political, economic, and social determinants of the covid-19 vaccination rate with focus on institutional quality and human development: a finite mixture approach

Introduction: although immunization against covid-19 is one of the most effective strategies to control the pandemic, political, economic, and social determinants play a vital role in improving vaccine access and vaccination rates across countries. the present study aimed to investigate the roles of political, economic, and social determinants in the performance of countries facing the covid-19covid-19 pandemic, focusing on institutional quality and human development. methods: the required data were gathered from international organizations’ databases. after descriptive and correlation analysis, finite mixture model (fmm) was used for estimation of the effect of institutional quality (iq), human development index (hdi), and other control variables (government health expenditure percentage of total health expenditure (ghe%the), logarithmic gross domestic production (lgdp) and unemployment rate (ur)) on the covid-19 complete vaccination (cfv). the researchers’ assumption in using fmm was that cfv had different dimensions and heterogeneity, and hdi had one observed dimension and several unobserved ones, which could better explain cfv heterogeneity than other explanatory variables. stata 17 was used for model estimation. results: in the first class estimation of the fmm model, coefficients of iq (γ1=0.1458, p=0.000), ghe%the (μ1,1=0.2761, p=0.009), and lgdp (μ1,2=0.0586, p=0.014) were significantly positive, and ur (μ1,3=-.0124, p=0.000) was significantly negative. moreover, class-two estimation showed a significant effect of hdi on cfv (δ2=63.0537, p=0.009). there is also a significant and positive relationship between cfv and iq (γ2=0.1199, p=0.000), ghe%he (μ2,1=0.27085, p=0.002), and lgdp (μ2,2=0.0559, p=0.000) and ur (μ2,3=0.0169, p=0.000). conclusion: countries with high human development and better institutional quality (voice and accountability, control of corruption, political stability and absence of violence/terrorism, rule of law, regulatory quality, and government effectiveness) reported higher vaccination rates. in other words, political, economic, and social determinants played a significant role in the performance of health systems amid critical conditions, such as the pandemic, particularly in access to vaccines and vaccination rates against covid-19.