Ash Ramsey W, Carpenter-Song Elizabeth, Sosin Anne N, Moen Erika L, Gunn Christine
Department of Anthropology, Dartmouth College, Hanover, NH, USA.
Department of Anthropology, Dartmouth College, Hanover, NH, USA.
Soc Sci Med. 2025 May;373:118019. doi: 10.1016/j.socscimed.2025.118019. Epub 2025 Mar 25.
Nuanced understandings of the origins of vaccine hesitancy are imperative to increasing vaccine uptake in hesitant populations. This paper examines the viability of the framework of place-based consciousness and its components (out-group resentment and in-group identity) to predict vaccine hesitancy across rural and urban subgroups.
We conducted a national survey of 300 U.S. adults (150 urban, 150 rural) from February 12 to March 5, 2024. We used bivariate correlation tests to assess differences in urban and rural place-based consciousness and regression models to assess the relationship between place-based consciousness and influenza and COVID-19 vaccine hesitancy, controlling for measured personal characteristics.
The relationship between place-based consciousness and vaccine hesitancy was significantly modified by rurality for COVID-19 but not influenza vaccine hesitancy. Rural, but not urban, place-based consciousness was a significant predictor of greater odds of COVID-19 vaccine hesitancy. Out-group resentment among rural participants (anti-urban resentment) significantly predicted greater COVID-19 vaccine hesitancy while strength of rural in-group identity was a significant predictor of decreased COVID-19 vaccine hesitancy, both controlling for measured personal characteristics including political leaning, race, and education level.
Our finding that rural resentment, but not identity, predicted greater odds of COVID-19 vaccine hesitancy suggests a rural ethos which encourages rural community members to protect their community health via vaccination while rural resentment toward urban-appearing vaccines and their dissemination may be an important facet of rural vaccine hesitancy. Further exploration into these relationships should adopt ethnographic methods of deep inquiry to render visible the mechanisms through which they may operate.
要提高对疫苗持犹豫态度人群的疫苗接种率，就必须对疫苗犹豫的根源有细致入微的理解。本文探讨了基于地点的意识框架及其组成部分（群体外怨恨和群体内认同）在预测农村和城市亚群体中疫苗犹豫情况方面的可行性。
我们于2024年2月12日至3月5日对300名美国成年人（150名城市居民、150名农村居民）进行了全国性调查。我们使用双变量相关性检验来评估城乡基于地点的意识差异，并使用回归模型来评估基于地点的意识与流感和新冠疫苗犹豫之间的关系，同时控制已测量的个人特征。
对于新冠疫苗犹豫，基于地点的意识与疫苗犹豫之间的关系因农村地区而有显著变化，但流感疫苗犹豫情况并非如此。农村而非城市的基于地点的意识是新冠疫苗犹豫可能性更高的显著预测因素。农村参与者中的群体外怨恨（反城市怨恨）显著预测了更高的新冠疫苗犹豫程度，而农村群体内认同的强度是新冠疫苗犹豫程度降低的显著预测因素，两者均控制了包括政治倾向、种族和教育水平在内的已测量个人特征。
我们的研究发现，农村怨恨而非认同预测了更高的新冠疫苗犹豫可能性，这表明存在一种农村风气，鼓励农村社区成员通过接种疫苗来保护社区健康，而农村对看似具有城市特征的疫苗及其传播的怨恨可能是农村疫苗犹豫的一个重要方面。对这些关系的进一步探索应采用深入探究的人种志方法，以揭示它们可能发挥作用的机制。
