Religion, beliefs, trust, and COVID vaccination behavior among rural people in Malawi

This study investigates the religious and other beliefs related to the corona/COVID-19 pandemic and how they are related to covid risk perceptions, trust in COVID vaccines, and how these are affected by the religious beliefs, religious affiliations, trust in authorities, generalized trust, and how these affect vaccine demand/vaccine hesitancy. The study took place in rural areas in six districts in Central and Southern Regions of Malawi during April-May 2022 towards the end of the fourth wave of the pandemic that was dominated by the omicron variant of the virus, through personal interviews of 835 subjects. The study revealed five religious beliefs associated with the pandemic and one non-religious belief that vaccination would lead to infertility in women. This belief (14% of the sample) and the belief that vaccination leads to a triple-six mark from the Devil (33% of the sample) were strongly negatively associated with trust in the vaccine and the trust in the vaccine had a strong impact on the demand for vaccine/vaccine hesitancy. In addition, certain religious groups were associated with more of these pandemic-related beliefs, lower trust in the vaccines, and lower vaccine demand/stronger vaccine hesitancy. Trust in politicians, health personnel, and generalized trust contributed to stronger trust in vaccines. It may be important to address both the beliefs and some of the religious groups and their leaders to promote vaccine demand and reduce vaccine hesitancy