Far-right political ideology and COVID-19 vaccine hesitancy: Multilevel analysis of 21 European countries

Insa Backhaus; Hanno Hoven; Ichiro Kawachi

doi:10.1016/j.socscimed.2023.116227

Far-right political ideology and COVID-19 vaccine hesitancy: Multilevel analysis of 21 European countries

Soc Sci Med. 2023 Oct:335:116227. doi: 10.1016/j.socscimed.2023.116227. Epub 2023 Sep 9.

Authors

Insa Backhaus¹, Hanno Hoven², Ichiro Kawachi³

Affiliations

¹ Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. Electronic address: insa.backhaus@hhu.de.
² Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

PMID: 37722145
DOI: 10.1016/j.socscimed.2023.116227

Abstract

Background: Far-right political parties across the EU have downplayed the risk of COVID-19 and have expressed skepticism toward the safety of the COVID-19 vaccine. This may affect the risk perception of people who support far-right parties and may be associated with an elevated risk of vaccine hesitancy. We aimed to explore if voting far-right is associated with COVID-19 vaccine hesitancy and if the association varies by individual and country-level factors.

Methods: We used cross-sectional data from 28,057 individuals nested in 21 countries who participated in the tenth round of the European Social Survey (ESS). COVID-19 vaccine hesitancy was assessed by asking respondents whether they will get vaccinated against COVID-19. Voting behavior was measured by asking respondents which party they voted for in the last election. To test the association between far-right voting and COVID-19 hesitancy, we applied a series of multilevel regression models. We additionally ran models including interaction terms to test if the association differs by sociodemographic characteristics (e.g., institutional trust) or contextual factors (e.g., income inequality).

Results: We found that far-right voters were 2.7 times more likely to be COVID-19 vaccine hesitant compared to center voters (PR: 2.69, 95% CI: 1.46-4.94). The association persisted even after controlling for institutional trust and social participation (adjusted PR: 2.15, 95% CI: 1.35-3.42). None of the tested interaction terms were significant suggesting that the association between political ideology and COVID-19 vaccine hesitancy does not differ by sociodemographic characteristics or contextual factors.

Conclusion: Voting for far-right parties is associated with COVID-19 vaccine hesitancy. The association is similar among European countries, regardless of how stringent the public health measures were and magnitude of income inequality in each country. Our findings call for a more in-depth investigation of why, how and under which conditions political ideology affects vaccination behavior.

Keywords: COVID-19; Far-right-wing; Political ideology; Vaccine hesitancy.