Collectivism was Associated Late Vaccination Uptake During COVID Pandemic: A National Survey and A Global Analysis

Introduction Vaccination by enabling herd immunity was crucial to ending the COVID-19 pandemic. Collectivism as a cultural value prioritizes social responsibility over personal choice and prescribes the use of the wait-and-adjust heuristic in decision-making. Past COVID-19 research showed that in more collectivist cultures, enforcement of non-pharmaceutical interventions was more effective and infection and mortality rates were lower. However, more collectivist cultures, with their greater reliance on the wait-and- adjust heuristic in decision-making, might delay vaccination before the vaccines’ effectiveness and safety was ascertained.Methods The hypothesized relationship between collectivism and slow vaccination uptake was tested in two studies. In a national survey (n = 5,438) conducted in China (a country with significant regional variations in collectivism), 153 days after COVID-19 vaccines were available, respondents’ collectivism and their vaccination behavior and intention were measured (Study 1). Next, data on collectivism and daily changes in vaccination rates from 183 cultures were analyzed with a series of multilevel models to assess the relationship of collectivism with changes in the vaccination rates across cultures (Study 2).Results When vaccines were unavailable, more collectivist cultures had fewer COVID-19 infection and death rates. However, after vaccines were released in China, more collectivist Chinese citizens were less likely to receive early vaccination (Study 1). Furthermore, around the world, more collectivist cultures had slower vaccination rates in the first year of vaccination administration (Study 2). Conclusions Although collectivism motivates compliance with NPI requirements, it is associated with late vaccination uptake. Past research shows that strengthening a shared sense of identity and inoculation against misinformation are two effective COVID-19 control strategies. The present research suggests that for pandemic management, identity strengthening is particularly commendable in less collectivist cultures before and after vaccines are available, whereas misinformation inoculation is particularly commendable in more collectivist cultures when vaccines are available.