Contextual generalized trust and immunization against the 2009 A(H1N1) pandemic in the American states: A multilevel approach

COVID-19 vaccine acceptance: A comparative longitudinal analysis of the association between risk perception, confidence, and the acceptance of a COVID-19 vaccine

Following the outbreak of COVID-19, scientists rushed to develop vaccines to protect individuals and ferry the world out of the pandemic. Unfortunately, vaccine hesitancy is a major threat to the success of vaccination campaigns. Research on previous pandemics highlighted the centrality of perceived risk and confidence as core determinants of vaccine acceptance. Research on COVID-19 is less conclusive, and frequently it relies on one-country, cross-sectional data, thus making it hard to generalize results across contexts and observe these relationships over time. To bridge these gaps, in this article, we analyzed the association between perceived risk, confidence, and vaccine acceptance cross-sectionally at individual and country levels. Then, we longitudinally explored whether a within-country variation in perceived risk and confidence was correlated with a variation in vaccine acceptance. We used data from a large-scale survey of individuals in 23 countries and 19 time-points between June 2020 and March 2021 and comparative longitudinal multilevel models to estimate the associations at different levels of analysis simultaneously. Results show the existence of cross-sectional relationships at the individual and country levels but no significant associations within countries over time. This article contributes to our understanding of the roles of risk perception and confidence in COVID-19 vaccines' acceptance by underlining that these relationships might differ at diverse levels of analysis. To foster vaccine uptake, it might be important to address individual concerns and persisting contextual characteristics, but increasing levels of perceived risk and confidence might not be a sufficient strategy to increase vaccine acceptance rates.

Interaction between varying social ties on health: Perceived partner responsiveness and institutional trust

The interplay between different forms of social relationships, that is, perceived partner responsiveness and institutional trust, on subjective health evaluations was examined for the first time. There were 1241 respondents who had a romantic relationship. After adjusting for the covariates, findings suggested that greater perceived partner responsiveness and institutional trust led respondents to report better subjective health. The positive link between perceived partner responsiveness and subjective health was more pronounced among the respondents reporting a lower level of institutional trust. Such an interaction could be an indicator pointing out the compensatory role of close relationship dynamics. Given that finding, public health authorities and practitioners could be encouraged to be aware of the adaptive function of social ties on health and focus on maintaining the strength of intimate social ties and building trust between authority gradients. This suggestion could especially be adaptive not only during "normal" times but also during post-disaster circumstances (e.g., COVID-19).

Opposing views: associations of political polarization, political party affiliation, and social trust with COVID-19 vaccination intent and receipt

INTRODUCTION

Political polarization has increased in the USA within recent years. Studies have shown Republicans are less likely to accept COVID-19 vaccinations than Democrats; however, little is known regarding the association between COVID-19 vaccination acceptance and political polarization.

METHODS

We used data from a nationally-representative survey of 1427 participants conducted between 9 February 2021 and 17 February 2021. We estimated multivariate-adjusted odds ratios for COVID-19 vaccination intent and receipt according to perceived political polarization (measured as the perceived size of the ideological gap between Democrats and Republicans), political party affiliation, and social trust, controlling for demographic and socioeconomic factors.

RESULTS

Among participants perceiving high levels of polarization, Republicans (versus Democrats) reported a 90% lower odds of vaccination intent (OR = 0.10 [0.05, 0.19], P < 0.001). Participants with high (versus low) social trust and low perceived polarization had a 2-folder higher vaccination intent (OR = 2.39 [1.34, 4.21], P = 0.003); this association was substantially weaker in the high perceived polarization group.

CONCLUSIONS

High perceived levels of political polarization appear to magnify the decrease in the odds of receiving the COVID-19 vaccine and the intent to get vaccinated among Republicans versus Democrats. Political polarization may further attenuate the protective associations of high social capital with vaccination.

