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EXPRESS: Vaccination Acceptance across Cultures: The Roles of Collectivism, Empathy, and Homophily
Abstract
How does culture influence vaccination acceptance? This is an important question facing managers, policymakers, and global health organizations. Even with effective vaccines for highly contagious diseases, humankind remains at risk from vaccine hesitancy. We conduct a largescale multilevel analysis of more than 400,000 survey respondents, finding that COVID-19 vaccination intentions are higher among people from countries higher in cultural collectivism (Study 1). Follow-up studies indicate that vaccination acceptance is higher among people that endorse collectivistic values because they feel more empathy for those afflicted by the disease (Studies 2a, 2b, 3), especially when victims of the disease have similar characteristics (e.g., political affiliation, lifestyle, personality) as themselves (Study 3). To encourage vaccination acceptance, we suggest promoting collectivistic values and empathic concern, as well as homophily through the portrayal of victims with characteristics like those hesitant to accept vaccination.
... Opinions around vaccination sometimes develop in complex and unexpected ways, presenting challenges such as resistance or insufficient acceptance within segments of the population that were not anticipated by policymakers. Empirical observations of significant differences in vaccination opinions across different societies [18,19] further highlight the importance of studying opinion dynamics. For example, willingness to be vaccinated against COVID-19 was found to be higher among people from countries with a higher degree of cultural collectivism or who endorse collectivistic values [19]. ...
... Empirical observations of significant differences in vaccination opinions across different societies [18,19] further highlight the importance of studying opinion dynamics. For example, willingness to be vaccinated against COVID-19 was found to be higher among people from countries with a higher degree of cultural collectivism or who endorse collectivistic values [19]. ...
... For instance, collectivism has been associated with a lower number of deaths [28], limited the spread of the virus [14], and more mask usage [22] during the COVID-19 pandemic. With regard to vaccination, most existing studies believe that collectivism fosters opinion consensus [19,25]. In collectivist societies, individuals are more likely to conform to prevailing opinions within their community. ...
Culture plays a pivotal role in shaping collective level processes, with implications for public opinion on issues such as COVID-19 vaccination. Drawing on Hofstede's cultural dimension theory, we theoretically examine the influence of two key dimensions of culture, individualism/collectivism and power distance, on the opinion formation of individuals within a dynamic and evolving context. While former models suggest that collectivism promotes opinion consensus, our findings reveal a more complex relationship, particularly in scenarios where centralization or decentralization of a society is considered. By conducting multiple simulation experiments through an agent-based model, we find that collectivism can contribute to opinion consensus in a simple scenario in which only social norms work without any impact from authorities. However, a collectivist society also has the potential to experience high opinion polarization in the presence of greater decentralization among authorities, particularly in settings of high power distance. Simulation results further demonstrate that disagreement between authorities is more likely to result in opinion polarization in individualist cultures compared to collectivist cultures.
... To the best of our knowledge, the existing literature has not sufficiently addressed this issue, as little is known about the underlying determinants of people's response to perceived vaccine artificiality. Therefore, we offer a novel mechanism based on a socio-cultural construct, vertical collectivism [4][5][6][7][8][9][10][11][12], defined as the degree to which people acknowledge their dependency within the social hierarchy. In this article, we propose and empirically examine that vertical collectivism makes people react to perceived vaccine artificiality less negatively. ...
... A wide range of vaccination intent determinants has been heavily studied, including perceptual constructs like perceived vaccine unnaturalness (artificiality) [2, 3] and socio-cultural ones, like collectivism [4][5][6][7][8][9][10][11][12]. While each of those two constructs was, separately, demonstrated to be an important antecedent of vaccination intent, their interplay remains unclear. ...
... While collectivism has been consistently found to increase vaccination intent [4][5][6][7][8][9][10][11][12], the perception of vaccine unnaturalness (artificiality) constitutes a challenge for vaccination programs. That is, previous studies showed vaccines to be perceived mainly as unnatural (artificial) [3], which contributed to vaccination hesitancy [2]. ...
Vaccine "unnaturalness" (artificiality) is one of the major anti-vaccine arguments raised in public debate. Therefore, health communication should rebut unnaturalness arguments and be cautious when emphasizing human intervention (e.g., advanced vaccine technology), which may entail perceiving vaccines as artificial. Understanding how the relationship between perceived vaccine artificiality and vaccination intent differs across social groups can help enforce the above health communication efforts by focusing them on specific audiences. The objective of the current paper is to assess the moderating role of a particular socio-cultural factor—vertical collectivism (reflecting the orientation on social hierarchy)—in the relationship between perceived vaccine artificiality and vaccination intent. It is proposed that vertical collectivism diminishes the negative effect of perceived vaccine artificiality. Two studies with European young adults measured COVID-19 vaccination intent and vertical collectivism. Study 1 (N = 418) was correlational, measuring perceived vaccine artificiality. The data were analyzed with a moderation model. Study 2 (N = 203) was experimental, manipulating perceived vaccine artificiality by human-intervention appeal (i.e., emphasizing human intervention in vaccine development and operation). The data were analyzed with moderation and moderated mediation models. Study 1 demonstrated that the effect of perceived vaccine artificiality on vaccination intent was less negative when the level of vertical collectivism was higher. In Study 2, with higher levels of vertical collectivism, the effect of human-intervention appeal on vaccination intent was less negative, and the indirect effect through perceived vaccine artificiality turned even positive. Those results contribute to the fields of perceived naturalness/artificiality, vaccination behavior, health communication, and cultural dimensions theory, providing empirical evidence that the negative effect of perceived vaccine artificiality on vaccination intent is diminished by vertical collectivism, as proposed. Health practitioners are guided on how to consider different levels of collectivism of their audiences while referring to vaccine artificiality in their communication. Specifically, it is suggested that rebutting "unnaturalness" anti-vaccine arguments should be focused on people low in vertical collectivism, and messages featuring human intervention (e.g., a vaccine’s technological advancement) should be targeted at people high in vertical collectivism.
... For instance, Chen, Frey & Presidente (2021) analyzed daily data on geographic mobility in 111 countries during the early epidemic and discovered that people were less likely to adhere to lockdown regulations in countries with a higher degree of individualism such as the United States, compared to countries with a higher degree of collectivism such as China. Furthermore, Leonhardt & Pezzuti (2022) surveyed 400,000 people in more than 50 countries and found that people from collectivistic countries tended to have positive attitudes towards COVID-19 vaccine compared to those from individualistic countries. Connecting the dots, it is less surprising that countries with a greater degree of individualism had higher numbers of confirmed cases and mortality rates than countries with a greater degree of collectivism (Chen & Biswas, 2022;Maaravi et al., 2021;Rajkumar, 2021;Ritchie et al., 2020). ...
... Interestingly, when countries in both regions have arguably similar resources, vaccination rates in the Eastern countries such as Singapore tended to be higher than those in Western countries such as the United Kingdom (Ritchie et al., 2020). While it can be attributed to the cultural framework as previously mentioned, i.e., (Leonhardt & Pezzuti, 2022), it could also be due to different political situations. In the Western countries which are predominantly democratic, the governments have less authority to force people to get vaccinated. ...
... Another possible explanation is individualist culture, which appears to influence how the public in the Western region reacted to COVID-19 security measures and policies (Chen, Frey & Presidente, 2021;Leonhardt & Pezzuti, 2022). The pandemic has urged people, regardless of their health status, to take various preventive measures to stop the virus' spread and mitigate casualties. ...
Newspapers and other mass media outlets are critical in shaping public opinion on a variety of contemporary issues, including the COVID-19 pandemic. This study examines how the pandemic is portrayed in the news and how the public reacted differently in the West and East using archival data from Facebook posts about COVID-19 news by English-language mass media between January 2020 and April 2022 ( N = 711,646). Specifically, we employed the Valence Aware Dictionary and sEntiment Reasoner (Vader) to measure the news tone on each COVID-19 news item shared on Facebook by mass media outlets. In addition, we calculated a polarity score based on Facebook special reactions ( i.e ., love, angry, sad, wow, haha, and care) received by each post to measure public reactions toward it. We discovered that people in Western countries reacted significantly more negatively to COVID-19 news than their East counterparts, despite the fact that the news itself, in aggregate, generally contained a relatively similar level of neutral tone in both West and East media. The implications of these distinctions are discussed in greater detail.
... In the context of health risks, collectivist values can both oppose and mitigate these risks by promoting communityoriented health behaviors and decision-making. Hence, collectivism had beneficial effects in reducing COVID-19 spread (Gomez & Spencer, 2024;Huang et al., 2024;Jiang et al., 2022) by fostering increased concern for family and in-group members (Hussein, 2022) and was beneficial to vaccination acceptance due to the greater prevalence of empathy (Leonhardt & Pezzuti, 2022). Accordingly, in the context of the 2020 Olympics, collectivism may have positively influenced agreement with controversial decisions, to the extent that these decisions were put in place to limit health risks. ...
as the cOViD-19 pandemic started to disrupt the global economy, organizations had to make controversial decisions under unprecedented uncertainty. hence, mega sport event organizers had to decide whether their events should proceed. in this context, the present research investigates whether the international Olympic committee was able to leverage its values and commitment to sustainable development by comparing the influence of three measures of value congruity (including two novel sustainability-based instruments) on brand trust and consumers' agreement with controversial cOViD-19-related decisions. a Pls-seM method was used to analyze data from five countries (n = 1241). Results reveal that the novel sustainability-based measures are at least as influential as the traditional measure, and that brand trust mediates the relationship. Moderations of risk perceptions and cultural differences are exhibited. these findings contribute to the literature by comparing sustainability-based and traditional measures in the context of global disruptions. Marketers are encouraged to use novel sustainability-based instruments. GRAPHICAL ABSTRACT Notes: unmediated effects are reported for value congruity on agreement; range of coefficients from global model only (regional effects not represented).
... The findings of this study provide important insights into the factors influencing COVID-19 vaccination and general attitudes towards vaccines among a socioeconomically disadvantaged and culturally diverse population attending free clinics. health challenges in their countries of origin, making them more receptive to vaccination through targeted initiatives [28]. ...
Background
Misinformation and vaccination hesitancy contribute to disparities in vaccination rates, particularly in under-resourced communities. This study aims to investigate perceptions and factors influencing vaccination decisions at free clinics serving diverse, under-resourced communities.
