Impact of Political Leaning on COVID-19 Vaccine Hesitancy: A Network-Based Multiple Mediation Analysis

Prior studies have shown that political affiliation affected COVID-19 vaccine hesitancy. This study re-examined the data to see if these findings hold after controlling for alternative explanations. The dependent variable in the study was COVID-19 vaccination rates in 3,109 counties in the United States as of April 2022. The study examined 36 possible alternative explanations for vaccine hesitancy, including demographic, social, economic, environmental, and medical variables known to affect vaccine hesitancy. County-level political affiliation was measured as a percent of voters in the county who were affiliated with Democratic or Republican political parties. Data were analyzed using a temporally constrained multiple mediation network, which allowed for the identification of both direct and indirect predictors of vaccination rates. Despite controlling for alternative explanations of hesitancy, there was a statistically significant relationship between the percentage of Republican supporters and rates of vaccine hesitancy. The higher the Republican affiliation, the lower the vaccination rates. It is possible that the Republican Party has played an organizing role in encouraging vaccine hesitancy and patient harm.