A pandemic occurs when an infectious disease unexpectedly becomes prevalent across a large part of the world. Trends such as globalization, climate change, land use due to population growth, drug resistant bacteria, and new challenges in coordinated efforts to control common vectors all contribute to increased risk of pandemics in the future (Piret & Boivin, 2021). Given the biological (e.g., evolution and adaptation of bacterial or viral sources) and unpredictable origins of pandemics, they are often seen as inevitable events that happen to a society. However, institutions and individuals can take actions to prevent, prepare, and respond to pandemics. Research published during the COVID-19 pandemic has illuminated the unique ways that individual personality traits are related to behaviors that help mitigate and slow the spread of pandemic illness.

Governments and institutions can facilitate primary research in disciplines such as preventative medicine, virology, epidemiology, genetics, and pharmaceuticals; implementation of vector control and disease surveillance programs; and public health and safety measures (e.g., regulatory actions to close public spaces, stay-at-home orders, limit gatherings etc.). These efforts can help increase the preparedness of a society to delay the spread, control, and even curtail disease in a pandemic. Generally, greater levels of stringency of government or institutional pandemic mitigation efforts will slow the rate of infection spread and reduce stress on institutional systems, increasing the ability to save lives.

However, centralized mitigation efforts will also have significant positive (e.g., less industrial pollution) and negative (e.g., poorer educational outcomes for students and reduced economic production) secondary impacts to societies. For example, in their October 2021 World Economic Outlook report, the International Monetary Fund reported -3.1% gross domestic product in 2020, lower growth than at any other year in the last six decades. Taken together, the secondary impacts make it impractical to sustain the most stringent preventative measures for extended periods of time. For that reason, there is a relatively more balanced approach that some societies prefer for long-term mitigation efforts: one that does not completely shut down and instead allows a “new normal” level of activities while entrusting individuals to adhere to public health advice to protect themselves and others.

Individual behavior and adherence to recommended public health preventative actions such as sheltering in place, hand washing, and vaccine adoption are important factors for society to slow the pace of infection and lower hospitalizations and deaths during a pandemic. Certainly, there are many factors that impact whether an individual is likely to follow the recommended actions, such as access to personal protection equipment, socioeconomic status, health care needs, gender, and age. For example, the ability to shelter in place will depend on the person’s access to food delivery and whether they require in-person health treatment.

Beyond these very practical considerations, recent research during the COVID pandemic provides insights into how individual differences in personality also provide unique insight into individual compliance with public health advice during a pandemic. These are important considerations for individuals and policy makers alike, enabling a better understanding of the how the persistent thoughts, feelings and behaviors of friends, family, and neighbors is related to their willingness to adhere to public health measures (e.g., their ability to adapt to a “new normal” responsibly). This understanding can help to increase the effectiveness of communications and outreach during a pandemic, influence public health behavior, and ultimately increase health outcomes for communities.

When disease transmission occurs through everyday interactions with other people, one way to limit the spread of infection is to implement rules encouraging people to not travel away from home, sheltering in place. An individual’s willingness to adhere to this restriction will depend on many factors, including external pressures such as the level of stringency of the rule (e.g., expansiveness of the public closures and limits on travel and penalties for violation) and how personal prepared they are physically, financially, socially, and psychologically to shelter in place for an extended period.

COVID-19 is a disease transmitted via small particles in the air, highly contagious in everyday settings, and as a result many governments issued varying levels of restriction or guidance for sheltering in place as a method to prevent broad exposure. To understand the impact of individual personality to adherence with these rules, Götz et al. (2020) analyzed results from over 100,000 participants comparing their adherence with sheltering in place rules relative to personality traits after controlling for socioeconomic factors.

Unsurprisingly, extraversion was found to be a significant negative predictor of sheltering in place. Extraverts prefer social interaction and engaging with the external world so, even when the reason is to protect oneself and others, being pressured to stay indoors in one location is inherently more difficult.

Openness, Conscientiousness, Agreeableness, and Neuroticism are all related to higher likelihood of sheltering in place, with openness displaying the largest effect size, which is interesting given the fact that openness is associated with adventurous and sometimes risky behaviors like drug use and abuse. In this context, it is possible that other aspects of openness such as receptivity to new ideas and an appreciation for more liberal politics – which are often associated with more positive attitudes towards government involvement in public health - are more pronounced in the context of a novel pandemic.

