Abstract
During a pandemic, noncompliance with vaccination programs is a complex issue that has the potential to create uncertainty for public health outcomes and undermine management efforts. Vaccines are intended to reduce the introduction of infection into the body, and thus are associated with moral purity. Moral purity is about protecting people and communities against potentially harmful pathogens. According to studies on moral foundations, people with high levels of moral purity avoid individuals, objects, and experiences that violate a sense of sanctity or self-control or that induces disgust. Furthermore, people with high moral purity fear biological contamination and see disease antigen injection as a damaging corruption of the body’s integrity. While we know that during a pandemic, people make trade-offs between accepting or rejecting the offered vaccines, it is critical to understand how moral purity shapes preferences and trade-offs for vaccination policies enacted to reduce virus transmission and excess death.
We use a DCE and a moral attitudes survey to investigate how moral purity influences preferences for vaccination campaigns to mitigate the effects of a pandemic. Because the effectiveness of vaccination campaigns is dependent on individuals’ willingness to be vaccinated, it is important to understand preferences for vaccination programs. The DCE included vaccine-related attributes (efficacy, risk of side effects, origin of manufacturer, duration of protection, time spent in development), as well as the corresponding policy adopted (societal restrictions and employment mandates). The survey was sent to residents in 21 countries: Australia, Brazil, Chile, Croatia, France, India, Israel, Italy, Latvia, Norway, Russia, Singapore, Slovak Republic, Slovenia, Spain, South Africa, South Korea, Sweden, Turkey, UK, and the US), via an online panel managed by DemetraOpinioni, between July and December 2022. The total sample size is 51,000 respondents, who are representative of the country’s population in terms of age, gender, and geographical distribution. We estimated the effects of moral purity on preferences for COVID-19 vaccine characteristics and hesitancy using a mixed logit model.
Moral purity consistently influenced preferences for COVID-19 vaccine characteristics. We also find that individuals with a higher moral purity are more likely to be vaccine hesitant. Vaccines may feel wrong to someone with significant moral purity concerns. Thus, people with high moral purity have a negative preference for most vaccine attributes and are more likely to become vaccine hesitant. The purity foundation includes “physical and spiritual contagion, including virtues of chastity, wholesomeness, and control of desires”, the need to avoid people with diseases and being pure. During a pandemic, vaccination campaigns may be identified as potential threats to individuals and their families in their households.
Understanding moral attitudes may be useful for communication strategies, with information tailored around moral purity attitudes. Using messages focused on moral purity to promote vaccine campaigns, for example, may encourage vaccine roll-out.