Individual Empowerment, Institutional Confidence, and Vaccination Rates in Cross-National Perspective, 1995 to 2018

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 vaccina...

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Bibliographic Details
Published in:American sociological review 2023-06, Vol.88 (3), p.379-417
Main Authors: Cole, Wade M., Schofer, Evan, Velasco, Kristopher
Format: Article
Language:English
Subjects:
Childhood
Confidence
COVID-19
Cultural change
Diphtheria
Empowerment
Immunization
Individualism
International comparisons
Macrosociology
Measles
Neoliberalism
Pandemics
Panel data
Refusal
Tetanus
Uptake
Vaccines
Whooping cough
World culture
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Summary: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.
ISSN:0003-1224
1939-8271
DOI:10.1177/00031224231162869