Does highlighting COVID-19 disparities reduce or increase vaccine intentions? evidence from a survey experiment in a diverse sample in New York State prior to vaccine roll-out

Abstract

Racial identity and political partisanship have emerged as two important social correlates of hesitancy towards COVID-19 vaccines in the United States. To examine the relationship of these factors with respondents' intention to vaccinate before the vaccine was available (November/December, 2020), we employed a multi-method approach: a survey experiment that randomized a vaccine-promotion message focused on racial equity in vaccine targeting, stepwise regression to identify predictors of hesitancy, and qualitative analysis of openended survey questions that capture how respondents reason about vaccination intentions. Experimental manipulation of a racial equity vaccine promotion message via an online survey experiment had no effect on intention-to-vaccinate in the full sample or in racial, ethnic and partisan subsamples. Descriptively, we find heightened hesitancy among non-Hispanic Black respondents (OR = 1.82, p<0.01), Hispanics (OR = 1.37, p<0.05), Trump voters (OR = 1.74, p<0.01) and non-Voters/vote Other (OR = 1.50, p<0.01) compared with non-Hispanic White respondents and Biden voters. Lower trust in institutions, individualism and alternative media use accounted for heightened hesitancy in Trump voters, but not non-Hispanic Blacks and Hispanics. Older age and female gender identity also persistently predicted lower vaccine intentions. Qualitatively, we find that most hesitant responders wanted to 'wait-and-see,' driven by generalized concerns about the speed of vaccine development, and potential vaccine side-effects, but little mention of conspiracy theories. Identity appears to be an important driver of vaccinate hesitancy that is not fully explained by underlying socioeconomic or attitudinal factors; furthermore, hesitancy was not significantly affected by racial equity messages in this setting.