A sudden federal halt to the one-dose Johnson & Johnson COVID-19 vaccine has dampened hopes among NYC Muslim leaders who were planning for a substantial vaccination push during Ramadan.

Universal eligibility for the vaccines arrived not long before Muslim New Yorkers welcomed Ramadan on April 12th. Religious leaders and the city had debuted pop-up vaccination sites at three mosques, ICNA Markaz and Jamaica Muslim Center in Queens and Al-Masjidu Adam in the Bronx. Each mosque had its own rules on securing a vaccine—from simply walking in to filling out google forms.

Mayor Bill de Blasio visited Al-Masjidu Adam days before Ramadan to speak with Black Muslim Leaders on the city’s program, and city officials had hoped to expand the program to all five boroughs.

“We're going to be working with all faiths, all houses of worship, because we found this has been really effective way to get more people to come in and be vaccinated in a setting that they trust and feel comfortable in,” the mayor said on April 12th. “So, good news for the Muslim community.”

A day later, federal regulators recommended a pause on all Johnson & Johnson COVID-19 vaccine shots, interrupting many of the city’s efforts to reach its sprawling Islamic community. More than 760,000 Muslims live in the five boroughs, an incredibly diverse group composed of U.S.-born members and immigrants from more than 75 countries that accounts for almost nine percent of the city’s population. Due to the J&J pause, the pop-up sites at the mosques canceled all appointments and dates after April 13.

This setback came as COVID case rates were plateauing and hospitalizations were low, resulting in more mosques reopening in time for the holy month-long holiday. Vaccination efforts through community mosques would be convenient and beneficial for the community, according to Lamiya Khandaker, the project manager at the Islamic Leadership Council of New York (ILCNY), an umbrella organization that represents 90 mosques and Islamic organizations.

“Doing outreach to mosques right now and offering language services and offering available appointments directly through the mosque would be the most ideal thing to do especially during Ramadan, because the Muslim community, they visit the mosque, they go to pick up their meal, or they go to pray taraweeh and isha,” she said.

Friends and family also rank higher than health care providers when it comes to the most trusted conduits of vaccine info, according to national surveys conducted by the Kaiser Family Foundation. This trend applies to both pro-vaccine messages and misinformation, meaning Ramadan offers an opportunity to promote inoculation while also addressing concerns over the shots.

New York City’s Islamic community saw hesitancy when the COVID-19 vaccines first came out and there was a lot of misinformation and confusion, according to Farah Salam, the community health and wellbeing coordinator at the Arab American Family Support Center (AAFSC). Her organization provides social services to many in the Muslim community.

During the holy month, Muslims abstain from food, water, and other substances during the day—raising a question about whether vaccinations are acceptable during fasting hours. Various Islamic scholars worldwide ultimately agreed the shots are permissible during Ramadan because the injection goes into the muscle and not the stomach.

Another concern has centered around being physically able to handle the mild side-effects caused by the COVID-19 vaccine while also dealing with the stress of fasting. Muslim New Yorker Wacef Chowdhury didn’t hesitate after an extra dose at a local pharmacy in the Bronx was offered to him days before Ramadan. But ideally, he would’ve liked an overnight appointment or one toward the end of Ramadan so his second dose wouldn’t fall in the middle, impacting his fast.

Men pray at Masjid Al-Farooq

Men pray at Masjid Al-Farooq for the Muslim holiday of Eid al-Fitr in Brooklyn, June 15th, 2018.

Men pray at Masjid Al-Farooq for the Muslim holiday of Eid al-Fitr in Brooklyn, June 15th, 2018.
Mark Lennihan/AP/Shutterstock

“I’ve heard symptoms can be demanding, almost severe,” Chowdhury said. “If it gets to a point where fasting is no longer possible or would damage my health, I probably will avoid the fast.”

Salam says a few community members have told her they are waiting due to similar worries. “It’s not the vaccine itself, but they don’t want to experience the side effects of the vaccine while they’re fasting,” or to break their observance because of it, she said. Other community members are strategically scheduling their appointments closer to sunset as a precaution in case they need to take pain killers or toward the end of Ramadan, so their second dose falls after it ends.

Questions like “What is in the vaccine?” or “Why was it made so quickly?” also circulated within the Arab and Bangladeshi groups Salam works with, but she said after those hesitations were addressed, many community members wanted quick access to the vaccine. A majority of Muslims are now “very accepting of vaccinations because we are a religion of science,” Khandaker agreed.

“We get information from the city, we pass it down to partner organizations and member mosques, and then it gets distributed,” said Khandaker. Through its partnership with the city government, ILCNY has been the go-to source for mosques and Islamic centers on virus and vaccine facts. They have created resources and videos on vaccines during Ramadan, in-person prayer guidelines, and more.

AAFSC has more of a grassroots approach in educating the community through language-sensitive webinars, direct contact with those with questions and securing appointments for community members.

The organization previously partnered with the city and received resources for the census outreach, but according to Kerry Sesil, AAFSC senior director of resource development, “there is not quite that momentum” for COVID-19 vaccine education and outreach. “Community-based organizations like the AAFSC are so critical as trusted resources to get this information out in a language that people understand,” she said.

The city’s Commission on Human Rights has also released guidance for vaccination sites that will be serving fasting Muslims this month. Its suggestions include a designated prayer space, signage in different languages to restrooms, a designated space for Muslims to break their fast, and a way for people to keep their spot in line during prayer time. One accommodation, however, has driven much of the conversation in city council: offering appointments before dark or after sunset.

Councilmember Mark Levine, the chair of the city’s council health committee, has been publicly calling for an expansion in overnight appointments for Muslims alongside Councilmember Daneek Miller. Currently, three vaccination sites in the city offer overnight appointments for both doses of Pfizer and Moderna vaccines: at Bathgate, CitiField, and Brooklyn Army Terminal. Three others are only administering second shots.

While AAFSC isn’t a direct partner on vaccine outreach, the city gave them backend access to the Department of Health portal, meaning they receive a certain number of appointments set aside for their organization. Salam noted that the number has been low but improving, ranging from 15-40 per week. As of April 16th, AAFSC had secured 140 appointments since the middle of March.

The city is listening, said Salam, “but there are some things we would appreciate as community-based organizations to get those vaccine appointments for our clients.”