A strong reduction in the deleterious effects of the COVID-19 pandemic can be achieved by vaccination. Religiosity and spirituality (R/S) may play an important role in vaccine acceptance. However, evidence is lacking for the associations with religious conspiracy theories (RCT) in a non-religious environment. This study investigated the associations between R/S and RCT about COVID-19 vaccination and the links of R/S with vaccine refusal and hesitancy. A sample of Czech adults (n = 459) participated in the survey. We measured R/S, RCT, religious fundamentalism, and COVID-19 vaccination intentions. We found spirituality to be significantly associated with RCT belief, with odds ratios (OR) of 2.12 (95% confidence interval [CI] 1.42-3.19). A combination of R/S groups revealed that spirituality with non-religious affiliation was associated with higher beliefs in RCT, with ORs from 3.51 to 7.17. Moreover, associations were found between spirituality with non-religious affiliation [OR 2.22(1.33-7.76)] with vaccine refusal. Our findings showed associations of spirituality and religious fundamentalism with RCT about COVID-19 vaccination. Furthermore, spirituality was linked to a higher possibility of vaccine refusal. Understanding these associations may help prevent the development of RCT and negative impact of spirituality on vaccine intentions and contribute to the effectiveness of the vaccination process.

Department of Community and Occupational Medicine University Medical Center Groningen University of Groningen 9713GZ Groningen The Netherlands

Graduate School Kosice Institute for Society and Health P J Safarik University in Kosice 04011 Kosice Slovakia

Olomouc University Social Health Institute Palacky University in Olomouc 77111 Olomouc Czech Republic

Zobrazit více v PubMed

Dubé E.D., Gagnon D., Macdonald N.E. Strategies intended to address vaccine hesitancy: Review of published reviews. Vaccine. 2015;33:4191–4203. doi: 10.1016/j.vaccine.2015.04.041. PubMed DOI

Harrison E.A., Wu J.W. Vaccine confidence in the time of COVID-19. Eur. J. Epidemiol. 2020;35:325–330. doi: 10.1007/s10654-020-00634-3. PubMed DOI PMC

World Health Organization COVID-19 Weekly Epidemiological Update 49. 20 July 2021–26 July 2021. [(accessed on 28 July 2021)]. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports.

Baden L.R., El Sahly H.M., Essink B., Kotloff K., Frey S., Novak R., Diemert D., Spector S.A., Rouphael N., Creech C.B., et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N. Engl. J. Med. 2021;384:403–416. doi: 10.1056/NEJMoa2035389. PubMed DOI PMC

Hogan C.A., Sahoo M.K., Pinsky B.A. Sample Pooling as a Strategy to Detect Community Transmission of SARS-CoV-2. JAMA. 2020;323:1967. doi: 10.1001/jama.2020.5445. PubMed DOI PMC

Saad-Roy C.M., Wagner C.E., Baker R.E., Morris S.E., Farrar J., Graham A.L., Levin S.A., Mina M.J., Metcalf C.J.E., Grenfell B.T. Immune life history, vaccination, and the dynamics of SARS-CoV-2 over the next 5 years. Science. 2020;370:811–818. doi: 10.1126/science.abd7343. PubMed DOI PMC

Schwarzinger M., Watson V., Arwidson P., Alla F., Luchini S. COVID-19 vaccine hesitancy in a representative working-age population in France: A survey experiment based on vaccine characteristics. Lancet Public Health. 2021;6:e210–e221. doi: 10.1016/S2468-2667(21)00012-8. PubMed DOI PMC

Walsh E.E., Frenck R.W., Falsey A.R., Kitchin N., Absalon J., Gurtman A., Lockhart S., Neuzil K., Mulligan M.J., Bailey R., et al. Safety and Immunogenicity of Two RNA-Based COVID-19 Vaccine Candidates. N. Engl. J. Med. 2020;383:2439–2450. doi: 10.1056/NEJMoa2027906. PubMed DOI PMC

Krammer F. SARS-CoV-2 vaccines in development. Nature. 2020;586:516–527. doi: 10.1038/s41586-020-2798-3. PubMed DOI