That agreeableness and conscientiousness are found as positively related to adherence to sheltering in place guidelines is unsurprising: these traits are associated with concern for others, social harmony, and self-discipline. However, it is surprising that neuroticism is aligned with adherence with shelter in place policies, as this trait is often associated with lower self-control and higher rates of antisocial behavior. Possible explanations include that high anxiety, fear of the disease threat, and a sense of vulnerability may be triggered in a pandemic and cause individuals who are relatively less emotionally stable to respond by taking protective actions that are aligned with shelter in place guidelines.

In terms of personality traits within populations, large-scale studies (Johnson, 2014) indicate that about 32% of people have trait configurations that are aligned with an overall net positive combination of low extraversion, high openness, high conscientiousness, high agreeableness, and high neuroticism which would indicate a relatively strong association with sheltering in place. Trait configurations with net neutral or negative association to sheltering in place are about 36% and 32%, respectively.

If someone is going to be around others during a pandemic that can be easily spread via droplets through the air, masking is another preventative measure that can reduce the risk of person-to-person transmission of a disease. If the associated disease has a significant incubation period, during which it can be spread by someone who does not show symptoms (estimated at 6.38 days for COVID-19 according to Elias et al., 2021) then masking is especially helpful.

However, the practice only works when people don them. One study in the US indicated that voluntary mask wearing behavior, where health authorities recommended that individuals wear masks in public, observed that 41.5% of people followed this advice (Haischer, 2020). Demographically, females, those who are in urban and suburban areas (versus rural), and older people were more likely to wear masks voluntarily. When mask mandates were then put into place, compliance increased to over 90% in all groups. However, there was still a group of about 4% that resisted the requirement to wear masks. Observations such as this indicate that voluntary masking is quite low in some communities and that compliance is also challenged by some even with a public masking requirement, prompting the question what distinguishes people who are willing to wear a mask to protect themselves and others in a pandemic.

Several studies have been conducted to understand how personality traits are related to masking. The most common finding indicates that individuals higher in agreeableness are more likely to voluntarily don masks to protect themselves and others as well as comply with mask mandates (Rothwell, 2021; Wilroth et al., 2021). This makes sense in consideration that highly agreeable people are generally compassionate, altruistic, and cooperative. Masking is something that they can do to help others stay healthy.

Openness has also found to be positively related to masking behavior, which in this context (e.g., the studies took place in regions that had not experienced pandemic conditions in recent history) may have to do with the novelty of the situation and the political environment (Milad & Bogg, 2021; Heyman, 2021). Also, individuals high in openness are more likely to react positively, proactively, and adapt to new situations, adopting novel approaches to health and safety more readily. They tend also to be more liberal in their political views with relatively more malleable social values that can evolve based on new information and ideas, such as the need to change daily behavior during a pandemic. Given the trend in many countries towards politicization of social issues such as masking, this association between openness, liberal political ideology, and messaging from liberal politicians about the importance of masking may be self-reinforcing.

In terms of personality traits within populations, about 25% of people have trait configurations that are aligned with an overall net positive combination of high openness or high agreeableness, which would indicate a relatively strong association with masking behavior. Trait configurations with net neutral or negative association to masking are about 50% and 25%, respectively.

Equitable distribution and adoption of vaccines are among the most effective public health tools to end a pandemic (The World Health Organization, 2021). Widespread vaccination enables a safer path to broad immunity to the disease, ending its ability to transmit effectively within a population. For COVID-19, that herd immunity threshold is estimated at around 67% of the population (Randolph & Barreiro, 2020). Emergency use of some effective COVID-19 vaccines became available in as early as December 2020 with full authorizations following in mid-2021.

However, the rate of people eligible to vaccinate who were willing to accept the vaccination varied greatly by location, demographic, and across time (Sallam, 2021 & Solís Arce, 2021), resulting in slower immunity rates through vaccination and more time for the disease to proliferate. Vaccine adoption and acceptance refer to people who either passively or actively seek to receive a vaccination. Vaccine hesitancy and resistance refers to a situation where someone is unsure or against vaccination. Some of the more common reasons cited for vaccine hesitancy and resistance include concern about side effects, perception that there is low risk of serious illness from the disease, and belief that the efficacy of the vaccines is low. Understanding the reasons for hesitancy, including associated individual characteristics, have important implications for policies such as where and when to deliver vaccines to people who will use them as well as public health messaging to increase vaccine adoption rates.

