Yves here. Even though the authors of this study depict Fox News as having reduced vaccination levels, I doubt that this relationship is as strongly causal as they suggest.

First, even though the authors attribute significance to cable viewing, it’s been in sharp decline. In May 2021, according to Statista, only 44% of American households said they subscribed to cable. But in this diminishing medium, Fox dominates. Fox News has been the most watched network, both in total and in primetime, for the last 60 weeks. In the last week, its news shows accounted for 97 of the 100 most watched news programs. So if Fox is this influential, one might expect vax levels to be even lower.¹

Second, this analysis is consistent with the narrative that vaccine refusniks are white and lesser educated, and Fox viewership would overlap with that demographic. But even if true, that does not establish that causality does not go the other way. Just as stalwart Russiagaters flocked to Rachel Maddow because she affirmed their views, it’s not hard to see anti vaxxers, vaccine skeptics, and “not having Big Government tell me what to do” types prefer Fox.

Third, note that one of their controls for vaccine uptake in the early stages of supposedly “healthcare capacity”. That does not allow at all for disparities in access. They were pronounced in Jefferson County, Alabama.  Jefferson County is over 40% black and voted 51.6% for Hillary Clinton in 2016, versus 44.3% for Trump. Even so, blacks faced overt discrimination in getting vaccines in 2021. From a March NPR story:

In Birmingham, Ala., Alabama Regional Medical Services — a health clinic that primarily serves a lower-income, Black neighborhood — has not administered a single dose of the COVID-19 vaccine. That is scheduled to begin Saturday.

Meanwhile, the first doses in the state went to nearby Mountain Brook, an affluent white suburb of Birmingham, says Sheila Tyson, a commissioner for Jefferson County, where Birmingham is located

What’s happening in Alabama’s vaccine rollout is playing out across the country and is another way racial disparities have surfaced during a pandemic that has been killing people of color at disproportionately high rates…..

According to the most recent data provided by the state’s health department, in cases where race was reported — white people have received 54.6% of vaccinations, compared to 14.6% for Black people.

Tyson says state officials have told her that they are not distributing vaccines to majority-Black neighborhoods because they expect people there may be hesitant to take them.

“They had stuck in their head that Black and brown communities will actually turn the vaccine down without even doing a survey, without even having a plan, without having a person representing those communities at the table with the planning session,” she says.

And in April 2021, from Al.com:

Data from the Alabama Department of Public Health shows a disparity between white and Black Alabamians in terms of COVID-19 vaccinations in several of the state’s largest counties – including Jefferson County, the most populous in the state…

In Jefferson County – home to Birmingham – 43 percent of the population is Black, but just 29 percent of vaccinated people are Black.

Black vaccination rates now slightly exceed those of whites in Jefferson County.

Mind you, the above is not to say that Fox may not have played a role. But the problem almost assuredly has much deeper and more intractable roots. As Matt Taibbi described in Hate Inc, the rise of cable and the Internet allows for much more targeted media messaging, which was once called narrowcasting. Programmers and advertisers found that more extreme views would attract loyal viewers, and “sticky” audiences are also more highly valued by advertisers. Fox was one of the leaders in the shift to catering to and heightening viewer prejudices, but they were also far from alone.

By Matteo Pinnam, Doctoral candidate, Center for Law and Economics, ETH Zurich; Léo Picard, PhD student in Public Economics, University of Basel; Doctoral Research Affiliate, ETH Zürich; and Christoph Goessmann, PhD Candidate, Chair for Law, Economics, and Data Science, ETH Zurich. Originally published at VoxEU

Ever since COVID-19 vaccines were introduced in late 2020, vaccine resistance has remained a common phenomenon. Lower willingness to get the COVID-19 vaccine has been associated with exposure to online misinformation. This column investigates the role of cable news on vaccine scepticism and vaccination rates in the US. It finds that exposure to Fox News reduces COVID-19 vaccination rates, while exposure to CNN or MSNBC does not. Cable media appears to shape beliefs about the effectiveness of COVID-19 vaccines.

Since their introduction in late 2020, COVID-19 vaccines have bolstered the fight against the pandemic, substantially reducing the likelihood of infection and especially severe cases (Amit et al. 2021, Dagan et al. 2021, Polack et al. 2020, Voysey et al. 2021). Given their proven effectiveness as well as the continued social costs of infection and public health measures like lockdowns, the persistent resistance to vaccination poses an urgent policy problem. Correspondingly, understanding the factors shaping decisions to get vaccinated or not constitutes an urgent scientific question.

Scholars have offered some initial findings. For example, exposure to online misinformation is associated with a decline in willingness to get vaccinated against COVID-19 (Loomba et al. 2021, Roozenbeek et al. 2020), and individuals who are opposed to COVID-19 vaccines are less likely to obtain information about the pandemic from traditional and authoritative sources (Murphy et al. 2021). Conservative media consumption is associated with less social distancing (Ash et al. 2020, Gollwitzer et al. 2020, Simonov et al. 2020) and worse COVID-19 health outcomes (Bursztyn et al. 2020).

