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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
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
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