Russian vaccine hesitancy and the paradox of state-society relations

Vaccine poster in a Moscow citizen service centre – ‘The Risk of Infection Remains: make an informed decision and get vaccinated’

Russia will likely maintain its statistically dubious plateau of around 800 deaths a day for some time. This will mean that Russia will become the world ‘leader’ in deaths per million people (around six). The other leaders are Mexico and South Africa with similar figures. The USA is rapidly increasing from over three deaths per million at the moment. Most large European countries have fewer than two deaths per million at the moment. Germany and Denmark have 0.2 deaths/million. It might even be much worse – Demographer Rakshasaid at the beginning of August that perhaps 2400 people a day were dying of Covid in Russia.

I’ve been meaning to come back to the topic of Covid for some time. I wrote two posts on it early on in 2020. One asking whether social solidarity and state mobilization would help ameliorate the pandemic in Russia.  And another in May 2020 about the need to avoid over-simplifying public attitudes and ‘lay normativity’. I didn’t mention vaccine hesitancy there, but it’s clearly the major issue now in terms of public health in Russia. [See also this great BBC article for an anthropological take on distrust]

Here’s my quick take based on two months of being around people – both vaccinated and unvaccinated – in Moscow and Kaluga region.

  1. Russians are no different from anyone else: hesitancy ‘decays’ once people encounter others (usually family, friends and colleagues) who don’t turn zombie/alien/corpses/infertile after getting a jab. However, because of lower generalized social trust in Russia, this decay might be slower than elsewhere.
  2. Unlike elsewhere, there is an occupational and employment vaccine ‘divide’ in Russia – many people in jobs that don’t force them to get a jab continue to resist – a lot of the time as much due to ‘principle’ than fear (more on that below). These are homemakers (women score higher on hesitancy), pensioners, people working in the informal economy, but also workers in smaller companies – many of which are afraid of using duress on employees.
  3. Getting a high threshold of vaccinated people will be hard because of both 1 and 2. That, and the dominance of Delta variant in Russia and the coming ‘fourth wave’, means the demographic hit will continue: more than half a million people will have died of Covid by the end of 2021 in Russia. Many others will have died because of a lack of access to medical care for other conditions (I personally know of two people in this category in 2021 already). As Nick Trickett points out, demographic effects have economic and social implications.

While I telegraphed in earlier posts that the main thing in Russia was the (in)coherence of the state’s response to Covid, what I failed to account for was the very thing I’m working on in a side project: the complex nature of trust and distrust among Russians towards the state. Now, as I said, hesitancy is decaying strongly everywhere, and Russia is like in France in that respect – high initial hesitancy now falling. However, when people tell me they won’t get jabbed, they all say different things, but digging down and pressing them, they all express a desire to make their own choices, avoid being forced into doing something that might be risky/unnecessary/a hassle.

I quote (nenormativnaia leksika!):

‘The Russian state gives me nothing. If it suddenly wants me to do something: fuck them on principle!’

‘The state cannot organise an adequate response to basic things like potholes and recycling. Suddenly in a short time they made a safe vaccine? There must be something dodgy about the jab.’

‘I don’t want any shit in my arm that comes from god-knows-where – some shithole [mukhosransk] beyond the Urals and tested in a hurry on monkeys.’

‘You know, when I try to get something simple done like a passport renew it’s such a pain in the arse. Just the thought of interacting with a vaccine centre reminds me of all the crap one has to go through with our state. I don’t want to do it. Why should I have to! I don’t want to have anything to do with them if I can help it’

‘The boss wants us all to get it, but he’s afraid of us quiting. I’m not going to do it. We all got sick last winter and have anti-bodies. Why the hell should I do something that’s unnecessary like that?’

I know I am like a stuck record on this, but vaccine hesitancy at least partly reflects one of my core themes – the paradox of Russians’ view of the state: on the one hand, many want a socially interventionist state that protects them from harm (and protects them from the more coercive parts of the state itself!). On the other, they know its limitations, and moreover, they know too well the potential dangers of interacting with what is a fickle and rather callous bureaucratic machine (perhaps no more so than many Western states, if we’re honest).

To wrap up, here’s an interesting study that among other things compares hesitancy between the USA and Russia. Some things of note: hesitancy was higher in Russia (to January 2021) than the USA, and higher than in some other middle-income countries. Russian women especially were hesitant in comparison with US women (so were Russian men, but the baseline hesitancy for women was worse). Educated Russians were just as hesitant as others, whereas in the US there’s a pronounced difference depending on education.

Perhaps even more interestingly, when we get to survey data explaining the hesitancy, it’s noticeable that there is a lack of data in the data about ‘why’ people are hesitant. In contrast to the USA, where side effects are feared, Russians fail to give an unequivocal ‘why’ response. As readers will know, I would argue this is an artefact of the methodological shortcomings of surveys themselves. But it’s also about how rejection (not hesitancy) of the vaccine reflects complex feelings and rationalisations that are hard to articulate and which have multiple causes.  Even for the US, rejection in 50% of cases is due to ‘other issues’. On the other hand, for Russians, “family and friends” are key positive motivators for moving from rejection to acceptance.

What’s not captured in this survey data is the problem of hesitancy among health workers being transmitted to lay persons – a clear problem in Russia. High uptake requires the continual maintenance of ‘social proof’ of vaccine safety and efficacy. At the moment, some health workers as well as the ordinary ‘rejecters’ make the achievement of a high threshold of take-up a far from foregone conclusion.  

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