The role of generalized trust in COVID-19 vaccine acceptance

Immunization by vaccination is one of the most important tools for fighting the COVID-19 pandemic. Yet in many countries, immunization campaigns have been hampered by vaccine hesitancy within the population. Building on the idea that vaccination decisions are embedded in the broader societal context, we study the role of generalized trust-the belief that most people can generally be trusted-in vaccine acceptance. Immunization campaigns face an inherent collective action problem: As all individuals benefit collectively from high immunization rates regardless of individual contribution, especially those with a low risk of severe COVID infection have an incentive to decide against the (perceived) costs and risks of vaccination. We argue that generalized trust may help to overcome this problem by encouraging the belief that cooperation for the common good is achievable and that those who cooperate are unlikely to be exploited by others. We further argue that the positive effect of generalized trust on vaccination decisions is weaker among individuals who are at higher risk of severe outcomes from the disease, as the collective action problem is less pronounced in this group. To test our predictions, we used data from the SOEP-CoV survey, which queried a representative probability sample of Germany's population between January and February 2021 on topics connected to the pandemic. Using multiple logistic regression models, and in line with expectations, we found a positive and robust link between generalized trust and the willingness to accept vaccination as soon as offered. However, overall, our examination of heterogeneous effects does not unequivocally support the idea that the role of generalized trust varies according to individual COVID risk.

Trust and vaccination intentions: Evidence from Lithuania during the COVID-19 pandemic

In this paper, we study the relationship between trust and COVID-19 vaccination intentions. Vaccinating a large share of the population is essential for containing the COVID-19 pandemic. However, many individuals refuse to get vaccinated, which might be related to a lack of trust. Using unique survey data from Lithuania during the COVID-19 pandemic, we show that trust in government authorities, science, and pharmaceutical companies are important predictors of individual vaccination intentions. We do not find evidence that trust in strangers, the healthcare system, or the media predict intentions to get vaccinated against COVID-19.

Shared understandings of vaccine hesitancy: How perceived risk and trust in vaccination frame individuals' vaccine acceptance

Extensive research has framed vaccine hesitancy as a property of a heterogeneous group of individuals, ranging from total acceptance to complete refusal. Nevertheless, not much research has explored this heterogeneity, mainly focusing on central tendencies of single belief-related items. Using data from an original survey on a sample of Italian citizens, this paper examines this heterogeneity, exploiting individuals’ cognitive variation to map clusters of individuals who share similar cognitive schemas on vaccine uptake. The results showed the existence three groups, characterized by a different articulation of predictors of vaccine hesitancy, revealing different understandings of vaccine uptake. We then analyzed within-cluster characteristics and showed that cognitive segmentation was connected to different levels of perceived risk, confidence, and support for vaccination. We further showed that cognitive clustering also entailed a mean of social stratification that was correlated with individuals’ educational levels, and that the predictors of vaccine hesitancy were articulated differently in each group. This study, adopting a recent perspective in the analysis of systems of beliefs, moves one step further in disentangling the complexity of vaccine acceptance. Results suggested the usefulness of including individuals’ cognitive characteristics in vaccine hesitancy research and in the development of interventions addressed at increasing vaccine acceptance.

Individual-level social capital and COVID-19 vaccine hesitancy in Japan: a cross-sectional study

To reduce vaccine hesitancy, it is important to identify factors that can intervene at the individual or community level. Social capital is a possible factor because it is associated with various vaccine hesitancy, such as for measles and influenza. However, limited studies have explored the association between social capital and vaccination for COVID-19, which is an unprecedented pandemic and infodemic. Therefore, this study aimed to clarify the association between social capital and COVID-19 vaccination during the pandemic. This cross-sectional study used quota sampling for an online-based survey. Participants were asked whether they had previously been vaccinated for COVID-19 and their intention to receive a COVID-19 vaccine booster. Social capital was evaluated using three measures (individual-level civic participation, social cohesion, and reciprocity). Multiple logistic regression analysis was performed to clarify the association between social capital and previous COVID-19 vaccination status as well as intention to receive a COVID-19 booster. Participants were 2,313 individuals, of whom 87.2% had received a COVID-19 vaccine; 72.3% intended to obtain a COVID-19 booster. Individuals with any social capital are more likely to receive a COVID-19 vaccination than those with none (OR: 1.73, 95%CI: 1.18-2.54; OR: 1.58, 95%CI: 1.22-2.05; OR: 3.05, 95%CI: 2.15-4.33). These indicators were also associated with the intention to receive a COVID-19 booster. Thus, our results suggest that among the general public, those with individual-level social capital are more likely to receive a COVID-19 vaccination than those with none. Social capital may be a factor that can reduce vaccine hesitancy during a pandemic.

