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Recent scholarship finds linkages between religiosity and vaccination practices but neglects the role of religious, social structural influences. The relationship between religious beliefs and immunization in the context of closed religious communities remains understudied. We use a survey of Amish and Old Order Mennonite parents to explore relationships between religious belief, group closure, perceived vaccine effectiveness, and vaccine uptake. The results indicate higher group and individual closure levels are positively related to having unvaccinated children and vaccine hesitancy. Perceptions of vaccine effectiveness partially explain these associations. Healthcare providers should consider constructing culturally competent programs to reach closed communities.

Echo Chambers in a Closed Community: Vaccine Uptake and Perceived Effectiveness among the Amish and Old Order Mennonites