The ethics and moral psychology of HPV vaccination: evidence from a cross-cultural study

Vaccine hesitancy is a major threat to public health worldwide. Debates about vaccines are often moralized; however, how ethics and ethical judgments relate to vaccination intention remains underexplored. Here, we identify ethically relevant concerns from the academic literature that we operationalize for a pre-registered survey to study how ethical judgments relate to parents’ intentions to vaccinate their children against HPV. We also investigate potential sociocultural influences on ethical judgments: we compare parents from the US, the UK, and Germany. We find that parents’ ethical judgments in all countries are strongly associated with vaccination intention. We also find cross-cultural differences in how their trust in science, physicians, and institutions relates to perceived sociomoral pressure. Still, in the three countries trust moderates the negative correlation between perceived health risks and vaccination intention. These results suggest that campaigns highlighting ethical aspects of vaccination and targeting relevant moral concerns could be effective against hesitancy. • Ethical considerations correlate significantly with HPV vaccination intention • Trust in doctors, science and institutions moderates the effects of perceived risk • Cross-cultural differences exist in concerns of vaccination affecting sexual activity • The “illusion of knowledge” effect does not explain HPV vaccination hesitancy