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Misinformation Belief and Trust in Local Authority: A Multilevel Modelling of COVID-19 Vaccine Confidence in 14 Asia-Pacific Countries

22 Pages Posted: 22 Feb 2023

See all articles by Leesa Lin

Leesa Lin

London School of Hygiene & Tropical Medicine - Department of Infectious Disease Epidemiology

Ruobing Mei

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Eric H.Y. Lau

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Michael Yuxuan Ni

The University of Hong Kong - School of Public Health

Kathy Leung

The University of Hong Kong - School of Public Health; The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Joseph Tsz Kei Wu

The University of Hong Kong - School of Public Health; The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

Heidi J. Larson

London School of Hygiene & Tropical Medicine - Department of Infectious Disease Epidemiology

More...

Abstract

Background: Vaccination, as an effective health intervention to control the COVID-19 pandemic, is challenged by continued skepticism. The emerging wave of misinformation and trust deficits in local authorities pose additional threats to the COVID-19 vaccination protocols. Understanding the drivers of vaccine hesitancy is of great importance to designing tailored measures to combat the COVID-19 pandemic.

Methods: We included 12,866 participants aged 18 years or older between June and August 2021 across 14 Asia-Pacific countries. Multilevel analysis with random slope models examined the determinants of COVID-19 vaccine confidence in a hierarchical setting, including (i) country-level COVID-19 misinformation belief, (ii) individual local authority trust, and (iii) individual socio-demographics and country characteristics.

Findings: Overall, 69·2% of participants reported confidence about COVID-19 vaccines. Vaccine confidence varied across different characteristics at two levels, with greater variations attributable to country-level factors. At the country-level, jurisdictions with lower misinformation belief were associated with higher COVID-19 vaccine confidence. At the individual level, trust in local authorities was positively associated with COVID-19 vaccine confidence, particularly in countries with higher levels of misinformation belief. Males, the elderly group, and individuals who attained post-/secondary educational degrees were associated with higher vaccine confidence.

Interpretation: Our study highlights the crucial role of local authority trust in building vaccine confidence and mitigating the adverse effect of misinformation. Our findings shed light on developing a breadth of country-specific countermeasures to refute misinformation and promote vaccine confidence.

Funding: Vaccine Confidence Fund (#VCF-020) and AIR@InnoHK administered by the Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region.

Declaration of Interest: The authors declare no conflict of interest.

Ethical Approval: Ethics approval (LSHTM 26636) is granted by the Institutional Review Board at the London School of Hygiene and Tropical Medicine.

Keywords: COVID-19, vaccine hesitancy, vaccine confidence index, misinformation, trust, government

Suggested Citation

Lin, Leesa and Mei, Ruobing and Lau, Eric H.Y. and Ni, Michael Yuxuan and Leung, Kathy Sze Man and Wu, Joseph Tsz Kei and Larson, Heidi J., Misinformation Belief and Trust in Local Authority: A Multilevel Modelling of COVID-19 Vaccine Confidence in 14 Asia-Pacific Countries. Available at SSRN: https://ssrn.com/abstract=4364881 or http://dx.doi.org/10.2139/ssrn.4364881

Leesa Lin (Contact Author)

London School of Hygiene & Tropical Medicine - Department of Infectious Disease Epidemiology ( email )

Ruobing Mei

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Eric H.Y. Lau

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Hong Kong
China

Michael Yuxuan Ni

The University of Hong Kong - School of Public Health ( email )

Kathy Sze Man Leung

The University of Hong Kong - School of Public Health ( email )

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Joseph Tsz Kei Wu

The University of Hong Kong - School of Public Health ( email )

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Heidi J. Larson

London School of Hygiene & Tropical Medicine - Department of Infectious Disease Epidemiology ( email )

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