Methods
Surveys were conducted across eight free clinics in the Greater Sacramento area, targeting uninsured or underinsured individuals. Information on demographics, sources of vaccine information, access to vaccines, vaccine perceptions, and vaccination decisions as pertaining to influenza and COVID-19 were collected on Qualtrics software. Chi-square and t-tests were used to analyze associations between demographics and vaccination rates.
Results
Among 109 participants (24–82 years old), vaccination rates were found to be higher than the county average, with notable demographic variations. Contrary to initial hypotheses, men had higher vaccination rates than women, and recent immigrants exhibited higher vaccination rates than more long-term U.S. residents. A higher number of participants regarded the COVID-19 vaccine as effective than as safe, while the reverse was true for the influenza vaccine. Healthcare providers were the most trusted and influential sources for vaccine information, followed by government agencies, and then family and friends. Answers to hypothetical vaccine scenarios elicited assessments on risks and benefits.
Conclusion
The study provides insight into the dynamics of vaccine hesitancy and factors that play into the decision-making process in under-resourced communities, underscoring the role of trust in healthcare providers. These findings are vital for tailoring community outreach strategies to create trust, address barriers, and enhance vaccine uptake within free community clinics.
... Altruistic motivation was measured using the validated 14-item Individualism/Collectivism Scale Cronbach's α = 0.66 for the individualistic orientation and α = 0.65 for the collectivistic orientation (23). Previous research has shown that elevated COVID-19 vaccine intentions were found in individuals from collectivist cultures (37). ...
Younger adults, aged 18–39 years, exhibit low COVID-19 additional vaccine (i.e., vaccination beyond the original 2-dose series) uptake recommended in Canada. No study has examined how altruistic and individualistic messaging can influence COVID-19 additional dose intentions. The present study aimed to estimate the efficacy of altruism and individualism-based videos on vaccine intentions and to explore the multivariable associations between vaccine related individual psychosocial factors and intention to receive the COVID-19 vaccine. Using a web-based survey in a three-arm, pre-post randomized control trial design, we recruited Canadians aged 18–39 years in both English and French. Participants were randomly allocated in a 1:1:1 ratio to receive the active control (COVID-19 general information), control + altruism or control + altruism + individualism. The video interventions were developed with a media company, based on results of a focus group study conducted previously. The measurement of COVID-19 additional dosage intentions before and after completing the interventions was informed by the multistage Precaution Adoption Process Model. The McNemar Chi-square was used to evaluate within-group changes, and the Pearson Chi-square test was used to evaluate between-group changes post-intervention. The measurement of various psychosocial factors was informed by use of validated scale and self-report questions. We employed a generalized Structural Equation Model to evaluate the associations between COVID-19 vaccine intentions and the psychosocial factors. Analyses were performed on 3,431 participants (control: n = 1,149, control + altruism: n = 1,142, control + altruism + individualism: n = 1,140). Within-group results showed that participants transitioned significantly in all three groups in the direction of higher intentions for receiving additional COVID-19 vaccine doses. The between-group differences in post intervention vaccine intentions were not significant. We found that psychosocial factors that include, collectivism, intellectual humility, intolerance to uncertainty, religiosity, identifying as gender diverse, and being indigenous were associated with higher vaccine intentions, whereas pandemic fatigue was associated with lower vaccine intentions. Our study highlighted that a short video that includes altruism and individualism messaging or general COVID-19 information can increase intentions to vaccine among young adults. Furthermore, we gained a comprehensive understanding of various psychosocial factors that influence ongoing COVID-19 vaccination. Our findings can be used to influence public health messaging around COVID-19 vaccination.
... However, concerning social opportunity, which involves the influence of the social environment and cultural norms, the absence of significant results may be attributed to specific contextual factors, such as cultural values and well-developed healthcare infrastructure [19]. For example, in collectivist cultures, where community values are important, individuals are more likely to receive the COVID-19 vaccine than in individualistic cultures [57]. Cultural values might act also as mediators in the relationship between social opportunity and vaccination intention such as specific religious beliefs that encourage or discourage vaccination and trust in government and healthcare systems. ...
Background
Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual’s health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions.
Methods
A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey.
Results
A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust.
Conclusions
When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated.
... Social Science & Medicine 361 (2024) 117180 networks within these societies inadvertently create environments conducive to corrupt practices (Davis and Ruhe, 2003;Seleim and Bontis, 2009). However, individuals in collectivist societies are also more inclined to engage in actions that benefit society, potentially reducing vaccine hesitancy (Yu et al., 2021;Leonhardt and Pezzuti, 2022;Lui, 1985;Lamot and Kirbiš, 2024). Lastly, masculinity reflects a society's emphasis on assertiveness, competition, and achievement, in contrast to nurturing, cooperation, and relationship-building (Hofstede, 2011). ...
Over the past four years, the COVID-19 pandemic has caused significant uncertainty, suffering, and economic disruption worldwide. Consequently, governments have faced pressure to ensure fair vaccine access while achieving vaccination targets quickly. Such challenging circumstances can create opportunities for nepotism and bribery, increasing attention to corruption risks associated with the pandemic response. This study investigates the relationship between public attitudes towards corruptive behaviour and the efficiency and equity of the UK's COVID-19 vaccination programme. It combines primary data on public tolerance towards corruptive behaviour with secondary data on the efficiency of the vaccination program at the local authority level in England and Scottland. We employ a survival analysis approach, estimating Cox Proportional Hazards Models, which examine the time taken to reach vaccination targets. Our findings suggest moderate tolerance towards nepotism/favouritism and bribery among the British public, with 28% of survey participants considering monetary bribery and 34% considering nepotism/favouritism as acceptable means to secure early vaccination access. Moreover, while public tolerance towards corruptive behaviour generally had a negative impact on the efficiency of the vaccination programme, it appears to have expedited the vaccination rollout in politically aligned local authorities governed by the Conservative and Unionist Party. However, this positive effect on efficiency appears to have come at the expense of reduced equity in vaccine distribution. These findings underscore the trade-off between efficiency and equity in vaccine distribution during public health crises, emphasising the need for health policies that balance efficiency with equity to ensure fair and effective distribution of vaccines in the future.
... Many factors could explain these differences. For example, collectivistic values, which are generally high among many Asian and Hispanic/Latino cultures [44] have been previously linked to feelings of collective responsibility and trust in vaccines [45][46][47]. Perhaps, in counties where residents had fewer concerns about healthcare access and greater exposure to information and providers, collectivistic values emerged as important considerations when making vaccination decisions. Within barrier themes, this study found that among American Indian/Alaska Native, Hispanic/ Latino ELP, and Multiracial adults, concerns over access were more prevalent in counties with higher barriers. ...
Background
County-level barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, low vaccination history) may impact individuals’ reasons for receiving the COVID-19 vaccine.
Methods
This study linked data from REACH-US (Race-Related Experiences Associated with COVID-19 and Health in the United States), a nationally representative, online survey of 5475 adults living in the U.S (January-March 2021) to county-level barriers in the COVID-19 Vaccine Coverage Index. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Participants reported why they would or would not receive the COVID-19 vaccine in an open-ended item and their responses were coded using thematic analysis. Descriptive statistics and chi-square tests assessed whether reasons for COVID-19 vaccination intentions varied by county-level barriers and whether these distributions varied across racial/ethnic groups.
Results
Thematic analysis revealed twelve themes in participants’ reasons why they would or would not receive the COVID-19 vaccine. Themes of societal responsibility (9.8% versus 7.7%), desire to return to normal (8.1% versus 4.7%), and trust in science/healthcare/government (7.7% versus 5.1%) were more frequently reported in counties with low/medium barriers (versus high/very high) (p-values < 0.05). Concerns of COVID-19 vaccine side effects/safety/development (25.3% versus 27.9%) and concerns of access/costs/availability/convenience (1.9% versus 3.6%) were less frequently reported in counties with low/medium barriers (versus high/very high) (p-values < 0.05). Trends in the prevalence of these themes varied across racial/ethnic groups (p-values < 0.05).
Conclusions
Future pandemic responses should consider potential ways county-level barriers shape reasons for COVID-19 vaccination.
... Collectivistic societies emphasize group cohesion and promote group goals above individual desires. 18 Although a collectivist cultural orientation is linked to greater willingness to get vaccinated, 19 members of collectivist societies are more likely to hold conspiracy theory beliefs, 5 which are a predictor of vaccine hesitancy. 1,20,21 A moderation effect might thus be plausible, whereby the relationship between conspiracy theories and COVID-19 vaccination intention may vary based on the level of the country's collectivism. ...
Background:
Predictors of COVID-19 (coronavirus) vaccination have been extensively researched; however, the contextual factors contributing to understanding vaccination intention remain largely unexplored. The present study aimed to investigate the moderating role of economic development (Gross domestic product - GDP per capita), economic inequality (Gini index), the perceived corruption index and Hofstede's measurements of cultural values-index of individualism/collectivism and power distance index-in the relationship between determinants of satisfaction with the healthcare system, trust in political institutions, conspiracy beliefs and COVID-19 vaccination intention.
Methods:
A multilevel modelling approach was employed on a sample of approximately 51 000 individuals nested within 26 countries. Data were drawn from the European Social Survey Round 10. The model examined the effect of individual- and country-level predictors and their interaction on vaccination intention.
Results:
Satisfaction with the healthcare system had a stronger positive effect on intention to get vaccinated in countries with lower perceived corruption and more individualistic countries. Trust in political institutions had a stronger positive effect on vaccination intention in countries with higher economic development and lower perceived corruption, while a negative effect of conspiracy beliefs on vaccination intention was stronger in countries with lower economic development, higher perceived corruption and a more collectivistic cultural orientation.
Conclusion:
Our findings highlight the importance of considering individual and contextual factors when addressing vaccination intention.
... Diversi studi si concentrano sui determinanti della propensione a vaccinarsi (Wellcome 2018; Wu et al., 2021;Brewer et al., 2017;Piltch-Loeb andDiClemente, 2020) e, nello specifico, contro il Covid-19 (Wellcome 2020;WHO, 2020;Leonhardt e Pezzuti, 2022;Burke et al., 2021;Dror et al., 2020;Al-Alamer et al., 2022;Falcone et al., 2022;Chou e Budenz, 2020), sia a livello di paese che individuale. ...
