Work

Politics in Public Health: Growing Partisan Divides in COVID-19 Vaccine Attitudes and Uptake Post-2021 Presidential Inauguration

Year: 2025

Type: article

Abstract: Objectives: To investigate whether the 2021 U.S. presidential inauguration contributed to a widening of partisan divides in COVID-19 vaccine attitudes and uptake. Methods: We leverage the presidential inauguration as a natural experiment and analyze data from the Household Pulse Survey and CDC vaccination records. Using a difference-in-differences framework with continuous treatment, we examine how the transition differentially affected state-level vaccine refusal rates and county-level vaccination rates, based on varying levels of partisanship as measured by the Trump-Biden vote gap. Results: Following Biden's inauguration, vaccine refusal declined more in pro-Biden states. Distrust in government and vaccines accounted for approximately 80% of the interstate variation. County-level analysis revealed that for every 1 percentage point increase in Trump's vote share over Biden's, counties experienced an additional 0.515%-2.674% decline in vaccination rates among adults aged 65+. These effects were more pronounced in politically loyal and high-turnout counties. Conclusion: The presidential transition appears to have widened partisan divides regrading COVID-19 vaccines. These findings highlight the need for depoliticized health messaging and bipartisan strategies to mitigate the influence of partisanship on public health.

Source: International Journal of Public Health

DOI: 10.3389/ijph.2025.1608162

Authors: Hongbin Fan, Zhongliang Zhou, Guanping Liu, Chi Shen, Qi Zhang

Institutions: Xi'an Jiaotong University, Old Dominion University

Language: English

Topic: Vaccine Coverage and Hesitancy

Subfield: Health

Field: Social Sciences

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities, Peace, justice, and strong institutions

Open Access status: gold

Estimated APC paid: $2,775