Social Capital, Urbanization Level, and COVID-19 Vaccination Uptake in the United States: A National Level Analysis

Vaccination remains the most promising mitigation strategy for the COVID-19 pandemic. However, existing literature shows significant disparities in vaccination uptake in the United States. Using publicly available national-level data, we aimed to explore if county-level social capital can further explain disparities in vaccination uptake rates when adjusting for demographic and social determinants of health (SDOH) variables, and if association between social capital and vaccination uptake may vary by urbanization level. Bivariate analyses and a hierarchical multivariable quasi-binomial regression analysis were conducted, where the regression analysis was stratified by urban–rural status. The current study suggests that social capital contributes significantly to the disparities of vaccination uptake in the US. The results of the stratification analysis show common predictors of vaccine uptake but also suggest various patterns based on urbanization level regarding the associations of COVID-19 vaccination uptake with SDOH and social capital factors. The study provides a new perspective to address disparities in vaccination uptake through fostering social capital within communities; which may inform tailored public health intervention efforts to enhance social capital and promote vaccination uptake.

Public health spending, primary care, and perceived risk promoted vaccination against H1N1

The purpose of this study is to examine factors affecting the intent to vaccinate during the 2009 H1N1 pandemic and to leverage the results to inform public health policy decisions aimed at increasing vaccine uptake during the COVID-19 pandemic. Using the National 2009 H1N1 Flu Survey data and state-level administrative data, we employ logistic regression and mediation models to estimate the association between vaccine uptake and state level public health spending, political ideology, and H1N1 case and death rates as well as a set of individual and household characteristics. We find that higher public health spending can significantly increase the intent to vaccinate, mainly through raising concerns about the pandemic and promoting vaccine relevant doctor patient interactions. We conclude that physicians, especially primary care physicians, should play more important roles in the ongoing vaccination efforts against the COVID-19 virus.

Effect of public corruption on the COVID-19 immunization progress

The coronavirus disease (COVID-19) outbreak has resulted in the death of over four million people since late 2019. To reduce the human and economic costs of COVID-19, different vaccines have been developed and distributed across countries. There has been significant cross-country variation in the vaccination of people against COVID-19. In this study, we focus on public corruption to explain the significant cause of cross-country variation in immunization progress. We suggest that countries with a higher degree of public corruption have been less successful in the vaccination of their population, controlling for other important determinants of immunization progress.

Does social capital contribute to prevention and control of the COVID-19 pandemic? Empirical evidence from China

By exploiting anonymized travel records of patients with COVID-19, this study examines the impact of social capital on individuals' responses to control measures during the early stage of the COVID-19 pandemic in China. The empirical results show that social capital measured by social trust, media publicity of social norms, and public recognition of social norms has a significant effect on reducing individuals' close contact behavior in the context of the COVID-19 pandemic. The mechanism tests indicate that social capital reduces the prevalence of close contact behavior by encouraging people to comply with public morality, which refers to self-monitored quarantine in this pandemic. Further analysis reveals that social trust shows no significant effects on all types of entertainment activities, that media publicity of social norms is more conducive to preventing family entertainment activities than public recognition of social norms, and that improving public recognition of social norms plays a decisive role in preventing social entertainment activities. This study sheds substantial light on the key role that informal institutions play in epidemic prevention and control.

