Multilevel analysis of COVID-19 vaccination intention: the moderating role of economic and cultural country characteristics

• Published in: European journal of public health 2024-04, Vol.34 (2), p.380-386
• Main Authors: Lamot, Monika, Kirbiš, Andrej
• Format: Article
• Language: English
• Subjects: Collectivism; Conspiracy; Coronaviruses; Corruption; COVID-19; COVID-19 - prevention & control; COVID-19 Vaccines; Cultural Characteristics; Cultural values; Economic development; Economics; Evaluation; GDP; Gross Domestic Product; Health behavior; Health care; Health services; Humans; Immunization; Indexes; Individualism; Inequality; Influence; Intention; Multilevel Analysis; Political factors; Political institutions; Political systems; Satisfaction; Slovenia; Vaccination
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckae022

Background Predictors of COVID-19 (coronavirus) vaccination have been extensively researched; however, the contextual factors contributing to understanding vaccination intention remain largely unexplored. The present study aimed to investigate the moderating role of economic development (Gross domestic product - GDP per capita), economic inequality (Gini index), the perceived corruption index and Hofstede’s measurements of cultural values—index of individualism/collectivism and power distance index—in the relationship between determinants of satisfaction with the healthcare system, trust in political institutions, conspiracy beliefs and COVID-19 vaccination intention. Methods A multilevel modelling approach was employed on a sample of approximately 51 000 individuals nested within 26 countries. Data were drawn from the European Social Survey Round 10. The model examined the effect of individual- and country-level predictors and their interaction on vaccination intention. Results Satisfaction with the healthcare system had a stronger positive effect on intention to get vaccinated in countries with lower perceived corruption and more individualistic countries. Trust in political institutions had a stronger positive effect on vaccination intention in countries with higher economic development and lower perceived corruption, while a negative effect of conspiracy beliefs on vaccination intention was stronger in countries with lower economic development, higher perceived corruption and a more collectivistic cultural orientation. Conclusion Our findings highlight the importance of considering individual and contextual factors when addressing vaccination intention.