... Conversely, consumers in collectivistic cultures (e.g., China) are encouraged to attune their personal preferences to social expectations (Chen et al. 1998;Miller 1984;Trommsdorff 2009). People living in these cultures appear interdependent, placing much importance on social connectedness and welfare of their groups (Hofstede 1983(Hofstede , 2001Markus and Kitayama 1991;Leonhardt and Pezzuti 2022). They even sacrifice their preferences to social expectations when the two are discordant (Chan and Lau 2002;Miller 1984;Savani, Morris, and Naidu 2012). ...
... In terms of vaccination, Leonhardt and Pezzuti (2022) found a connection between collectivist orientation of individuals and their decision to get vaccinated against COVID-19, explaining this finding through empathy towards one's compatriots. Henceforth, when it comes to cultural orientations and pandemics, it is expected that collectivists feel more threatened when the virus occurs, are conscientious towards the community, worried about infecting others, adhere to measures, as well as trust that their community and country will protect them (Germani et al., 2020). ...
Collectivism is consistently correlated with a positive attitude toward COVID-19 vaccination. Nevertheless, qualitative evidence on how collectivism benefits vaccination is scarce. Serbia has been transitioning from a socialist to a neoliberal country for decades now, and its unique ideological context provokes different forms of collectivism. Young adults are usually the ones who represent radical political, non-neoliberal opposition, embracing collectivistic ideas. We selected a group of self-declared collectivists from Serbia and encouraged them to express their attitude toward vaccination. The final sample consisted of 16 narratives (four female), written by 13 vaccinated and three unvaccinated participants. We conducted two types of thematic analyses, resulting in 12 semantic (five collectivistic and seven individualistic) and two latent themes. The results unambiguously showed the presence of individualism in the argumentation of self-declared collectivists, especially those unvaccinated. We proposed the term Neoliberal collectivism to reach a better understanding of young people’s perspectives in the specific socio-political context.
... The study revealed some cross-national differences in Covid-19 vaccination intention and its associations with attention to media and social norms. In line with previous research on the cultural dependence of vaccination intention (Betsch et al., 2017;Böhm et al., 2016;Leonhardt & Pezzuti, 2022), we found that vaccination intention is higher in Singapore than in Switzerland. We will discuss these differences in light of the vaccination intention's associations with communication and norms and against the backdrop of both countries' cultural values and media systems. ...
Social norms are a promising factor for pandemic control, as they motivate people to engage in preventive behaviours. However, little is known about the influence of perceived social norms on the intention to get vaccinated against Covid-19 and the role of communication in shaping such normative perceptions. Moreover, despite the pandemic’s global scale, a cross-cultural perspective is scant in research on Covid-19 preventive behaviour. The present study examined the relationships between communication (i.e., attention to mass media and social media), social norms (i.e., perceived norms in the population and personal environment), and people’s intention to get vaccinated against Covid-19 using a cross-national survey in Singapore (N = 998) and Switzerland (N = 1,022). Multigroup structural equation modelling revealed that attention to mass media was positively correlated with perceived norms in both countries, whereas attention to social media was correlated with normative perceptions only in Singapore. Normative perceptions regarding the population and personal environment were positively correlated with vaccination intention in Singapore. However, in Switzerland, only perceived norms in the personal environment were positively related to vaccination intention. The results are discussed against the background of both countries’ media systems and cultural values (i.e., individualism/collectivism) and are instructive for norms-based interventions in times of crises.
... Thus our work complements recent cross-national investigations of the antecedents of vaccination (e.g. Lazarus et al., 2023;Leonhardt & Pezzuti, 2022;Pagliaro et al., 2021). ...
A plethora of research has highlighted that trust in science, political trust, and conspiracy theories are all important contributors to vaccine uptake behavior. In the current investigation, relying on data from 17 countries (N = 30,096) from the European Social Survey we examined how those who received (and wanted to receive the COVID-19 vaccine) compared to those who did not differ in their trust in: science, politicians and political parties, international organizations and towards people in general. We also examined whether they differed in how much they believed in conspiracy theories. Those who received (or wanted to receive) the COVID vaccine scored significantly higher in all forms of trust, and lower in conspiracy theory beliefs. A logistic regression suggested that trust in science, politicians, international organizations, as well as belief in conspiracy theories were significant predictors, even after accounting for key demographic characteristics. K E Y W O R D S conspiracy theories, European social survey, multilevel modelling , political ideology, political trust, trust in science, vaccination behavior E M P I R I C A L
... Vaccine hesitancy is not unique to COVID-19. Thus, considering culture is key to understanding vaccine acceptance and subsequent behaviors [40]. Currently, the role of culture on behavioral outcomes, particularly vaccine uptake, is under researched. ...
Vaccines are one of the most successful tools for protecting the public’s health. However, widespread vaccine hesitancy in the Southern United States is preventing effective mitigation of the current COVID-19 pandemic. The purpose of this study was to assess COVID-19 vaccine acceptance among adults living in a largely rural Southern state. This cross-sectional study collected data from 1,164 Arkansas residents between October 3 and October 17, 2020 using random digit dialing. The primary outcome was a multidimensional COVID-19 vaccine acceptance measure with scores between -3 to +3. The full COVID-19 vaccine acceptance scale was measured along with perceived vaccine safety, effectiveness, acceptance, value, and legitimacy subscales. Statistical analyses were conducted using multivariable linear regression. Results indicated Black participants had the lowest overall vaccine acceptance (0.5) compared to White participants (1.2). Hispanic participants had the highest scores (1.4). In adjusted models, Black participants had 0.81 points lower acceptance than White participants, and Hispanic participants had 0.35 points higher acceptance. Hispanic participants had the highest scores for all five vaccine acceptance subscales, relatively equivalent to White participants. Black participants had consistently lower scores, especially perceived vaccine safety (mean -0.2, SD 0.1). In conclusion, the lowest vaccine acceptance rates were among Black participants particularly on perceived vaccine safety. While Black participants had the lowest acceptance scores, Hispanic participants had the highest. This variability shows the value of a multidimensional vaccine acceptance measure to inform COVID-19 vaccination campaign strategies.
... In hindsight, it has become clear that Portugal is in a better position than many other member states of the European Union, and the question is whether this could inform governance in other countries. A study conducted by Leonhardt and Pezzuti (2022) found that collectivism was positively associated with vaccine acceptance across more than 50 countries. Indeed, according to Hofstede Insights (2021) Portugal scores relatively high on the cultural dimension of collectivism. ...
Ever since the Covid-19 vaccination rollout, governments have aimed for herd immunity. Yet, many countries are far from achieving this goal mainly due to vaccine refusal. Previous research has pointed to conspiracy beliefs and the role of trust in governments as predictors of vaccine acceptance, yet a more comprehensive explanatory model is still missing. Using data from a convenience sample of 377 residents in Portugal (Mage = 33.56, SD = 13.67), the present study extends previous research by proposing a serial mediation model in the prediction of vaccine acceptance. The results confirm the critical role of conspiracy beliefs mediating the link between perceived quality of government communication and general vaccine acceptance (Model 1) as well as national stereotypes and acceptance of the Sinovac vaccine from China (Model 2). The implications are discussed considering that Portugal is currently ranked the second country in the world with the highest vaccination rate.
... Emphasizing community benefits in health messaging has also been shown to increase vaccination in individualistic-leaning societies [11]. This phenomenon may function at both the community and individual levels; data comparing COVID-19 vaccine uptake across 50 countries found that vaccine intentions were higher in countries with more collectivistic cultures and that individuals from individualistic cultures who endorsed collectivistic values were more likely to accept a COVID-19 vaccine [12]. What is unknown, and what we investigate in this paper, is the extent to which the collectivistic or individualistic orientation in society can be made salient through vaccine videos and whether such heightened salience affects how people view and interpret the underlying message to get vaccinated. ...
Vaccination hesitancy is a barrier to India’s efforts to control the COVID-19 pandemic. Considerable resources have been spent to promote COVID-19 vaccination, but evaluations of such efforts are sparse. Our objective was to determine how vaccine videos that manipulate message appeal (collectivistic versus individualistic), tone (humorous versus serious), and source (male versus female protagonist) toward vaccines and vaccination. We developed eight videos that manipulated the type of appeal (collectivistic or individualistic), tone of the message (humor or serious), and gender of the vaccine promoter (male or female) in a 2 × 2 × 2 between-subjects experiment. Participants (N = 2349) were randomly assigned to watch one of eight videos in an online experiment. Beliefs about vaccines and those about vaccination were obtained before and after viewing the video. Manipulation checks demonstrated that each of the three independent variables was manipulated successfully. After exposure to the video, beliefs about vaccines became more negative, while beliefs about vaccination became more positive. Humor reduced negative beliefs about vaccines. Collectivism and protagonist gender did not affect beliefs about vaccines or vaccination. Those able to remember the protagonist’s gender (a measure of attention) were likely to develop favorable beliefs if they had also seen the humorous videos. These findings suggest that people distinguish beliefs about vaccines, which deteriorated after exposure to the videos, from beliefs about vaccination, which improved. We recommend using humor when appropriate and focusing on the outcomes of vaccination, rather than on the vaccines themselves.
... These nuanced dimensions of vertical and horizontal individualism-collectivism have important implications for how culture may influence COVID-19 prevention. For example, vertical hierarchism may produce greater obedience and horizontal egalitarianism greater empathy for others (Atalay & Solmazer, 2021;Leonhardt & Pezzuti, 2022)leading to greater uptake of COVID-19 prevention behaviors, regardless of their individualism and collectivism. Indeed, while collectivism may be generally predictive of better uptake of prevention behaviors, egalitarian individualists might also be inclined to comply with public health guidance, even if it requires some self-sacrifice. ...
Background
Collectivism has been identified as a protective factor against COVID-19 – perhaps due to increased conformity with social norms regarding prevention behaviors. Other studies have also found that individualism can inspire uptake of preventative behaviors as a means of personal protection. It is possible that these cultural orientations may promote different patterns of prevention (e.g. mask wearing vs. social distancing). Furthermore, existing studies examining the role of individualism and collectivism during the COVID-19 pandemic have frequently failed to account for other psychological processes, including differences in personality, which could help provide a better understanding of the psychological process underlying prevention behavior.
Methods
Participants were recruited using social media advertisements. The Cultural Orientations Scale measured individualism–collectivism and hierarchism-egalitarianism. The Ten Item Personality Inventory measured the five factor model of personality. Multivariable models, dominance analyses and structural equation mediation tests were used to identify the most important predictors of COVID-19 prevention behavior (i.e. mask-wearing, hand-washing, reducing social interactions, physical distancing, staying at home and social bubbling), controlling for demographic and situational factors.
