Religious belongings and Covid-19 vaccination

Abstract

Introduction

Vaccine hesitancy poses a complex global challenge. Our study investigates correlations between COVID-19 vaccination rates, religious demographics, and educational performance.

Materials and methods

Using cross-sectional analysis, data from reputable sources were analyzed for correlations using Pearson’s correlation and linear regression.

Results

We found statistically significant positive correlations between COVID-19 vaccination rates and PISA scores, Catholic populations, non-religious, and atheist populations. Conversely, negative correlations were observed with Muslim and Eastern Orthodox populations. Our findings suggest potential influences of religious beliefs and educational attainment on vaccination rates.

Conclusion

The data reveals a positive correlation between COVID-19 vaccination rates and the percentages of Catholic, Non-Religious, and Atheist populations, while indicating a negative correlation between COVID-19 vaccination rates and the percentages of Muslim and Eastern Orthodox populations. These findings underscore the potential significance of engaging religious leaders in promoting vaccinations as a strategy to address vaccine hesitancy.

Introduction

Vaccine hesitancy presents a multifaceted challenge that persists globally. Our prior investigation revealed a positive correlation between COVID-19 vaccination rates and indicators such as the Human Development Index (HDI) and Education Index (EI) [1]. However, disparities persist in Eastern Europe, where vaccination rates lag behind expectations based on EI and HDI. Conversely, Catholic countries exhibit higher vaccination rates than anticipated. These observations led us to explore the relationship between vaccination rates and the religious composition of populations [1, 2]. Additionally, the release of new PISA scores during our data collection period sparked our interest, prompting us to investigate their correlation with COVID-19 vaccination rates.

Materials and methods

This study adopts a cross-sectional design to investigate potential correlations between COVID-19 vaccination rates, religious beliefs, religiosity, and PISA scores. Our primary data sources comprise the World Population Review and the World Health Organization, with secondary sources including Our World in Data and the Financial Times COVID-19 dashboard. Notably, no specific exclusion criteria were applied to countries or territories. It’s essential to acknowledge that while healthcare logistics and infrastructure may significantly influence vaccination rates, this study focuses solely on the relationship between vaccination rates and religious factors, along with educational performance as indicated by PISA scores. These logistical and infrastructural aspects were not directly analyzed within the scope of this research. We classified countries as Catholic-, Protestant-, Eastern Orthodox-, or Muslim-dominant if more than 50% of the population adhered to the respective denomination. We will also include a data analysis that excludes populations where adherence to a particular religion is below 5%, ensuring that very small religious groups do not skew the results.

Data collection

We gathered data encompassing various demographic and COVID-19 vaccination metrics. Specifically, we compiled percentages for Catholic, Muslim, Eastern Orthodox, Protestant, Christian excluding Eastern Orthodox, atheist, and non-religious populations [3, 4]. The primary source of the data was World Population Review, the data that was not available was incoprorated from The Association of Religion Data Archives. It should be noted that the atheist and non-religious population might overlap with individuals who were baptized into a particular religion. Non-religious people are defined as those who do not follow religious rules; however, this does not necessarily mean they are atheists. As per World Population Review, true atheism involves individuals who have considered but ultimately dismissed the possibility of the existence of deities. Additionally, COVID-19 vaccination rates, including figures for one-dose, two-dose, and booster doses (January 2023), as well as latest PISA score were collected [5,6,7,8] (Table 1). It’s important to note that COVID-19 information was not directly sourced from primary authorities, such as local public health departments. Instead, we relied on reputable secondary sources that curate and vet the data. Our primary data source was the World Health Organization (WHO) COVID-19 dashboard, recognized for its continuous verification process through official channels to uphold data accuracy, reliability, and timeliness. However, in instances where specific country or territory data (e.g., Taiwan) was unavailable on the WHO dashboard, we turned to alternative trusted platforms such as Our World in Data or the Financial Times COVID-19 dashboards. Furthermore, it’s worth mentioning that countries reporting vaccination rates exceeding 100% of their population for first or second doses were adjusted to 100% for the sake of consistency and accuracy.

Table 1 This table contains all the data collected through the study – COVID-19 vaccination rates, PISA scores and population percentage of people with certain religious beliefs

Statistical analysis

The statistical analysis was done with SPSS 26 to determine the strength of correlation via Pearson’s correlation and linear regression analysis for scale variables, mean, confidence interval (CI) – 95%, p values (< 0.05), etc.

Results

PISA score and COVID-19 vaccination rate

The results indicate statistically significant weak to moderate positive correlations between COVID-19 vaccination rates (1-dose, 2-dose, booster dose, and combined values) and PISA scores across countries (Table 2; Fig. 1). Strongest positive correlation was found between PISA score and booster dose.

