul.
This positive view of public health is not a recent development. The Church has historically supported measures aimed at preserving life and health within the broader community. A powerful example comes from 1804, when the Holy Governing Synod of the Russian Orthodox Church issued a decree recommending that bishops and priests actively "explain to the people the benefits of vaccinations from smallpox". At that time, clergy were even educated on the basic methods of applying the vaccine.
In the modern era, high-level leaders across the Orthodox world have continued this tradition by strongly and publicly endorsing vaccination. His All-Holiness Ecumenical Patriarch Bartholomew, the spiritual leader of Orthodox Christians, has urged everyone to get vaccinated "with no reservations," emphasizing the Church's respect for science and stating that a person who refuses vaccination "is not thinking rationally". Similarly, the Holy Eparchial Synod of the Greek Orthodox Archdiocese of America, the largest Orthodox jurisdiction in the United States, issued a powerful statement affirming that the Church "not only permits vaccinations against diseases... but that She encourages Her Faithful... to be vaccinated". The Archdiocese was also unequivocal in stating that "there is no exemption in the Orthodox Church for Her faithful from any vaccination for religious reasons" and instructed its clergy not to issue such letters. These clear and authoritative endorsements from respected hierarchical figures provide a strong theological foundation for accepting and promoting vaccination within the community.
While the Orthodox hierarchy is broadly pro-vaccine, there is a parallel and deeply held theological and cultural emphasis on free will, parental responsibility, and voluntary, informed consent. Any public health approach that appears coercive or dismissive of parental authority is likely to be met with resistance.
Respect for Free Will
Statements from various Orthodox bodies, particularly the Moscow Patriarchate, have consistently stressed that vaccination must be a voluntary choice. The Patriarchal Commission of the Russian Orthodox Church has stated that parents should "retain the right to make informed decisions regarding the health of their children... without being subjected to any pressure" and that persecution of parents for exercising this right is "unacceptable". This position is rooted in the Orthodox understanding of the human person as being created with free will, a faculty that must be respected.
Harmonizing Public Health with Personal Liberty
This emphasis on choice can be a point of significant friction with public health mandates. However, it is important to recognize that the Church's position is not anti-vaccine. The same church bodies that oppose mandates also call for the provision of "complete, verified and reliable information" so that parents can make sound decisions. This presents an opportunity for public health. The communication strategy should not be framed as a demand for compliance but as a partnership in decision-making. This approach is particularly critical when engaging with the Ukrainian community. The official stance of various Orthodox jurisdictions is not uniform. While the Greek Orthodox Archdiocese of America has issued strong pro-vaccine statements, some recent immigrants from Ukraine may be more influenced by the rhetoric of the Moscow Patriarchate in Ukraine, which has been more skeptical and has used apocalyptic language to describe vaccination efforts. A communications strategy that relies solely on quoting a Greek-American bishop may therefore be ineffective. A more successful approach is to find common ground: the shared value of protecting children and the shared respect for the parent's role as the ultimate decision-maker.
Effective communication with the Ukrainian community in Spartanburg requires more than the presentation of scientific facts and theological endorsements. It demands a deep, empathetic understanding of the historical and cultural context that shapes perceptions of healthcare and authority. For many Ukrainians, vaccine hesitancy is not born of ignorance, but of experience. It is a rational response to a history in which state institutions, including the medical system, have been sources of corruption, inefficiency, and trauma. Acknowledging this painful history is the essential first step toward building the trust necessary for a successful public health partnership.
A Legacy of Distrust in Official Systems
The modern Ukrainian perspective on public health is heavily influenced by the legacy of the Soviet Union and the turbulent decades that followed its collapse. This history has cultivated a profound and justified skepticism toward official pronouncements and state-run programs.
The Soviet Inheritance
The healthcare system Ukraine inherited from the Soviet Union was the "Semashko model," a centralized, state-run system that prioritized bureaucratic control over patient well-being. It was characterized by chronic underfunding, outdated facilities, low-paid and unmotivated health workers, and pervasive corruption. Patients routinely had to provide informal "out-of-pocket" payments or bribes for everything from exams and medications to basic supplies like bandages and soap. This experience, spanning generations, created a deep-seated belief that the state's healthcare system was not a trustworthy guardian of public health but a broken and often predatory institution.
The 2010–2013 Vaccination Campaign Trauma
This general distrust was crystallized into specific vaccine-related fear by a catastrophic public health failure between 2010 and 2013. During a routine vaccination campaign, numerous children experienced complications following immunization. It was later revealed that these adverse events were linked to serious protocol violations in the storage and administration of the vaccines. The official response from the authorities at the time was not transparency and accountability, but silence and an active cover-up of the incidents. This event was a profound betrayal of public trust and is widely cited as the origin point for the modern anti-vaccination movement in Ukraine. It provided tangible, recent evidence for the belief that the state could not be trusted with the health and safety of children.
Low Vaccine Confidence in the Homeland
The cumulative effect of this history is that Ukraine has one of the lowest rates of vaccine confidence in the world. A 2018 survey found that only 28% of Ukrainians felt that vaccines were safe, a dramatic decline from 66% just three years earlier in 2015. More recent polls have shown that over half of the adult population is not planning to be vaccinated against COVID-19, with 43% strongly opposed. This context is vital for any outreach effort in Spartanburg. Communicators must understand that they are likely engaging with a community where vaccine skepticism is not a fringe belief but a mainstream, culturally ingrained perspective rooted in legitimate historical grievances.
The journey from Ukraine to Spartanburg introduces a new set of challenges and considerations that directly impact health behaviors and the reception of public health messaging.
Potential for Under-Vaccination
Families arriving from Ukraine may be under-vaccinated according to the U.S. schedule for several reasons. National immunization schedules can differ, and access to routine care may have been disrupted by social instability or, more recently, by war. Furthermore, the distrust of the official system in Ukraine led to a reported culture of obtaining false immunization certificates by bribing officials, a practice seen as a way to avoid the perceived risks of vaccination. This means that a child's vaccination records may not accurately reflect their immunization status, necessitating a careful and non-judgmental review by a trusted healthcare provider.
Information and Access Barriers
Upon arrival in the U.S., immigrant families face the dual challenge of navigating an unfamiliar healthcare system while being cut off from their previous, albeit distrusted, sources of information. This can create an information vacuum that is often filled by misinformation circulating on social media and within diaspora communities. Newcomers may struggle to find credible health information in their own language and may face significant barriers to care, including lack of insurance, cost, and linguistic challenges.
For many immigrants, community and religious institutions serve as the primary centers of social life, support, and trusted information. Engaging these hubs is not optional for a successful public health campaign; it is the only viable strategy.
Identifying Key Locations
Spartanburg County is home to a significant and growing Ukrainian community, with notable populations in Inman and Boiling Springs. Several key institutions serve as focal points for this community. These include explicitly Ukrainian churches, such as the New Life Ukrainian Church and the Ukrainian Bible Baptist Church of Spartanburg. Additionally, broader Eastern Orthodox churches, such as St. Nicholas Greek Orthodox Church, often serve as a spiritual home for Orthodox Christians from various ethnic backgrounds, including Ukrainians.
Trusted Messengers
These churches are more than places of worship; they are the epicenters of community life where trust is established and information is shared. The priests, pastors, and established lay leaders within these congregations are the most credible and influential messengers. Any external public health effort that bypasses these leaders is likely to be viewed with suspicion. A successful strategy must involve approaching these leaders with humility, seeking to build genuine partnerships, and co-creating health messages that are culturally and spiritually resonant. By working through these trusted channels, public health information can be received not as a directive from an unknown authority, but as caring advice shared within the family of the community.