Vaccine hesitancy and trust in government: a cross-national analysis

ABSTRACT 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 do not include 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.