Zhang Y., Zeng G., Pan H., Li C., Hu Y., Chu K., Han W., Chen Z., Tang R., Yin W., et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: A randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect. Dis. 2021;21:181–192. doi: 10.1016/S1473-3099(20)30843-4. PubMed DOI PMC

Skjefte M., Ngirbabul M., Akeju O., Escudero D., Hernandez-Diaz S., Wyszynski D.F., Wu J.W. COVID-19 vaccine acceptance among pregnant women and mothers of young children: Results of a survey in 16 countries. Eur. J. Epidemiol. 2021;36:197–211. doi: 10.1007/s10654-021-00728-6. PubMed DOI PMC

Grabenstein J.D. What the world’s religions teach, applied to vaccines and immune globulins. Vaccine. 2013;31:2011–2023. doi: 10.1016/j.vaccine.2013.02.026. PubMed DOI

Larson H.J., Jarrett C., Schulz W.S., Chaudhuri M., Zhou Y., Dube E., Schuster M., MacDonald N.E., Wilson R., SAGE Working Group on Vaccine Hesitancy Measuring vaccine hesitancy: The development of a survey tool. Vaccine. 2015;33:4165–4175. doi: 10.1016/j.vaccine.2015.04.037. PubMed DOI

Lin C., Tu P., Beitsch L.M. Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review. Vaccines. 2020;9:16. doi: 10.3390/vaccines9010016. PubMed DOI PMC

Yin F., Wu Z., Xia X., Ji M., Wang Y., Hu Z. Unfolding the Determinants of COVID-19 Vaccine Acceptance in China. J. Med. Internet Res. 2021;23:e26089. doi: 10.2196/26089. PubMed DOI PMC

Best A.L., Thompson E.L., Adamu A.M., Logan R., Delva J., Thomas M., Cunningham E., Vamos C., Daley E. Examining the Influence of Religious and Spiritual Beliefs on HPV Vaccine Uptake Among College Women. J. Relig. Health. 2019;58:2196–2207. doi: 10.1007/s10943-019-00890-y. PubMed DOI PMC

Larson H.J., De Figueiredo A., Xiahong Z., Schulz W.S., Verger P., Johnston I.G., Cook A.R., Jones N.S. The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey. EBioMedicine. 2016;12:295–301. doi: 10.1016/j.ebiom.2016.08.042. PubMed DOI PMC

Ruijs W.L.M., Hautvast J.L.A., Van Ijzendoorn G., Van Ansem W.J.C., Van Der Velden K., Hulscher M.E. How orthodox protestant parents decide on the vaccination of their children: A qualitative study. BMC Public Health. 2012;12:408. doi: 10.1186/1471-2458-12-408. PubMed DOI PMC

Koenig H.G. Religion, Spirituality, and Health: The Research and Clinical Implications. ISRN Psychiatr. 2012;2012:278730. doi: 10.5402/2012/278730. PubMed DOI PMC

Zinnbauer B.J., Pargament K.I., Cole B., Rye M.S., Butter E.M., Belavich T.G., Hipp K.M., Scott A.B., Kadar J.L. Religion and Spirituality: Unfuzzying the Fuzzy. J. Sci. Study Relig. 1997;36:549. doi: 10.2307/1387689. DOI

Thomas T., Blumling A., Delaney A. The Influence of Religiosity and Spirituality on Rural Parents’ Health Decision Making and Human Papillomavirus Vaccine Choices. Adv. Nurs. Sci. 2015;38:e1–e12. doi: 10.1097/ANS.0000000000000094. PubMed DOI PMC

Shelton R.C., Snavely A.C., De Jesus M., Othus M.D., Allen J.D. HPV Vaccine Decision-Making and Acceptance: Does Religion Play a Role? J. Relig. Health. 2013;52:1120–1130. doi: 10.1007/s10943-011-9553-x. PubMed DOI PMC

