Drivers of Noncompliance With Vaccine Mandates—The Interplay Between Distrust, Rationality, Morality, and Social Motivation

COVID-19 amplified the issue of public resistance to government vaccination programs. Little attention has focused on people's moral reasons for noncompliance, which differ from—but often build upon—the epistemic claims they make about vaccine safety and efficacy, disease severity, and the trustworthiness of government. This study explores the drivers of noncompliance with the COVID-19 vaccination program in Western Australia, using in-depth interviews with refusers. Distrust in the government and concerns about safety, efficacy, and necessity (rationality) drive noncompliance when vaccination is voluntary. When governments mandate vaccines, rationales expand to include cost–benefit analyses of consequences, consideration of available alternatives, and moral justifications, with policytakers expressing “morality policy reactance” toward mandates as morality (rather than regulatory) policies. Our theoretical framework of vaccine noncompliance drivers shows distrust, rationality, and morality as interrelated and supported by social motivation. We consider policy implications and suggest holistic measures.