Social cohesion predicts COVID-19 vaccination intentions and uptake

COVID-19 vaccination is widely regarded as an individual decision, resting upon individual characteristics and demographic factors. In this research, we provide evidence that psychological group membership, and more precisely, social cohesion—a multidimensional concept that encompasses one's sense of connectedness to, and interrelations within, a group—can help us understand COVID-19 vaccination intentions (Study 1) and uptake (Study 2). Study 1 is a repeated-measures study with a representative sample of 3026 Australians. We found evidence that social cohesion can be conceptualised as a multidimensional structure; moreover, social cohesion at Wave 1 (early in the COVID-19) predicted greater vaccination intention and lower perceived risk of vaccination at Wave 2 (4 months later). In Study 2 (a cross-sectional study, N = 499), the multidimensional structure of social cohesion was associated with greater uptake of vaccine doses (in addition to willingness to receive further doses and perceived risk of the vaccine). These relations were found after controlling for a series of demographic (i.e., sex, age, income), health-related factors (i.e., subjective health; perceived risk; having been diagnosed with COVID-19), and individual differences (political orientation, social dominance orientation, individualism). These results demonstrate the need to go beyond individual factors when it comes to behaviours that protect groups, and particularly when examining COVID-19 vaccination—one of the most important ways of slowing the spread of the virus.     

The effects of social comparison,emotion induction,and parent vaccination status on parental intentions for COVID-19 vaccine uptake in children

Parental vaccine hesitancy—delays in vaccine uptake for children—is a significant public health concern. Using an online adult sample of U.S. parents (N = 183), the current research experimentally examined how exposure to cautious or risky social comparison models on social media (in terms of their COVID-19 beliefs and behaviors) influenced parental intentions to vaccinate their children against COVID-19 in the early stages of the pandemic. Additionally, we examined whether the influence of social comparison models was moderated by emotional state (fear or contentment) and parental vaccination status. Overall, we found that parents exposed to cautious (vs. risky) comparison models and vaccinated (vs. unvaccinated) parents reported greater vaccine intentions for their children. We further found that vaccination intentions were highest among unvaccinated parents after exposure to cautious (vs. risky) comparison models, whereas intentions were highest among vaccinated parents after exposure to risky (vs. cautious) comparison models (but only when induced to feel content). Overall, our findings highlight the importance of understanding the additive and interactive impact of psychological and situational factors in shaping parental vaccine hesitancy.     

Implicit and explicit COVID-19-vaccine harmfulness/helpfulness associations predict vaccine beliefs,intentions, and behaviors

We investigated the role of implicit and explicit associations between harm and COVID-19 vaccines using a large sample (N = 4668) of online volunteers. The participants completed a brief implicit association test and explicit measures to evaluate the extent to which they associated COVID-19 vaccines with concepts of harmfulness or helpfulness. We examined the relationship between these harmfulness/helpfulness COVID-19 vaccine associations and vaccination status, intentions, beliefs, and behavior. We found that stronger implicit and explicit associations that COVID-19 vaccines are helpful relate to vaccination status and beliefs about the COVID-19 vaccine. That is, stronger pro-helpful COVID-19 vaccine associations, both implicitly and explicitly, related to greater intentions to be vaccinated, more positive beliefs about the vaccine, and greater vaccine uptake.     

Prosocial orientation and COVID-19 vaccine willingness in the U.S.

Despite evidence of the safety and effectiveness of COVID-19 vaccines and their wide availability, many in the U.S. are not vaccinated. Research demonstrates that prosocial orientations predict COVID-19 health behaviors (e.g., social distancing) and vaccination intentions, however, little work has examined COVID-19 vaccination willingness in the U.S. since vaccines were approved. Findings from two U.S. samples show that, in contrast to other COVID-19 health behaviors, vaccine willingness in unvaccinated people is unrelated to prosocial orientation. Study 2 demonstrates that the lack of association between vaccine willingness and prosocial orientation in unvaccinated participants was specific to those with stronger beliefs that COVID-19 vaccines are ineffective. Thus, in prosocial people, perceptions of vaccines' ineffectiveness may undermine COVID-19 vaccine willingness.     

