Abstract
Research has shown that building public trust in institutions contributes to vaccine confidence. However, this association has not been validated in the cross-cultural context, which requires retesting using a larger, and more representative cross-cultural sample and considering potential moderating factors, such as sociocultural context. Using a large sample from Gallup (involving 102,156 participants from 134 countries), we explored the link of institutional trust and vaccine confidence in a global context, and the role of cultural religiosity and individualism in this relationship. Individual-level institutional trust and vaccine confidence were measured using respective Gallup data. Country-level cultural religiosity scores were used to capture the sociocultural context, while Hofstede’s individualism scores reflected the societal inclination towards individual or collective orientation. The results of the multilevel analyses found that institutional trust positively correlates with vaccine confidence on the global scale. Furthermore, the benefits of institutional trust on vaccine confidence is weaker in more religious or individualistic countries. We also identified several individual and cross-country characteristics that influence vaccine confidence, such as age, income, Gini coefficient, and uncertainty avoidance. These findings reveal the influence of individual factors on vaccine confidence and emphasize the importance of understanding the interaction of personal factors with sociocultural context.
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References
Adamus, M., Čavojová, V., & Mikušková, E. B. (2022). Fear trumps the common good: Psychological antecedents of vaccination attitudes and behaviour. Acta Psychologica, 227. https://doi.org/10.1016/j.actpsy.2022.103606
Badur, S., Ota, M., Öztürk, S., Adegbola, R., & Dutta, A. (2020). Vaccine confidence: The keys to restoring trust. Human Vaccines & Immunotherapeutics, 16(5), 1007–1017. https://doi.org/10.1080/21645515.2020.1740559
Bagasra, A. B., Doan, S., & Allen, C. T. (2021). Racial differences in institutional trust and COVID-19 vaccine hesitancy and refusal. Bmc Public Health, 21(1). https://doi.org/10.1186/s12889-021-12195-5
Bavel, J. J. V., Baicker, K., Boggio, P. S., Capraro, V., Cichocka, A., Cikara, M., Crockett, M. J., Crum, A. J., Douglas, K. M., Druckman, J. N., Drury, J., Dube, O., Ellemers, N., Finkel, E. J., Fowler, J. H., Gelfand, M., Han, S., Haslam, S. A., Jetten, J., Kitayama, S., et al. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour, 4(5), 460–471. https://doi.org/10.1038/s41562-020-0884-z
Bourdin, S., Tuzcu, S. E., & Satıcı, E. (2023). Explaining COVID-19 vaccine uptake: A spatial sociodemographic study in Turkey. Papers in Regional Science, 102(2), 307–329. https://doi.org/10.1111/pirs.12723
Bovan, K., Baketa, N., Kovačić, M., & Čorkalo Biruški, D. (2022). Trust us, we know what we are doing: Institutional trust in Croatia during the COVID-19 crisis. Southeast European and Black Sea Studies, 22(3), 381–402. https://doi.org/10.1080/14683857.2022.2044670
Caroli, E., & Weber-Baghdiguian, L. (2016). Self-reported health and gender: The role of social norms. Social Science & Medicine, 153, 220–229. https://doi.org/10.1016/j.socscimed.2016.02.023
Chen, X., Lee, W., & Lin, F. (2022). Infodemic, institutional trust, and COVID-19 vaccine hesitancy: A cross-national survey. International Journal of Environmental Research and Public Health, 19(13). https://doi.org/10.3390/ijerph19138033
