Religious Traditions Exhibit Heterogeneous Effects on Vaccination Uptake: A U.S. County-Level Regression Analysis Supporting Tailored Health Outreach.

Abstract

Objective: To examine whether specific religious traditions-rather than just "religion" itself-demonstrate significant associations with COVID-19 vaccination rates.

Method: This study analyzes county-level COVID-19 vaccination data (2021-2022) matched with religious composition data from the 2020 U.S. Religion Census for six major religious traditions. The analysis uses negative binomial regression to examine how religious adherence is associated with vaccination rates, controlling for other variables.

Results: Catholic and Mainline Protestant populations showed significant positive associations with vaccination rates (+12.4% and +25.1% respectively), while Evangelical Protestant populations demonstrated significant negative associations (-12.9%). Associations persisted when controlling for other variables, including political ideology, with Republican voting preference emerging as the strongest predictor across all religious traditions (coefficients ranging from -55.6% to -93.7%). Mormon, Black Protestant, and Muslim populations showed no significant associations, including in national and region-specific analyses.

Conclusions: Religious traditions influence preventive health measures through limited but significant group-specific processes. Church-sect positioning partially explains these patterns, with historically culturally-integrated traditions showing greater receptivity to vaccination than those maintaining some cultural tension. Given the contrasts in associations across religious traditions, public health outreach approaches should consider context of specific religious traditions rather than merely approaching "religion" as a monolithic variable.