Larson H., Fleck F. Underlying issues are key to dispelling vaccine doubts. Bull. World Health Org. 2014;2:84–85. doi: 10.2471/blt.14.030214. PubMed DOI PMC

Pelcic G., Karacic S., Mikirtichan G.L., Kubars O.I., Leavitt F., Cheng-TekTai M., Morishita N., Vuletic S., Tonnasevic L. Religious exception for vaccination or religious excuses for avoiding vaccination. Croat. Med. J. 2016;57:516–521. doi: 10.3325/cmj.2016.57.516. PubMed DOI PMC

Nagata J. Beyond Theology: Toward an Anthropology of “Fundamentalism”. Am. Anthropol. 2001;103:481–498. doi: 10.1525/aa.2001.103.2.481. DOI

Altemeyer B., Hunsberger B. Authoritarianism, religious fundamentalism, quest, and prejudice. Int. J. Psychol. Relig. 1992;2:113–133. doi: 10.1207/s15327582ijpr0202_5. DOI

Altemeyer B., Hunsberger B. A Revised Religious Fundamentalism Scale: The Short and Sweet of it. Int. J. Psychol. Relig. 2004;14:47–54. doi: 10.1207/s15327582ijpr1401_4. DOI

Pargament K.I. The bitter and the sweet: An evaluation of the costs and benefits of religiousness. Psychol. Inq. 2002;13:168–181. doi: 10.1207/S15327965PLI1303_02. DOI

Whitehead A.L., Perry S.L. How Culture Wars Delay Herd Immunity: Christian Nationalism and Anti-vaccine Attitudes. Socius Soc. Res. Dyn. World. 2020;6:237802312097772. doi: 10.1177/2378023120977727. DOI

Sturm T., Albrecht T. Constituent COVID-19 apocalypses: Contagious conspiracism, 5G, and viral vaccinations. Anthropol. Med. 2021;28:122–139. doi: 10.1080/13648470.2020.1833684. PubMed DOI

Costa J.C., Weber A.M., Darmstadt G.L., Abdalla S., Victora C.G. Religious affiliation and immunization coverage in 15 countries in Sub-Saharan Africa. Vaccine. 2020;38:1160–1169. doi: 10.1016/j.vaccine.2019.11.024. PubMed DOI PMC

van Prooijen J.W., Douglas K.M. Belief in conspiracy theories: Basic principles of an emerging research domain. Eur. J. Soc. Psychol. 2018;48:897–908. doi: 10.1002/ejsp.2530. PubMed DOI PMC

Douglas K.M., Sutton R.M., Callan M.J., Dawtry R.J., Harvey A.J. Someone is pulling the strings: Hypersensitive agency detection and belief in conspiracy theories. Think. Reason. 2016;22:57–77. doi: 10.1080/13546783.2015.1051586. DOI

Abaido G.M., Takshe A.A. COVID-19: Virus or Viral Conspiracy Theories? Am. J. Biomed. Sci. 2020;8:122–124. doi: 10.34297/AJBSR.2020.08.001252. DOI

Imhoff R., Lamberty P. How paranoid are conspiracy believers? Toward a more fine-grained understanding of the connect and disconnect between paranoia and belief in conspiracy theories. Eur. J. Soc. Psychol. 2018;48:909–926. doi: 10.1002/ejsp.2494. DOI

Jolley D., Douglas K.M. The Effects of Anti-Vaccine Conspiracy Theories on Vaccination Intentions. PLoS ONE. 2014;9:e89177. doi: 10.1371/journal.pone.0089177. PubMed DOI PMC

Douglas K.M., Sutton R.M., Jolley D., Wood M.J. The social, political, environmental, and health-related consequences of conspiracy theories: Problems and potential solutions. In: Bilewicz M., Cichocka A., Soral W.W., editors. The Psychology of Conspiracy. Routledge/Taylor & Francis Group; London, UK: 2015. pp. 183–200.