Safety first,but for whom? Shifts in risk perception for self and others following COVID-19 vaccination

Vaccines can affect the mind as well as the body. Research on the psychological impact of vaccines has largely focused on risk-related judgments and behaviors involving the recipient. Here, we extend this work to risk-related judgments of others. In a prospective cohort study involving three samples and two timepoints (N = 588 adults), we tested competing hypotheses about the effects of receiving a COVID-19 vaccine on perceived risks to the unvaccinated: (1) a self/other differentiation hypothesis (vaccination will lead to estimation of lower risk for the self but higher risk for others) versus (2) a self/other correspondence hypothesis (vaccination will lead to estimation of lower risk from contracting COVID-19 for both self and others). Results revealed risk estimates as well as preferences for COVID-related social policies more consistent with the former hypothesis. We discuss potential psychological mechanisms and implications of these findings.     

The sociodemographic and psychosocial correlates of COVID-19 vaccine concerns among urban college students

COVID-19 vaccine concerns remain high among Americans. Although recent studies have investigated the sociodemographic disparities in vaccine concerns, less attention has been given to reasons for vaccine skepticism and psychosocial factors that may explain it. The current study examined specific types of vaccine concerns among a diverse sample of college students (N = 1985) living in New York City. Participants who identified as Black, younger, with later immigrant generational status, and those with more conservative political leanings reported more vaccine concerns. Concerns regarding vaccine side effects were the most frequently reported source of concern. Reason for getting vaccinated, personal experiences with COVID, and COVID stress was also associated with vaccine concerns. Study results emphasize the importance of sociodemographic factors and COVID knowledge and stress in examining and addressing vaccine concerns.     

Childhood vaccine refusal and hesitancy intentions in Croatia: insights from a population-based study

Considering that programmatic data suggest a recent rise in vaccine refusal in Croatia, this study, first of its kind in Southeast Europe, aimed to estimate the prevalence, and sociodemographic, and sociocultural determinants of childhood vaccine refusal and hesitancy (CVRH) intentions among Croatian adults. Multi-stage stratified population-based survey included 1000 individuals aged 18–88 years (M_age = 47.7, SD = 17.8), of whom 51.7% were women. The outcome, a categorical indicator, distinguished among individuals who would approve vaccinating their children (vaccine accepting), those who would approve some but not all vaccines (vaccine hesitant), and those who would refuse vaccination (vaccine refusing). A sizeable minority of participants was characterized by childhood vaccine refusal (10.6%) and hesitancy intentions (19.5%). In a multivariate assessment controlling for parenthood, the odds of vaccine hesitancy were significantly increased by a younger age (AOR = 1.96–3.03, p < .01). Religiosity (AOR = 1.12, p < .05) and the use of alternative medicine (AOR = 2.85, p < .001) increased the odds of vaccine refusal. However, individual characteristics seem to be relatively poor predictors of CVRH intentions in Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.     

“I'll wait for the English one”: COVID-19 vaccine country of origin,national identity,and their effects on vaccine perceptions and uptake willingness

Vaccines can play a crucial role in reducing the negative outcomes of pandemics. In this paper we explore how vaccine perceptions and uptake willingness can be affected by vaccine-related information, the vaccine's country of origin, and national identity. Study 1 (N = 800) showed that a vaccine manufactured by China was perceived more negatively compared to vaccines from the UK, Germany, and Chile. Providing vaccine effectiveness information (83%) increased preference for waiting for an alternative vaccine and reduced perceived effectiveness of a vaccine from China. Brexit supporters perceived vaccines as less safe in general, and particularly thought of a vaccine from China as less competent, effective, and trustworthy, and were less prepared to have it. Study 2 (N = 601) largely replicated findings of Study 1 regarding the effects of a vaccine's country of origin. Moreover, participants who reported a higher sense of British superiority reported more negative attitudes towards a vaccine from China. However, apart from the aforementioned main effects of Study 2, our attempt to manipulate British identity vis a vis a Global identity in order to examine particular national-identity related outcomes was not successful. Overall, vaccine characteristics can interact with various social psychological factors, potentially affecting people's perceptions and willingness to uptake particular measures to support personal and public health.     

Distrustful Complacency and the COVID-19 Vaccine: How Concern and Political Trust Interact to Affect Vaccine Hesitancy

We test the hypothesis that COVID-19 vaccine hesitancy is attributable to distrustful complacency—an interactive combination of low concern and low trust. Across two studies, 9,695 respondents from different parts of Britain reported their level of concern about COVID-19, trust in the UK government, and intention to accept or refuse the vaccine. Multilevel regression analysis, controlling for geographic area and relevant demographics, confirmed the predicted interactive effect of concern and trust. Across studies, respondents with both low trust and low concern were 10%–22% more vaccine hesitant than respondents with either high trust or high concern, and 26%–29% more hesitant than respondents with both high trust and high concern. Results hold equally among White, Black, and Muslim respondents, consistent with the view that regardless of mean-level differences, a common process underlies vaccine hesitancy, underlining the importance of tackling distrustful complacency both generally and specifically among unvaccinated individuals and populations.     