Results
Among 774 participants, most (i.e. 60–80%) reported uptake of COVID-19 prevention behaviors. Higher vertical (hierarchical) collectivism was associated with staying at home and higher horizontal (egalitarian) individualism was associated with mask-wearing and reducing social interactions. Neither Vertical Collectivism nor Horizontal Collectivism were significantly associated with any of the prevention behaviors when controlling for personality traits and confounding variables. Agreeableness was identified as a key mediator of the correlation between these cultural orientations on general uptake of COVID-19 prevention behaviors.
Conclusions
Cultural orientations (e.g. collectivism-individualism, hierarchism-egalitarianism) and personality traits (e.g. Agreeableness) are salient correlates of COVID-19 prevention behaviors and therefore should be accounted for in the development, design and delivery of health promotion messages aiming to increase uptake of these behaviors.
Purpose
This research introduces and validates psychological ownership of health as a novel theoretical construct characterized by individuals’ perceived possessiveness, attachment and responsibility toward their health. This study aims to examine the construct’s ability to predict and explain consumers’ health-related decision-making for themselves and others.
Design/methodology/approach
Two online surveys with US participants ( N = 680) were conducted. The psychological ownership of health scale was first validated through confirmatory factor analysis. Next, the influence of psychological ownership of health on positive health behaviors and blood donation intentions was assessed using multiple regression analyses and conditional process modeling.
Findings
Psychological ownership of health demonstrated significant positive associations with health-promoting behaviors (dietary choices, physical activity, sleep hygiene) mediated by health self-efficacy. In addition, psychological ownership of health predicted increased blood donation intentions, and this relationship is amplified among individuals high in cultural collectivism.
Practical implications
The findings suggest that interventions fostering psychological ownership of health may simultaneously promote personal health maintenance and prosocial health behaviors. These dual implications offer promising applications for individualized and public health initiatives.
Originality/value
This research advances psychological ownership theory by establishing and validating a health-specific dimension that predicts critical health behaviors at individual and societal levels. By identifying cultural collectivism as a moderator, this research also integrates psychological ownership theory with cultural dimensions theory, revealing cultural variability in health ownership’s influence on prosocial health outcomes.
Major disasters and public health crises require effective communication strategies to disseminate vital information and save lives. During the recent COVID-19 pandemic, use of digital communication to communicate information became critical as governments enacted measures to protect public health, including COVID-19 curtailment strategies intended to save lives. To increase response effectiveness to critically important messaging, it is imperative to understand how to communicate with different communities to best achieve cooperation and compliance. Studies have identified culture as being a strong determinant of how people reacted to COVID-19 messaging. The following chapter describes a survey of 184 Hispanic and Latino Americans and non-Hispanic and Latino Americans to determine their attitudes towards COVID-19 mitigation protocol compliance and effective messaging strategies. The study found that significant differences between Hispanic and Latino and non- Hispanic and Latino culture and preferences for specific messaging strategies during the pandemic.
This systematic review explores the psychological antecedents of Vaccine Hesitancy, a significant determinant of vaccination behavior. Following PRISMA guidelines, an extensive search was conducted starting from 1673 papers and resulting in 48 publications from various databases. The review identifies psychological factors, specifically cognitive, personality, experiential, and social factors contributing to hesitancy. Cognitive factors include health literacy, conspiracy beliefs, trust, and perceived risk. Personality traits such as extraversion, openness, and psychological capital impact hesitancy, while psychopathy increases it. Personal experiences, like perceived stress and racial discrimination, indirectly affect hesitancy. Social factors, including social relationships and norms, play a significant role in reducing hesitancy. Tailored interventions addressing these factors can enhance vaccine acceptance.
Background
Most studies assessing the impact of online media and social media use on COVID-19 vaccine hesitancy predominantly rely on survey data, which often fail to capture the clustering of health opinions and behaviors within real-world networks. In contrast, research using social network analysis aims to uncover the diverse communities and discourse themes related to vaccine support and hesitancy within social media platforms. Despite these advancements, there is a gap in the literature on how a person’s social circle affects vaccine acceptance, wherein an important part of social influence stems from offline interactions.
Objective
We aimed to examine how online media consumption influences vaccination decisions within real-world social networks by analyzing unique quantitative network data collected from Romania, an Eastern European state and member of the European Union.
Methods
We conducted 83 face-to-face interviews with participants from a living lab in Lerești, a small rural community in Romania, using a personal network analysis framework. This approach involved gathering data on both the respondents and individuals within their social circles (referred to as alters). After excluding cases with missing data, our analysis proceeded with 73% (61/83) of the complete personal networks. To examine the hierarchical structure of alters nested within ego networks, we used a mixed multilevel logistic regression model with random intercepts. The model aimed to predict vaccination status among alters, with the focal independent variable being the respondents’ preferred source of health and prevention information. This variable was categorized into 3 types: traditional media, online media (including social media), and a combination of both, with traditional media as the reference category.
Results
In this study, we analyzed 61 personal networks, encompassing between 15 and 25 alters each, totaling 1280 alters with valid data across all variables of interest. Our primary findings indicate that alters within personal networks, whose respondents rely solely on online media for health information, exhibit lower vaccination rates (odds ratio [OR] 0.37, 95% CI 0.15-0.92; P=.03). Conversely, the transition from exclusive traditional media use to a combination of both traditional and online media does not significantly impact vaccination rate odds (OR 0.75, 95% CI 0.32-1.78; P=.52). In addition, our analysis revealed that alters in personal networks of respondents who received the vaccine are more likely to have received the vaccine themselves (OR 3.75, 95% CI 1.79-7.85; P<.001).
Conclusions
Real-world networks combine diverse human interactions and attributes along with consequences on health opinions and behaviors. As individuals’ vaccination status is influenced by how their social alters use online media and vaccination behavior, further insights are needed to create tailored communication campaigns and interventions regarding vaccination in areas with low levels of digital health literacy and vaccination rates, as Romania exposes.
Understanding vaccination decision-making processes is vital for guiding vaccine promotion within pandemic contexts and for routine immunization efforts. Vaccine-related attitudes influencing individual decision-making can be affected by broader cultural and normative contexts. We conducted 73 qualitative interviews with adults in China ( n = 40) and Germany ( n = 33) between December 2020 and April 2021 to understand COVID-19 vaccination intentions and preferences, and we analyzed transcripts using a five-step framework approach. During early analysis, we identified moral considerations in line with the tenets of the Model of Moral Motives (MMM) as a recurrent theme in the data. The MMM guided further analysis steps, particularly with its distinction between motives that are proscriptive (focus on avoiding harm by inhibiting “bad” behavior) and prescriptive (focus on actively seeking positive outcomes). Proscriptive vaccination arguments that compelled vaccination in our data included avoiding negative attention, being a law-abiding citizen, preventing harm to others, and protecting one’s country. Prescriptive motives focused on self-efficacious behavior such as protecting the health of oneself and others via widespread but voluntary vaccination, prioritizing elderly and predisposed individuals for vaccination, and favoring a fair and equitable distribution of vaccines at the global level. In the interviews in China, both lines of arguments emerged, with a general tendency toward more proscriptive reasoning; interviews conducted in Germany tended to reflect more prescriptive motives. We encourage research and vaccine promotion practice to reflect moral considerations when aiming to understand public health preventive behavior and when developing tailored health promotion campaigns.
Background
Parental acceptance of HPV vaccination remains low. This study investigates the influence of different message framing on Chinese parental intentions to vaccinate their daughters against HPV.
Methods
A 2 (appeal framing: gain vs. loss) × 2 (cultural value: individualism vs. collectivism) × 2 (evidence type: narrative vs. non‐narrative) factorial design was used in an online experiment. Parents of unvaccinated junior high school girls were recruited and included in the experiment. The primary outcome assessed was the reduction in HPV vaccine hesitancy (VH). The analysis of variance tests (ANOVAs) and hierarchical regression analyses were conducted to test the hypotheses.
Results
Of 4012 participants, the majority were women with low VH. Only loss‐framing exerted a direct effect on advocacy ( p = .036). Initial VH negatively moderated this effect ( p = .027). Except for narrative evidence ( p = .068), message framings showed significant small effects in low‐hesitant participants ( p = .032). An incentive policy negatively moderated the initial VH's effect on advocacy ( p = .042). Persuasion was evident only among low‐hesitant participants not receiving incentives ( p = .002). In contrast, for highly hesitant individuals without incentive policies, loss‐framing ( p = .024) and collectivism perspective ( p = .033) produced counterintuitive effects.
Conclusions
Message framing is effective among low‐hesitant parents of female adolescents in improving HPV vaccination decisions without economic incentives. Non‐narrative evidence and loss‐framing messages should be prioritized over narrative evidence and gain‐framing messages. Nonetheless, caution is warranted when engaging with highly hesitant parents.
The majority of the hospitalizations and deaths associated with COVID-19 occurred in people over the age of 65. In addition, previous studies have shown that intergenerational contacts played a key role in COVID-19-related infection and fatality. This paper utilized two large-scale multinational surveys to uncover the important role of family ties in infection prevention across 93 countries. Using the World Values Survey, we measured country-level family ties emphasizing respondents’ view of their parents. We elicited individual willingness to uptake infection prevention measures from a panel study conducted each month in the early phase of the COVID-19 pandemic between March 2020 and July 2021. We find that in countries with stronger family ties, people show more support for non-pharmaceutical interventions and higher vaccine acceptance; moreover, young people are more supportive of mandatory vaccination. The association between strength of family ties and compliance with infection prevention measures was salient before COVID-19 vaccines became available and was persistent before the global vaccination coverage reached 25%.
Despite evidence of the safety and effectiveness of COVID‐19 vaccines and their wide availability, many in the U.S. are not vaccinated. Research demonstrates that prosocial orientations predict COVID‐19 health behaviors (e.g., social distancing) and vaccination intentions, however, little work has examined COVID‐19 vaccination willingness in the U.S. since vaccines were approved. Findings from two U.S. samples show that, in contrast to other COVID‐19 health behaviors, vaccine willingness in unvaccinated people is unrelated to prosocial orientation. Study 2 demonstrates that the lack of association between vaccine willingness and prosocial orientation in unvaccinated participants was specific to those with stronger beliefs that COVID‐19 vaccines are ineffective. Thus, in prosocial people, perceptions of vaccines' ineffectiveness may undermine COVID‐19 vaccine willingness.
