Investigating how historical legacies of militarized violence can motivate COVID-19 vaccine hesitancy: Evidence from global dyadic survey

BACKGROUND: In almost all countries, COVID-19 vaccines available for public use are produced outside of that country. Consistent with recent social science research, we hypothesize that legacies of violent conflict from vaccine-producing against vaccine-consuming countries may motivate vaccine hesitancy among people in targeted countries that purchase vaccines produced by the erstwhile aggressor. METHODS: Our analyses draw on data from the Correlates of War project and a large, representative survey of 18,291 adults that asked respondents in 16 countries to self-report their attitudes toward COVID-19 vaccines originating from 12 potential vaccine-producing countries in December 2020 (184 country-pairs, 208,422 ratings). For the main analysis, we used random-effect linear probability models and turned to Bayesian Model Averaging to probe the robustness of the main findings. RESULTS: We demonstrate that elevated levels of historical violence between vaccine-producing and vaccine-consuming countries are associated with increased negative feelings toward a COVID-19 vaccine produced by the vaccine producer. CONCLUSION: Global vaccine hesitancy may result, at least in part, from public perceptions of historical conflict between vaccine-producing and vaccine-consuming countries. These results can help public health practitioners better preempt and adjust for cross-national vaccine resistance.