Outgroup mistrust drives the link between health conspiracy beliefs and vaccine hesitancy across cultures

Abstract

**Author(s):** Salali, GD; Uysal MS; Akpinar, E; Aksu, A; Bozyel, G Introduction: Studies to date have shown a strong correlation between belief in conspiracies and vaccine hesitancy. In this study, we go a step further and examine the pathway underlying the relationship between belief in health conspiracies and scepticism towards vaccines. We propose that conspiracy beliefs are deeply rooted in our tendency to form cultural groups, which throughout human evolution, has facilitated large-scale cooperation. We put forward the hypothesis that mistrust in outgroup members is the main driver of belief in conspiracies leading to vaccine hesitancy. Methods: In a demographically representative cross-cultural survey with over 4500 participants from the UK, US and Turkey, we tested this hypothesis and controlled for several psychological and demographic variables including psychological reactance, belief in science, general mistrust, political orientation, religiosity, sex, age, education and financial satisfaction. Results: Outgroup mistrust was the strongest predictor of belief in health (COVID-19-related) conspiracies across all countries, followed by psychological reactance- intolerance of others telling one what to do and being sceptical of consensus views. Control variables, including belief in science and general mistrust, had much weaker associations with the endorsement of health conspiracies compared to outgroup mistrust. There were considerable differences in the predictors of general conspiracy mentality and health-specific conspiracy beliefs, suggesting that distinct conspiracy beliefs have different psychological pathways. Our mediation analysis revealed that outgroup mistrust contributed to vaccine hesitancy through its association with health conspiracies. Participants in Turkey and the US scored higher on belief in health conspiracies, vaccine hesitancy and outgroup mistrust compared to the participants in the UK. The association between outgroup mistrust - but not reactance and belief in science- and health conspiracies held across countries. Discussion: These findings suggest that cultures exhibiting higher outgroup mistrust are more inclined to believe in health conspiracies and in turn exhibit higher levels of vaccine hesitancy. Considering these findings, we suggest ways to tackle conspiracy beliefs and vaccine hesitancy.