In the past decade, before the onset of the Covid-19 pandemic, rates of childhood vaccination against diseases such as measles, diphtheria, pertussis, and tetanus declined worldwide. An extensive literature examines the correlates and motives of vaccine hesitancy—the reluctance or refusal to vaccinate despite the availability of vaccines—among individuals, but little macrosociological theory or research seeks to explain changes in country-level vaccine uptake in global and comparative perspective. Drawing on existing research on vaccine hesitancy and recent developments in world society theory, we link cross-national variation in vaccination rates to two global cultural processes: the dramatic empowerment of individuals and declining confidence in liberal institutions. Both processes, we argue, emerged endogenously in liberal world culture, instigated by the neoliberal turn of the 1980s and 1990s. Fixed- and random-effects panel regression analyses of data for 80 countries between 1995 and 2018 support our claim that individualism and lack of institutional confidence contributed to the global decline in vaccination rates. We also find that individualism is itself partly responsible for declining institutional confidence. Our framework of world-cultural change might be extended to help make sense of recent post-liberal challenges in other domains.
Understanding how individual beliefs and societal values influence support for measures to prevent SARS-CoV-2 (COVID-19) transmission and risk is vital to developing and implementing effective prevention policies. Around the world, surges in COVID-19 infections continue to be prevalent; strategies to address the increase in vaccine hesitancy and related conspiracy theories are being enacted globally. Using the theoretical lenses of social identity theory and system justification theory, we examined how individual-level conceptualizations of global identity, system legitimacy, conspiracy beliefs, trust in science, government, and healthcare can influence an uptick in COVID-19 vaccine adherence. Data from an international survey of adults (Mage = 26.8, SD = 9.2) from China, the Philippines, and the United States (N = 358) allowed the present study to investigate how cultural values and governmental policies intersect with COVID-19 risk perception and vaccine hesitancy. The present study provides insight into the potential cultural influences of misinformation about COVID-19 and informs strategies for increasing vaccine uptake globally for future pandemics.
The COVID-19 pandemic had an unprecedented impact on mental health. In particular, the impact on adolescents was likely significant due to vulnerability factors linked to this developmental stage and pre-existing conditions of hardship. The present work aimed at grasping the particular effects of the pandemic on social and cultural aspects of adolescence, providing a cross-sectional picture of this historical moment of contemporary youth culture. Further research is needed to verify the findings.
Vaccine hesitancy is a worldwide phenomenon rooted in cultural beliefs and perceptions of health and sickness. The paper presents an exploratory analysis of available scientific research that investigates COVID-19 vaccine hesitancy in global cultures. The cultural aspects are based on Hofstede's model of cultural dimensions, which incorporates individualism and collectivism. We believe that cultures in these dimensions would show a proclivity to reject or accept vaccinations and their influence on the human body. The paper also discusses the basic notions of vaccine trust and vaccine hesitancy and the role of vaccination policies and public health strategies to fight the disease. The text also discusses different interpretations of vaccine hesitancy, such as a lack of collective empathy. The present research employs three hypotheses. First, populations in individualistic cultures around the world are more likely to choose vaccinations as a form of protection (high interpersonal empathy outside of the family unit, high degree of public responsibility and awareness). Second, populations in collectivistic cultures are more likely to reject vaccinations as a form of protection (low degree of interpersonal empathy outside of the family unit, low degree of public responsibility and awareness). Third, populations in both groups of cultures make their vaccination choices based on consuming messages from strategic communications used to popularize COVID-19 vaccinations. Research methods include the descriptive and deductive analysis of hypotheses. A secondary deductive analysis is provided to classify vaccine hesitancy as an individualistic or collectivistic trait. Hypotheses are based on the premise that there is a cultural difference in the degree of public responsibility and awareness and in interpersonal empathy outside of the family unit. This is based on some authors' consideration of intrinsic motivation as a result of affiliation with an individualistic or collectivistic group. The paper attempts to understand the link between individualism and collectivism as cultural value orientations and vaccine confidence. We conclude that Western cultures have cultural aspects that are similar to individualism, whereas Eastern cultures are more similar to collectivism. However, we cannot find a direct connection between individualism and collectivism as cultural dimensions and the personal choice to vaccinate against COVID-19 because the available data does not support that. The authors believe that the socio-cultural, political, and economic environments have a stronger influence on people's proclivity to vaccinate. Media messages remain key to addressing vaccine hesitancy according to cultural norms and perceptions.
This cross-sectional study explored factors associated with the corona virus disease 2019 (COVID-19) vaccination acceptance among higher education students in southwestern Germany. We conducted a cross-sectional online survey at six state-approved higher education institutions (HEIs) between July and November 2021. In addition to descriptive analyses, univariate as well as multivariate binary logistic regression analyses were conducted. A total of 6556 higher education students aged 18 years and older participated in our survey; 91.4% of participating students had been vaccinated against COVID-19 at least once. The factors that significantly contributed to the explanation of higher education students’ vaccination status in the multivariate analysis (area under curve—AUC = 0.94) were variables on the perception of the virus SARS-CoV-2 (affective risk perception: Adjusted odds ratio—aOR = 1.2; perception of the outbreak as a media-hype: aOR = 0.8), attitudes towards personal (aOR = 0.7) and study-related (aOR = 0.8) health and safety measures to prevent transmission of SARS-CoV-2, and attitudes towards COVID-19 vaccination (preservation of own health: aOR = 1.3; confidence in vaccine safety: aOR = 1.7; supporting higher education through vaccination: aOR = 1.2; own contribution to the containment of the pandemic: aOR = 1.7). The findings target assisting HEIs in returning to face-to-face teaching after previous semesters of online teaching.
Faced with a threat to their very lives, one might imagine that people would act in ways that promised a rapid end to the suffering. Perhaps the greatest puzzle about the US response to the COVID-19 pandemic is why so many people failed to cooperate with even the most basic mitigation measures. For some, failure to cooperate reflected practical concerns. For others, it reflected confusion. But for a third group, the explanation lies at the intersection between recent social changes in the USA and individual psychological processes. This also explains why these beliefs and behaviors so often coincided with adherence to right-wing ideologies and parties.KeywordsConservatismPsychological reactanceIndividualismSocial mediaMisinformationRessentimentAnti-vaxxersMotivated reasoningSocial dominance orientationSocial identity
Among the myriad challenges created by the COVID-19 pandemic, many touched on how individuals chose to utilize their resources to protect their personal well-being and the downstream impact on society. Marketing researchers rose to the challenge, and much work in the 2020–2022 period has been devoted to improving well-being by using marketing theory to create better health messaging, develop effective interventions, understand mechanisms that shift purchasing patterns, motivate cooperation and compliance, and speak to the high-impact decisions that people and organizations are being forced to make each day. Here, the author introduces the Protection Knowledge Model to synthesize much of the research to date on COVID-19 response. This model highlights the individual–institution interaction in how people choose (and institutions promote) protective strategies and focuses on the dangers of misalignment in individuals’ and institutions’ knowledge of each other and of the situation.
Some people feel they are invincible to the novel coronavirus SARS-CoV-2 (COVID-19). They believe that being infected with COVID-19 would not be a serious threat to their health. While these people may or may not be correct in their personal risk assessment, we find that such perceived invincibility may undermine community efforts to achieve herd immunity. Multi-level analysis of survey respondents across 51 countries finds that perceived invincibility from COVID-19 is negatively associated with believing there is a need to prevent the spread of COVID-19 in one’s community (n = 218,956) and one’s willingness to inoculate against the disease (n = 71,148). These effects are most pronounced among individuals from countries lower in cultural collectivism (e.g., USA, UK, Canada) and highlight the need to consider the interplay of individual and cultural factors in our efforts to understand, predict, and promote preventative health behavior during a pandemic.
Objective: An effective vaccine against COVID-19 is a desired solution to curb the spread of the disease. However, vaccine hesitancy might hinder high uptake rates and thus undermine efforts to eliminate COVID-19 once an effective vaccine became available. The present contribution addresses this issue by examining two ways of increasing the intention to get vaccinated against COVID-19. Method: Two preregistered online studies were conducted (N = 2,315 participants from the United Kingdom) in which knowledge about and beliefs in herd immunity through vaccination, as well as empathy for those most vulnerable to the virus, were either measured (Study 1) or manipulated (Study 2). As a dependent variable, individuals’ self-reported vaccination intention once a vaccine against COVID-19 became available was assessed. Results: In Study 1 (N = 310), the intention to get vaccinated against COVID-19 was correlated with knowledge about and belief in herd immunity through vaccination (r = .58, p < .001), as well as with empathy for those most vulnerable to the virus (r = .26, p < .001). In Study 2 (N = 2,005), information about herd immunity through vaccination (Cohen’s d = .13, p = .003) and empathy (Cohen’s d = .22, p < .001) independently promoted vaccination intention. Conclusions: The motivation to get vaccinated against COVID-19 was related to and could be causally promoted by both mere information about herd immunity through vaccination and by empathy. As such, the present research provides a better understanding of the intention to get vaccinated against COVID-19.
This research investigates why people refuse the COVID-19 vaccine despite medical argumentation and dangerous COVID-19 consequences. As the global pandemic development is beyond each person's control, we predicted that two basic assumptions about the world, namely its order and positivity, would play an important role. Two studies on the Polish population took place in December 2020 and January 2021. The most interesting finding was that in both studies, belief in world orderliness negatively moderated, i.e., hampered, the positive relationship between belief in the world's positivity and willingness to vaccinate. It seems that the COVID-19 vaccination might evoke ia feeling of disruption in biological and social natural functioning. If we generalize, any idea undermining our habits and shared beliefs is the more challenged and opposed we have strong faith in the world as an ordered and predictable reality. Believing in the world's positivity may even aggregate this attitude. In discussing these results, we propose how to introduce new ideas or innovative products to consumers.