The evolution of the association between community level social capital and COVID-19 deaths and hospitalizations in the United States

We use county level data from the United States to document the role of social capital the evolution of COVID-19 between January 2020 and January 2021. We find that social capital differentials in COVID-19 deaths and hospitalizations depend on the dimension of social capital and the timeframe considered. Communities with higher levels of relational and cognitive social capital were especially successful in lowering COVID-19 deaths and hospitalizations than communities with lower social capital between late March and early April. A difference of one standard deviation in relational social capital corresponded to a reduction of 30% in the number of COVID-19 deaths recorded. After April 2020, differentials in COVID-19 deaths related to relational social capital persisted although they became progressively less pronounced. By contrast, the period of March-April 2020, our estimates suggest that there was no statistically significant difference in the number of deaths recorded in areas with different levels of cognitive social capital. In fact, from late June-early July onwards the number of new deaths recorded as being due to COVID-19 was higher in communities with higher levels of cognitive social capital. The overall number of deaths recorded between January 2020 and January 2021 was lower in communities with higher levels of relational social capital. Our findings suggest that the association between social capital and public health outcomes can vary greatly over time and across indicators of social capital.

Information Sharing and Community Resilience: Toward a Whole Community Approach to Surveillance and Combatting the "Infodemic"

Developing and strengthening systems for information sharing as well as detecting and addressing dis/misinformation can not only protect capacity for public health emergency preparedness and response, but potentially increase overall community resilience and social capital. More actively involving citizens in the government's collection and sharing of information can generate more public buy‐in so people will be more invested in making certain that such information is not arbitrarily dismissed or drowned out by conspiracy theories. Such an approach may have the added the benefit of creating stronger collaborative connections between government, individual citizens, and civic organizations to promote overall resilience. More community involvement in terms of the collection and dissemination of information can provide value in terms of preparation for a public health emergency by bolstering surveillance efforts to detect a threat early on. Getting the public more integrated into the public health information system can also be valuable in terms of diminishing the threat of mis/disinformation. Building up relationships between the public and the public health sector can advance the mission of improving community resilience through education, engagement, and collaboration. In this review, we will examine existing evidence for this approach and will then conclude with possible new approaches.

Italian Community Psychology in the COVID-19 Pandemic: Shared Feelings and Thoughts in the Storytelling of University Students

This study investigated how young Italian people experienced the period of peak spread of COVID-19 in their country by probing their emotions, thoughts, events, and actions related to interpersonal and community bonds. This approach to the pandemic will highlight social dimensions that characterized contextual interactions from the specific perspective of Community Psychology. The aim was to investigate young people's experiences because they are the most fragile group due to their difficulty staying home and apart from their peers and because they are, at the same time, the most potentially dangerous people due to their urge to gather in groups. The research involved 568 university students, 475 females, and 93 males, with an average age of 21.82 years (SD = 4.836). The collected data were analyzed with the Grounded Theory Methodology, using the Atlas 8.0 software. From the textual data, representative codes were defined and grouped into 10 categories, which reflect the individuals' prosocial attitudes, behaviors, and values. These categories formed three macro-categories, called: "Collective Dimensions," which includes Connectedness, Solidarity, Italian-ness, Social Problems, and Collective Mourning; "Prosocial Orientation," which includes Trust and Hope; and "Collective Values," which includes Values of Freedom, Respect of Social Rules, and Civic-Mindedness. All these macro-categories are indicative of the shared feelings experienced by Italians during the first time of the pandemic. Further practical implications of these results will be discussed, including a consideration of the risk of developing distress and improving well-being, as well as promoting preventive behaviors.

Experiences matter: A longitudinal study of individual-level sources of declining social trust in the United States

The US has experienced a substantial decline in social trust in recent decades. Surprisingly few studies analyze whether individual-level explanations can account for this decrease. We use three-wave panel data from the General Social Survey (2006-2014) to study the effects of four possible individual-level sources of changes in social trust: job loss, social ties, income, and confidence in political institutions. Findings from fixed-effects linear regression models suggest that all but social ties matter. We then use 1973-2018 GSS data to predict trust based on observed values for unemployment, confidence in institutions, and satisfaction with income, versus an alternative counterfactual scenario in which the values of those three predictors are held constant at their mean levels in the early 1970s. Predicted values from these two scenarios differ substantially, suggesting that decreasing confidence in institutions and increasing unemployment scarring may explain about half of the observed decline in US social trust.

