# Spirituality, Conspiracy Beliefs, and Use of Complementary Medicine in Vaccine Attitudes: A Cross-Sectional Study in Northern Italy

## TL;DR

This study explores how spirituality and beliefs in conspiracies affect attitudes toward vaccines in Northern Italy, finding that higher spirituality is linked to greater perceived vaccine harm.

## Contribution

The study introduces a novel mediation model linking spirituality, CAM use, and conspiracy beliefs to vaccine perceptions.

## Key findings

- Higher experiential spirituality correlates with increased perceived harmfulness of vaccines.
- Spirituality and CAM use are linked to conspiracy thinking but not directly to institutional distrust.
- Spirituality indirectly influences vaccine perceptions through CAM use and conspiracy beliefs.

## Abstract

Distinct spiritual attitudes and convictions may promote scepticism towards medical interventions, potentially influencing vaccine attitudes. This study investigated the impact of spirituality and CAM (complementary and alternative medicine) use on perceptions of vaccine harmfulness, with a focus on COVID-19 and mandatory childhood vaccinations. Additionally, it examines whether spirituality indirectly influences vaccine hesitancy through CAM use and beliefs in conspiracies. A cross-sectional probability-based survey was conducted with over 1300 participants from South Tyrol, Italy, in 2023, using the GrAw-7 (Gratitude/Awe) scale as a measure of the experiential aspect of non-religious spirituality. Statistical analysis encompassed Spearman’s correlation and linear regression to assess the associations between spirituality and vaccine perceptions. A mediation model was applied to evaluate the role of spirituality in shaping attitudes towards vaccination. Higher experiential spirituality was associated with increased perceived harmfulness of COVID-19 and mandatory childhood vaccinations. Spirituality as well as perceived harmfulness of COVID-19 vaccination and mandatory childhood vaccination were correlated with age, increased CAM utilisation and conspiracy ideation, while institutional distrust was solely associated with vaccine scepticism but not with spirituality; well-being and altruism were only associated with spirituality. Mediation analysis revealed that experiential spirituality accounted for a modest but significant portion of the influence of CAM use and conspiracy thinking on vaccine perceptions. Experiential spirituality may indirectly influence vaccine perception by affecting CAM use and conspiracy thinking. Public health initiatives should incorporate spiritual beliefs and convictions into communication strategies and present vaccinations as a community responsibility. Engaging spiritual and community leaders can enhance the acceptance of vaccines among spiritually inclined groups.