Political context of the European vaccine debate on Twitter

At the beginning of the COVID-19 pandemic, fears grew that making vaccination a political (instead of public health) issue may impact the efficacy of this life-saving intervention, spurring the spread of vaccine-hesitant content. In this study, we examine whether there is a relationship between the political interest of social media users and their exposure to vaccine-hesitant content on Twitter. We focus on 17 European countries using a multilingual, longitudinal dataset of tweets spanning the period before COVID, up to the vaccine roll-out. We find that, in most countries, users' endorsement of vaccine-hesitant content is the highest in the early months of the pandemic, around the time of greatest scientific uncertainty. Further, users who follow politicians from right-wing parties, and those associated with authoritarian or anti-EU stances are more likely to endorse vaccine-hesitant content, whereas those following left-wing politicians, more pro-EU or liberal parties, are less likely. Somewhat surprisingly, politicians did not play an outsized role in the vaccine debates of their countries, receiving a similar number of retweets as other similarly popular users. This systematic, multi-country, longitudinal investigation of the connection of politics with vaccine hesitancy has important implications for public health policy and communication.

Psychological variables linked to hesitation toward vaccination against COVID-19 among late adolescents and young adults: The role of magical thinking and right-wing authoritarianism

INTRODUCTION

Several studies on the predisposition to be subjected to vaccination have shown that vaccine hesitation is a global phenomenon influenced by a lack of knowledge and awareness, as well as perceived risks and benefits. The purpose of this study was to investigate the mediating role of right-wing authoritarianism in the relationship between magical thinking and positive attitudes toward COVID-19 vaccines (i.e. trust of vaccine benefits, worries over unforeseen future effects, concerns about commercial profits, preference for natural immunity).

METHOD

The sample consisted of 201 Italian young adults, 49 males (24.4%), and 152 females (75.6%), aged between 18 and 25. Data were collected during 2022.

RESULTS

The results confirmed the role of right-wing authoritarianism as a mediator for magical thinking on positive vaccine attitudes. Findings indicated a positive association between right-wing authoritarianism and magical thinking and a negative relationship of both the aforementioned variables on positive vaccine attitudes. SEM analyses showed a direct positive association from magical thinking to right-wing authoritarianism and a direct negative association from right-wing authoritarianism to trust of vaccine benefits, to low worries over unforeseen future effects, to lack of concerns about commercial profits and to low preference for natural immunity.

CONCLUSIONS

The findings highlight that common contribution of odd or magical beliefs and right-wing authoritarianism may slow the spread of vaccines among late adolescents and young adults. Our findings provide insight on what effective communication with vaccine-resistant individuals should look like in order to increase the chances of reaching vaccine-hesitant individuals.

Impact of Political Leaning on COVID-19 Vaccine Hesitancy: A Network-Based Multiple Mediation Analysis

Prior studies have shown that political affiliation affected COVID-19 vaccine hesitancy. This study re-examined the data to see if these findings hold after controlling for alternative explanations. The dependent variable in the study was COVID-19 vaccination rates in 3,109 counties in the United States as of April 2022. The study examined 36 possible alternative explanations for vaccine hesitancy, including demographic, social, economic, environmental, and medical variables known to affect vaccine hesitancy. County-level political affiliation was measured as a percent of voters in the county who were affiliated with Democratic or Republican political parties. Data were analyzed using a temporally constrained multiple mediation network, which allowed for the identification of both direct and indirect predictors of vaccination rates. Despite controlling for alternative explanations of hesitancy, there was a statistically significant relationship between the percentage of Republican supporters and rates of vaccine hesitancy. The higher the Republican affiliation, the lower the vaccination rates. It is possible that the Republican Party has played an organizing role in encouraging vaccine hesitancy and patient harm.

Collective Views of Vaccination Predict Vaccine Hesitancy and Willingness to Receive a COVID-19 Vaccine

We examined the association between sociodemographic factors, views of vaccines as being an individual choice to protect oneself vs. a collective choice to protect others, general vaccine hesitancy, and willingness to receive a COVID-19 vaccine. In a sample of adults (N = 619; 33% non-white), we showed that demographic factors explain significant variance in both vaccine hesitancy and willingness to receive a COVID-19 vaccine. Viewing vaccines as an individual choice to protect oneself explained additional variance in vaccine hesitancy. However, people who viewed vaccines as a collective choice to protect others showed both less vaccine hesitancy and greater willingness to receive a COVID-19 vaccine. These findings suggest that promoting prosocial attitudes about vaccinations may decrease vaccine hesitancy and increase vaccine uptake.