Table 2 This table depicts the results of Pearson’s correlation and linear regression results between variables

Fig. 1

The figure depicts linear relationship between PISA scores and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

Catholic population and COVID-19 vaccination rate

Our findings suggest a statistically significant weak positive correlation between the proportion of the Catholic population and COVID-19 vaccination rates across different categories (1-dose, 2-dose, booster dose, and combined values) (Table 2; Fig. 2). Specifically, regions with a higher proportion of Catholic residents tend to exhibit higher vaccination rates.

Fig. 2

The figure depicts linear relationship between percentages of catholic population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

When applying the 5% population cutoff, the results remain unchanged, showing a statistically significant weak positive correlation between the Catholic population and vaccination rates; This correlation is observed for 1-dose (r(111) = 0.23, p = 0.006), 2-dose (r(111) = 0.23, p = 0.007), and booster doses (r(111) = 0.29, p = 0.001), as well as for combined vaccination categories (r(111) = 0.26, p = 0.003).

Eastern orthodox population and COVID-19 vaccination rate

Our findings reveal statistically significant weak negative correlations between the proportion of the Eastern Orthodox population and COVID-19 vaccination rates across all examined categories (1-dose, 2-dose, booster dose, and combined values) (Table 2; Fig. 3).

Fig. 3

The figure depicts linear relationship between percentages of eastern orthodox population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

When applying the 5% population cutoff, the results are showing a statistically insignificant weak negative correlation between the Eastern Orthodox population and vaccination rates; This correlation is observed for 1-dose (r(21) = -0.10, p = 0.33), 2-dose (r(21) = 0.09, p = 0.35), and booster doses (r (21) = 0.22, p = 0.16), as well as for combined vaccination categories (r (21) = 0.15, p = 0.25), when applying the 5% population cutoff.

Christian excluding eastern orthodox population and COVID-19 vaccination rate

Our findings reveal no statistically significant correlations between the proportion of the Christian Population Excluding Eastern Orthodox population and COVID-19 vaccination rates across all examined categories (1-dose, 2-dose, booster dose, and combined values) (Table 2; Fig. 4).

Fig. 4

The figure depicts linear relationship between percentages of christian excluding eastern orthodox population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

Muslim population and COVID-19 vaccination rate

Our findings reveal statistically significant weak negative correlations between the proportion of the Eastern Orthodox population and COVID-19 vaccination rates across all examined categories (1-dose, 2-dose, booster dose, and combined values) (Table 2; Fig. 5).

Fig. 5

The figure depicts linear relationship between percentages of muslim population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

When applying the 5% population cutoff, the results remain unchanged, revealing a statistically significant weak negative correlation between the Muslim population and vaccination rates, except for the 1-dose results, where the p-value exceeds 0.05; This correlation is observed for 1-dose (r(94) = 0.15, p = 0.07), 2-dose (r(94) = 0.19, p = 0.03), booster doses (r(94) = 0.21, p = 0.02), and combined vaccination categories (r(94) = 0.19, p = 0.03).

Non-religious population and COVID-19 vaccination rate

The results indicate statistically significant moderate positive correlations between COVID-19 vaccination rates (1-dose, 2-dose, booster dose, and combined values) and non-religious population across countries (Table 2; Fig. 6).

Fig. 6

The figure depicts linear relationship between percentages of non-religious population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

Atheist population and COVID-19 vaccination rate

The results indicate statistically significant moderate positive correlations between COVID-19 vaccination rates (1-dose, 2-dose, booster dose, and combined values) and atheist population across countries (Table 2; Fig. 7).

Fig. 7

The figure depicts linear relationship between percentages of atheist population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

Protestant population and Covid-19 vaccination rate

Our findings reveal no statistically significant correlations between the proportion of the Protestant Population and COVID-19 vaccination rates across all examined categories (1-dose, 2-dose, booster dose, and combined values) (Table 2; Fig. 8).

Fig. 8

The figure depicts linear relationship between percentages of protestant population and COVID-19 vaccination rates (A – 1-dose, B – 2-dose, C – booster, D – Combined)

When applying the 5% population cutoff, the results remain unchanged, showing a statistically insignificant correlation between the Protestant population and vaccination rates; This correlation is observed for 1-dose (r (99) = 0.07, p = 0.24), 2-dose(r(99) = 0.08, p = 0.20), and booster doses (r(99) = 0.05, p = 0.16), as well as for combined vaccination categories (r (99) = 0.08, p = 0.21).

Mean vaccine coverage in repect to dominating religion

Mean vaccine coverage was found to be highest in Catholic-dominant countries, with the difference being especially pronounced in booster dose coverage. While other countries (Protestant-, Eastern Orthodox-, and Muslim-dominant) saw more than a 50% drop in booster dose coverage, Catholic-dominant countries experienced a smaller decline, with an average drop of less than 40% (Table 3; Fig. 9).

