Institutional trust is a distinct construct related to vaccine hesitancy and refusal

Abstract

Background Vaccine hesitancy is driven by a heterogeneous and changing set of psychological, social and historical phenomena, requiring multidisciplinary approaches to its study and intervention. Past research has brought to light instances of both interpersonal and institutional trust playing an important role in vaccine uptake. However, no comprehensive study to date has specifically assessed the relative importance of these two categories of trust as they relate to vaccine behaviors and attitudes. Methods In this paper, we examine the relationship between interpersonal and institutional trust and four measures related to COVID-19 vaccine hesitancy and one measure related to general vaccine hesitancy. We hypothesize that, across measures, individuals with vaccine hesitant attitudes and behaviors have lower trust—especially in institutions—than those who are not hesitant. We test this hypothesis in a sample of 1541 Canadians. Results A deficit in both interpersonal and institutional trust was associated with higher levels of vaccine hesitant attitudes and behaviors. However, institutional trust was significantly lower than interpersonal trust in those with high hesitancy scores, suggesting that the two types of trust can be thought of as distinct constructs in the context of vaccine hesitancy. Conclusions Based on our findings, we suggest that diminished institutional trust plays a crucial role in vaccine hesitancy. We propose that this may contribute to a tendency to instead place trust in interpersonally propagated belief systems, which may be more strongly misaligned with mainstream evidence and thus support vaccine hesitancy attitudes. We offer strategies rooted in these observations for creating public health messages designed to enhance vaccine uptake.

Understanding attitudes and beliefs regarding COVID-19 vaccines among transitional-aged youth with mental health concerns: a youth-led qualitative study

“…Participants who were vaccine hesitant often cited decreased trust in institutions (eg, healthcare organisations, government) and relied increasingly on information from their social networks, a phenomenon which has been characterised in the literature. 34 This adds further evidence to support the notion of vaccine hesitancy being a social phenomenon in addition to, and perhaps to a greater degree than a cognitive one. 34 Vaccine hesitancy raises complex questions about the role of trust, which means that exploring these factors during clinical conversations and when developing targeted interventions to promote vaccines is an important next step in improving vaccine uptake among youth with mental health concerns.…”

“… 34 This adds further evidence to support the notion of vaccine hesitancy being a social phenomenon in addition to, and perhaps to a greater degree than a cognitive one. 34 Vaccine hesitancy raises complex questions about the role of trust, which means that exploring these factors during clinical conversations and when developing targeted interventions to promote vaccines is an important next step in improving vaccine uptake among youth with mental health concerns.…”

Malaria vaccination: hurdles to reach high-risk children

“…To determine the number of vaccines needed to prevent a malaria adverse outcome (VN), the vaccine wastage (VW) rate needs to be factored in as follows: where DF denotes the number of indicated doses, currently set at four for full-immunization. The propensity of VW increases as (a) the geographical distance from the most advantaged urban center (MA) (G D ), (b) the developmental distance from MA (D D ), and (c) institutional mistrust (I M ) increase [ 12 – 14 ], that is, subnationally, . Thus, in case only a national average of VW rate is available, then district- or municipality-level VW rates need to be corrected accordingly depending on their G D , D D , and I M .…”

A systematic approach to microbial forensics

“…Outside Asia, the idea of rigorous civilian lockdowns and mandatory mask wearing was foreign in 2020. The public health messaging about preventive measures met with significant hostility in developed countries [35] and may have contributed an additional layer to conspiracy theories in circulation [36]. The introduction of effective vaccines met with considerable community resistance and may in turn have contributed to selection of virus escape mutants.…”