Factors Affecting the Public Intention to Repeat the COVID-19 Vaccination: Implications for Vaccine Communication

Although most of the pandemic-related mandatory restrictions have been lifted or eased, vaccination is still recommended as an effective measure to minimize the damage from COVID-19 infection. Since COVID-19 eradication is unlikely, it is necessary to understand the factors affecting the public's vaccination intention when COVID-19 vaccination is continuously recommended. This study aims to explore the factors that affect the intention to repeat the COVID-19 vaccination in South Korea. An online survey was conducted in January 2022 with adults living in Gyeonggi-do, South Korea. In a hierarchical logistic regression analysis, sociodemographic factors, COVID-19 infection-related factors, COVID-19 vaccination-related factors, sociocultural factors, and communication factors were taken into account. In this study, more than three-quarters (78.1%) of Koreans were willing to repeat the COVID-19 vaccination. People who had high-risk perceptions, had been vaccinated against COVID-19 at least once, had more authoritarian attitudes, regarded the vaccination as a social responsibility, and had positive attitudes toward health authorities' regular briefings were more likely to repeat the vaccination. In contrast, those who directly or indirectly experienced COVID-19 vaccine side effects and who showed psychological reactance against the government's vaccination recommendation were less likely to repeat the vaccination. Our research indicates that empathetic communication, promotion of the prosocial aspect of vaccination, and regular and transparent provision of vaccine information are essential for promoting the intention to repeat the COVID-19 vaccination.

The psychological causes and societal consequences of authoritarianism

Over the past two decades, citizens’ political rights and civil liberties have declined globally. Psychological science can play an instrumental role in both explaining and combating the authoritarian impulses that underlie these attacks on personal autonomy. In this Review, we describe the psychological processes and situational factors that foster authoritarianism, as well as the societal consequences of its apparent resurgence within the general population. First, we summarize the dual process motivational model of ideology and prejudice, which suggests that viewing the world as a dangerous, but not necessarily competitive, place plants the psychological seeds of authoritarianism. Next, we discuss the evolutionary, genetic, personality and developmental antecedents to authoritarianism and explain how contextual threats to safety and security activate authoritarian predispositions. After examining the harmful consequences of authoritarianism for intergroup relations and broader societal attitudes, we discuss the need to expand the ideological boundaries of authoritarianism and encourage future research to investigate both right-wing and left-wing variants of authoritarianism.

Authoritarianism weakens democratic institutions and fosters societal divisions. In this Review, Osborne et al. describe the psychological processes and situational factors that give rise to authoritarianism, as well as the societal consequences of its apparent resurgence within the general population.

Political Ideology and Trust in Government to Ensure Vaccine Safety: Using a U.S. Survey to Explore the Role of Political Trust

Since early 2020, the rapid expansion of COVID-19 has raised concerns about vaccine safety and the government's handling of it. Particularly notable and concerning has been a growing number of people who oppose vaccines, as this opposition poses a threat to public health. Those for and against vaccination have become polarized along a political divide. Within this context, this study focuses on the role of political trust, exploring whether political ideology is associated with the perception that the government can ensure the safety of vaccines and whether there is a moderator that can alleviate the concerns of those who oppose the government's handling of vaccine safety on ideological grounds. This study relies on the 2021 U.S. General Social Survey (GSS) and employs an ordered probit method because the dependent variable is an ordered category. The ordered probit model includes a weight provided by the U.S. GSS to account for the population. The sample size was 473 because of the inclusion of all the variables relevant to this study. The results obtained are as follows: First, conservatives associate negatively with support for the government's handling of vaccine safety. Second, more importantly, conservatives exhibit a higher trust level toward the government to ensure vaccine safety if their level of political trust increases. The results point to important implications. Political ideology matters in how individuals view the government's handling of vaccine safety. Political trust plays a key role in helping individuals alter their views toward the government's handling of vaccine safety. This points to a need for the government to take political trust seriously and work hard to improve the public's trust in the government.

Not Getting Vaccinated? It Is a Matter of Problem-Solving Abilities and Socio-Cognitive Polarization

The anti-COVID-19 vaccination campaign in the United States provided a significant contribution to the control of the virus spread. Despite the recommendations by public health institutions, vaccine skepticism and hesitancy contributed to low vaccine uptake, thus possibly disrupting the management of preventable diseases associated with the COVID-19 infection. The process that led individuals to accept COVID-19 vaccines required the ability to gather, synthesize, and weigh-up information within a novel, dynamically changing, complex, and ambiguous context. To deal with such complexity, we hypothesized that both the ability of reflection and flexible adaptation played a fundamental role. Based on previous research on cognitive predictors of vaccine refusal, we decided to investigate the combined role of two constructs, namely, problem-solving skills and socio-cognitive polarization (SCP), on vaccine acceptance and uptake. Two-hundred-seventy-seven US participants completed an online survey aimed to measure problem-solving ability, through a rebus puzzles task, and SCP, through a composite measure of absolutist thinking, political conservatism, and xenophobia. Mediation analyses indicated that SCP mediated the association between problem-solving ability and vaccine acceptance, so lower problem-solving abilities associated with higher polarization predicted vaccine rejection. Thus, our findings suggested that low problem-solving skills may represent a risk factor for COVID-19 vaccine refusal, with cognitive and social rigidity playing a crucial role in undermining the anti-COVID-19 vaccine uptake.

