Among Americans who have yet to be vaccinated against the coronavirus, Republicans have been most consistently hesitant. The gap in vaccination rates between counties that voted for Joe Biden and those that voted for Donald Trump has only widened over time. States with lagging vaccination rates, including Arkansas, Florida and Missouri, are seeing surges of cases as the delta variant spreads through the country. But until recently, prominent figures in the party have largely remained silent about vaccination. For example, CNN recently found that almost half of House Republicans would not say publicly whether they had been vaccinated.
But a growing number of Republican elected officials have finally begun publicly promoting vaccination. Florida Gov. Ron DeSantis, who has derided masks and medical experts, recently acknowledged, “these vaccines are saving lives.” Rep. Steve Scalise, R-La., long a vaccine holdout, got his shot in late July. Even Sean Hannity -- perhaps the most influential anti-vaccine Fox News commentator -- joined the ranks of prominent conservatives calling for holdouts to vaccinate last week.
Will the lawmakers’ statements have any effect on their constituents’ behavior? Our research shows that vaccination endorsements from elite Republicans - and, conversely, the silence that preceded them - can have an important impact on the vaccination intentions of everyday Republicans. In a new experiment published this week in Proceedings of the National Academy of Sciences, we find that direct encouragement from Republican leadership - in particular from former president Donald Trump - leads to higher intentions to vaccinate among Republicans.
With collaborators Sophia Pink, James Chu and James Druckman, we recruited a sample of vaccinated and unvaccinated Republicans and randomly assigned two of the groups to view pro-vaccine content. One group viewed a short video of Trump encouraging Americans to vaccinate before reading a short essay highlighting vaccine endorsements by Trump and other prominent Republicans and hailing Republicans’ contributions to vaccine development and distribution. Another group viewed a short video featuring President Biden, and read a short essay featuring prominent Biden supporters and other Democrats’ endorsements. A third group saw a video and read an essay on a neutral topic, the history of neckties.
Results showed that the unvaccinated Republicans who saw the video and essay from Republican elites reported 7% greater vaccine intentions than those who saw an equivalent video and essay from Democratic elites, and 5.7% higher vaccine intentions than those in the necktie control group. Looking more closely at the data, we found that unvaccinated Republicans presented with Republican elite encouragement were more likely to report that they thought Trump and other Republicans would want them to get vaccinated, and this view was associated with their increased vaccine intentions.
We also found some evidence of a backlash effect among the vaccinated and unvaccinated Republicans who viewed vaccine endorsements from Democratic elite: They reported being less willing to promote vaccination among friends and family. This is an important finding in its own right, as the weight of peer influence in Republicans’ social networks is likely to have an important effect on vaccination rates.
These findings cut against widely-covered focus group data from March, in which vaccine-hesitant Republicans said they would be unlikely to follow Republican leaders’ vaccination encouragements. Here, the results of experiments testing the anonymously-recorded views of randomly-assigned groups of people is, scientifically, far preferable to a focus group. People may be unaware of their own tendencies to follow trusted leaders. But even more, people may be disinclined to publicly report that they would simply follow their leaders on a major issue, even if they actually would.
Our research echoes a larger literature from political science on “elite cues,” which finds that party supporters tend to take up the views of their trusted political leaders on issues ranging from the economy to war. Polling data suggests these effects can be sudden and profound, as in Republicans’ shifting views of Russia early in Trump’s term. While our results speak most directly to the influence that Trump, specifically, can have on Republicans’ vaccination intentions, the elite cues literature suggests that trusted and respected sources in general can influence people’s public health behaviors, especially when those sources share a valued group identity with the recipients of a message. Our findings also fit with efforts to promote public health behaviors in West Africa during the Ebola crisis, where partnering with local faith leaders was considered critical for building credibility in local communities.
How can this knowledge be applied by public health officials? Organizations like Ad Council and state health departments could aggressively promote those Republicans who now support vaccination, crafting ads featuring figures such as Trump, Hannity and Senate Minority Leader Mitch McConnell, Ky. It should not be assumed that Republicans have heard these voices: Prominent officials have only recently begun consistently encouraging vaccination, and with little amplification from conservative news outlets. For example, one CBS poll found that a third of Republicans had heard “nothing at all” about Trump getting the vaccine or encouraging all Americans to get vaccinated, weeks after he did so at the annual meeting of the Conservative Political Action Conference in February.
Of course, these organizations are wary of promoting partisan voices, preferring the neutrality of doctors and public health officials. They also may feel reluctant to give a platform to leaders who have behaved irresponsibly throughout the pandemic, promoting false information with disastrous consequences. These instincts are understandable and morally justified. But at a moment when views are extremely polarized, effectively fighting this pandemic requires political tools calibrated to the nature of our problem.
The country cannot contain the virus without higher vaccination rates among Republicans. We can only hope that to address their vaccine hesitancy, and to save red states from the impending disaster of the delta variant, Republican leaders will take up vaccine promotion efforts with greater enthusiasm - and that public health officials will help them do it. There’s good reason to believe that their supporters will listen.
Robb Willer is a professor of sociology, psychology, and organizational behavior at Stanford University. His research studies the social and psychological forces shaping Americans’ political attitudes, with a particular focus on techniques for building coalitions to address major social problems.
David G. Rand is the Erwin H. Schell professor of Management Science and Brain and Cognitive Sciences at MIT. His research focuses on why people believe and share misinformation and “fake news,” understanding political psychology and polarization and promoting human cooperation.
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