Trust and Vaccine Hesitancy?

Or what those in power will work on for the next pandemic.

The notion of “trust” has been thrown around rather loosely in the case of COVID. Trust in institutions, trust in the vaccines, trust in science, etc. etc.

Suffice it to say, the idea of trust has been weaponized to an extensive degree, to the point that lacking trust in an institution or concept is akin to losing faith in a religious sense- it’s heretical to not be “trustworthy” of institutions.

And yet, when trust is brought up, it’s never within the context of fleshing out why one may be leery to relegate all of their trust into an individual or organization. Just the mere notion of lacking trust is dangerous.

Throughout COVID, there’s been a few of these so-called “trust” studies which have popped up, especially within the context of COVID vaccines.

They all have the same premise, in which those who do not trust the vaccines or government tend to be on the fringes of society, usually seeking information on online forums and social media rather than the mainstream press.

Essentially, the general intent of these studies are to infer that there are distinct groups of people who are usually hesitant of the COVID vaccines, and they usually carry negative connotations.

As COVID has died down from a lot of the social discourse, and as things continue to return to normal, it’s a bit strange to consider a study on COVID vaccine trust coming out, especially in 2023.

Yet a few weeks ago a study was published in Nature¹ outlining exactly that.

As mentioned, this study is no different than the other studies out there detailing the same narrative, and in general surveys are highly subjective measures of opinion anyways, so these sorts of studies can be easily manipulated to show whatever the researchers wanted.

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In this case, the researchers used data collected from surveys sent out to people in the EU through an organization called Eurofound. Eurofound appears to have sent out 5 surveys pertaining to the pandemic over the course of two years, and it’s the 3rd one in particular in which the question of trust was asked.

The third survey took place within the first quarter of 2021, and encapsulated weekly survey data from over 35,000 EU citizens in relation to topics on trust, including trust in government, trust in police (?), trust in the EU (??), trust in the media, and trust in pharmaceutical companies, and how those relate to the levels of vaccine hesitancy among those surveyed.

The vaccine hesitancy topic is rather interesting, given that the survey took place at a time in which concerns were raised about AstraZeneca’s adenoviral vaccines. Thus, this survey actually adds a rather interesting point to the topic of vaccine safety and efficacy by way of this information.

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Vaccine Hesitancy and “Conspiracy Beliefs”

Given that the findings here are no different than other studies, it would seem unnecessary to rehash them here.

However, just note that the results are one would expect in these sorts of studies, in that those who had lower levels of “trust” in science were more likely to be vaccine hesitant:

We found that trust in all dimensions is negatively correlated with vaccine hesitancy except for trust in people, and more importantly, trust in social media. For the latter, an increase of one point in the trust scale—spanning from 1 to 10—is found to significantly increase vaccine hesitancy by 2 percentage points (two-sided p-value = 0.000). On the contrary, trust in science is found to be the most relevant predictor of low vaccine hesitancy among all trust variables: an increase of 1 point in the trust scale is associated with a reduction of vaccine hesitancy by around 3 percentage points (two-sided p-value = 0.000).

I have tried searching for the actual questions used and wasn’t able to find much of anything aside from the question topic (i.e. “trust in science”). The only thing I was able to discern is that the survey used a Likert scale from 1-10, with 1 being akin to “do not trust at all” and 10 being “trust completely”. Responders were classified as being vaccine hesitant if they responded to the question on “intent to vaccinate” with “rather unlikely” or “very unlikely” scores.

But the question here is figuring out what it means to “trust in science”. Are people being asked if they trust science carte blanche, or is there some context to the “trust in science” remarks? A key issue with surveys is that you can eek out whatever result you want by way of wording/phrasing which may bias how people respond on surveys.

I certainly don’t have any trust in Fauci or Walensky, but if Fauci were to proclaim himself as a representative of science (as he has done previously), does that then mean that my lack of trust in him is inherently a lack of trusting science? I mean, that already seems to have been the case in the past for those who dared to question Fauci, and so how exactly does one define both trust and science in this case?

