Even though COVID-19 vaccines are safe, effective and widely available in the United States, many Americans are still hesitant to get vaccinated. Indeed, there are stark disparities in COVID-19 vaccination rates across the United States: In some counties, almost all residents are vaccinated while, in other counties, only a minority of residents are vaccinated. A new study from USC researchers sheds light on the beliefs that underlie these consequential disparities in vaccination rates.

The study, published Wednesday in American Psychologist, found that, in line with what we already know about vaccination behavior, structural barriers such as access to health care, historic undervaccination and political barriers explained why residents of some counties were less likely to be vaccinated against COVID-19. Beyond that, however, the researchers showed that we need to consider Americans’ moral values to understand the stark disparities in COVID-19 vaccination rates.

“If you look at a map of the proportion of vaccinations across U.S. counties, you find very stark differences across counties, across regions and across states,” said Nils Karl Reimer, study co-author and postdoctoral researcher at the USC Dornsife College of Letters, Arts and Sciences. “Our goal is to interrogate why these differences in political ideology coincide with differences in vaccination rates. We know already that, especially in the United States, conservatives and liberals endorse different values.

“The goal of our research was to understand how regional differences can help us explain differences in vaccination rates beyond the structural barriers, and indeed that’s what we found. Moral values help explain these differences, above and beyond the well-known variables of political ideology and structural barriers.”

Fairness, loyalty and purity most impactful values in determining COVID vaccination acceptance

The study rests on moral foundations theory, which argues there are five basic moral foundations: care, fairness, loyalty, authority and purity. Relying on data collected from the crowd-sourced website yourmorals.org — an online platform which collects an array of psychological data — the researchers estimated county-level moral values and county-level conservatism. This data was integrated with county-level vaccination rates from the Centers for Disease Control and Prevention, the U.S. COVID-19 Vaccine Coverage Index and presidential election data to control for variables not included in the study.

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