Cognitive flexibility predicts attitudes towards vaccination: evidence from a New Zealand sample

Vaccine hesitancy (the reluctance or refusal to vaccinate) poses a significant threat to public health worldwide, with declining vaccination coverage resulting in the resurgence of vaccine-preventable diseases (e.g., measles) in recent years. Despite efforts to combat vaccine hesitancy through information-based campaigns and other interventions, vaccine-hesitant attitudes persist. Given that such interventions likely expose individuals to information that conflicts with their own viewpoints about vaccination, cognitive flexibility - the ability to adapt one's thoughts, attitudes, beliefs, or behavior in response to changing information or environmental demands - may play a role in vaccine hesitancy.

The current study investigated the relationship between cognitive flexibility and attitudes towards vaccination in a sample of New Zealand residents (N = 601). Cognitive flexibility was measured using perseverative responses in the Wisconsin Card-Sorting Task, and vaccination attitudes were measured using an adapted version of the Multidimensional Vaccine Hesitancy Scale (MVHS). Linear regression was used with MVHS scores as the dependent variable and cognitive flexibility and sociodemographic variables (age, gender, ethnicity, education level, religion) as predictors.

Cognitive flexibility predicted personal barriers to vaccination (e.g.," vaccines go against my personal beliefs"), with participants with lower levels of cognitive flexibility reporting greater personal barriers. In contrast, there was no significant relationship between cognitive flexibility and external barriers to vaccination (e.g., "vaccines cost too much"). Additionally, religious participants reported overall higher levels of vaccine hesitancy than non-religious participants.

These findings join others demonstrating that individual differences in cognitive style are associated with attitudes towards vaccination, and tentatively suggest that interventions aiming to reduce vaccine hesitancy may be more effective if combined with techniques to increase cognitive flexibility. To be sure, future work is needed to test the causal relationship between cognitive flexibility and attitudes towards vaccination.