It’s the same issue with the moronic idiom of “follow the science”, because what is THE referring to here when it comes to science, and why is it that anyone who questions some concept is science is labeled as being a science denialist?

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The results go on to further suggest that those who show high trust in social media, tend to live in rural regions, and even those who are of lower income and health are more prone towards vaccine hesitancy:

Figure 3. Correlates of trust. The data is based on results relative to reference points. Note that the results are stratified as noted by the groups on the y-axis. Results to the left are indicative of less trust relative to reference.

Again, the results here are redundant relative to past studies- it infers, at least what I assume it infers, is that those who are “less educated” and “less wealthy” are usually the ones to be vaccine hesitant in contrast to those who show high propensity for trust in science.

Or put another way, poorer individuals who may already be critical of the government are more prone to vaccine hesitancy. This sort of approach, and one that appears rather often, is to assume that those who are vaccine hesitant are ones who tend to not fit in within the typical standards of society, and those who may tend to deviate from established narratives or consensus.

That is, to deviate is to be inherently conspiratorial, or to construct a worldview in which differing opinions should not be allowed.

Consider here, that I have begun to receive ads over Congress “allowing” misinformation to spread, and why that’s a bad thing. But why exactly is this so-called “misinformation”, and why is it that we don’t allow better ideas to compete with those we deem conspiratorial? Is it up to the job of people who assume to be better than us to dictate how we receive information?

What I find interesting is that the language used by Carrieri, et al. use the term “conspiracy” several times, especially in the context of certain questions leaning more towards “conspiracy beliefs” (emphases mine):

We divide between non-vaccinating reasons that relate to "fear" and "others—mainly conspiracy beliefs". “Fear” measures if a person answered “Yes” to the statements: “Reason for not taking vaccine: I am worried that it will make my health issues worse” and “Reason for not taking vaccine: I do not trust the safety of the vaccine”. “Others—mainly conspiracy beliefs” measures if a person answered “Yes” to the statements: “Reason for not taking vaccine: I think the risk of COVID-19 is exaggerated”; “Reason for not taking vaccine: I think COVID-19 doesn't exist” and “Reason for not taking vaccine: Other reason”.

In this case, Carrieri, et al. seems to have taken it upon themselves to categorize specific questions into being related to conspiracies.

Note that the results published by Eurofound make no mention of the word “conspiracy”. Rather, they refer to these correlations as suggesting a need for clearer information on the safety and efficacy of the vaccines:

As the European Parliament stated in January 2021, only complete transparency can build public trust in the vaccination campaign across Europe.13 It is clear that there is a need for clear political and scientific communication about vaccine safety. The risk is that an unclear political stance about vaccines and a less than straightforward communication over their safety may have a detrimental effect on public trust in vaccines and could foster vaccine hesitancy.

I’d be remiss if I didn’t make mention that I also don’t trust Eurofound’s remarks (the intent here again seems more in favor of homogeny, rather than transparency), but what this seems to suggest is that Carrieri, et al. have interpreted the meaning of these results by way of referring to those who are vaccine hesitant as being more prone to conspiracies.

This would go in line with the idea that those who are more inclined to watch and trust social media are likely to be more inclined towards conspiracies, in contrast to those who view typical media outlets. It’s a good way to dictate the discourse of information, and it’s certainly something that has happened over the course of COVID in which it has been revealed that many social media platforms censored any comments over the vaccines or the origins of COVID.

Consider how this finding around social media and vaccine hesitancy is portrayed by Carrieri, et al. (emphasis mine):

Moreover, we found that people using social media as the main source of information are much more vaccine hesitant compared to people who use classical media sources (TV, Press and Radio) especially because of conspiracy beliefs (COVID risk is exaggerated and/or COVID does not exist). This finding is important and might be explained by two symmetric reasons. On one hand, traditional media sources are more often run by public institutions than social media, and therefore the information published through classical media sources might be more likely to be associated with official opinions that are less critical about vaccination. On the other hand, the diffusion of vaccine-related misinformation on social media might exacerbate the levels of vaccine hesitancy and hamper progress toward vaccine-induced herd immunity as argued by Muric et al. based on a description and assessment of data posts on Twitter³³. Thus, further research is necessary to understand why media sources are so relevant for vaccine hesitancy and public policy should address the media-specific causes and mechanisms when allocating pro-vaccine campaigns.