At the early stages of the vaccination roll-out, news providers varied in their scepticism toward COVID-19 vaccines. Therefore, it seems reasonable to assume that differential exposure to their programmes might have influenced vaccine hesitancy and, consequentially, vaccine uptake. For example, Fox News’ primetime show Tucker Carlson, one of the most popular shows on the network, took a strong stance against vaccines, misleadingly representing deaths after vaccination as being caused by the vaccination (Barr 2021, Stelter 2021). In addition, the network has generally doubted scientific research and experts (Feldman et al. 2012, Huertas and Kriegsman 2014, Hmielowski et al. 2014).

Analysis

In order to assess the effects of media misinformation on vaccination rates, we pair data on county-level vaccination rates with data on viewership of the main cable news providers: Fox News Channel, MSNBC, and CNN. The results from the analysis show that, starting May 2021, counties with higher Fox News viewership report lower vaccination rates: watching one additional hour of Fox News per week for the average household reduces the number of vaccinations by 0.35 to 0.76 per 100 people.

In the early months of the vaccination campaign, we do not observe a relationship between cable channel viewership and vaccinations. However, starting in May 2021, Fox News viewership starts reducing vaccine uptake. The relationships for the other cable news networks, MSNBC and CNN, remain without any statistically significant effect.

Figure 1 Effect of network viewership on weekly vaccination rates (2SLS)

Notes: Regressional coefficient plots with 95% CIs of the effect of one standard deviation changes in viewership on weekly vaccinations per 100 people. Our viewership measure is instrumented using the channel line-up positions.

We observe that results are driven by people aged 18 to 65 years, with no significant effect on the group older than 65 years. To strengthen our analysis, we control for the main networks’ relative channel position and viewership, as well as for geographical confounders – including socio-demographic characteristics and political preferences of the counties.

We can show that there is a causal relationship between exposure to Fox News Channel and lower vaccination uptake. Our statistical analysis exploits the fact that networks are exogenously assigned a channel position in the television line-up, with casual viewers being more likely to watch channels with a lower channel number. We therefore use the geographical variation of the network’s channel position as an instrument for the network’s viewership. This empirical approach has been widely used in economics and political science to study the effects of biased media coverage (Ananyev et al. 2020, Ash et al. 2021, Galletta and Ash 2019, Martin and Yurukoglu 2017, Simonov et al. 2020). The causal estimates are also coherent with the correlational results of the Ordinary Least Squares regressions of viewership on vaccination rates.

Mechanism

Overall, our results support the interpretation that Fox News Channel promulgated a uniquely sceptical narrative about vaccines and that this narrative caught on and reduced uptake among the marginal vaccine recipient. We back this interpretation with the following observations.

First, in areas with higher exposure to Fox News Channel, respondents to a national survey reported higher COVID-19 vaccine hesitancy. This agrees with a behavioural mechanism where Fox News Channel’s sceptical vaccine narrative affects vaccination rates by changing attitudes and intentions regarding the vaccine, discouraging in particular the population with low health-related risks.

Second, we consider whether the effects that we see might be driven by local healthcare capacity. If the difference in vaccination rates were due to healthcare capacity, we should see similar effects throughout all stages of the vaccination campaign. Yet we find there was no effect on vaccine uptake in the early months, when the vaccines were only available to older/at-risk individuals. Thus, we infer that the effect of cable news is most pronounced for relatively low-risk individuals, such as the younger population, helping to rule out an effect due to local healthcare capacity.

It could also be that the healthcare systems in areas with higher Fox News viewership systematically differ in their capability to handle a COVID-19 outbreak, for example, due to effects on local government funding (Galletta and Ash 2019). Or it could be that these counties suffered more cases and deaths in 2020 or in the period before the vaccinations. We find that Fox News Channel has no effect on measurements of local healthcare capacity, including the number of ICU beds, number of hospitals, and Centers for Disease Control and Prevention–estimated risk indexes. We also rule out that the difference in uptake is due to differences in infections or deaths.

Third, as Fox News viewership has been shown to be correlated with voting Republican (Ash et al. 2021, DellaVigna and Kaplan 2007, Martin and Yurukoglu 2017), we check if partisan affiliation or political ideology are driving the Fox News effect. Republicans or conservatives could overall be more sceptical of the COVID-19 vaccine, indicating that the observed effect was driven by Fox News Channel increasing the number of Republicans or conservatives. Our results show that this is unlikely to be the case, as the effect of Fox News Channel on vaccine uptake holds in several tests that control for partisan affiliation and political ideology.

Finally, we consider whether Fox has affected general attitudes towards vaccines, for example through anti-science rhetoric. To check this, we look at the effects on seasonal flu vaccination rates (2017–2019) and conclude that the network does not contribute to a generic anti-vaccination sentiment and that the effect on COVID-19 vaccines is due to a COVID-specific narrative.

Conclusion

This column provides evidence that the main cable news television providers are affecting vaccination decisions, suggesting that Fox’s COVID-19 coverage is at least partially responsible for reducing vaccination rates. Fox News’ slanted media rhetoric is linked to vaccination hesitancy, producing significant behavioural effects in the under-65 population with low health risks. Future efforts by government agencies and health organisations to encourage vaccine uptake should account for how media narratives may strengthen or weaken those efforts.

See original post for references

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¹ While the plural of anecdote is not data, only one of the non-vaccine-takers I know is a Fox adherent, and does not fit the stereotype: very high income highly educated professional. The others are female versions of the soy boy man bun types: health fanatics who are skeptical of what they call allopathic medicine and see doctors minimally.