People often find truth and meaning in claims that have no regard for truth or empirical evidence. We propose that one reason is that people value connecting and fitting in with others, motivating them to seek the common ground of communication and generate explanations for how claims might make sense. This increases the likelihood that people experience empty claims as truthful, meaningful, or even profound. Seven studies (N > 16,000 from the U.S. and China) support our prediction. People who score higher in collectivism (valuing connection and fitting in) are more likely to find fake news meaningful and believe in pseudoscience (Studies 1 to 3). China-U.S. cross-national comparisons show parallel effects. Relative to people from the U.S., Chinese participants are more likely to see meaning in randomly generated vague claims (Study 4). People higher in collectivism are more likely to engage in meaning-making, generating explanations when faced with an empty claim, and having done so, are more likely to find meaning (Study 5). People who momentarily experience themselves as more collectivistic are more likely to see empty claims as meaningful (Study 6). People higher in collectivism are more likely to engage in meaning-making unless there is no common ground to seek (Study 7). We interpret our results as suggesting that conditions that trigger collectivism create fertile territory for the spread of empty claims, including fake news and misinformation.
Do geographic differences in collectivism relate to COVID-19 case and death rates? And if so, would they also replicate across states within arguably the most individualistic country in the world—the United States? Further still, what role might the U.S.'s history of ethnic strife and race-based health disparities play in either reinforcing or undermining state-level relations between collectivism and COVID-19 rates? To answer these questions, we examined archival data from 98 countries (Study 1) and the 48 contiguous United States (Study 2) on country/state-level collectivism, COVID-19 case/death rates, relevant covariates (per-capita GDP, population density, spatial dependence), and in the U.S., percent of non-Whites. In Study 1, country-level collectivism negatively related to both cases (r = −0.28) and deaths (r = −0.40) in simple regressions; however, after controlling for covariates, the former became non-significant (rp = −0.07), but the latter remained significant (rp = −0.20). In Study 2, state-level collectivism positively related to both cases (r = 0.56) and deaths (r = 0.41) in simple regressions, and these relationships persisted after controlling for all covariates except race, where a state's non-White population dominated all other predictors of COVID-19 cases (rp = 0.35) and deaths (rp = 0.31). We discuss the strong link between race and collectivism in U.S. culture, and its implications for understanding COVID-19 responses.
The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. However, to be effective, a vaccine must be accepted and used by a large majority of the population. The aim of this study was to understand the attitudes towards and obstacles facing vaccination with a potential COVID-19 vaccine. To measure these attitudes a survey was administered to 316 respondents across the United States by a survey corporation. Structural equation modeling was used to analyze the relationships of several factors with attitudes toward potential COVID-19 vaccination. Prior vaccine usage and attitudes predicted attitudes towards COVID-19 vaccination. Assessment of the severity of COVID-19 for the United States was also predictive. Approximately 68% of all respondents were supportive of being vaccinated for COVID-19, but side effects, efficacy and length of testing remained concerns. Longer testing, increased efficacy and development in the United States were significantly associated with increased vaccine acceptance. Messages promoting COVID-19 vaccination should seek to alleviate the concerns of those who are already vaccine-hesitant. Messaging directed at the benefits of vaccination for the United States as a country would address the second predictive factor. Enough time should be taken to allay concerns about both short- and long-term side effects before a vaccine is released.
Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 61.4% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so.
Background:
There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019.
Methods:
In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty.
Findings:
Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake.
Interpretation:
To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence.
Funding:
European Commission, Wellcome, and Engineering and Physical Sciences Research Council.
The COVID-19 pandemic presents a major challenge to societies all over the globe. To curb the spread of the disease, two measures implemented in many countries are minimizing close contact between people (“physical distancing”) and wearing face masks. In the present research, we tested the idea that physical distancing and wearing face masks can be the result of a prosocial emotional process — empathy for those most vulnerable to the virus. In four preregistered studies (N=3,718, Western population), we show that (i) empathy indeed relates to the motivation to adhere to physical distancing and to wearing face masks, and (ii) inducing empathy for those most vulnerable to the virus promotes the motivation to adhere to these measures (whereas merely providing information about its importance is not). In sum, the present research provides a better understanding of the promoting factors underlying the willingness to follow two important measures during the COVID-19 pandemic.
Background:
Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage.
Objective:
To assess intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identify predictors of and reasons for vaccine hesitancy.
Design:
Cross-sectional survey, fielded from 16 through 20 April 2020.
Setting:
Representative sample of adults residing in the United States.
Participants:
Approximately 1000 adults drawn from the AmeriSpeak probability-based research panel, covering approximately 97% of the U.S. household population.
Measurements:
Intent to be vaccinated against COVID-19 was measured with the question, "When a vaccine for the coronavirus becomes available, will you get vaccinated?" Response options were "yes," "no," and "not sure." Participants who responded "no" or "not sure" were asked to provide a reason.
Results:
A total of 991 AmeriSpeak panel members responded. Overall, 57.6% of participants (n = 571) intended to be vaccinated, 31.6% (n = 313) were not sure, and 10.8% (n = 107) did not intend to be vaccinated. Factors independently associated with vaccine hesitancy (a response of "no" or "not sure") included younger age, Black race, lower educational attainment, and not having received the influenza vaccine in the prior year. Reasons for vaccine hesitancy included vaccine-specific concerns, a need for more information, antivaccine attitudes or beliefs, and a lack of trust.
Limitations:
Participants' intent to be vaccinated was explored before a vaccine was available and when the pandemic was affecting a narrower swath of the United States. Questions about specific information or factors that might increase vaccination acceptance were not included. The survey response rate was 16.1%.
Conclusion:
This national survey, conducted during the coronavirus pandemic, revealed that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. Targeted and multipronged efforts will be needed to increase acceptance of a COVID-19 vaccine when one becomes available.
Primary funding source:
Agency for Healthcare Research and Quality.
Heterogeneity and herd immunity
In response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), some politicians have been keen to exploit the idea of achieving herd immunity. Countering this possibility are estimates derived from work on historical vaccination studies, which suggest that herd immunity may only be achieved at an unacceptable cost of lives. Because human populations are far from homogeneous, Britton et al. show that by introducing age and activity heterogeneities into population models for SARS-CoV-2, herd immunity can be achieved at a population-wide infection rate of ∼40%, considerably lower than previous estimates. This shift is because transmission and immunity are concentrated among the most active members of a population, who are often younger and less vulnerable. If nonpharmaceutical interventions are very strict, no herd immunity is achieved, and infections will then resurge if they are eased too quickly.
Science , this issue p. 846
Over the past two decades, there has been a marked increase in partisan social polarization, leaving scholars in search of solutions to partisan conflict. The psychology of intergroup relations identifies empathy as one of the key mechanisms that reduces intergroup conflict, and some have suggested that a lack of empathy has contributed to partisan polarization. Yet, empathy may not always live up to this promise. We argue that, in practice, the experience of empathy is biased toward one’s ingroup and can actually exacerbate political polarization. First, using a large, national sample, we demonstrate that higher levels of dispositional empathic concern are associated with higher levels of affective polarization. Second, using an experimental design, we show that individuals high in empathic concern show greater partisan bias in evaluating contentious political events. Taken together, our results suggest that, contrary to popular views, higher levels of dispositional empathy actually facilitate partisan polarization.
Understanding how determinants of environmental behavior vary across countries and national cultures is an urgent, understudied need. The current research applies meta-analysis to test within the theory of planned behavior (TPB) the moderating role of country (development) and national culture (individualism-collectivism) characteristics, using the most recent research (2004–2014), involving 67 articles from 28 countries. The results suggest that in developed and individualistic countries, intention to behave environmentally is more likely to translate to actual behavior, and that attitudes toward the environment are related to environmental intention. Also, in developed countries perceived behavioral control is partially related to environmental intention. Furthermore, the environmental context studied influences the results.
Group Empathy Theory posits empathy felt by members of one group can boost support for another even when the groups are in direct competition for rights, security, and resources. We employ our theory to explain divergent reactions of majority versus minority groups to immigration threats. We conduct a two-wave national survey experiment with 1,799 participants consisting of a randomized sample of Anglos and randomized, stratified oversamples of African Americans and Latinos. The experiment manipulates racial/ethnic cues in a vignette depicting an ambiguous yet potentially threatening incident at an immigrant detention center. African Americans and Latinos are significantly more likely to side with minority detainees and support pro-civil rights policies and actions. The theory’s presumed causal mechanism—group empathy—is substantially stronger among African Americans and Latinos, and has a significant mediating effect on such distinct reactions.
International relationships are increasingly critical to business performance. Yet despite a recent surge in international research on relationship marketing (RM), it is unclear whether or how RM should be adapted across cultures. The authors adopt Hofstede's dimensions of culture to conduct a comprehensive, multivariate, metaregression analysis of 47,864 relationships across 170 studies, 36 countries, and six continents. To guide theory, they propose four tenets that parsimoniously capture the essence of culture's effects on RM. Study 1 affirms these tenets and emphasizes the importance of taking a fine-grained perspective to understand the role of culture in RM because of the high degree of heterogeneity across different cultural dimensions and RM linkages. For example, the magnitude of individualism's effect is 71% greater on RM than other cultural dimensions, whereas masculinity has almost no effect; however, accounting only for individualism ignores significant moderating effects of power distance and uncertainty avoidance dimensions. To guide managers, Study 2 adopts a country-level approach and reveals that RM is much more effective outside the United States such that relationships are 55% more effective, on average, for increasing business performance in Brazil, Russia, India, and China.
The constructs of individualism and collectivism have been used in the social sciences from the beginning of research. However, the constructs gained popularity in the 1980s, and they continue to draw the attention of social scientists in all disciplines even today. A theoretical framework using the independent and interdependent concepts of selves at its core is presented to explain the differences between these constructs. Because of differences in concepts of selves, people treat their ingroup and outgroup differently; they act differently in the society by following their attitude or conforming to social norms; and they engage in a different pattern of social exchange with other individuals. The entry discusses these differences and their implications for intercultural communication.
In March 2012, the SAGE Working Group on Vaccine Hesitancy was convened to define the term "vaccine hesitancy", as well as to map the determinants of vaccine hesitancy and develop tools to measure and address the nature and scale of hesitancy in settings where it is becoming more evident. The definition of vaccine hesitancy and a matrix of determinants guided the development of a survey tool to assess the nature and scale of hesitancy issues. Additionally, vaccine hesitancy questions were piloted in the annual WHO-UNICEF joint reporting form, completed by National Immunization Managers globally. The objective of characterizing the nature and scale of vaccine hesitancy issues is to better inform the development of appropriate strategies and policies to address the concerns expressed, and to sustain confidence in vaccination. The Working Group developed a matrix of the determinants of vaccine hesitancy informed by a systematic review of peer reviewed and grey literature, and by the expertise of the working group. The matrix mapped the key factors influencing the decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine-specific. These categories framed the menu of survey questions presented in this paper to help diagnose and address vaccine hesitancy.
