Global Variation in COVID-19 Beliefs and Behaviors
The objective of this international study is to document how health “influencers” such as scientific, governmental, political, and religious organizations disseminate and shape COVID-19 vaccine beliefs and behaviors.
The COVID-19 pandemic is an unprecedented global event that has impacted billions of people. The development and launch of vaccination programs are expected to curb the pandemic, and many are eagerly anticipating a return to pre-COVID life again. Yet the path to herd immunity at a global scale is rocky, for a variety of complex reasons ranging from access to vaccines, unknown consequences of new vaccine variants, and concerns about the safety and side effects of COVID-19 vaccinations.
We seek to understand the contextual variables that predict when health influencers work collaboratively to achieve common goals (e.g., health-promoting behavior, vaccination), and when they work at odds with each other. To this end, we will examine cultural and contextual variation in COVID-19 vaccine beliefs and behaviors at a global scale. Specifically, we will examine: 1) the sources of COVID-19 related information people consume and trust, 2) the kinds of information people use when explaining the cause, spread, prevention, and treatment of COVID-19, and 3) how this information impacts vaccine-related knowledge, attitudes, beliefs, and behaviors. Our data will help inform future national and international research on knowledge and practices relevant to preventing the spread of COVID-19. This study promises to afford important insights into factors influencing compliance with preventative health behavior and people’s attitudes towards vaccination.
Since the beginning of the pandemic, the World Health Organization (WHO) has stated that we are also facing an infodemic: the overabundance of misinformation that can negatively impact people’s responses to health decisions (WHO, 2020). Public health experts have recommended certain behaviors to mitigate the spread of the virus, yet many people also accept recommendations from outside of the scientific community. In some cases, people may accept unsubstantiated recommendations that public health officials do not endorse. This does not only apply to information regarding COVID-19 but also novel information surrounding newly developed vaccines.
At this point, it is clear that until 75-90% of the global population becomes vaccinated and we reach herd immunity, COVID-19 will continue to become a severe threat to the population (Dr. Fauci to the New York Times, 2020). Nearly half of U.S. adults surveyed indicated that they would not be willing to receive a COVID-19 vaccine (Pew Research Center, 2020). People may have different motivations for expressing hesitancy towards vaccines (Hornsey et al., 2017), and there is likely no single motivation for why people express hesitancy or reject getting a COVID-19 vaccine. Some adults may express hesitancy because of the rushed development (Pew Research Center). Other adults may believe in conspiracy theories claiming that the COVID-19 pandemic is a way for elites to develop vaccines that contain microchips to track individuals (Evstatieva, 2020). Miracle cures are one of the most prevalent topics of misinformation (Evanega, Lynas, Adams, Smolenyak, 2020) suggesting people may opt for alternative treatments that do not involve vaccines at all. Studying how people seek, reason and share information about COVID-19 vaccination can inform the design of future interventions to ensure effective, fact-based communication.
It is critical to understand where people seek information and who they trust, particularly when conflicting sources may undermine best practices and guidelines to reduce the spread of COVID-19. The WHO and CDC have disseminated information about best preventative practices and have updated guidelines throughout the pandemic. Nonetheless, people may distrust scientific expertise and instead rely on non-scientific outlets as sources that present messages that conflict with scientific guidelines. For example, the former U.S. president and current Brazilian president have recommended the use of hydroxychloroquine to treat COVID-19 even though medical experts claim there is no evidence of its efficacy. Belief in conspiracy theories and distrust of the medical establishment is associated with disregarding preventive behaviors (e.g., facial masks) and engaging in selfish behaviors that have personally benefited them (e.g., hoarding supplies; Imhoff & Lamberty, 2020). When people consume inaccurate sources of information, individuals may underestimate the severity of the virus, and neglect preventative health behaviors that can severely affect local communities. Thus, where people seek information can shape perceptions of risk and the types of norms practiced.
Examining how people consume sources and share information with others is imperative to understand how people are adapting to a rapidly changing information marketplace. Some may recognize that science constantly changes and may tentatively accept the best current information until new information is available. Others may be confused or skeptical by the changing guidelines from the medical community and, in the worst case, may dismiss scientific information altogether. The findings from this research would help pave the way for understanding how information consumption can impact people’s attitudes, beliefs, and behaviors towards COVID-19 vaccination and has implications for how we can mitigate the spread of misinformation.
