Political Ideology and Childhood Vaccination in Cross-National Perspective, 1995 to 2018

Abstract Although the Covid-19 pandemic has renewed attention to the problem of vaccine hesitancy, vaccination rates for common childhood vaccines such as measles and pertussis have declined in many countries around the world for over a decade. To investigate the potential role of politicization in this decline, I analyze the relationship between the ideological composition of societies and childhood vaccination rates for measles, diphtheria, pertussis, and tetanus in 88 countries between 1995 and 2018, using pooled cross-national data from the World Values Survey, World Bank, and other sources. Controlling for other key determinants of vaccine uptake, coverage is highest in ideologically moderate societies and lowest in countries that skew to the Right of the political spectrum, while vaccination rates increase when countervailing ideological views are sufficiently well represented in a society. I relate these findings to theories of identity construction and maintenance, focusing especially on the “plausibility structures” approach in the phenomenological tradition and the “subcultural identity” perspective developed in religious contexts.