An article in humanities and social sciences communications in January 2023 considers the “slow” progress in ensuring equitable vaccine coverage with an investigation into COVID-19 vaccine coverage inequality, seeking to explore the “predictive effect of attitudes toward science and religion” on vaccine acceptance. The results, the authors state, suggest that scientists and policymakers should consider “social and cultural characteristics” when addressing vaccine inequality.
“Countries where a higher proportion of the population prioritise religious beliefs over scientific evidence when the two come into conflict tend to have lower vaccination coverage rates and slower vaccination speeds.”
Vaccine inequality
Although it is acknowledged that COVID-19 vaccine distribution and uptake is “notably unequal”, the authors reflect that “certain socio-cultural factors”, like societal norms and religious influences related to vaccination, are “frequently underemphasised” in addressing this inequality. Despite this lack of emphasis, these factors “consistently wield a significant influence on vaccine uptake”. A 2020 representative-sample survey study identified that “nearly one-third” of the population of Ireland and the UK were hesitant or resistant to accept a vaccine.
Why is this? The study considers attitudes to science and religion, which serve as “fundamental” guiding principles, yet are frequently overlooked as contributing factors to vaccine coverage.
What do we know already?
The study establishes a context through previous research, including the evidence that “trust or distrust of science is associated with hesitancy and uptake of a vaccine”. Other studies have revealed that trust in the science community encourages positive evaluation of vaccines, whereas distrust of science can predict lower vaccine intention. Indeed, it can “exacerbate the negative effect of political beliefs on vaccine uptake”.
The study also considers the reasons that “stronger religious faith is related to lower vaccination uptake”, such as the need for psychological relief during a crisis, or conflict between scientific evidence and religious doctrine.
“Although science and religion are not always opposed, tension between them under the vaccination challenge is clear. Importantly, we argue that trust in science versus in religious faith could explain vaccination inequality across countries, not only because they could predict vaccine attitudes and decisions at individual level, but also because countries are different in terms of science trust and religious faith.”
The study
This study employs data from several datasets to “describe the remarkable fact of global vaccine coverage” and “examine whether trust in science, religious faith, and science-religion choice are associated with it”. The authors use the term “science-religion choice” for the preference that people have for “either science or religion when the two are in conflict”.
The data covered over 200 countries with records of number of people with at least one dose per hundred of the population and number of people who received “all” vaccine doses per hundred of the population. Data on science trust and science-religion choice came from two large-scale programmes.
Study findings
The authors state that “the supply problem could be removed from the main factors affecting vaccination coverage” because of international efforts. However, socio-cultural characteristics” could “dominate” vaccine inequality considerations.
“It is time to consider why people are unwilling to get vaccinated rather than how to promote vaccine supply.”
The study finds that countries with higher scores of aggregated science trust are higher on COVID-19 vaccine coverage; however, the relationship between them is less “robust” than expected. Despite this, at individual level, trust in science has been shown to “have a positive effect on vaccination behaviours”. The inference from this “incompatibility” between the study and previous research is that “a macro level of real-world vaccine uptake could be more complicated and determined by various factors associated with science other than country-level science trust”.
On the other hand, science-religion choice and religious faith are “more robustly linked with vaccine uptake”.
“Science-religion choice and religious faith are always a successful predictor of current global vaccination coverage and its speed.”
However, the paper notes that religious effects are “complex” because teachings are varied by denomination. Therefore, further “rigorous examination” is demanded. From a broad perspective, religious beliefs are “predictive of lower vaccination rates” yet support for vaccines within religious faiths can mitigate this. For example, Christian and Islamic leadership have expressed support for the COVID-19 vaccine: “endorsements from religious authorities can enhance vaccination intentions”.
“It is worth to note that the relationship between religious faith, trust in science, and vaccination uptake is intricate. While we can derive a rough predictive coefficient, the interplay of these three, booth on an individual level and a national level, along with numerous other social-cultural characteristics, suggest that their true dynamics transcend the simple linear models described in this paper.”
Do check out the paper and let us know what you think it contributes to discussions about vaccine uptake. For more on encouraging acceptance of vaccines globally, do join us at the Congress in Washington this April or subscribe to our newsletters here.