Copyright © 2015. Published by Elsevier Ltd.
The purpose of this systematic review is to identify, describe and assess the potential effectiveness of strategies to respond to issues of vaccine hesitancy that have been implemented and evaluated across diverse global contexts.
A systematic review of peer reviewed (January 2007-October 2013) and grey literature (up to October 2013) was conducted using a broad search strategy, built to capture multiple dimensions of public trust, confidence and hesitancy concerning vaccines. This search strategy was applied and adapted across several databases and organizational websites. Descriptive analyses were undertaken for 166 (peer reviewed) and 15 (grey literature) evaluation studies. In addition, the quality of evidence relating to a series of PICO (population, intervention, comparison/control, outcomes) questions defined by the SAGE Working Group on Vaccine Hesitancy (WG) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria; data were analyzed using Review Manager.
Across the literature, few strategies to address vaccine hesitancy were found to have been evaluated for impact on either vaccination uptake and/or changes in knowledge, awareness or attitude (only 14% of peer reviewed and 25% of grey literature). The majority of evaluation studies were based in the Americas and primarily focused on influenza, human papillomavirus (HPV) and childhood vaccines. In low- and middle-income regions, the focus was on diphtheria, tetanus and pertussis, and polio. Across all regions, most interventions were multi-component and the majority of strategies focused on raising knowledge and awareness. Thirteen relevant studies were used for the GRADE assessment that indicated evidence of moderate quality for the use of social mobilization, mass media, communication tool-based training for health-care workers, non-financial incentives and reminder/recall-based interventions. Overall, our results showed that multicomponent and dialogue-based interventions were most effective. However, given the complexity of vaccine hesitancy and the limited evidence available on how it can be addressed, identified strategies should be carefully tailored according to the target population, their reasons for hesitancy, and the specific context.
Copyright © 2015. Published by Elsevier Ltd.
In five studies, the present research examines the impact of having an independent (vs. interdependent) mindset on consumer adoption of new products. A first study finds that consumers in a predominantly independent (vs. interdependent) culture are more willing to adopt really new products (RNPs), while consumers in a predominantly interdependent (vs. independent) culture are more willing to adopt incrementally new products (INPs). Studies 2 and 3 conceptually replicate these findings using situationally activated mindsets, and demonstrate that this effect is driven by the perceived fit between the product’s newness level and the optimal level of distinctiveness sought by consumers. Finally, studies 4a and 4b show that the presence of distinctiveness-dampening cues (i.e., popularity cues) and distinctiveness-enhancing cues (i.e., scarcity cues) can reverse the effect of self-perspective, such that the independent self becomes less willing to adopt RNPs and more willing to adopt INPs than the interdependent self. These findings offer practical implications for managing innovation adoption in both domestic and international marketplaces.
The relationship between culture and language was examined across 39 languages spoken in 71 cultures. Correlations were computed across languages and cultures between the use of first- and second-person singular pronouns (e.g., "I" and "you") and global cultural dimensions such as Individualism, which were previously extracted in large-scale cross-cultural surveys. The personal pronouns were analyzed in terms of the number of first- and second-person singular pronouns and whether the pronouns can be dropped when used as the subject of a sentence in speech. Cultures with pronoun drop languages tended to be less Individualistic than those with nonpronoun drop languages. The number of personal pronouns correlated with some cultural dimensions that reflected different conceptions of the person. Personal deixis (person-indexing pronouns) may provide a window through which cultural practices can be investigated.
This study of relationship quality contributes to the field of global industrial services marketing by examining relational and economic determinants and an outcome of relationship quality in a cross-cultural setting. The sample includes 202 buyers of industrial services from 42 countries. A conceptual model is proposed and tested using structural equation modeling. The study concludes that a buyer's expectation of continuity with a service provider is influenced more by relationship quality than by perceived economic value. Relationship quality, in turn, is impacted by perceived economic value, relationship bonds, and relationship investments. Results partially confirm the interpersonal predispositions of collectivist cultures. For example, buyers from collectivist cultures place significantly more emphasis on relationship investments than do buyers from individualist cultures. These findings have important implications for marketing theory and practice.
What accounts for variation in empathy felt for strangers in need? Currently, one of the most popular explanations among personality and social psychologists is perceived similarity: We feel sympathy and compassion for others to the degree that we perceive them to be like us. Two experiments designed to test the perceived similarity explanation more directly than previous research failed to find support. Results of the second experiment instead supported a classical, but currently less popular, explanation of empathy felt for strangers: nurturant tendencies based on the impulse to care for and protect offspring. We noted distinct theoretical and practical implications of the similarity and nurturance explanations. In addition, we encourage increased attention to nurturance as a possible source of empathy.
Existing models of forgiveness and the strategies to promote forgiveness that draw from them are predominantly individualistic. As the United States becomes more diverse and counseling psychology becomes a more global field, counseling psychologists are increasingly likely to encounter clients who have a collectivistic worldview. The authors propose a theoretical model that clarifies the relationship between collectivism and forgiveness. The importance of maintaining social harmony in collectivistic cultures is central to this relationship. The model has two propositions. First, collectivistic for- giveness occurs within the broad context of social harmony, reconciliation, and relational repair. Second, collectivistic forgiveness is understood as pri- marily a decision to forgive but is motivated largely to promote and maintain group harmony rather than inner peace (as is more often the case in individ- ualistically motivated forgiveness). Finally, the authors suggest a research agenda to study collectivistic forgiveness and provide guidelines for address- ing forgiveness with collectivistic clients.
Policy and communication responses to COVID-19 can benefit from better understanding of people's baseline and resulting beliefs, behaviors, and norms. From July 2020 to March 2021, we fielded a global survey on these topics in 67 countries yielding over 2.0 million responses. This paper provides an overview of the motivation behind the survey design, details the sampling and weighting designed to make the results representative of populations of interest and presents some insights learned from the survey. Several studies have already used the survey data to analyze risk perception, attitudes towards mask wearing and other preventative behaviors, as well as trust in information sources across communities worldwide. This resource can open new areas of inquiry in public health, communication, and economic policy by leveraging one of the first ever large-scale, rich survey data on beliefs, behaviors, and norms during a global pandemic in new and innovative ways.
Introduction
The world is facing the COVID-19 pandemic. The development of a vaccine is challenging. We aimed to determine the proportion of people who intend to get vaccinated against COVID-19 in France or to participate in a vaccine clinical trial.
Methods
We conducted an anonymous on-line survey from the 26th of March to the 20th of April 2020. Primary endpoints were the intention to get vaccinated against COVID-19 if a vaccine was available or participate in a vaccine clinical trial.
Results
Three thousand two hundred and fifty nine individuals answered the survey; women accounted for 67.4% of the respondents. According to their statements, 2.512 participants (77.6%, 95% CI 76.2–79%) will certainly or probably agree to get vaccinated against COVID-19. Older age, male gender, fear about COVID-19, being a healthcare worker and individual perceived risk were associated with COVID-19 vaccine acceptance. Vaccine hesitancy was associated with a decrease in COVID-19 vaccine acceptance. One thousand and five hundred and fifty respondents (47.6% 95% CI 45.9–49.3%) will certainly or probably agree to participate in a COVID-19 vaccine clinical trial. Older age, male gender, being a healthcare worker and individual perceived risk were associated with potential acceptance to participate in a COVID-19 vaccine clinical trial. Vaccine hesitancy was associated with refusal for participation in a COVID-19 vaccine clinical trial.
Conclusions
Nearly 75% and 48% of the survey respondents were respectively likely to accept vaccination or participation in a clinical trial against COVID-19. Vaccine hesitancy will be the major barrier to COVID-19 vaccine uptake.
Researchers have been working quickly and collaboratively for the development of vaccines against the COVID-19 virus. The effort of the scientific community in searching a vaccine for COVID-19 may be hampered by a diffused vaccine hesitancy. Two waves of data collection on representative samples of the Italian population (during the “first” and “second” phase of the Italian Covid-19 mitigation strategy) were conducted to understand citizens’ perceptions and behaviors about preventive behaviors willingness to vaccine for COVID-19. Our study shows that willingness to COVID-19 vaccine is correlated to trust in research and in vaccines, which decreased between phase 1 and phase 2 of the Italian pandemic. According to the results of our study, the proportion of citizens that seem to be intentioned to get the Covid-19 vaccine is probably too small to effectively stop the spreading of the disease. This requires to foster a climate of respectful mutual trust between science and society, where scientific knowledge is not only preached but also cultivated and sustained thanks to the emphatic understanding of citizens worries, needs of reassurance and health expectations.
Despite major advances in vaccination over the past century, resurgence of vaccine-preventable illnesses has led the World Health Organization to identify vaccine hesitancy as a major threat to global health. Vaccine hesitancy may be fueled by health information obtained from a variety of sources, including new media such as the Internet and social media platforms. As access to technology has improved, social media has attained global penetrance. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. Users may self-select content streams, contributing to ideological isolation. As such, there are considerable public health concerns raised by anti-vaccination messaging on such platforms and the consequent potential for downstream vaccine hesitancy, including the compromise of public confidence in future vaccine development for novel pathogens, such as SARS-CoV-2 for the prevention of COVID-19. In this review, we discuss the current position of social media platforms in propagating vaccine hesitancy and explore next steps in how social media may be used to improve health literacy and foster public trust in vaccination.
This research uncovers a social factor that helps to explain how a consumer’s cultural orientation affects the extent to which they engage in online word-of-mouth (eWOM). The first study aggregates archival data from 52 countries and finds a positive relationship between collectivism and the extent that consumers share product-related information on social networking sites; however, collectivism is not found to relate to the extent that consumers rate and review products online. A second study examines why collectivism is positively associated with sharing product-related information on social networking sites. Collectivism is measured at the individual level among consumers in two culturally distinct countries—India and the United States. The results demonstrate that a collectivistic orientation is positively associated with similarity among members of one’s online social network (i.e., homophily) and that homophily is positively associated with sharing product-related information on social networking sites. In an increasingly global online marketplace, these findings provide needed guidance on how culture affects eWOM.
