Trust in Science, Social Consensus and Vaccine Confidence

"If the global challenge of widespread immunization against the coronavirus is to succeed, it is crucial that we better understand the social, economic and psychological factors that encourage or inhibit vaccine uptake."

Vaccines must work at both the individual and the societal levels to be effective at eliminating viral infections. Scholarly attention to date has focused on individual-level drivers of vaccine confidence, but public confidence in immunisation programmes is related to factors operating at the community level as well. This article examines how societal-level scientific trust is associated with vaccination uptake, asking: Is the average level of trust in science in a country positively related to vaccine confidence, over and above the individual-level relationship?

A key observation shaping this inquiry is the fact that people look to the attitudes and behaviours of others to determine what is normal, beneficial, and accepted, and when the normative principle about the positive or negative value of an agent or institution such as scientists and science is widely held, there will be a stronger social influence on individual assessments of what is and is not socially acceptable or appropriate.

More specifically: "The proposed mechanism here is not that people have a conscious or explicit mental representation of the level and variability of trust among their fellow citizens (although this may be true for some people). Rather, they acquire informal impressions of how science is valued or contested through local social interactions, media representations, and cultural and political debate, and these factors combine to shape individual assessments of the trustworthiness of science....In short, instead of costly information processing, people rely on heuristics about the trustworthiness of science, and this tendency is likely to be more pronounced when there is a strong societal consensus about the value, utility and safety of science and technology....What applies at the macro level we also expect to manifest for individual-level trust - that is, people's assessments of the trustworthiness of scientists will have a stronger positive association with vaccine confidence in countries with a high level of social consensus that trust in science is the normatively appropriate assessment to make of these actors."

To understand if this hypothesis is correct, the researchers analysed data from the 2018 Wellcome Global Monitor survey, covering over 120,000 respondents in 126 countries. As detailed in the paper's methods section, vaccine confidence is measured using three items from the vaccine confidence scale developed by Larson et al., which ask respondents to state their level of agreement that vaccines are important for children to have, are safe, and are effective. Trust in science is measured using seven questions (e.g., the extent to which the respondent trusts scientists to find out accurate information about the world).

As has been reported elsewhere, this survey reveals a high level of trust in science globally, with more than four-fifths of people around the world reporting "some" or "a lot" of trust in science, and similar numbers reporting this level of trust in scientists (76%) and their ability to find out accurate information about the world (81%).

Among the findings of the present investigation:

• Trust in science is higher in wealthier countries and in countries where income inequality is lower. Men, people with more education, and people with higher incomes also report more trust in science. The social consensus on trust in science is substantially stronger (that is, the within-country standard deviation is lower) in countries with higher levels of formal education and with lower levels of income inequality. Within countries, social consensus around trust in science is greater among more educated people and those with higher incomes.
• The Czech Republic has the lowest social consensus on trust, and Guinea, Romania, Botswana, and the United Arab Emirates also show low levels of agreement about whether science can be trusted. At the other end of the spectrum, Thailand, Latvia, Togo, Iran, Nepal, Italy, and Japan have the highest national consensus on trust in science. There is no obvious regional, political, religious, or economic pattern to these country groupings.
• In countries with a high aggregate level of trust in science, people are more likely to be confident about vaccination, over and above their individual-level scientific trust. Societal consensus around trust in science moderates these individual-level and country-level relationships. In countries with a high level of consensus regarding the trustworthiness of science and scientists, the positive correlation between trust in science and vaccine confidence is stronger than it is in comparable countries where the level of social consensus is weaker.
• For the overall vaccine confidence measure, people who are more trusting of science and scientists are also more vaccine confident.

In conclusion, these findings "point to the importance of looking beyond individual-level correlates of vaccine confidence to incorporate a consideration of how norms of trust and mistrust of science are produced and maintained in different social contexts. An important avenue for future research will be to identify factors that contribute to the production of societal consensus around trust in science to inform effective public communication strategies around vaccination programmes."