ABSTRACT
BACKGROUND: COVID-19 disproportionately affects those with preexisting conditions, but little research has determined whether those with chronic diseases view the pandemic itself differently - and whether there are differences between chronic diseases. We theorized that while individuals with respiratory disease or autoimmune disorders would perceive greater threat from COVID-19 and be more supportive of non-pharmaceutical interventions (NPIs), those with autoimmune disorders would be less likely to support vaccination-based interventions. METHODS: We conducted a two-wave online survey conducted in February and November 2021 asking respondents their beliefs about COVID-19 risk perception, adoption and support of interventions, willingness to be vaccinated against COVID-19, and reasons for vaccination. Regression analysis was conducted to assess the relationship of respondents reporting a chronic disease and COVID-19 behaviors and attitudes, compared to healthy respondents adjusting for demographic and political factors. RESULTS: In the initial survey, individuals reporting a chronic disease had both stronger feelings of risk from COVID-19 as well as preferences for NPIs than healthy controls. The only NPI that was still practiced significantly more compared to healthy controls in the resample was limiting trips outside of the home. Support for community-level NPIs was higher among individuals reporting a chronic disease than healthy controls and remained high among those with respiratory diseases in sample 2. Vaccine acceptance produced more divergent results: those reporting chronic respiratory diseases were 6% more willing to be vaccinated than healthy controls, while we found no significant difference between individuals with autoimmune diseases and healthy controls. Respondents with chronic respiratory disease and those with autoimmune diseases were more likely to want to be vaccinated to protect themselves from COVID-19, and those with an autoimmune disease were more likely to report fear of a bad vaccine reaction as the reason for vaccine hesitancy. In the resample, neither those with respiratory diseases nor autoimmune diseases reported being more willing to receive a booster vaccine than healthy controls. CONCLUSIONS: It is not enough to recognize the importance of health in determining attitudes: nuanced differences between conditions must also be recognized.
ABSTRACT
The American reaction to the COVID-19 pandemic is polarized, with conservatives often less willing to engage in risk-mitigation strategies such as mask-wearing and vaccination. COVID-19 narratives are also polarized, as some conservative elites focus on the economy over public health. In this registered report, we test whether combining economic and public health messages can persuade individuals to increase support for COVID-19 risk mitigation. We present preliminary evidence that the combination of messages is complementary, rather than competing or polarizing. When given a message emphasizing COVID-19's negative health and economic effects in a pilot study, conservatives increased their support for a broad range of risk-mitigation strategies, while liberals maintained high levels of support. A preregistered larger-n follow-up study, however, failed to replicate this effect. While complementary frames may be a promising way to persuade voters on some issues, they may also struggle to overcome high levels of existing polarization.