Moral values predict county-level COVID-19 vaccination rates in the United States.

Abstract

Despite the widespread availability of COVID-19 vaccines, the United States has a depressed rate of vaccination relative to similar countries. Understanding the psychology of vaccine refusal, particularly the possible sources of variation in vaccine resistance across U.S. subpopulations, can aid in designing effective intervention strategies to increase vaccination across different regions. Here, we demonstrate that county-level moral values (i.e., Care, Fairness, Loyalty, Authority, and Purity) are associated with COVID-19 vaccination rates across 3,106 counties in the contiguous United States. Specifically, in line with our hypothesis, we find that fewer people are vaccinated in counties whose residents prioritize moral concerns about bodily and spiritual purity. Further, we find that stronger endorsements of concerns about Fairness and Loyalty to the group predict higher vaccination rates. These associations are robust after adjusting for structural barriers to vaccination, the demographic makeup of the counties, and their residents' political voting behavior. Our findings have implications for health communication, intervention strategies based on targeted messaging, and our fundamental understanding of the moral psychology of vaccination hesitancy and behavior. Public Significance StatementWhy do people refuse to get vaccinated against COVID-19 even when vaccines are widely available, safe, and efficacious? We show that differences in moral values can help us understand discrepancies in vaccination rates across U.S. counties. Specifically, Purity This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.Morteza Dehghani https://orcid.org/0000-0002-9478-4365 Mohammad Atari and Farzan Karimi-Malekabadi contributed equally to this work.Nils Karl Reimer played the lead role in formal analysis and an equal role in data curation, methodology, writing of original draft, and writing of review and editing. Mohammad Atari played the lead role in writing of original draft, a supporting role in methodology, and an equal role in data curation and writing of review and editing. Farzan Karimi-Malekabadi played the lead role in data curation and visualization and an equal role in investigation, methodology, writing of original draft, and writing of review and editing. Jackson Trager played a supporting role in data curation, writing of original draft, and writing of review and editing. Brendan Kennedy played a supporting role in project administration, supervision, writing of original draft, and writing of review and editing. Jesse Graham played a supporting role in funding acquisition, supervision, and writing of review and editing.Morteza Dehghani played the lead role in conceptualization, funding acquisition, and supervision; a supporting role in writing of original draft; and an equal role in writing of review and editing.

Morality beyond the WEIRD: How the nomological network of morality varies across cultures.

“…Even when we completely excluded proportionality, MFQ-2 still significantly outperformed MFQ-1, indicating that MFQ-2’s superior predictive performance is not due to having several more items or a new subscale. This finding is promising as it opens the door to future theory-driven examination of morally relevant behaviors and judgments, as well as modeling approaches that use MFT to minimize out-of-sample prediction error in predicting a behavioral outcome (e.g., Reimer et al, 2022). Furthermore, Studies 2 and 3 collectively provided evidence that the individualizing-binding distinction made in Graham et al (2011) may actually be culture dependent.…”

The paucity of morality in everyday talk

“…Finally, it has been argued that the self is “essentially moral,” in that people reliably judge moral attributes to be the most important contributors to personal identity 14 , 15 . These empirical findings suggest that morality is not specific to one or even a few domains of everyday life (e.g., vaccination 16 , online political discussions 17 ); rather, morality plays an important role in a variety of socio-cognitive domains and interpersonal contexts.…”

A randomized controlled trial of an information intervention to bolster COVID-19 vaccination intention among people with purity concerns.

“…Other important empirical findings showed that purity is a solid predictor of COVID-19 vaccination rates across regions (Reimer et al, 2022). For instance, at the state level, the correlation coefficient between purity foundations (Hoover et al, 2022) and the COVID-19 vaccination rate was −0.86, 95% CI [−0.92, −0.81], Figure 1, which remained highly significant even when partisanship was controlled…”

“…For instance, the purity moral foundation originates from the emotion of disgust for biological contaminants (Rozin et al, 2008), while the Center for Disease Control-recommended messenger Ribonucleic acid vaccines direct human bodies to produce copies of a protein on the outside of the coronavirus as an immune process (Centers for Disease Control and Prevention, 2021). Furthermore, the violation of the exterior envelope of the body (including gore and deformity) may elicit disgust and thus be interpreted as impure (Rozin et al, 2008), while the vaccination process involves body-membrane breaking (Reimer et al, 2022). Somewhat ironically, the biological and psychological instinct that protects people from contaminants may cultivate contagious disease transmission by enhancing vaccine hesitancy (Clay, 2017).…”