Politics matters for individual attitudes toward vaccine donation: cross-national evidence from the United States and Taiwan.

BACKGROUND: Vaccine equity has been a major concern during the COVID-19 pandemic. According to the principle of vaccine equity, donor countries should apply the criterion of needs to make decisions about vaccine donation instead of considering recipient countries' economic status. We examine whether people follow the same criterion or consider other factors to decide which country to donate vaccines and how many vaccines should be delivered. METHODS: We conducted online surveys with the design of conjoint experiment in the United States and Taiwan in 2021. 1,532 American citizens and 1,587 Taiwanese citizens were interviewed. The respondents were broadly quota-matched to their respective demographic proportions on the dimensions of age, gender, and education. We estimated the average marginal component effects (AMCEs) of the conjoint attributes by using the OLS regression models with standard errors clustered at the respondent level. RESULTS: 15,320 and 15,870 decisions on vaccine donation generated by conjoint experiment respectively in the United States and Taiwan were included in the analysis. Both American and Taiwanese people tend to donate vaccines to countries that suffer severe consequences of COVID-19 and democracies compared to authoritarian countries. However, they are less willing to donate vaccines to those with higher levels of capability in response to COVID-19. Taiwanese people tend to donate vaccines to countries having formal diplomatic relations with Taiwan (AMCE 13.4%, 95% CI 11.8%-15.1%). Nonetheless, American people would rather donate vaccines to countries without formal diplomatic relations with the United States (AMCE - 4.0%, 95% CI -5.6%--2.4%). CONCLUSIONS: The findings reveal that politics plays a significant role in people's decisions about vaccine donation. Under electoral pressure, political leaders must think about how to respond to the public's preferences over vaccine donation to achieve vaccine equity and address the global health crisis.

Personality and individual attitudes toward vaccination: a nationally representative survey in the United States.

BACKGROUND: Although past studies have identified factors associated with individual perceptions of vaccination, limited attention has been paid to the role of personality in individual attitudes toward vaccination. This study aimed to evaluate the effect of personality as measured by the Big Five personality traits on individual attitudes toward vaccination using a nationally representative survey in the United States. METHODS: A cross-sectional study was conducted with a sample of 3276 American citizens who were aged 18 and above and lived in 50 U.S. states and Washington D.C. from the American National Election Studies. The survey was collected through face-to-face and online interviews using structured questionnaires in 2016. The multistage stratified cluster sampling procedure was used for face-to-face interview, whereas the USPS DSF was used to select the sample for online interview. Multivariable ordinal logistic regression was used to assess how personality traits (extraversion, agreeableness, conscientiousness, emotional stability, and openness to experience) as main explanatory variables influence the outcome variables - individual attitudes toward health benefits of vaccination and support for school vaccination. RESULTS: More than two-thirds of respondents perceive health benefit of vaccination and support vaccination requirements for school entry, whereas about one-tenth of respondents have safety concerns about vaccination and oppose the vaccination requirements. After adjusting for ideology, insurance status, and demographic variables, the traits of agreeableness, conscientiousness and emotional stability remain significantly associated with attitude toward vaccination; conscientiousness is significantly associated with support for school vaccination. The odds of reporting health benefits of vaccination associated with one-point increase in agreeableness, conscientiousness and emotional stability are 1.05 (95% confidence intervals [CI] = 1.01-1.08), 1.05 (95% CI = 1.02-1.09) and 1.03 (95% CI = 1.00-1.06), respectively. For a one-point increase in conscientiousness, the odds of supporting school vaccination increase by 1.08 (95% CI = 1.05-1.12). CONCLUSIONS: People high in agreeableness, conscientiousness and emotional stability are more likely to regard vaccination as beneficial, whereas those high in conscientiousness are more likely to support school-based vaccine requirement. This study highlights the importance of personality in shaping individual attitudes toward vaccination. More research is needed to understand the role of personality in individual health attitudes and behavior.