Impaired vaccine responses in older individuals are associated with alterations in both the quantity and quality of the T-cell compartment with age. As reviewed herein, the T-cell response to vaccination requires a fine balance between the generation of inflammatory effector T cells versus follicular helper T (TFH) cells that mediate high-affinity antibody production in tandem with the induction of long-lived memory cells for effective recall immunity. During aging, we find that this balance is tipped where T cells favor short-lived effector but not memory or TFH responses. Consistently, vaccine-induced antibodies commonly display a lower protective capacity. Mechanistically, multiple, potentially targetable, changes in T cells have been identified that contribute to these age-related defects, including posttranscription regulation, T-cell receptor signaling, and metabolic function. Although research into the induction of tissue-specific immunity by vaccines and with age is still limited, current mechanistic insights provide a framework for improved design of age-specific vaccination strategies that require further evaluation in a clinical setting.
Knowing what predicts consumers’ reliance on web-based information when making purchase decisions is crucial for managing a firm’s digital marketing strategy. The present research takes a cross-cultural perspective and finds that the cultural dimension of collectivism predicts the extent to which consumers rely on user-generated, but not brand-generated, product information when making purchase decisions. Extending research on cultural mindset to self-other perceptions on social media, we identify a conditional process by which collectivism influences seeking user-generated product information. Collectivistic consumers discount differences (e.g., differences in lifestyle, personality, or political orientation) between themselves and other social media users, which fosters a sense of similarity with others (i.e., perceived homophily). Perceived homophily increases trust and, in turn, consumers’ reliance on user-generated product information. We discuss implications for managers and public policy communications.
Prior research indicates the importance of new product launches across international markets for firm performance. However, little is known about if, and how, new product launches in international markets drive firm financial value. This study examines the drivers of stock market reactions to a new product introduction in a foreign country, along with the moderating impact of cultural context. Using a sample of 1,154 products in 34 product categories launched in 48 countries between 2011 and 2018, the authors investigate how product characteristics such as product innovativeness and product type affect abnormal stock reactions to a new product launch event. Furthermore, the authors assess the role of the national culture by considering the individualism, uncertainty avoidance, and indulgence characteristics of the country where the new product is launched. Results of a mixed-effects estimation model indicate that product launches in international markets with innovativeness and hedonism characteristics positively affect firm value. The effects of culture are complex and multifarious, providing valuable insights regarding the impact of new product introductions in global markets on firm value.
Social media has become a popular venue for support seeking, which often involves self-disclosure about one's misfortune. To examine how help-related emotions and cognitions as responses to such disclosure might be influenced by technological factors, we conducted a 2 (interpersonal similarity: low vs. high) x 3 (message publicness: private vs. moderate vs. public) between-participants experiment online. Findings suggest that seeing disclosure about a personal misfortune from a dissimilar other, as compared with a similar other, elicited schadenfreude and inhibited empathy via heightened perceived deservingness among message recipients. Also, such effects were more prominent when the self-disclosure messages were visible within a given network of friends as compared to when messages were made completely public to everyone or exclusively directed to the observer.
The authors examine antecedents of consumer innovativeness in a cross-national context. They propose a framework that distinguishes individual difference variables and national cultural variables. Two types of individual difference variables are considered: personal values and consumer-context-specific dispositions. The authors develop hypotheses pertaining to the main effects of the variables and their interactions and test them on data collected from 3283 consumers in 11 countries of the European Union. The empirical results are broadly supportive of the hypotheses. The cross-national data used in this study provide a strong test of the generalizability of the findings.
Purpose
This paper investigates how language homophily between service providers and migrant consumers affects migrant consumers’ intentions to engage with financial and medical service providers.
Design/methodology/approach
Three empirical studies were conducted with migrant consumers living in Chile, England and the USA. Participants were presented information on service providers, and language homophily was manipulated between subjects. In the high (low) language homophily condition, service providers were described as having (not having) the ability to speak the native language of the migrant consumer.
Findings
Language homophily was found to increase migrant consumers’ expectation of control over a service encounter and, in turn, increase their intention to use a provider’s services. Collectivism was identified as a boundary condition. Among high collectivist consumers, language homophily did not affect service usage intentions; however, language homophily did positively affect service usage intentions among low collectivist consumers.
Originality/value
This work extends prior research on service provider language by finding a positive effect of language homophily on service usage intentions and by identifying mediating (i.e. expected control over the outcome of the service encounter) and moderating (i.e. collectivism) mechanisms for this effect.
Online brand messaging, e.g., blogging or posting on social media platforms, has an important role in digital marketing strategy. Such messaging is largely text based and provides an opportunity for brands to interact with many consumers simultaneously. The marketing literature, however, has yet to provide sufficient guidance on effective online brand messaging strategies. In particular, research has yet to address how the inclusion of second person pronouns in online brand messaging affects relevant consumer outcomes. The present research proposes that second person pronouns should work to enhance consumer involvement and brand attitude as a result of increasing the extent that consumers engage in self-referencing. A field study involving actual brand posts on Facebook and two subsequent experiments provide support for this hypothesis. In addition, drawing on cultural dimensions theory, individual levels of collectivism are identified as a boundary condition. The presence (vs. absence) of second person pronouns in online brand messaging enhances involvement and brand attitude for consumers that are lower, but not higher, in collectivism. The results provide marketers with needed guidance for creating effective online brand messaging.
The constructs of horizontal (H) and vertical (V) individualism (I) and collectivism (C) were theoretically defined and emperically supported. Study 1 confirmed, via factor analysis, that the 4 constructs, HI, VI, HC, and VC, which were previously found in the United States, which has an individualist culture, also were found in Korea, which has a collectivist culture. Study 2 investigated multimethod-multitrait matrices measuring the constructs and generally supported their convergent and divergent validity. Study 3 showed how these 4 constructs relate to previously identified components by H. C. Triandis and colleagues. Study 4 showed the relationships of the measurement of the 4 constructs to some of the measures used by other researchers.
Extant literature on innovation has produced important and significant results. However, no study to date has provided researchers with a framework to understand innovation from a cultural differences perspective. To fill this research gap, the author proposes a framework that categorizes culture and innovation studies into the following six approaches: (1) innovation characteristics, (2) adoption of/propensity to adopt innovations, (3) geographical innovations, (4) market characteristics, (5) learning effect, and (6) organizational functions. Each approach contains two perspectives. From these approaches and perspectives, the author identifies unique and general insights on culture and innovation, discusses the implications of implementing this framework, and recognizes possible areas of further research.
A theory of individualism and collectivism The evolution of individualism and collectivism theory and research is reviewed. The antecedents of collectivism–individualism can be found in the ecology, family structure, wealth distribution, demography, history, cultural diffusion, and situational conditions. The consequences of collectivism–individualism include differences in attention, attribution, cognition, emotion, motivation, self-definitions, values, language use, and communication, as well as other kinds of social and organizational behavior. Applications of individualism and collectivism include improvements in conflict resolution, health, international relations, and cross-cultural training. Culture is to society what memory is to individuals (Kluckhohn, 1954). It consists of what “has worked” in the experience of a group of people so it was worth transmitting to peers and descendents. Another definition of culture was provided by anthropologist Redfield (1941): “Culture is shared understandings made manifest in act and artifact.” In short, culture is shared behavior and shared human-made aspects of the society. Thus, ...
Research on discrepancies between the actual self and ideal self has examined self-discrepancies in knowledge, skills and stature but age-based self-discrepancies have only recently received attention and so we studied this phenomenon in young adolescents. In three studies we identified a product-category contextual cue that apparently caused adolescents to respond to an existing age-based self-discrepancy. Specifically we found that when the contextual cue was advertising for an age-restricted product, adolescents conformed to dissimilar young adult advertising models and diverged from similar adolescent models. This indicated that the contextual cue caused them to respond to an age-based self-discrepancy and use a product associated with the ideal self rather than the actual self. Importantly, this response was stronger among adolescents that were more dissatisfied with their age. With advertising for an age-unrestricted product, adolescents conformed to adolescent advertising models and diverged from young adult models. Industry policies for age-restricted products assume that similarity drives influence and therefore mandate that advertising models be young adults rather than adolescents. Our findings suggest this assumption is invalid for age-restricted products.
Drawing on recent analyses of the self in many cultures, the authors suggest that the cultural ideal of independence of the self from the collective has dominated European-American social psychological theorizing. As a consequence, the existence of considerable interdependence between the self and the collective has been relatively neglected in current conceptual analysis. The authors (a) argue that a group's cultural ideal of the relation between the self and the collective is pervasive because it is rooted in institutions, practices, and scripts, not just in ideas and values; (b) show how a given cultural ideal whether it is independence or interdependence, can shape the individual's experience and expression of the self; and (c) discuss how a comparative approach may enrich and expand current theory and research on the interdependence between the self and the collective.
The authors explore when and how collectivism influences the importance of service quality and relationship quality for behavioral intentions. Using goal and action identification theories, they argue that collectivist tendencies become salient depending on a buyer's particular goal in a given service context and that when collectivist characteristics are salient, they can influence the importance of service or relationship quality. In the first study, the authors demonstrate the moderation effect of collectivism in a high-social-interaction context, in which they argue that collectivist tendencies are salient, using data collected in countries characterized as high and low in collectivism, and find that collectivism increases the importance of relationship and service quality (contrary to the hypothesized negative effect) for behavioral intentions. In the second study, the authors find that collectivism does not moderate the aforementioned relationships in contexts in which social interaction is expected to be low. The cross-national and cross-contextual findings provide multinational retailers guidance in designing the customer retail experience on the basis of the collectivist tendencies of consumers in various markets.
This study tested the prediction derived from the empathy-altruism hypothesis that more empathically concerned persons would be more sensitive to the long-term consequences of their intervention for recipients. Subjects (N = 84), instructed either to observe the situation or to imagine another's feelings, were exposed to a person in immediate distress who requested assistance (hints) to complete an anagram task. Half the subjects were informed that giving too many hints could have long-term detrimental effects (potential-detrimental-effect condition); half were given no information about future consequences (no-detrimental-effect condition). Consistent with the predictions, although the anticipated effect of intervention made no difference in the number of hints given by subjects in the observe-set condition, imagine-set subjects gave fewer hints when they were informed of potentially detrimental effects of intervention. These results suggest that empathy enhances sensitivity to the needs of others, including considering the potential consequences that one's intervention may have for the recipient.
Focuses on population characteristics that appear to make one nation more or less innovative for technical consumer products. Finds three predictors - individualism, uncertainty avoidance and purchasing power - to be related to national levels of new product ownership within Europe. Discusses the results, focusing on their implications for marketers seeking to export innovative technological consumer goods to Europe and elsewhere.