It’s interesting that they appear to have glossed over the fact that most standard media outlets receive plenty of advertisement space and funding from pharmaceutical manufacturers, and yet this issue isn’t brought up.

Should I offend readers again with “The Vax-Scene” dance on Colbert’s show?

Well, maybe:

So one source of propaganda is allowed, but not others deemed “conspiratorial”.

Public Perception of Adverse Events

What’s interesting about this study period is that it includes a time in which the AstraZeneca vaccine was under scrutiny for associations with blood clots.

Here, the findings are rather telling- at least within the short term, vaccine hesitancy appeared to increase after the suspension of the AstraZeneca vaccine, and appeared to negatively correlate with trust in science (i.e. those who were lest trustful of science became more vaccine hesitant):

Finally, we found that the AstraZeneca temporary suspension was associated with an increase in hesitancy by more than 4 percentage points in the week just after the suspension, especially among those who are worried that the vaccine damages their health. Among people with low trust in science, the suspension caused an increase of approximately 10 percentage points in vaccine hesitancy. The effect of the ban on vaccine hesitancy is found to be larger for people with low trust in science and living in rural areas, women, people with financial difficulties, and reporting bad health. Moreover, we found that education played a protective role among people with low trust in science. All these findings suggest that trust is a key determinant of vaccine hesitancy that generates both a direct effect and an interaction effect along with individual-level factors traditionally associated with a higher risk of vaccine hesitancy. In terms of policy implications, this suggests that pro-vaccine campaigns aiming to increase the trust in public and health authorities could be successfully targeted toward these groups with a high baseline risk of hesitancy.

This effect doesn’t appear to be long-lived, and it’s likely due to the fact that the other vaccines are available (the effects are also argued to be minor).

However, I think this adds to the significance in what we have seen with the downplaying of adverse events, as in adverse events may be minimized in order to encourage (or really enforce) vaccination.

Note that the last sentence refers to an approach that targets more hesitant demographics. Thus, wouldn’t there be an incentive to downplay adverse reactions in order reduce vaccine hesitancy among the most vaccine hesitant?

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In Regards to the Future

I will admit that this post is highly redundant- the study just points out things that have always been known.

However, I find these sorts of studies concerning because they can easily be used by politicians and doctors as a way of justifying certain actions and policies.

Note that the researchers found that those who were already sick with COVID were far less inclined towards vaccination, and that those who knew of loved ones who died were far more inclined.

Overall, this paints an important picture on how information and perception can be weaponized to fit the needs of those in power. It’s a dirty blueprint of who to target, how to censor, and why these actions may be deemed necessary for consensus.

But it’s important to remember that these surveys are, by their very nature, inherently biased. Most readers won’t take the time to discern what it means to be “conspiratorial”, or why people may hold the beliefs that they do outside of “somoene online told them”. Rather, these sorts of studies are a clear way to echo back to one’s group, and to further validate the actions that these groups must take in order to quell misinformation and dissenting viewpoints.

More importantly, all of this outlines the approaches that will likely come in the future:

Having these limitations in mind, the results of the study provide valuable implications for our understating of the role of trust in immunization choices, and for the design of global health policies aimed to fight vaccine hesitancy and obtain long-term herd immunity of the population.

Thus, these sorts of studies serve to act as teaching tools for whatever catastrophe may come in the future.

Be mindful that these tactics are likely to appear in the future, and it’s important to understand what deceptive tactics are being deployed.

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1. Carrieri, V., Guthmuller, S. & Wübker, A. Trust and COVID-19 vaccine hesitancy. Sci Rep 13, 9245 (2023). https://doi.org/10.1038/s41598-023-35974-z