Chumakov, K., Avidan, M. S., Benn, C. S., Bertozzi, S. M., Blatt, L., Chang, A. Y., Jamison, D. T., Khader, S. A., Kottilil, S., Netea, M. G., Sparrow, A., & Gallo, R. C. (2021). Old vaccines for new infections: Exploiting innate immunity to control COVID-19 and prevent future pandemics. Proceedings of the National Academy of Sciences, 118(21), Article e2101718118. https://doi.org/10.1073/pnas.2101718118
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
Cook, T. E., & Gronke, P. (2005). The skeptical american: Revisiting the meanings of trust in government and confidence in institutions. The Journal of Politics, 67(3), 784–803. https://doi.org/10.1111/j.1468-2508.2005.00339.x
Croucher, S. M., Murray, N., Ashwell, D., Cullinane, J., & Nguyen, T. (2022). Predicting vaccine confidence: Patient self-advocacy and fear of COVID-19 in the United States. Southern Communication Journal, 87(4), 348–360. https://doi.org/10.1080/1041794X.2022.2099569
Dal, A., & Tokdemir, E. (2022). Social-psychology of vaccine intentions: The mediating role of institutional trust in the fight against COVID-19. Political Behavior, 44(3), 1459–1481. https://doi.org/10.1007/s11109-022-09793-3
Eriksson, K., & Vartanova, I. (2022). Vaccine confidence is higher in more religious countries. Human Vaccines & Immunotherapeutics, 18(1), 1–3. https://doi.org/10.1080/21645515.2021.1883389
Fan, G., Song, H., Yip, S., Zhang, T., & He, D. (2022). Impact of low vaccine coverage on the resurgence of COVID-19 in Central and Eastern Europe. One Health, 14, 100402. https://doi.org/10.1016/j.onehlt.2022.100402
Fox, A., Choi, Y., Lanthorn, H., & Croke, K. (2022). Does highlighting COVID-19 disparities reduce or increase vaccine intentions? Evidence from a survey experiment in a diverse sample in New York State prior to vaccine roll-out. PLoS One, 17(12). https://doi.org/10.1371/journal.pone.0277043
Garrison, A., Fressard, L., Mitilian, E., Gosselin, V., Berthiaume, P., Casanova, L., Gagneur, A., & Verger, P. (2023). Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants. Human Vaccines & Immunotherapeutics, 19(1). https://doi.org/10.1080/21645515.2022.2163809
Gebauer, J. E., & Sedikides, C. (2021). Cultural religiosity: A neglected but powerful dimension of culture. Current Opinion in Psychology, 40, 73–78. https://doi.org/10.1016/j.copsyc.2020.08.027
Gewirtz-Meydan, A., Mitchell, K., Shlomo, Y., Heller, O., & Grinstein-Weiss, M. (2022). COVID-19 among youth in Israel: Correlates of decisions to vaccinate and reasons for refusal. Journal of Adolescent Health, 70(3), 396–402. https://doi.org/10.1016/j.jadohealth.2021.11.016
Goel, R. K., Nelson, M. A., & Goel, V. Y. (2021). COVID-19 vaccine rollout—scale and speed carry different implications for corruption. Journal of Policy Modeling, 43(3), 503–520. https://doi.org/10.1016/j.jpolmod.2021.04.003
Greyling, T., & Rossouw, S. (2022). Positive attitudes towards COVID-19 vaccines: A cross-country analysis. PLoS One, 17(3). https://doi.org/10.1371/journal.pone.0264994
Haldane, V., Ariyarajah, A., Berry, I., Loutet, M., Salamanca-Buentello, F., & Upshur, R. E. G. (2023). Global inequity creates local insufficiency: A qualitative study of COVID-19 vaccine implementation challenges in low-and-middle-income countries. PLoS One, 18(2). https://doi.org/10.1371/journal.pone.0281358
Hofstede, G. (1984). Cultural dimensions in management and planning. Asia Pacific Journal of Management, 1(2), 81–99. https://doi.org/10.1007/BF01733682
Hofstede, G., Hofstede, G. J., & Minkov, M. (2010). Cultures and organizations: Software of the mind: Intercultural cooperation and its importance for survival (3rd ed.). McGraw-Hill.
