Determinants of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy: findings from a national population survey of U.S. adults

Abstract

Background The enduring presence of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy is an ongoing impediment to the global response effort to the current pandemic. This study seeks to identify determinants of skepticism and vaccine hesitancy in U.S. adults. Methods Data are from the Values and Beliefs of the American Public Survey, conducted in 2021 by the Gallup Organization in conjunction with Baylor University. The survey used stratified random probability sampling of the U.S. adult population (N = 1222). Outcome measures were respective single items assessing COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy. Exposure variables included political, religious, and sociodemographic indicators, and moderators assessed personal history of COVID-19 and losing a relative or close friend to COVID-19. Results Skepticism and vaccine hesitancy were strongly associated with conservative and Republican political preference and conservative religious beliefs, and less so with socioeconomic status. Personal experience with COVID-19 did not mitigate the effect of politics on skepticism and barely reduced the odds for hesitancy. Results confirm that attitudes toward COVID-19 are politically and religiously conditioned, and are especially a product of conservative political preference. Conclusion Skepticism about COVID-19 and hesitancy regarding SARS-CoV-2 vaccination are highest among the political and religious right. Efforts to increase immunization through public education may be inadequate; resistance appears ideological. Other solutions may need to be considered, which risk widespread pushback both politically and religiously motivated.

How Do Religious and Political Beliefs Predict COVID-19 Vaccination Behavior Among U.S. College Students? A Study Using the Health Belief Model

“…Political beliefs are a direct and negative predictor of vaccination behavior, while the direct effect of religious beliefs on vaccination behavior is non -significant. A similar finding was also reported in Levin and Bradshaw’s 6 study which found that, after adjusting for effects of sociodemographic variables, conservative political beliefs are still a significant predictor of COVID-19 vaccine hesitancy, while conservative religious beliefs are not. The present study corroborated that political beliefs have a much stronger impact than religious beliefs on COVID-19 vaccination, indicating that COVID-19 vaccination has indeed been politicized.…”

“…Numerous studies have been done on COVID-19 vaccination, but most have focused on intentions to receive a COVID-19 vaccine 3 - 5 or similar decision-related constructs such as COVID-19 vaccine hesitancy 6 or COVID-19 vaccine acceptance. 7 Although vaccine intention/hesitancy/acceptance are commonly used as proxies for the actual vaccine-intake behavior, these constructs do not always translate into action.…”

“…Additionally, many studies predicting COVID-19 vaccine decisions are not guided by health behavior theories, which makes them likely to miss important predictors identified by those theories. 5 , 6 Finally, since the start of vaccination in the U.S., there has been an intense debate over whether vaccination is safe or even necessary. 8 Polarized views toward vaccination have spread rapidly, especially among those who are very religious or politically conservative.…”

“…Among those studies, Milligan et al 26 reported that both reduced religiosity and Democratic Party membership predicted COVID-19 vaccine acceptance, in a sample of participants recruited from Amazon’s MTurk. Levin and Bradshaw 6 found that, after adjusting for effects of sociodemographic variables, Republican party identity and conservative political orientation remained significantly associated with COVID-19 vaccine hesitancy, but conservative religious beliefs became non-significant, using data from the Values and Beliefs of the American Public Survey conducted in 2021.…”

COVID-19 vaccine hesitancy and short-term and long-term intentions among unvaccinated young adults: a mixed-method approach

“…Surprisingly, a stronger sense of collective responsibility was associated with lower odds of intention to get vaccinated in the next three to five years, which is not consistent with previous literatures supporting the role of altruistic motives in vaccine uptakes [ 31 , 52 ]. Finally, political ideology was not found to be a significant predictor of two intention outcomes, despite the strong connection between individuals’ political ideology and COVID-19 vaccine issues [ 18 , 53 – 55 ]. This might have something to do with the relatively young ages of survey participants.…”