Public Health Resources, Religion, and Freedom as Predictors of COVID-19 Vaccination Rates: A Global Study of 89 Countries

Abstract

The COVID-19 global pandemic necessitated adequate compliance to safe and effective vaccinations developed against the disease. Vaccination reduces high infection, morbidity, and mortality rates, develops herd immunity, and alleviates overburdened healthcare systems and massive economic costs. COVID-19 also raised awareness about the importance of robust health systems, notably public health competence and the number and training of community health workers. Using the World Health Organization, Global Development of Applied Community Studies project, and other available cross-sectional secondary data on 89 countries, we found that the strength of community health training and research (CHTR), the importance of religion, and freedom score (political rights, civil liberties) are associated with COVID-19 full-vaccination rate. Significant bivariate correlations included per-capita-GDP, number of nurses, per-capita health spending, aged population, noncommunicable disease rate, life satisfaction, government response stringency, nonviolent activism, education, and strength of community development, urban planning, and liberation theology fields. Our assessment of CHTR contribution to the COVID-19 response revealed a great resource for effectively targeting vaccine-hesitant individuals and increasing vaccination rates. The results suggest that to motivate vaccine adherence countries need adequate community health workforce training and research, a population not hesitant to adhere to public health measures based on religion, and societal-level freedoms.

Community Health Resources, Globalization, Trust in Science, and Voting as Predictors of COVID-19 Vaccination Rates: A Global Study with Implications for Vaccine Adherence

“…The present study also explains vaccination acceptance by political and attitudinal factors, including government effectiveness, fiscal decentralization, trust in science, and parliamentary voter turnout. Perceived corruption and actual freedoms (political rights and civil liberties) related to vaccination rates in prior studies [15] were not significantly predictive when controlling for the above factors.…”

“…The present pandemic crisis is centered on the need to reduce the disease's spread through global vaccine distribution. Vaccination acceptance is essential for herd immunity, yet vaccine hesitancy in many countries impedes attaining this end [15]. This is the first study to model COVID-19 vaccination rates that considers resources, public attitudes, and politics based on a sample of up to 95 nations worldwide.…”

“…Many studies show that training in pandemic skills and knowledge enhance disease awareness, monitoring, and reporting [10,13,14]. However, the kind and extent of training for CHWs vary by country, which may influence vaccination rates [15]. Despite the importance of such training and education to the work and safety of CHWs, they are not always sufficient, frequent, and appropriate, reducing workforce efficiency in many countries [16].…”

“…Trust in science and experts is important for compliance with preventive measures because government requirements and restrictions are viewed as expert recommendations, and the effectiveness of these measures depends on individual cooperation [48,49]. Nevertheless, religion and ideology frequently undermine trust in science, which impairs public health behavioral compliance [15]. Plohl and Musil [50] found that political conservatives, religious orthodoxy, and conspiracy theorists have less confidence in science and are less likely to take precautions and get vaccinated.…”

“…According to pro-vaccine advocates, herd immunity is the most effective way for individuals to protect themselves and one another from a potentially fatal infection [66]. Somewhat paradoxically, vaccination requirements increase civil liberties by avoiding mass closures, lockdowns, travel restrictions, and other stringent public health measures [15]. They protect people with disabilities and weakened immune systems, young children, and communities of color severely affected by the disease.…”