Predictors of COVID-19 precautionary behaviors to protect people with disabilities

Disability is conceptualized using one of two major frameworks: the medical and the social model of disability. The medical model of disability describes disability as an individual issue in which the appropriate intervention is to remove the disability. The social model of disability describes disability as a social construction in which the appropriate intervention is societal change to increase accessibility. This study drew on models of disability to understand predictors of engagement in COVID-precautionary behavior prior to the vaccine to protect people with disabilities (PWD) from contracting COVID-19. Participants (n = 720) with and without disabilities (n = 77 and n = 633, respectively) completed an online questionnaire measuring disability beliefs, attitudes toward PWD, concerns about PWD contracting COVID-19, and engagement in behavior protecting PWD from contracting COVID-19. Medical model beliefs were negatively associated with behavior. In addition, negative attitudes toward PWD and low concern about PWD contracting COVID-19 fully accounted for the relationship. Social model beliefs were positively associated with behavior. In addition, positive attitudes toward PWD and greater concern about PWD contracting COVID-19 partially explained the relationship. These findings suggest that framing disability as a social construction rather than a medical issue could promote greater public health behavior to protect PWD from contracting COVID.     

“They'll take a gun to me before I get that shot”: Rationalization,emotions, and misinformation in COVID-19 vaccine hesitancy

Vaccine hesitancy—the reluctance, delay, or refusal to vaccinate regardless of availability—is not a new concept in psychology, medicine, or public health. However, given the emotions surrounding the COVID-19 vaccine, hesitancy has proven difficult to overcome. To-date, the bulk of available data on vaccine hesitancy are quantitative, leaving room for exploratory investigations into the reasons adults remain unvaccinated. This qualitative study assessed the motivations, beliefs, and perceptions of individuals who have decided to remain unvaccinated against COVID-19. We had one exploratory research question: What social psychological justifications emerge from vaccine hesitant people's explanations of their decisions to remain unvaccinated? To assess this question, we conducted 18 interviews with unvaccinated adults throughout 2021–2022. The interviews consisted of 20 questions regarding participants' perceptions of the COVID-19 vaccine and their intentions to get vaccinated. Thematic analysis revealed four main themes in the answers provided by participants: rationalization; identity, beliefs and potential modifiers; emotional responses; and information sources. These results offer insight for future vaccination efforts.     

Envy,entitlement, and cutting the line: Dark personality predicted selfishness during the U.S. COVID-19 vaccine rollout

Dark Triad personality traits (narcissism, psychopathy, and Machivellianism) predict increased selfish thinking and behavior. In the context of the COVID-19 pandemic, they have been related to behaviors such as greater hoarding and decreased COVID-preventative behaviors. Here we examined whether the Dark Triad might predict selfish beliefs and behavior surrounding COVID-19 vaccinations during the 2021 U.S. vaccine rollout—a time when availability was scarce and people were prioritized based on factors like preexisting medical conditions or line of work. In a sample of 499 people, we found that the constellation of Dark Triad traits predicted skipping one's priority in line to get the COVID-19 vaccine earlier among the vaccinated. Among the unvaccinated it predicted greater envy, entitlement, perceptions of unfairness, and willingness to skip the line. Taken together, these findings suggest that those high in the Dark Triad do not simply care less about their health and safety, instead there may be circumstances in which dark traits predict preventative, albeit selfish, behavior.     

A little shot of humility: Intellectual humility predicts vaccination attitudes and intention to vaccinate against COVID-19

Vaccinations remain a critical, albeit surprisingly controversial, health behavior, especially with the promise of widely available COVID-19 vaccine. Intellectual humility, a virtue characterized by nonjudgmental recognition of one's own intellectual fallibility, may counter rigidity associated with anti-vaccination attitudes and help promote vaccine-related behaviors. This study investigated whether intellectual humility is related to anti-vaccination attitudes and intentions to vaccinate against COVID-19, and whether intellectual humility can predict unique variance in these outcomes beyond participant demographic and personal factors. Participants (N = 351, 57.23% male, mean age = 37.41 years, SD = 11.51) completed a multidimensional measure for intellectual humility, the anti-vaccination attitudes (VAX) scale, and a two-item COVID-19 vaccination intention scale. Bivariate correlations demonstrated that intellectual humility was negatively related with anti-vaccination attitudes overall, r(349) = −.46, p < .001, and positively related to intentions to vaccinate against COVID-19, r(349) = .20, p < .001. Hierarchical multiple regression revealed that intellectual humility predicted all four types anti-vaccination attitudes, overall anti-vaccination attitudes, and COVID-19 vaccination intentions above and beyond demographic and personal factors (i.e., sex, race/ethnicity, age, education, socioeconomic status, and political orientation), ΔR² between .08 and .18, ps < .001. These results bolster intellectual humility as a malleable psychological factor to consider in efforts to combat anti-vaccination attitudes and promote COVID-19 vaccination uptake.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).     