Table 3 This table depicts mean vaccine coverage in countries where certain religions were dominant

Fig. 9

The figure depicts mean values of vaccination coverage in countries which are either Protestant-, Catholic-, Eastern Orthodox- or Muslim-dominated (A – 1-dose, B – 2-dose, C – booster, D – Combined)

Discussion

Our data suggests that there is a positive correlation between the higher percentage of non-religious and atheist population with Covid-19 vaccination rate. Several studies suggest that religious people might be more distrustful of scientific advances due to increased secularism in research, which is often perceived as a threat to religions [9, 10]. However, certain authors suggest that atheist and religious populations trust science at the same level [11].

A statistically significant negative correlation was observed solely in the relationship between the percentages of Muslim and Eastern Orthodox populations. While the precise cause remains elusive, there is reasonable suspicion that in countries where Eastern Orthodoxy is prevalent, this phenomenon might stem from anti-Western and anti-scientific disinformation campaigns often attributed to the Russian Federation [1]. Notably, various studies have addressed vaccine hesitancy in Muslim-majority nations, highlighting challenges such as the certification of vaccines as halal, adherence to Sharia law in vaccination practices, dissemination of misinformation via social media platforms, vaccine accessibility, and concerns regarding potential long-term complications [12,13,14]. The most official statements, that can be gathered online, though, is that COVID-19 vaccination is not against Sharia law.

Concerning Eastern Orthodox church officials, there are numerous representatives, including those from Russia, Georgia, and Ukraine, who have made statements in various media sources expressing opposition to COVID-19 vaccination. Some of these statements even associate the vaccines with apocalyptic scenarios. Research indicates differing perspectives on the actions of the Romanian church during the COVID-19 pandemic. While the church officially endorsed health measures, including vaccination promotion, these directives did not consistently reach all levels of the church [15, 16]. However, it is evident that the Orthodox church could have significantly influenced political and social responses in both Romania and Bulgaria [16]. Similarly, in Serbia, the loss of numerous archbishops and priests to COVID-19 prompted officials from the Serbian Orthodox church to advocate for vaccination. However, this advocacy had limited impact [17]. In both Romania and Serbia, Orthodox Christians tended to follow the guidance of local religious authorities rather than official church positions. Many of these local authorities did not align with the official stance [18]. The Russian Orthodox church has displayed skepticism toward COVID-19 therapeutics, including vaccines. This lack of trust extends to preventive measures, resulting in widespread noncompliance. There is evidence of coordination between elements within the Russian federation and far-right groups in the United States and Germany. This coordination includes dissemination of anti-science narratives through Russian state media and online platforms with global reach [19].

Conversely, a positive correlation was observed between the percentage of the Catholic population and COVID-19 vaccination rates. While pinpointing a singular cause proves challenging, it’s plausible that the proactive stance of the Catholic Church in advocating for vaccination could have contributed to this trend [1].

Multiple research papers have examined this subject regionally or sporadically, further supporting the findings of our study. A survey in the US indicates that belief in higher powers or God’s ability to intervene is negatively associated with COVID-19 vaccination [20]. Various factors, such as the prohibition of vaccination during Ramadan, concerns about non-halal ingredients, the perception of illness as a divine decision, the use of aborted fetal cells, and the stigma around sexual promiscuity related to the HPV vaccine, have been identified as conflicting with certain religious beliefs [21, 22]. A recent review article suggests that religiosity negatively impacts COVID-19 vaccine uptake across different religious groups [23]. Additionally, a study in the US found that unvaccinated Christians in the common identity condition were more likely to trust medical experts and promote vaccination, whereas more religious participants valued medical experts who shared their religious beliefs [24]. Another study suggests that countries with populations who trust religious leaders or views more than scientific facts tend to have lower vaccine coverage [25].

PISA scores, akin to EI (Education Index) and HDI (Human Development Index), exhibit a positive correlation with COVID-19 vaccination rates [1]. While the precise mechanism remains elusive and we cannot assert causality or the direction of the relationship, it might be hypothesized that individuals with higher levels of education are less susceptible to misinformation campaigns, which may lead to higher vaccination rates. There is also a hypothesis that a faster vaccine rollout might have led to a quicker resumption of classes, resulting in better PISA scores.

It should absolutely be mentioned, that observational studies offer valuable insights into real-world phenomena but face limitations. Establishing causality is challenging due to the absence of interventions or random assignment, necessitating reliance on statistical methods for inferring potential causal relationships. Additionally, these studies are prone to bias and confounding. These limitations underscore the need for careful interpretation and highlight the importance of complementary evidence from experimental research to strengthen causal inferences.

Conclusion

The data reveals a positive correlation between COVID-19 vaccination rates and the percentages of Catholic, Non-Religious, and Atheist populations, while indicating a negative correlation between COVID-19 vaccination rates and the percentages of Muslim and Eastern Orthodox populations. These findings underscore the potential significance of engaging religious leaders in promoting vaccinations as a strategy to address vaccine hesitancy.