Can Russia vaccinate?
New evidence suggests a stubborn social logic of vaccine hesitancy in Russia
One of the great things about teaching is how it forces you to think about old questions in new ways — or maybe about new questions in old ways.
In a summer-school session I was giving to a group of Russia-focused graduate students from around Europe earlier this week — after running through a series of overlapping and competing theories of how power in Russia works1 — I asked the group to reflect on three questions:
Why is Russia struggling to make progress on Covid-19 vaccination?
Where does the power lie to change vaccine-related behavior in Russia?
And is there reason to expect that Covid-19 may be a turning point in the relationship between Russian citizens and their state?
On the first question, there was a broad consensus among the students: it’s an issue of trust. And in this, they’ve got a growing amount of data on their side. According to a Levada Center survey published July 5th, vaccine hesitancy is highest among those who have the lowest approval of Vladimir Putin (71%), and the most popular reasons people give for not wanting to get vaccinated are that they’re afraid of side effects (33%) and that the vaccine hasn’t yet been sufficiently tested (20%).2
Question two, however, was trickier. Some students thought the state needed to work harder and more creatively to provide incentives — including, potentially, coercive incentives — for people to get vaccinated. Others worried that, if the state itself was not a locus of trust, that a state-led approach would be counter-productive. Instead, they argued, the solution must lie in the ability of horizontal networks to create social pressure.
In other words, the students had re-opened what is perhaps the central controversy in social science. On the one hand, we had a classical rational-choice approach, seeing large-scale social phenomena — like the fact that 54% of Russians are unwilling to get vaccinated — as the aggregate of millions of rational people acting individually to maximize their utility. On the other hand, we had a more constructivist approach, which sees people as fundamentally social animals, who make decisions as part of a group. For the former, changing group behavior requires altering the calculations of individuals. For the latter, changing individual behavior requires altering the dynamics of a group.
So, who’s right?
Well, we know from Levada’s data that people are engaging in a kind of rationalization of their vaccine hesitancy: the fact that most people seem to be justifying it in terms of safety does suggest that people are going through some sort of a risk-reward calculation, which is compatible with rational choice theory. But Levada’s data also suggest that there are limits to this rationality. Only 24% of respondents say they would be willing to get the vaccine once it has been fully tested and dangerous side effects have been ruled out, while fully 41% of respondents said they would refuse to be vaccinated under any circumstances. In other words, people are not just unconvinced about the vaccine: they are unwilling to be convinced.
Unfortunately, the survey data don’t really tell us anything about where this unwillingness comes from — but recent events suggest that a powerful social element may be at work.
On July 10th, authorities in Moscow began offering a second Russian-made vaccine, CoviVac, to people aged 18-60, the third vaccine available in the country, after Sputnik-V and EpiVac. According to media reports, lines stretched around and out of parks, as people waited five hours or more to get their shots, before doses finally ran out. So, what makes CoviVac more attractive than Sputnik V? Essentially — nothing. When a Novaya Gazeta correspondent took a vox-pop of people waiting in line on Saturday, interviewees were pretty clear about the limits of their own rationality. Another said:
“We read the information, and we wanted to get CoviVac. Our friends got Sputnik. We don’t like EpiVac at all. You need to be a specialist to know for sure what to get. Any kind of reflection about this is just manipulation. You can find stuff on any vaccine to make you want to take it, including EpiVac.”
So, why CoviVac? The most common response seemed to be something along the lines of “somebody told me”:
“If you don’t know what vaccine to get, read the Internet. In our circle, three people said they had serious side-effects after getting Sputnik V.”
Confused?
Neither the survey data nor the available journalism point to any kind of rhyme or reason here — and that’s the point. While information about the vaccines is available, people aren’t using that information to make decisions about the vaccine. Rather, they’re processing that information through a set of emotional responses and gut feelings, which determine which information should be taken seriously, and which information should be disregarded.
In this respect, vaccine hesitancy in Russia isn’t really any different from vaccine hesitancy in, say, the United States. Indeed, there is a significant body of evidence to suggest that emotion is a powerful factor in shaping people’s willingness to have their children vaccinated, their belief in vaccine-related conspiracy theories, and their confidence in Covid-19 vaccines specifically.
But there is one important difference. In the US, vaccine hesitancy breaks down clearly along political lines: Republicans (and Fox News viewers) are hesitant, Democrats are not. In Russia, the lines are much less clear. Voices urging people to get vaccinated are equally prominent among both regime proponents and opponents. And while, as the Levada Center found, people with low levels of trust in Putin are among those most unwilling to get the vaccine, there are not enough of those people to account for most of the problem.
My own answer to the second question, then, is this: there isn’t one. If signals from trusted authority figures and ideologically compatible opinion leaders aren’t changing behavior, it’s because they’re not reshaping the conversations that matter most to people. The power to change vaccine-related behavior in Russia lies in the dynamics of people’s closest social circles, circles that many people are accustomed to defending against outside influence.
Which brings me to the third question: Solving the pandemic will require a reimagining of people’s micro-social circles as locations of macro-social importance. The habits of small-group solidarity — which have been so important to surviving the dislocations and depredations of post-Soviet social, political and economic transformation — will need to become the basis for a broader social solidarity.3 If that happens, it would be a turning point in the relationship not between Russian citizens and their state, but among Russian citizens themselves.
In particular: Brian Taylor’s The Code of Putinism, Karen Dawisha’s Putin’s Kleptocracy, Alena Ledeneva’s Can Russia Modernise?, Henry Hale’s Patronal Politics, and — because a guy’s got to earn a living — Putin v the People, by Graeme Robertson and yours truly.
Vaccine hesitancy is also particularly high among younger people — 60% among those aged 18-24, and 65% among those 25-39 — and those who are unworried about getting sick from Covid-19. In other words, a large part of Russia’s vaccine problem boils down to young oppositionists who think they’re immortal. Which, I suppose, is unsurprising. The good news is that 19% of respondents said they had already been gotten at least one shot, nearly double the April numbers and in line with actual vaccination statistics.
This is an idea that Maxim Trudolyubov and I discussed at some length back when this pandemic began. That conversation, I think, is still relevant today.