Ideology,moral reframing,and persuasion in the context of COVID-19 vaccines

A possible strategy for circumventing vaccine hesitancy and increasing support for vaccines is moral reframing. Moral Foundations Theory suggests messages framed using individuating foundations should be more persuasive to liberals, while messages framed using binding foundations should be more persuasive to conservatives. In an experiment, we investigated the role of political ideology and moral reframing in persuading college students to support mandating COVID-19 vaccination on university campuses. We tested harm-framed and loyalty-framed interventions to persuade liberals and conservatives, respectively. Results indicated that overall conservatives were less persuaded than liberals. Liberals were more persuaded by a harm-framed than loyalty-framed message when measuring ideology categorically (but not continuously). There were no differences in persuasion among conservatives. With further research, moral reframing could be effective in increasing support for vaccines and mandatory vaccinations.     

Cultural influence on COVID-19 cognitions and growth speed: The role of collectivism

Major challenges faced by humans often require large-scale cooperation for communal benefits. We examined what motivates such cooperation in the context of social distancing and mask wearing to reduce the transmission intensity of the coronavirus pandemic (COVID-19). We hypothesized that collectivism, a cultural variable characterizing the extent that individuals see themselves in relation to others, contributes to people's willingness to engage in these behaviors. Consistent with preregistered predictions, across three studies (n = 2864), including a U.S. nationally representative sample, collectivist orientation was positively associated with intentions, positive beliefs, norm perceptions, and policy support for the preventive behaviors. Further, at a country level, more collectivist countries showed lower growth rates in both COVID-19 confirmed cases and deaths. Together, these studies demonstrate the role of collectivism in reducing COVID-19 transmission, and highlight the value of considering culture in public health policies and communications.     

COVID-19 Vaccination Acceptance: A Case of Interplay Between Political and Health Dimensions

Vaccines are essential for the eradication of diseases. Yet for many reasons, individuals do not embrace them completely. In the COVID-19 pandemic and with the possibility of the Brazilian population's immunization against the disease, both political and health-related dimensions might have had a role in individual COVID-19 vaccination acceptance. In two studies (n = 974), we tested the hypothesis that participants' vaccination acceptance is related to their past vote in the 2018 Brazilian presidential election (being or not being a Jair Bolsonaro voter) and their different levels of perceived vulnerability to disease (PVD). We further tested whether Bolsonaro's opposition or ambiguous messages towards vaccination (vs. control) increased vaccination rejection among those who have (vs. have not) voted for him and who are low (vs. high) in PVD. Results show that Bolsonaro (vs. non-Bolsonaro) voters accepted less vaccination, with higher rejection rates when participants expressed low (vs. high) PVD. Also, when primed either with Bolsonaro's opposed or ambiguous messages towards COVID-19 vaccination, such participants accepted less vaccines (vs. participants primed with neutral information). These findings are the first to show that the COVID-19 vaccine acceptance is related to their past vote and leadership influence but also different levels of perceived vulnerability to disease.     

Who do we trust? Differences in types of trust and beliefs in conspiracy theories between vaccinated and unvaccinated Europeans across 17 European countries

A plethora of research has highlighted that trust in science, political trust, and conspiracy theories are all important contributors to vaccine uptake behavior. In the current investigation, relying on data from 17 countries (N = 30,096) from the European Social Survey we examined how those who received (and wanted to receive the COVID-19 vaccine) compared to those who did not differ in their trust in: science, politicians and political parties, international organizations and towards people in general. We also examined whether they differed in how much they believed in conspiracy theories. Those who received (or wanted to receive) the COVID vaccine scored significantly higher in all forms of trust, and lower in conspiracy theory beliefs. A logistic regression suggested that trust in science, politicians, international organizations, as well as belief in conspiracy theories were significant predictors, even after accounting for key demographic characteristics.