Encouraging people to get vaccinated is often seen as a public health success story. However, understanding how persuading people to roll up their sleeves to get vaccines creates social division is crucial. Particularly in a post-COVID-19 world, where attitudes about infection control can influence conflict.
Recent research, published in Vaccine: X highlights the recent efforts of a team from Osaka University as their study aimed to better understand the relationship between vaccine messages and social harmony. The findings suggest that common justifications used to promote vaccination against COVID-19 may inadvertently exacerbate animosity between pro- and anti-vaccination individuals.
The team conducted four repeated online surveys between July 2023 and April 2024, after the official end of the COVID-19 emergency phase. More than 13,000 adults from eight countries participated: Japan, United Kingdom, United States, China, South Korea, Germany, Italy and South Africa. Participants were asked about their reasons for supporting vaccination, their intention to vaccinate in the future, and their feelings toward people who held opposing views.
The results show a striking trade-off: higher vaccination intention and support for vaccine promotion were associated with ideas of self-protection, prevention of harm to others, protection of society as a whole, and adherence to social norms. However, these same ideas were also associated with stronger negative attitudes toward people who disagreed with vaccination, particularly among those who already supported it.
“Public health communication often assumes that stronger moral or social arguments are always better,” says lead author Tomoyuki Kobayashi. “Our findings show that these messages can be double-edged swords. They motivate action, but they can also deepen social divisions.”
Senior author Asako Miura further explains, “When people view vaccination as a moral duty or collective responsibility, those who opt out may be seen as irresponsible or threatening. This perception can fuel social conflict, even after the immediate health crisis has passed.”
Interestingly, there was one exception. The likelihood of sanctions for not vaccinating did not influence vaccination intention, but the consequences appeared to reduce hostility toward those who hold opposing views on vaccinations.
“This was an amazing find,” says Miura. “While punishments are controversial, they may reduce interpersonal resentment by addressing fairness concerns, rather than placing moral responsibilities on individuals.”
The study comes at a critical time, as COVID-19 increasingly becomes a matter of personal choice rather than emergency response. The researchers observed that while overall approval of vaccination remained relatively stable, willingness to vaccinate in the future declined steadily over time.
The results suggest that public health messages need to do more than simply encourage vaccination compliance. Long-term consequences, such as social fragmentation, must also be considered to prepare the public to respond appropriately to future infectious disease outbreaks.