Current Studies
International study
We are collecting demographically representative international data using online surveys distributed via Qualtrics Panels. We have collected data in North America (United States, Canada, Mexico), South America (Brazil, Argentina), Europe (UK, Germany, Spain, Russia), Africa (South Africa, Nigeria), Asia (China, Japan, India), Oceania (Australia, New Zealand) and the Middle East (Israel, Turkey, Iran). These field sites are geographically and culturally representative, chosen due to their current access to COVID-19 vaccines. For example, countries where vaccinations have been halted (e.g., South Africa) may differ from countries where vaccination rates are slower and only available to a very small group of people (e.g., Mexico, India). Additionally, the international spread of this data covers the variety of COVID-19 vaccines that are currently developed, given that there is reason to believe that the vaccine hesitancy may differ due to the specific vaccines available.
Texas study
The United States has over 32 million COVID-19 cases, with Texas nearly reporting 2.8 million COVID-19 cases (as of February 2021). Policy and guidelines surrounding preventative practices can vary from state to state that can impact the rate of COVID-19 cases. During the early stages of the pandemic in Texas, urban areas accounted for most COVID-19 cases, yet rural areas accounted for higher case fatality rates. For certain preventative behaviors, U.S. political conservatives may perceive wearing a mask as emasculating because it conflicts with traditional norms of masculinity. Thus, when U.S. conservatives cite safety concerns about reducing the spread of COVID-19, their statements may differ from actual behaviors (e.g., not wearing a mask) or issue conflicting orders. In May 2020, Texas Governor Greg Abbott issued an executive order that would allow businesses to reopen and eased social gathering restrictions creating conflict for businesses that did not wish to reopen. Further, Texas did not opt to use mail-in voting ballots during the November 2020 Election, leaving people to evaluate whether one should risk their health to exercise their voting rights. Despite Democratic appeal efforts to allow all Texans to vote by mail, the U.S. Supreme Court ruled that a lack of immunity to COVID-19 was not a valid excuse for receiving a mail-in ballot.
The COVID-19 pandemic has become highly politicized within the U.S, severely impacting the infrastructure needed to address a global health crisis. Although most Americans express confidence in medical scientists, growing hyper partisan differences, both in the U.S. and around the world, contribute to variable beliefs about whether there is sufficient testing available and whether social distancing practices are effective in reducing the spread of COVID-19. Repeatedly, U.S. conservatives have expressed skepticism towards scientific topics such as climate change and evolution theory, and current leadership has expressed skepticism towards COVID-19 as well. In general, conservatives have expressed skepticism towards health-related behaviors needed to curve the pandemic and, in some cases, have downplayed the pandemic’s severity. For example, Donald Trump has claimed young people would recover from COVID-19 in one day, and Dr. Scott Atlas, Donald Trump’s former COVID-19 Health Advisor, has claimed that young people are not at risk and that getting COVID-19 is good for them. U.S. political conservatives are more likely to discount media reports on the spread of the virus, which in turn, is associated with downplaying the severity of the virus and not practicing preventative behaviors. The growing hyper partisan differences may magnify the different attitudes and behavioral responses to the COVID-19 pandemic within Texas. While Texas is traditionally a politically conservative state, it is becoming increasingly politically and ethnically diverse as people migrate to Texas for economic opportunities. Overall, our focus on Texas citizens would show regional differences in the consumption and reconciliation of conflicting information.
We are collecting demographically representative data using online surveys distributed via Amazon Mechanical Turk (MTurk). We aim to collect data within metropolitan (e.g., Dallas, Houston, Austin) and non-metropolitan areas of Texas (e.g., Armstrong, Brewster, Oldham) to capture geographical and cultural representation. Within Texas, the public has expressed vaccine hesitancy despite recent access to the vaccine. For example, White Republicans are more likely to refuse to get a COVID-19 vaccine than any other demographic group. Additionally, young people are more likely to refuse or express hesitancy in getting a COVID-19 vaccine. Thus, we aim to understand the underlying motivations for why different groups and individuals may accept or express vaccine hesitancy.
Collaborators
at Austin
- Project PI: Cristine Legare, Professor of Psychology and Director of the Center for Applied Cognitive Science, The University of Texas at Austin
- Oskar Burger, Director of Design & Development, Center for Applied Cognitive Science
- Alejandro Erut, Senior Research Scientist, Center for Applied Cognitive Science
- Frankie Fong, Postdoctoral Fellow
- Ajna F. Kertesz, Research Scientist, Center for Applied Cognitive Science
- Hannah Lunkenheimer, Research Scientist, Center for Applied Cognitive Science
- Jesse D. Peregrino, Research Scientist, Center for Applied Cognitive Science
Funding
The project is funded by Templeton Religious Trust, UT Austin VPR Research and Creative Grant, and the Office of the Vice President for Research and the College of Liberal Arts at The University of Texas at Austin.