Willingness to vaccinate against SARS-CoV-2: The role of reasoning biases and conspiracist ideation

BACKGR1OUND: Widespread vaccine hesitancy and refusal complicate containment of the SARS-CoV-2 pandemic. Extant research indicates that biased reasoning and conspiracist ideation discourage vaccination. However, causal pathways from these constructs to vaccine hesitancy and refusal remain underspecified, impeding efforts to intervene and increase vaccine uptake.

METHOD: 554 participants who denied prior SARS-CoV-2 vaccination completed self-report measures of SARS-CoV-2 vaccine intentions, conspiracist ideation, and constructs from the Health Belief Model of medical decision-making (such as perceived vaccine dangerousness) along with tasks measuring reasoning biases (such as those concerning data gathering behavior). Cutting-edge machine learning algorithms (Greedy Fast Causal Inference) and psychometric network analysis were used to elucidate causal pathways to (and from) vaccine intentions.

RESULTS: Results indicated that a bias toward reduced data gathering during reasoning may cause paranoia, increasing the perceived dangerousness of vaccines and thereby reducing willingness to vaccinate. Existing interventions that target data gathering and paranoia therefore hold promise for encouraging vaccination. Additionally, reduced willingness to vaccinate was identified as a likely cause of belief in conspiracy theories, subverting the common assumption that the opposite causal relation exists. Finally, perceived severity of SARS-CoV-2 infection and perceived vaccine dangerousness (but not effectiveness) were potential direct causes of willingness to vaccinate, providing partial support for the Health Belief Model's applicability to SARS-CoV-2 vaccine decisions.

CONCLUSIONS: These insights significantly advance our understanding of the underpinnings of vaccine intentions and should scaffold efforts to prepare more effective interventions on hesitancy for deployment during future pandemics.