Hotez, P. J., Batista, C., Amor, Y. B., Ergonul, O., Figueroa, J. P., Gilbert, S., Gursel, M., Hassanain, M., Kang, G., Kaslow, D. C., Kim, J. H., Lall, B., Larson, H., Naniche, D., Sheahan, T., Shoham, S., Wilder-Smith, A., Sow, S. O., Strub-Wourgaft, N., Yadav, P., et al. (2021). Global public health security and justice for vaccines and therapeutics in the COVID-19 pandemic. eClinicalMedicine, 39. https://doi.org/10.1016/j.eclinm.2021.101053
Islam, M. S., Kamal, A. H. M., Kabir, A., Southern, D. L., Khan, S. H., Hasan, S. M. M., Sarkar, T., Sharmin, S., Das, S., Roy, T., Harun, M. G. D., Chughtai, A. A., Homaira, N., & Seale, H. (2021). COVID-19 vaccine rumors and conspiracy theories: The need for cognitive inoculation against misinformation to improve vaccine adherence. PLoS One, 16(5). https://doi.org/10.1371/journal.pone.0251605
Jain, J., Saurabh, S., Kumar, P., Verma, M. K., Goel, A. D., Gupta, M. K., Bhardwaj, P., & Raghav, P. R. (2021). COVID-19 vaccine hesitancy among medical students in India. Epidemiology & Infection, 149. https://doi.org/10.1017/S0950268821001205
Jamison, A. M., Quinn, S. C., & Freimuth, V. S. (2019). You don’t trust a government vaccine”: Narratives of institutional trust and influenza vaccination among african american and white adults. Social Science & Medicine, 221, 87–94. https://doi.org/10.1016/j.socscimed.2018.12.020
Joshanloo, M., & Gebauer, J. E. (2020). Religiosity’s nomological network and temporal change. European Psychologist, 25(1), 26–40. https://doi.org/10.1027/1016-9040/a000382
Karafillakis, E., & Larson, H. J. (2017). The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in european populations. Vaccine, 35(37), 4840–4850. https://doi.org/10.1016/j.vaccine.2017.07.061
Kobau, R., Carry, M., Rubenstein, B. L., Denson, D., Uribe, C., Zajac, J., Kidder, D. P., Peacock, G., & Abad, N. (2022). Implementing the COVID-19 rapid community assessment on vaccine confidence: Lessons learned from Alabama and Georgia. Public Health Reports, 137(5), 832–840. https://doi.org/10.1177/00333549221112610
Larson, H. J. (2016). Vaccine trust and the limits of information. Science, 353(6305), 1207–1208. https://doi.org/10.1126/science.aah6190
Larson, H. J., Cooper, L. Z., Eskola, J., Katz, S. L., & Ratzan, S. (2011). Addressing the vaccine confidence gap. The Lancet, 378(9790), 526–535. https://doi.org/10.1016/S0140-6736(11)60678-8
Larson, H. J., Jarrett, C., Eckersberger, E., Smith, D. M. D., & Paterson, P. (2014). Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine, 32(19), 2150–2159. https://doi.org/10.1016/j.vaccine.2014.01.081
Larson, H. J., Schulz, W. S., Tucker, J. D., & Smith, D. M. (2015). Measuring vaccine confidence: Introducing a global vaccine confidence index. PLoS Currents, 7, 1–22. https://doi.org/10.1371/currents.outbreaks.ce0f6177bc97332602a8e3fe7d7f7cc4
Larson, H. J., de Figueiredo, A., Xiahong, Z., Schulz, W. S., Verger, P., Johnston, I. G., Cook, A. R., & Jones, N. S. (2016). The state of vaccine confidence 2016: Global insights through a 67-country survey. eBioMedicine, 12, 295–301. https://doi.org/10.1016/j.ebiom.2016.08.042
Larson, H. J., Clarke, R. M., Jarrett, C., Eckersberger, E., Levine, Z., Schulz, W. S., & Paterson, P. (2018). Measuring trust in vaccination: A systematic review. Human Vaccines & Immunotherapeutics, 14(7), 1599–1609. https://doi.org/10.1080/21645515.2018.1459252
Lazarus, J. V., Ratzan, S. C., Palayew, A., Gostin, L. O., Larson, H. J., Rabin, K., Kimball, S., & El-Mohandes, A. (2021). A global survey of potential acceptance of a COVID-19 vaccine. Nature Medicine, 27(2), 225–228. https://doi.org/10.1038/s41591-020-1124-9
Lipps, J., & Schraff, D. (2021). Regional inequality and institutional trust in Europe. European Journal of Political Research, 60(4), 892–913. https://doi.org/10.1111/1475-6765.12430
Lu, J. G. (2023). Two large-scale global studies on COVID-19 vaccine hesitancy over time: Culture, uncertainty avoidance, and vaccine side-effect concerns. Journal of Personality and Social Psychology, 124(4), 683–706. https://doi.org/10.1037/pspa0000320
Pertwee, E., Simas, C., & Larson, H. J. (2022). An epidemic of uncertainty: Rumors, conspiracy theories and vaccine hesitancy. Nature Medicine, 28(3), 456–459. https://doi.org/10.1038/s41591-022-01728-z
Raude, J., Fressard, L., Gautier, A., Pulcini, C., Peretti-Watel, P., & Verger, P. (2016). Opening the ‘Vaccine Hesitancy’ black box: How trust in institutions affects french GPs’ vaccination practices. Expert Review of Vaccines, 15(7), 937–948. https://doi.org/10.1080/14760584.2016.1184092
Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed., 1 vol.). SAGE Publications.