Preliminary findings from several studies in the context of COVID-19 vaccine provide insight into personality traits that may be associated with vaccine hesitancy and resistance. The most consistent findings so far are that higher neuroticism and lower agreeableness appear to be related to greater hesitancy and resistance. Likewise, people who are lower in neuroticism and higher in agreeableness are more likely to be accepting of the vaccine (Moffitt et al., 2022; Murphy et al., 2021; and Rothwell, 2021).

There are several possible reasons for the finding that higher neuroticism is related to greater vaccine hesitancy. Facets of neuroticism include anxiety and vulnerability which can result in individuals being less trustworthy of experts and institutions, which could result in a relatively skeptical interpretation of public health advise. Another related facet is anger, which may result in a shutdown of information processing if that information is perceived to conflict with their held beliefs and attitudes. It could also result in an individual attempting to avoid negative emotions and seeking information that does not challenge their held understanding of issues. More generally, high neuroticism is also linked to lower verbal fluency which may also result in slower uptake and processing of vaccine-related information.

The relationship between higher agreeableness and an increased vaccine acceptance and adoption may be related to similar altruistic mechanisms that have been discussed above for other public health related behaviors. People who are agreeable are more likely to trust the advice of public health officials; seek to act in the interest of others around them; and work through differences to seek cooperative problem-solving opportunities that benefit all. An agreeable person will sincerely want to help take action to improve the welfare of their community in the face of a pandemic. If they are skeptical of the efficacy or risks of vaccination then they will error on the side of trusting their local health experts and heed their advice.

In terms of personality traits within populations, about 24% of people have trait configurations that are aligned with an overall net positive combination of low neuroticism or high agreeableness, which would indicate a relatively stronger associations with vaccine acceptance or adoption. Trait configurations with net neutral or more negative association to vaccine adoption are about 51% and 25%, respectively.

Overall, adherence to public health advice during pandemics is driven by many practical considerations, including: healthcare and economic support, access to personal protective equipment and approved vaccines, and access to a source for trusted health advice who can answer questions. While these enabling factors create conditions where people can adhere to public health advice, information on individual personality adds important insights into how persistent thoughts, feelings, and actions are related to ones’ receptivity, follow-through, and adherence to pandemic-related health measures.

These insights can inform policy and outreach strategies to improve a societies ability to respond to pandemic health needs. For example, to avoid the worst health outcomes (e.g., overloading healthcare systems), speed of public adoption of pandemic-related health measures is critical and certain personality traits are associated with people who are more likely to respond quickly without the need to invest time and attention to convince them that the benefits outweigh the costs of adoption.

Three health measures were reviewed in this article: sheltering in place, masking, and vaccine acceptance and adoption. Neuroticism has been found to have mixed association with those higher in the trait more likely to shelter in place, but less likely to accept the vaccine. Lower extraversion is associated with a greater likelihood to shelter in place. Openness was associated with higher levels of sheltering in place and masking. Agreeableness has been consistently found as being related to uptake on all pandemic health measures. Finally, conscientiousness is associated with higher rates of sheltering in place. The table below illustrates the relationship of each trait to the three pandemic health measures discussed in this article.

Agreeableness and openness stand out as being particularly associated with adherence to pandemic-related public health measures. Given that agreeableness is defined as concern for others, altruistic behavior, and cooperation it makes sense that this trait would align well with taking actions to protect others who may be at high risk from disease, even at the cost of inconvenience, lifestyle changes, or minor risks to themselves. The association of adherence to these health measures with the trait of openness is less clear but may be related to ones’ increased ability to adapt to new circumstances and values in a changing environment; interest in seeking, receiving, and processing complex public health information; and willingness to engage in new behaviors.

Ongoing trends of climate change, globalization, increased contact between humans and wildlife, and pathogenic resistances point to increased risks of future pandemics. The time and place of any pandemic is unpredictable, so it is important for all societies to coordinate together and prepare themselves for resiliency by building an interconnected infrastructure to proactively monitor for potential pandemic events and to enable quick response to prevent and slow transmissions as well as provide medical care when they inevitably occur. Beyond these structural and programmatic resiliency measures, having the ability to engage effectively with and help the public to guide their understanding in the importance of measures such as social distancing, masking, and vaccinating will be critical to avoid the need to shutdown normal lifestyles while protecting the health of as many people as possible. Understanding the dynamics of personality and its associations with adherence to public health practices should inform future outreach and educational efforts to effectively engage with and prepare people for the “new normal”.