The political climate where people live may matter as much as what they believe politically when it comes to COVID-19 vaccination, according to a study published this week in PLOS One.

Researchers from Colgate University and Syracuse University found that politically conservative US adults living in liberal areas were both less hesitant about COVID vaccines and more likely to receive booster doses than conservatives living in conservative regions of the country. 

There is a well-documented relationship between conservatism and vaccine hesitancy in the United States, and these findings suggest that local political climates may moderate that relationship, the authors say. 

For the study, the researchers surveyed 683 adults from March 8 to April 19, 2023. Participants completed an online questionnaire assessing political ideology, COVID vaccine and booster status, and vaccine hesitancy. The team determined regional political climate by using ZIP code data and 2020 presidential election results.

Conservatives in liberal regions 60% likely to be boosted

Consistent with earlier research, political conservatism was associated with greater COVID vaccine and booster hesitancy and lower rates of vaccine uptake. 

But when researchers examined how personal ideology interacted with local political climate, conservatives appeared more responsive to their surroundings. Conservative participants living in liberal political climates were less hesitant about vaccination and substantially more likely to have received a COVID booster than conservatives living in conservative areas. 

“As political conservatism increases vaccine hesitancy also increases, but this increase is even greater for individuals who live in a more conservative regional climate,” the authors write.

Liberals showed consistently low vaccine and booster hesitancy, regardless of whether they lived in conservative or liberal regions. That contrast was especially pronounced for booster doses. Politically liberal participants were more than 65% likely to receive a booster, regardless of regional political climate. 

Among conservatives, booster uptake varied widely: those living in liberal regions had a 60% likelihood of receiving a booster dose, compared with less than 35% among conservatives in conservative regions.

Local influences appear more pronounced in conservatives

While the study did not directly examine the mechanisms driving these differences, the findings suggest that local contexts may shape vaccination decisions, with these influences appearing more pronounced among conservatives living in predominantly liberal areas.

The study design had some limitations, including reliance on self-reported vaccination status and a participant pool limited to Black and White participants that may not generalize to other populations across the country, 

“The interaction between political climate and orientation suggests that liberal environments may exert more influence on conservative individuals than conservative environments exert on liberal individuals,” the researchers write. “It could also be the case that conservative individuals are more influenced by their environments than their liberal counterparts. Future research should explore the extent to which political climate, and other related regional variables, are associated with vaccine attitudes and behavior.”