Sallam M., Dababseh D., Yaseen A., Al-Haidar A., Ababneh N.A., Bakri F.G., Mahafzah A. Conspiracy Beliefs Are Associated with Lower Knowledge and Higher Anxiety Levels Regarding COVID-19 among Students at the University of Jordan. Int. J. Environ. Res. Public Health. 2020;17:4915. doi: 10.3390/ijerph17144915. PubMed DOI PMC

Kim S., Kim S. Searching for General Model of Conspiracy Theories and Its Implication for Public Health Policy: Analysis of the Impacts of Political, Psychological, Structural Factors on Conspiracy Beliefs about the COVID-19 Pandemic. Int. J. Environ. Res. Public Health. 2020;18:266. doi: 10.3390/ijerph18010266. PubMed DOI PMC

Allington D., Duffy B., Wessely S., Dhavan N., Rubin J. Health-protective behaviour, social media usage and conspiracy belief during the COVID-19 public health emergency. Psychol. Med. 2020;51:1763–1769. doi: 10.1017/S003329172000224X. PubMed DOI PMC

Bertin P., Nera K., Delouvee S. Conspiracy Beliefs, Rejection of Vaccination, and Support for hydroxychloroquine: A Conceptual Replication-Extension in the COVID-19 Pandemic Context. Front. Psychol. 2020;11:565128. doi: 10.3389/fpsyg.2020.565128. PubMed DOI PMC

Sallam M., Dababseh D., Eid H., Al-Mahzoum K., Al-Haidar A., Taim D., Yaseen A., Ababneh N.A., Bakri F.G., Mahafzah A. High Rates of COVID-19 Vaccine Hesitancy and Its Association with Conspiracy Beliefs: A Study in Jordan and Kuwait among Other Arab Countries. Vaccines. 2021;9:42. doi: 10.3390/vaccines9010042. PubMed DOI PMC

Beller J. Religion and Militarism: The Effects of Religiosity, Religious Fundamentalism, Religious Conspiracy Belief, and Demographics on Support for Military Action. Peace Confl. 2017;23:179–182. doi: 10.1037/pac0000250. DOI

Bezalel G.Y. Conspiracy Theories and Religion: Reframing Conspiracy Theories as Bliks. Episteme. 2019:1–19. doi: 10.1017/epi.2019.46. DOI

Furstova J., Malinakova K., Sigmundova D., Tavel P. Czech Out the Atheists: A Representative Study of Religiosity in the Czech Republic. Int. J. Psychol. Relig. 2021 doi: 10.1080/10508619.2020.1844967. DOI

Ministry of Health of the Czech Republic Aktualne o koronaviru—COVID-19 Epidemic. [(accessed on 19 April 2021)];2021 April; Available online: https://koronavirus.mzcr.cz/

Underwood L.G. Ordinary Spiritual Experience: Qualitative Research, Interpretive Guidelines, and Population Distribution for the Daily Spiritual Experience Scale. Arch. Psychol. Relig. 2006;28:181–218. doi: 10.1163/008467206777832562. DOI

Malinakova K., Trnka R., Sarnikova G., Smekal V., Furstova J., Tavel P. Psychometric evaluation of the Daily Spiritual Experience Scale (DSES) in the Czech environment. Czech. Psychol. 2018;62:100–113.

Liht J., Conway L.G.I., Savage S., White W., O’Neill K.A. Religious fundamentalism: An empirically derived construct and measurement scale. Arch. Psychol. Relig. 2011;33:299–323. doi: 10.1163/157361211X594159. DOI

Kosarkova A., Malinakova K., Koncalova Z., Tavel P., van Dijk J.P. Childhood Trauma Is Associated with the Spirituality of Non-Religious Respondents. Int. J. Environ. Res. Public Health. 2020;17:1268. doi: 10.3390/ijerph17041268. PubMed DOI PMC

McDuffie D.C. Sacred immunity: Religion, vaccines, and the protection of public health in America. J. Public Health. 2020 doi: 10.1007/s10389-020-01254-7. DOI

Buchtova M., Malinakova K., Kosarkova A., Husek V., Van Dijk J.P., Tavel P. Religious Attendance in a Secular Country Protects Adolescents from Health-Risk Behavior Only in Combination with Participation in Church Activities. Int. J. Environ. Res. Public Health. 2020;17:9372. doi: 10.3390/ijerph17249372. PubMed DOI PMC

Robertson D.G., Asprem E., Dyrendal A. Introducing the Field: Conspiracy Theory in, about, and as Religion. In: Robertson D.G., Asprem E., Dyrendal A., editors. Handbook of Conspiracy Theory and Contemporary Religion. Brill Academic Publishers; Leiden, The Netherlands: 2018. pp. 1–18.

