Perceptions and tolerance of uncertainty: relationship to trust in COVID-19 health information and vaccine hesitancy

Abstract

The COVID-19 crisis has exposed the public to considerable scientific uncertainty, which may promote vaccine hesitancy among individuals with lower tolerance of uncertainty. In a national sample of US adults in May–June 2020, we examined how both perceptions of uncertainty about COVID-19 and trait-level differences in tolerance of uncertainty arising from various sources (risk, ambiguity, and complexity) are related to vaccine hesitancy-related outcomes, including trust in COVID-19 information, COVID-19 vaccine intentions, and beliefs that COVID-19 vaccines should undergo a longer testing period before being released to the public. Overall, perceptions of COVID-19 uncertainty were not associated with trust in information, vaccine intentions, or beliefs about vaccine testing. However, higher tolerance of risk was associated with lower intentions to get vaccinated, and lower tolerance of ambiguity was associated with lower intentions to get vaccinated and preferring a longer period of vaccine testing. Critically, perceptions of COVID-19 uncertainty and trait-level tolerance for uncertainty also interacted as predicted, such that greater perceived COVID-19 uncertainty was more negatively associated with trust in COVID-19 information among individuals with lower tolerance for risk and ambiguity. Thus, although perceptions of uncertainty regarding COVID-19 may not reduce trust and vaccine hesitancy for all individuals, trait-level tolerance of uncertainty arising from various sources may have both direct and moderating effects on these outcomes. These findings can inform public health communication or other interventions to increase COVID-19 vaccination uptake. Supplementary Information The online version contains supplementary material available at 10.1007/s10865-022-00302-9.

Intolerance of Uncertainty and Attitudes towards Vaccination Impact Vaccinal Decision While Perceived Uncertainty Does Not

“…However, as IU is indeed a significant predictor of the majority of our measures, this implies that IU could predict vaccination decisions (i.e., getting vaccinated, having children vaccinated, and recommending the vaccine), regardless of the level of uncertainty perceived in the situation. This is in line with the results of Gillman et al [ 4 ] who concluded in their study, “We found that individual trait-level differences in tolerance of uncertainty were associated with vaccine hesitancy”. A similar pattern was found for attitudes towards vaccination which predicted vaccination decisions, whereas our ANOVAs showed little evidence of differences based on the perceived level of uncertainty (except for recommendations and vaccinating one’s children if one had any).…”

“…The results of this exploratory mediation make sense if we consider IU as a construct closely related to stress and anxiety (i.e., this construct was originally studied in the context of anxiety disorders and has shown strong links with anxiety in studies about the perceived viral threat during a pandemic; [ 10 , 38 ]) and that stress can lead to favorable attitudes towards vaccination [ 39 ]. In addition, a recent study showed that IU was associated with more threat perception and pandemic-related stress, which were associated with more pandemic-related anxiety [ 4 ]. The links between IU and confidence in one’s judgment were also previously studied by Jensen et al [ 29 ] who showed that a high level of IU can be associated with decreasing confidence in decisions across several blocks of decision-making, while a low level of IU is associated with increasing confidence.…”

“…The final choice results from this process, and this choice can be an opinion or an action” [ 2 ]. Many decisions are made in uncertain contexts, that is, a situation where information about the outcome of behavior remains unclear or limited [ 3 , 4 , 5 , 6 ].…”

“…Intolerance of uncertainty (IU) is a variable of primary interest when investigating the impact of uncertainty on decision-making [ 4 ]. IU can be defined as “the tendency of an individual to consider as unacceptable the possibility that a negative event will occur, regardless of the probability of its occurrence” [ 10 , 11 ], as well as “the set of negative and positive psychological responses-cognitive; emotional; and behavioural-provoked by the conscious awareness of ignorance about particular aspects of the world” [ 12 ].…”

“…The COVID-19 case illustrates that pandemic contexts are particularly conducive to the study of the impact of uncertainty on decision-making. This type of situation also makes it possible to study decision-making in relation to traits of interest, such as attitude towards vaccines, which, in the case of COVID-19, reduced the probability of people with negative attitudes towards vaccines being vaccinated [ 28 ], or IU, as previously stated (especially as the lack of studies linking IU and COVID-19 has already been identified [ 4 ]).…”