Misinformation and COVID-19 vaccine hesitancy

BACKGROUND

COVID-19 vaccine hesitancy has emerged as a major public health challenge. Although medical and scientific misinformation has been known to fuel vaccine hesitancy in the past, misinformation surrounding COVID-19 seems to be rampant, and increasing evidence suggests that it is contributing to COVID-19 vaccine hesitancy today. The relationship between misinformation and COVID-19 vaccine hesitancy is complex, however, and it is relatively understudied.

METHODS

In this article, we report qualitative data from two related but distinct studies from a larger project. Study 1 included semi-structured, open-ended interviews conducted in October-November 2020 via phone with 30 participants to investigate the relationship between misinformation and COVID-19 vaccine hesitancy. Study 1's results then informed the design of open-ended questions for Study 2, an online survey conducted in May-June 2021 to consider the relationship between misinformation and vaccine hesitancy further. The data were examined with thematic analysis.

RESULTS

Study 1 led to the identification of positive and negative themes related to attitudes toward COVID-19 vaccines. In Study 2, responses from vaccine-hesitant participants included six categories of misinformation: medical, scientific, political, media, religious, and technological. Across both Study 1 and Study 2, six vaccine hesitancy themes were identified from the data: concerns about the vaccines' future effects, doubts about the vaccines' effectiveness, commercial profiteering, preference for natural immunity, personal freedom, and COVID-19 denial.

CONCLUSIONS

The relationship between misinformation and vaccine hesitancy is complicated. Various types of misinformation exist, with each related to a specific type of vaccine hesitancy-related attitude. Personal freedom and COVID-19 denial are vaccine attitudes of particular interest, representing important yet understudied phenomena. Medical and scientific approaches may not be sufficient to combat misinformation based in religion, media, or politics; and public health officials may benefit from partnering with experts from those fields to address harmful misinformation that is driving COVID-19 vaccine hesitancy.

Freedom of Choice to Vaccinate and COVID-19 Vaccine Hesitancy in Italy

Despite the availability of effective vaccines that lower mortality and morbidity associated with COVID-19, many countries including Italy have adopted strict vaccination policies and mandates to increase the uptake of the COVID-19 vaccine. Such mandates have sparked debates on the freedom to choose whether or not to get vaccinated. In this study, we examined the people's belief in vaccine choice as a predictor of willingness to get vaccinated among a sample of unvaccinated individuals in Italy. An online cross-sectional survey was conducted in Italy in May 2021. The survey collected data on respondents' demographics and region of residence, socioeconomic factors, belief in the freedom to choose to be vaccinated or not, risk perception of contracting and transmitting the disease, previous vaccine refusal, opinion on adequacy of government measures to address the pandemic, experience in requesting and being denied government aid during the pandemic, and intent to accept COVID-19 vaccination. The analysis employed binary logistic regression models using a hierarchical model building approach to assess the association between intent to accept vaccination and belief in the freedom to choose to vaccinate, while adjusting for other variables of interest. 984 unvaccinated individuals were included in the study. Respondents who agreed that people should be free to decide whether or not to vaccinate with no restrictions on their personal life had 85% lower odds of vaccine acceptance (OR = 0.15; 95% CI, 0.09,0.23) after adjusting for demographic and socioeconomic factors and their risk perception of contracting and transmitting COVID-19. Belief in the freedom to choose whether or not to accept vaccinations was a major predictor of COVID-19 vaccine acceptance among a sample of unvaccinated individuals in Italy in May 2021. This understanding of how individuals prioritize personal freedoms and the perceived benefits and risks of vaccines, when making health care decisions can inform the development of public health outreach, educational programs, and messaging.

The vaccination rift effect provides evidence that source vaccination status determines the rejection of calls to get vaccinated

COVID vaccination protects individuals and helps end the pandemic, but a sizable minority in Western countries rejects the vaccine. Vaccination status should serve as a group membership, critical communication between groups undermines trust, and we accordingly suggest that calls to get vaccinated by vaccinated sources lead to defensive rejection instead of desired behavior change. We term this the vaccination rift effect. A unique collaboration with national print, online and TV news media yielded a large (N = 1170), age-representative sample of Austrian citizens for our fully randomized experiment. Participants exhibited the vaccination rift: They ascribed less constructive motives, d = 0.28, 95% CI [0.17; 0.40], experienced more threat, d = - 0.30, 95% CI [- 0.42; - 0.19], and ascribed worse personality characteristics to vaccinated (vs. unvaccinated) commenters, d = 0.17, 95% CI [0.06; 0.29]. Constructiveness consistently predicted behavioral measures of counterarguing and vaccination planning (indirect effects B = 0.033, SE = 0.013 and B = - 0.056, SE = 0.014). The vaccination rift was substantially stronger among the critical group of unvaccinated participants, ds = |0.39-0.52|, than among those fully vaccinated, ds = |0.08-0.17|. We discuss how to apply these psychological mechanics of the vaccination rift to public campaigns.