Rozek, L., Jones, P., Menon, A., Hicken, A., Apsley, S., & King, E. (2021). Understanding vaccine hesitancy in the context of COVID-19: The role of trust and confidence in a seventeen-country survey. International Journal of Public Health, 66, 636255. https://doi.org/10.3389/ijph.2021.636255
Scherer, L. D., Shaffer, V. A., Patel, N., & Zikmund-Fisher, B. J. (2016). Can the vaccine adverse event reporting system be used to increase vaccine acceptance and trust? Vaccine, 34(21), 2424–2429. https://doi.org/10.1016/j.vaccine.2016.03.087
Schulte, J., Schmidt-Sane, M., Benninger, E., Hrynick, T., & Ripoll, S. (2022). COVID-19 vaccine hesitancy among minoritised youth in Cleveland, Ohio, United States. Social Science in Humanitarian Action Platform. https://doi.org/10.19088/SSHAP.2022.009
Shah, A., & Coiado, O. C. (2023). COVID-19 vaccine and booster hesitation around the world: A literature review. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.1054557
Sturgis, P., Brunton-Smith, I., & Jackson, J. (2021). Trust in science, social consensus and vaccine confidence. Nature Human Behaviour, 5(11), 1528–1534. https://doi.org/10.1038/s41562-021-01115-7
Szilagyi, P. G., Thomas, K., Shah, M. D., Vizueta, N., Cui, Y., Vangala, S., Fox, C., & Kapteyn, A. (2021). The role of trust in the likelihood of receiving a COVID-19 vaccine: Results from a national survey. Preventive Medicine, 153, 106727. https://doi.org/10.1016/j.ypmed.2021.106727
Troiano, G., & Nardi, A. (2021). Vaccine hesitancy in the era of COVID-19. Public Health, 194, 245–251. https://doi.org/10.1016/j.puhe.2021.02.025
Webb Hooper, M., Nápoles, A. M., & Pérez-Stable, E. J. (2021). No populations left behind: Vaccine hesitancy and equitable diffusion of effective COVID-19 vaccines. Journal of General Internal Medicine, 36(7), 2130–2133. https://doi.org/10.1007/s11606-021-06698-5
Wellcome, T., & Gallup. (2019). &. Wellcome global monitor 2018. https://doi.org/10.5255/UKDA-SN-8466-2
Westjohn, S. A., Magnusson, P., Franke, G. R., & Peng, Y. (2022). Trust propensity across cultures: The role of collectivism. Journal of International Marketing, 30(1), 1–17. https://doi.org/10.1177/1069031x211036688
Wheelock, A., & Ives, J. (2022). Vaccine confidence, public understanding and probity: Time for a shift in focus? Journal of Medical Ethics, 48(4), 250–255. https://doi.org/10.1136/medethics-2020-106805
Williams, N. L., Nguyen, T. H. H., Del Chiappa, G., Fedeli, G., & Wassler, P. (2022). COVID-19 vaccine confidence and tourism at the early stage of a voluntary mass vaccination campaign: A PMT segmentation analysis. Current Issues in Tourism, 25(3), 475–489. https://doi.org/10.1080/13683500.2021.1963216
World Bank (2022). DataBank. http://databank.worldbank.org
Xiao, C., & McCright, A. M. (2015). Gender differences in environmental concern: Revisiting the institutional trust hypothesis in the USA. Environment and Behavior, 47(1), 17–37. https://doi.org/10.1177/0013916513491571
Yaqub, O., Castle-Clarke, S., Sevdalis, N., & Chataway, J. (2014). Attitudes to vaccination: A critical review. Social Science & Medicine, 112, 1–11. https://doi.org/10.1016/j.socscimed.2014.04.018
Zheng, W. (2023). Cultural religiosity moderates the relationship between trust and altruism: A study in 64 countries. Current Psychology Advance online publication. https://doi.org/10.1007/s12144-023-04333-6
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Zheng, W. Multilevel evidence for institutional trust and vaccine confidence in 134 countries: moderating effects of cultural religiosity and individualism. Curr Psychol 43, 18898–18907 (2024). https://doi.org/10.1007/s12144-023-05067-1
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DOI: https://doi.org/10.1007/s12144-023-05067-1