Collectivism was Associated Late Vaccination Uptake During the COVID Pandemic: A National Survey and A Global Analysis

Uptake of vaccination was crutial to ending the COVID pandemic by enabling herd immunity. Collectivism is a cultural value that prioritizes collective over personal wellbeing, with which people are prone to compliance with prosocial norms and dependency on group opinions when making personal decisions. Past studies showed that collectivist (vs. individualist) cultures were more successful in enforcing non-pharmaceutical interventions, and hence had lower infection and death rates before vaccines were available. However, collectivists, being more influenced by group opinions in decision-making, might delay vaccination uptake until they are certain that the vaccines are effective and safe for others. We tested our hypotheses in a national survey of Chinese citizens (n = 5,438, Study 1) five months after COVID-19 vaccines were publicly available, and in a study of 183 countries and territories (Study 2). Consistent with past findings, before vaccines were available, more collectivist cultures had fewer COVID-19 infections and deaths per million. However, after vaccines were released in China, Chinese citizens with stronger endorsement of the collectivism were less likely to receive early vaccination (Study 1). Furthermore, more collectivist cultures had slower vaccination rates in the first year of vaccination administration (Study 2). These results have important implications for future pandemic control and public health communications.