This is in reference to Dr Morrison’s article ‘The impact of politics, religion, and rurality on COVID-19 vaccine hesitancy in Oregon: a cross-sectional study'1. In the article, Dr Morrison states that COVID-19 vaccine hesitancy was directly linked to religion, politics and rurality.
While the above stated factors are directly linked to hesitancy in taking the vaccination, literature also reveals that, in addition to these factors, an individual’s decision to take the vaccine was also dependent on age, race and education2. Recent data had reported that only 63% of the population of the USA was fully vaccinated against COVID-193. In a study, Hao and Shao had reported that, during the initial stages of the pandemic, the public turned to political parties for answers2. This fact is also supported by a national study held among 10 957 US adults, in which it was reported that the public’s confidence in scientists during the initial stages of COVID-19 was only 35% and has since then increased to 43%4. This study also found that 53% of the American adults who supported the Democratic Party reported a higher deal of confidence in medical scientists, up from the 37% in early 2019. while only 31% of the Republican adult supporters expressed a great deal of confidence in medical scientists, which was roughly similar to the 32% in 20194.
It is also believed that one of the factors that could have influenced this change was the way the Democratic and Republican party framed COVID-19 differently from its onset. It was often reported that President Biden highlighted the severity and risks of the virus in addition to mitigating safety measures and promoting the vaccine1. However, President Trump often downplayed the severity and risks of the virus in addition to disseminating misinformation about the vaccine2. It was also found that media outlets often reinforced the messages from the political parties in a way that influenced the public’s behaviour and attitude toward the pandemic2. In the same study by Hao and Shao, it was hypothesised that ‘individuals who trusted President Biden, individuals who supported the Democratic Party, individuals with a higher proportion of people in their social network who already took the vaccine, and people from states with higher vaccine rates’ were more likely to take the vaccine2.
In another study it was reported that, in highly religious states, which tended to be Republican dominant, people were often mobile despite measures of lockdown5. It was also reported that the counties that had a higher proportion of President Trump votes had more per-capita cases and deaths from COVID-19 than counties with fewer President Trump voters5. In another study held early in the pandemic, it was found that the counties where President Trump received a higher proportion of votes were initially safer from the virus, but this changed as the pandemic progressed as a result of the Republican party stating that the mandatory use of masks or getting a vaccine violated the freedom of individuals4. In addition to this, President Trump’s misinformation about the virus and its treatment (eg stating that the virus would magically disappear by spring weather and that injecting ‘disinfectants’ in humans could kill the virus) caused further chaos5.
As stated by Dr Morrison in the article, the percentage of individuals from urban counties that were fully vaccinated was higher than the percentage of individuals from rural counties. Similar findings were also found in a study by Sun and Monnat, where it was reported that 45.8% of the adults in rural counties were fully vaccinated compared to the 59.8% in urban counties, with factors such as education, healthcare infrastructure and President Trump’s vote share influencing this difference6.
To conclude, it is safe to state that various factors such as politics, race, education, social network and religion have influenced individual views on COVID-19 and vaccination. However, as doctors and medical scientists, our aim is to increase awareness about the virus and the vaccination among the general public. With various factors influencing an individual’s decision, a question arises about whether doctors and medical scientists would now need to target specific political and religious groups to increase awareness. Would the public be more favourable to doctors and scientists with similar political and religious views? Would doctors and scientists now need to support the favourable political party to increase awareness among politically active patients? On the bright side, multiple global studies have stated that the general public prefers to listen to doctors and medical scientists, with only 5–10% of the general public preferring to listen to political leaders and parties.
Matthew Antony Manoj, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
Animesh Jain, Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India