Individuals with higher cognitive flexibility are more positive toward vaccination

A study conducted in New Zealand has found a link between cognitive flexibility and attitudes toward vaccination. Individuals with lower levels of cognitive flexibility were more likely to report personal barriers to vaccination—that is, they tended to state that vaccination conflicted with their personal beliefs. The research was published in BMC Psychology.

Vaccines are biological preparations that stimulate the immune system to recognize and combat specific diseases. They contain weakened, inactivated, or genetic components of a pathogen, triggering an immune response without causing illness.

Vaccination is one of the most effective public health measures, preventing millions of deaths worldwide each year. It has successfully eradicated diseases like smallpox and has drastically reduced the prevalence of polio, measles, and other life-threatening illnesses. When a sufficiently large portion of the population becomes immune to a disease—either through vaccination or previous infection—the disease can no longer spread effectively within that population. This phenomenon, known as herd immunity, protects individuals who cannot receive vaccines due to medical conditions.

Despite these advantages, some individuals and groups refuse or hesitate to get vaccinated. This reluctance can stem from misinformation, distrust in pharmaceutical companies or governments, religious beliefs, or fear of side effects. The spread of anti-vaccine rhetoric on social media has contributed to vaccine hesitancy, leading to outbreaks of preventable diseases such as measles.

Study author Stephanie Gomes-Ng and her colleagues sought to examine the relationship between cognitive flexibility and attitudes toward vaccination. Cognitive flexibility refers to the ability to adapt one’s thinking, switch between tasks or perspectives, and adjust behavior in response to changing environments or new information. It is a core component of executive functioning.

The study involved 601 New Zealand residents, recruited through Prolific and social media posts. Of the participants, 245 were male, with an average age of 33 years. Additionally, 44% of participants were from Auckland, while most of the others resided in four other New Zealand cities.

Participants completed assessments measuring cognitive flexibility (using a shortened version of the Wisconsin Card-Sorting Task) and vaccine hesitancy (using the Multidimensional Vaccine Hesitancy Scale). They also answered several questions designed to assess the influence of their communities on their attitudes toward vaccination.

The researchers categorized attitudes toward vaccination into two groups: personal barriers and external barriers. Personal barriers referred to an individual’s beliefs that made them unwilling to get vaccinated (e.g., “Vaccines go against my beliefs,” “Vaccines are unsafe,” “I do not need vaccines to keep my whānau and community safe”). In contrast, external barriers referred to logistical or situational obstacles preventing vaccination, which were unrelated to personal beliefs about vaccines (e.g., “I do not have the time to get a vaccine,” “I am too busy to get a vaccine,” “Vaccines are too expensive”). Whānau is a Māori term that refers to extended family or kinship groups.

The results showed that individuals with lower levels of cognitive flexibility were more likely to report personal barriers to vaccination. However, external barriers were not associated with cognitive flexibility. Additionally, religious participants exhibited higher levels of vaccine hesitancy compared to 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,” the study authors concluded.

The study sheds light on the links between cognitive style and attitudes towards vaccination. However, it should be noted that the design of the study does not allow any causal inferences to be derived from the results.

The paper, “Cognitive flexibility predicts attitudes towards vaccination: evidence from a New Zealand sample,” was authored by Stephanie Gomes-Ng, Jay K. Wood, and Sarah Cowie.