Infodemic, Institutional Trust, and COVID-19 Vaccine Hesitancy: A Cross-National Survey.

The COVID-19 pandemic has been accompanied by a massive infodemic. Yet limited studies have quantified the impact of the COVID-19 infodemic on vaccine hesitancy. This study examined the effect of perceived information overload (IO) and misinformation on vaccine willingness and uptake within a cross-national context. It also investigated how trust in multiple institutions affected vaccine outcomes and moderated the relationship between the infodemic and vaccine attitude and behavior. A cross-national online survey of residents, representative of the general population aged ≥18 in six Asian and Western jurisdictions, was conducted in June 2021. The results showed that perceived IO was positively associated with COVID-19 vaccine willingness and uptake. Belief in misinformation was negatively associated with vaccine willingness and uptake. Institutional trust may increase vaccine willingness and uptake. Moreover, trust in the government and civil societies tended to strengthen the positive effect of IO and reduce the negative impact of misinformation on vaccine willingness and uptake. The relationship between belief in misinformation and getting vaccinated against COVID-19 was unexpectedly stronger among those with a higher level of trust in healthcare professionals. This study contributes to a better understanding of the main and interactive effect of the infodemic and institutional trust on vaccine outcomes during a pandemic.