Moral values and vaccination behavior in Russia during the COVID-19 pandemic

• Published in: Preventive medicine 2024-12, Vol.189, p.108143, Article 108143
• Main Authors: Kislitsyn, Dmitry, Meylakhs, Peter, Schapov, Dmitry, Kurakin, Dmitry, Aleksandrova, Ekaterina
• Format: Article
• Language: English
• Subjects: Adult; COVID-19; COVID-19 - prevention & control; COVID-19 - psychology; COVID-19 Vaccines; Cross-Sectional Studies; Female; Health behavior; Humans; Male; Middle Aged; Moral foundation theory; Morals; Pandemics - prevention & control; Persuasive Communication; Russia; SARS-CoV-2; Surveys and Questionnaires; Vaccination - psychology; Vaccination - statistics & numerical data; Vaccination Hesitancy - psychology; Vaccination Hesitancy - statistics & numerical data; Vaccine hesitancy
• ISSN: 0091-7435; 1096-0260; 1096-0260
• DOI: 10.1016/j.ypmed.2024.108143

Effective persuasive communication necessitates message matching; the conveyed message should resonate with the recipient's characteristics, including individual moral values. While studies examining the relationship between moral values and vaccination behavior have been conducted in a limited number of countries, this study seeks to provide evidence on this relationship beyond Western democracies. A cross-sectional online survey was conducted from November 4 to December 17, 2021, in Russia. Participants reported their COVID-19 vaccination behavior and completed the Moral Foundations Questionnaire, designed to measure the endorsement of moral values (n = 415). Regression analysis was employed to assess the association between each moral foundation and COVID-19 vaccination behavior. Our findings indicate that the moral foundations of Care, Loyalty, Fairness, and Sanctity significantly influence vaccination behavior. Individuals who strongly endorse Fairness (AME = −0.019; 95 % CI = −0.033, −0.005) and Sanctity (AME = −0.016; 95 % CI = −0.031, −0.002) were less likely to be vaccinated. Conversely, individuals endorsing Care (AME = −0.018; 95 % CI = −0.031, −0.005) and Loyalty (AME = −0.015; 95 % CI = −0.028, −0.001) were less likely to report refusal of vaccination. These results remain robust after adjusting for sociodemographic variables related to vaccination barriers. Our findings carry public health implications; an understanding of the moral psychology underlying vaccination behavior can facilitate more targeted and effective health communication. Employing skillfully crafted moral appeals may mitigate negative attitudes toward vaccination and enhance vaccination rates. •This study is the first to link moral foundations and vaccination behavior in a non-Western context, specifically in Russia.•Higher Care and Loyalty endorsements correlate with increased vaccination rates, while Sanctity and Fairness correlate with lower rates.•Tailoring health communication to align with moral values can enhance vaccine acceptance and improve public health outcomes.