Social Capital, Income Loss, and Psychobehavioral Responses amid COVID-19: A Population-Based Analysis

This study examined the associations of perceived social capital and income change since the outbreak with probable depression and preventive behaviors during the COVID-19 pandemic in Hong Kong. Random digit dialing recruited a population-representative sample of 3011 Hong Kong Chinese aged ≥ 15 years (mean = 44, 55% females) between February 25 and April 29 2020. Respondents reported social capital (perceived interpersonal trust, social harmony, and sense of belonging), income change since the outbreak (loss vs. gain/no change), depressive symptoms, preventive behaviors, and demographics. Controlling for sociodemographics, lack of perceived interpersonal trust was associated with probable depression and avoiding contact with people with respiratory symptoms. Lack of perceived sense of belonging was associated with probable depression and decreased odds of adopting preventive behaviors. Lack of perceived social harmony was associated with probable depression and increased odds of used face masks among respondents with income loss only. Our results suggest that social capital is related to lower risk of depression and to higher chance of used face masks particularly among those experiencing income loss related to COVID-19. Prevention of mental health problems and promotion of effective preventive behaviors could be implemented by focusing on support for those who are socioeconomically disadvantaged.

Association between social capital and second dose of measles vaccination in Japan: Results from the A-CHILD study

BACKGROUND AND OBJECTIVES

Measles vaccination is important to prevent outbreak, and social capital can be an important preventive factor. However, there have been very few studies that investigated the association between social capital and measles vaccination, especially the second dose, which is more likely to be suboptimal. This study aimed to investigate the association between social capital and second dose of measles vaccine.

METHODS

Data were derived from a population-based study of first-grade elementary school children (6-7 years old) in Adachi City, Tokyo. Caregivers were asked to complete a questionnaire, and 4291 of them provided a valid response (response rate: 80.1%). Among these 4291 valid responses, 69 responses were excluded since variables for social capital measures were missing, which resulted in analytic sample size of 4222. We analyzed the association between measles vaccination and social capital including social ties, social trust and mutual aid by multilevel logistic regression analysis with a random intercept model.

RESULTS

About 8.9% of the children did not receive a second dose of measles-containing vaccines. After covariates adjustments, increase of one-standard-deviation of poor individual-level social ties showed 11% lower odds of receiving measles-containing vaccines (OR: 0.89, 95% CI: 0.80-0.99). By contrast, no significant association between community-level social ties and measles vaccination was found. Regarding social trust, no significant association between individual-level social trust and measles vaccination was found. However, increase of one-standard-deviation of poor community-level social trust showed 11% lower odds of receiving measles-containing vaccines (OR: 0.89, 95% CI: 0.79-0.998). There was no association between mutual aid and measles vaccination.

CONCLUSION

Social ties and social trust were associated with second dose of measles vaccination. Fostering social capital may be effective in raising the low rate of second dose of measles vaccine.

Self-rated health, generalized trust, and the Affordable Care Act: A US panel study, 2006-2014

Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health. However, only recently have longitudinal studies suggested an additional reciprocal pathway from health back to trust. Drawing on a diverse body of literature that shows how egalitarian social policy contributes to the promotion of generalized trust, we hypothesize that this other 'reverse' pathway could be sensitive to health insurance context. Drawing on nationally representative US panel data from the General Social Survey, we examine whether the Affordable Care Act of 2010 could have had influence on the deteriorating impact of worsening self-rated health (SRH) on generalized trust. Firstly, using two-wave panel data (2008-2010, N = 1403) and employing random effects regression models, we show that a lack of health insurance coverage negatively determines generalized trust in the United States. However, this association is attenuated when additionally controlling for (perceived) income inequality. Secondly, utilizing data from two separate three-wave panel studies from the US General Social Survey (2006-10; N = 1652; 2010-2014; N = 1187), we employ fixed-effects linear regression analyses to control for unobserved heterogeneity from time-invariant factors. We demonstrate that worsening SRH was a stronger predictor for a decrease in generalized trust prior (2006-2010) to the implementation of the Affordable Care Act. Further, the negative effect of fair/poor SRH seen in the 2006-2010 data becomes attenuated in the 2010-2014 panel data. We thus find evidence for a substantial weakening of the previously established negative impact of decreasing SRH on generalized trust, coinciding with the most significant US healthcare reforms in decades. Social policy and healthcare policy implications are discussed.