Gotong royong and COVID-19 vaccination in Indonesia: Linking communal values to collective immunity.

Objective: This study examines the relationship between gotong royong participation and COVID-19 vaccine uptake in Yogyakarta, Indonesia. Study design: Cross-sectional survey. Methods: We conducted a cross-sectional survey of 804 adults across rural and urban subdistricts in Yogyakarta province. The survey assessed COVID-19 vaccination status, engagement in gotong royong activities, and demographic, experiential, and normative factors related to vaccination. Multivariable logistic regression models were used to identify associations between gotong royong involvement and vaccination outcomes. Results: Participation in gotong royong was reported by 44.3 % of respondents, with the most common activity being support and assistance (39.2 %). Among all participants, 10.8 % were unvaccinated, 43.9 % completed the primary series, and 41.8 % had received a booster dose. Individuals involved in gotong royong were less likely to be unvaccinated (5.3 % vs. 15.2 %) and, in multivariable analysis, had significantly higher odds of receiving at least one vaccine dose (OR: 3.41; 95 % CI: 1.78-6.54). They were also more likely to report community encouragement for vaccination, including from religious leaders (55.6 % vs. 40.2 %, P < 0.0001) and peers (83.7 % vs. 77.0 %, P = 0.0027). Conclusions: These findings highlight the importance of aligning vaccination campaigns with culturally embedded social structures. Leveraging communal values and trusted local actors may enhance vaccine uptake in collectivist settings and inform broader strategies for routine immunization and pandemic preparedness.