Vaccine Hesitancy and Trust in Government: A cross-national analysis

This paper uses a 22-country cross-national analysis to test whether high levels of citizen trust in governmental civil servants prompt high levels of confidence in vaccine safety, effectiveness and importance. Because vaccine initiatives have long been the responsibility of national governments and the civil servants who coordinate their development, distribution and implementation, vaccine hesitancy or acceptance can be expected not just to reflect citizens’ judgements of the efficacy of the vaccines themselves, but also of the governments who control almost every aspect of the vaccination programs. As existing global surveys on vaccine hesitancy have not included measures of attitudes toward governmental trust, we merge two pre-COVID-19 international datasets – one that measures citizen attitudes toward governmental civil servants and the other that measures citizens’ views of vaccines – and find that citizen trust in their civil servants is a significant predictor of citizen confidence in vaccines’ safety, effectiveness, and importance. Countries with high levels of trust in their government’s civil servants are significantly more likely to have confidence in vaccines – even when controlling for a set of national economic and health care factors, including GDP per capita, total per capita health expenditure and the mortality of young children across the nation. Overall, the results provide robust evidence supporting the need for governments not only to convey the urgency of vaccine initiatives themselves but also to promote citizen confidence in the government’s civil servants’ efforts to protect citizens’ health and well-being. These results underscore the significance of political trust in what has become a globally important divide between vaxxers and anti-vaxxers and their disparate contentions that “freedom” is assured by embracing, or resisting, government-orchestrated COVID-19 vaccinations.