Howard R.G. Sustainability and Narrative Plasticity in Online Apocalyptic Discourse after September 11, 2001. J. Media Relig. 2006;5:25–47. doi: 10.1207/s15328415jmr0501_2. DOI

Savage S., Liht J. Mapping fundamentalisms: The psychology of religion as a sub discipline in the prevention of religiously motivated violence. Arch. Psychol. Relig. 2008;30:75–91. doi: 10.1163/157361208X316971. DOI

Marchlewska M., Cichocka A., Łozowski F., Górska P., Winiewski M. In search of an imaginary enemy: Catholic collective narcissism and the endorsement of gender conspiracy beliefs. J. Soc. Psychol. 2019;159:766–779. doi: 10.1080/00224545.2019.1586637. PubMed DOI

Vatican COVID-19 Commission in collaboration with the Pontifical Academy for Life Vaccine for all. 20 Points for a Fairer and Healthier World. Dec 29, 2020. [(accessed on 28 September 2021)]. Available online: https://press.vatican.va/content/salastampa/it/bollettino/pubblico/2020/12/29/0697/01628.html#notaing.

Cichocka A. Understanding defensive and secure in-group positivity: The role of collective narcissism. Eur. Rev. Soc. Psychol. 2016;27:283–317. doi: 10.1080/10463283.2016.1252530. DOI

Pargament K., Feuille M., Burdzy D. The Brief RCOPE: Current Psychometric Status of a Short Measure of Religious Coping. Religions. 2011;2:51–76. doi: 10.3390/rel2010051. DOI

Browne M., Thomson P., Rockloff M.J., Pennycook G. Going Against the herd: Psychological and cultural factors Underly-ing the Vaccination confidence Gap. PLoS ONE. 2015;10:e0132562. doi: 10.1371/journal.pone.0132562. PubMed DOI PMC

Rumetta J., Abdul-Hadi H., Lee Y.K. A qualitative study on parents’ reasons and recommendations for childhood vaccination refusal in Malaysia. J. Infect. Public Health. 2020;13:199–203. doi: 10.1016/j.jiph.2019.07.027. PubMed DOI

Pontifical Academy for Life Statement: Moral Reflections on Vaccines Prepared from Cells Derived from Aborted Human Foetuses. Linacre Q. 2019;86:182–187. doi: 10.1177/0024363919855896. PubMed DOI PMC

Lisowski B., Yuvan S., Bier M. Outbreaks of the measles in the Dutch Bible Belt and in other places—New prospects for a 1000 year old virus. Biosystems. 2019;177:16–23. doi: 10.1016/j.biosystems.2019.01.003. PubMed DOI

Malinakova K., Geckova A.M., van Dijk J.P., Kalman M., Tavel P., Reijneveld S.A. Adolescent religious attendance and spirituality-Are they associated with leisure-time choices? PLoS ONE. 2018;13:e0198314. doi: 10.1371/journal.pone.0198314. PubMed DOI PMC

Wood M.J., Douglas K.M. Online communication as a window to conspiracist worldviews. Front. Psychol. 2015;6:836. doi: 10.3389/fpsyg.2015.00836. PubMed DOI PMC

COVID-19 Vaccination Refusal-Which Factors are Related in the Czech Republic, One of the Most Affected Countries in the World?

COVID-19 among Czech Dentistry Students: Higher Vaccination and Lower Prevalence Compared to General Population Counterparts

The Associations of Experiencing the COVID-19 Pandemic With Religiosity and Spirituality: A Cross-Sectional Study in Czech Adults

COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study