Abstract

As COVID-19 vaccines are rolled out across the world, there are growing concerns about the roles that trust, belief in conspiracy theories, and spread of misinformation through social media play in impacting vaccine hesitancy. We use a nationally representative survey of 1476 adults in the UK between 12 and 18 December 2020, along with 5 focus groups conducted during the same period. Trust is a core predictor, with distrust in vaccines in general and mistrust in government raising vaccine hesitancy. Trust in health institutions and experts and perceived personal threat are vital, with focus groups revealing that COVID-19 vaccine hesitancy is driven by a misunderstanding of herd immunity as providing protection, fear of rapid vaccine development and side effects, and beliefs that the virus is man-made and used for population control. In particular, those who obtain information from relatively unregulated social media sources—such as YouTube—that have recommendations tailored by watch history, and who hold general conspiratorial beliefs, are less willing to be vaccinated. Since an increasing number of individuals use social media for gathering health information, interventions require action from governments, health officials, and social media companies. More attention needs to be devoted to helping people understand their own risks, unpacking complex concepts, and filling knowledge voids.

Highlights

  • Governments are rapidly mobilising vaccines against COVID-19 [1], with success relying on sufficient uptake; yet there is a rise in vaccine hesitancy, linked to loss of trust, complacency, and misinformation [2,3]

  • The perceived personal threat of COVID-19 and confidence in government handling of the pandemic are associated with greater willingness to be vaccinated

  • We find some support for a relationship between social media use and increased vaccine hesitancy

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Summary

Introduction

Governments are rapidly mobilising vaccines against COVID-19 [1], with success relying on sufficient uptake; yet there is a rise in vaccine hesitancy, linked to loss of trust, complacency, and misinformation [2,3]. COVID-19 is a pandemic, but an ”infodemic” of complex and dynamic information—both factual and incorrect This can generate vaccine hesitancy [8], which the WHO listed as one of the top 10 threats to global health in 2019. A recent survey in England found that those endorsing conspiracy theories were less likely to adhere to government guidelines, and had a general distrust in institutions [12]. Another found a link between trust, conspiratorial beliefs, and vaccine hesitancy [13]. As a sub-hypothesis, we predict that those with higher levels of trust in health institutions and experts will exhibit higher vaccine willingness [11] (H1.1)

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