Comorbidities, sociodemographic factors, and determinants of health on COVID-19 fatalities in the United States

Previous studies have evaluated comorbidities and sociodemographic factors individually or by type but not comprehensively. This study aims to analyze the influence of a wide variety of factors in a single study to better understand the big picture of their effects on case-fatalities. This cross-sectional study used county-level comorbidities, social determinants of health such as income and race, measures of preventive healthcare, age, education level, average household size, population density, and political voting patterns were all evaluated on a national and regional basis. Analysis was performed through Generalized Additive Models and adjusted by the COVID-19 Community Vulnerability Index (CCVI). Effect estimates of COVID-19 fatality rates for risk factors such as comorbidities, sociodemographic factors and determinant of health. Factors associated with reducing COVID-19 fatality rates were mostly sociodemographic factors such as age, education and income, and preventive health measures. Obesity, minimal leisurely activity, binge drinking, and higher rates of individuals taking high blood pressure medication were associated with increased case fatality rate in a county. Political leaning influenced case case-fatality rates. Regional trends showed contrasting effects where larger household size was protective in the Midwest, yet harmful in Northeast. Notably, higher rates of respiratory comorbidities such as asthma and chronic obstructive pulmonary disease (COPD) diagnosis were associated with reduced case-fatality rates in the Northeast. Increased rates of chronic kidney disease (CKD) within counties were often the strongest predictor of increased case-fatality rates for several regions. Our findings highlight the importance of considering the full context when evaluating contributing factors to case-fatality rates. The spectrum of factors identified in this study must be analyzed in the context of one another and not in isolation.

Explaining vaccine hesitancy: A COVID-19 study of the United States

Using recent data on the unvaccinated population across US states, this paper focuses on the determinants of vaccine hesitancy related to the COVID-19 pandemic. Findings show that more prosperous states and states with more elderly residents and more physicians have lower vaccine hesitancy. There was some evidence of the significance of race, but internet access and history of other contagious diseases failed to make a difference. States with centralized health systems and those with mask mandates generally had a lower percentage of unvaccinated populations. Finally, the presence of Democrats in state legislatures tended to lower vaccination hesitancies, ceteris paribus.

Politics of COVID-19 vaccine mandates: Left/right-wing authoritarianism, social dominance orientation, and libertarianism

Mandatory and punitive vaccination policies, such as requiring vaccination certificates for public activities and firing employees who refuse vaccination, have raised considerable objections. With a sample of U.S. crowdsourced workers (N = 983), this study investigates how four ideologies-left-wing authoritarianism (LWA), right-wing authoritarianism (RWA), social dominance orientation (SDO), and libertarianism-explain vaccine acceptance and attitudes toward vaccine policies. Results show that LWA predicts higher vaccine acceptance and support for COVID-19 vaccine mandates and the punishment of unvaccinated individuals, whereas libertarianism and RWA show negative relationships. SDO is linked to opposition to vaccine mandates. This study underscores the role of specific ideological components in shaping attitudes toward vaccine policies while also contributing to the arguments that LWA and libertarianism have important implications for studying sociopolitical attitudes.

Predicting COVID-19 booster vaccine intentions

Achieving broad immunity through vaccination is a cornerstone strategy for long‐term management of COVID‐19 infections, particularly the prevention of serious cases and hospitalizations. Evidence that vaccine‐induced immunity wanes over time points to the need for COVID‐19 booster vaccines, and maximum compliance is required to maintain population‐level immunity. Little is known of the correlates of intentions to receive booster vaccines among previously vaccinated individuals. The present study applied an integrated model to examine effects of beliefs from multiple social cognition theories alongside sets of generalized, stable beliefs on individuals' booster vaccine intentions. US residents (N = 479) recruited from an online survey panel completed measures of social cognition constructs (attitude, subjective norms, perceived behavioral control, and risk perceptions), generalized beliefs (vaccine hesitancy, political orientation, and free will beliefs), and COVID‐19 vaccine intentions. Social cognition constructs were related to booster vaccine intentions, with attitude and subjective norms exhibiting the largest effects. Effects of vaccine hesitancy, political orientation, and free will beliefs on intentions were mediated by the social cognition constructs, and only vaccine hesitancy had a small residual effect on intentions. Findings provide preliminary evidence that contributes to an evidence base of potential targets for intervention messages aimed at promoting booster vaccine intentions.