Conspiracy theories in the era of COVID-19: A tale of two pandemics

Understanding facilitators and barriers to COVID-19 vaccination in the Zimbabwean population: a qualitative analysis

BACKGROUND

Vaccines are effective biological interventions that reduce health burdens. However, during the COVID-19 pandemic, there were concerns about varying levels of COVID-19 vaccination coverage in the Zimbabwean population. This study aimed to understand facilitators and barriers to COVID-19 vaccine uptake in the Zimbabwean population.

METHODS

In September-October 2023, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with a sample comprising health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected across the country. At each site, the participant sample was homogeneous. Data were collected using audiotapes, transcribed verbatim, and translated into English. Data were analysed manually using thematic analysis.

RESULTS

Ten FGDs and 30 KIIs were conducted across the country. Among the facilitators of COVID-19 vaccine uptake were the perceived benefits of COVID-19 vaccination, such as protection from infection, severe disease and death. People also complied with COVID-19 vaccination because of the government's call for mandatory vaccination, travel restrictions, restrictions when entering some premises for services, visiting, working, learning and functions. Barriers to COVID-19 vaccine uptake included low-risk perception, negative attitudes emanating from concerns about the origins of the vaccines, COVID-19 cases or death of vaccinated people, negative peer influence, religious doctrines, cultural beliefs and misconceptions circulating through social media. Other barriers included knowledge gaps on COVID-19 vaccines, safety, effectiveness, side effects, access-related challenges to COVID-19 services and concerns over the changing policy on COVID-19 vaccination.

CONCLUSIONS

The study has shown the importance of community engagement and data-driven public health communication strategies to facilitate behaviour change for increased uptake of a vaccine. In future epidemics, public health campaigns should focus on the timely provision of information explaining the benefits of an intervention, addressing safety concerns more effectively. To build trust and hence improve vaccine uptake by the public, there is a need for continuous engagement with people and to provide platforms for dialogue to address issues contributing to low vaccine uptake.

Media coverage of COVID-19 vaccines: sources of information, and verification practices of journalists in Ghana

BACKGROUND

Research on vaccines confirms the crucial role media play in framing discourses and mobilizing public support for successful immunization campaigns. What journalists cover on vaccination issues and their diligence in producing stories can influence attitudes to and uptake of vaccines. This paper contributes to emerging discussions on the role of the media in pandemics and in vaccination programs by interrogating the information seeking and verification practices of journalists reporting on COVID-19 vaccines in Ghana.

METHODS

A cross-sectional online survey was conducted among journalists from June to July 2021 through self-administered questionnaires by means of Google forms. The opinions of 300 respondents, randomly drawn from members of the Ghana Journalists' Association, were solicited and a response rate of 73% obtained.

RESULTS

Majority of journalists surveyed relied on official health sources for their information on COVID-19 vaccines (61.5%) and were confident the benefits of vaccines outweigh the risks (70%). While journalists relied on a variety of expert sources, social media platforms served as important sources of information also, with respondents stating a preference for Facebook (48.3%), and WhatsApp (44%). Journalists stated they were guided by sound practices such as source credibility and relevance, but betrayed weaknesses in their verification practices with a third of them admitting to sharing unsolicited information from social media.

CONCLUSIONS

Journalists in Ghana generally display a positive attitude towards COVID-19 vaccines and regularly search for information from official sources to inform their work, thus making them vital allies in overcoming vaccine hesitancy. Laxity in verification practices, however, makes them inadvertent agents of misinformation.

Vaccine Hesitancy and Susceptibility to SARS-CoV-2 Misinformation in Japanese Youth: The Contribution of Personality Traits and National Identity

During the pandemic, the Japanese government drew upon the cultural concept of jishuku, or personal self-constraint, requesting that individuals accept responsibility for their behaviors and consider minimizing the potential negative impact on others. While the jishuku approach to pandemic management rests upon the established and persuasive influence of cultural norms, variability in adherence can be expected according to age. This article documents an investigation into factors impacting vaccine hesitancy and susceptibility to SARS-CoV-2 misinformation among Japanese youth. The point of departure is the belief that attitudes and behaviors, such as those underpinning the jishuku approach to pandemic management, arise from within a relational framework. Therefore, developmental characteristics, such as personality traits, and in-group affinity attachments, such as facets of national identity, can be expected to function as predictors of health attitudes and behaviors. The tested structural model of hypothesized interactions accounted for 14% of the observed variance in vaccine hesitancy and 20% in susceptibility to SARS-CoV-2 misinformation. With the inclusion of gender, political ideology, and trust in government SARS-CoV-2 response as control variables, the respecified model increased the amount of variance observed in vaccine hesitancy to 30% and to 25% in susceptibility to SARS-CoV-2 misinformation. The outcomes are discussed in relation to the communication of coherent public health discourse relative to personality traits and facets of national identity.

The sexual politics of technology industry responses to online child sexual exploitation during COVID-19: "This pernicious elitism"

BACKGROUND

Increasing rates of online child sexual exploitation further spiked during the COVID-19 pandemic at a time of disrupted child protection capacity. While the technology industry is central to coordinated efforts to prevent online abuse and remove harmful content, it is largely exempt from formal child protection obligations.

OBJECTIVE

The aim of this study was to examine the response of the technology industry to online child sexual exploitation during COVID-19 from the perspective of anti-exploitation professionals.

PARTICIPANTS AND SETTING

An international sample of fifteen anti-exploitation professionals were interviewed as part of a larger study on the impacts of COVID-19 on online child sexual exploitation.

METHODS

Interviews were coded based on a template analysis with a focus on interactions with the technology sector during COVID-19.

RESULTS

Major themes arising from the analysis were 1) the burden of online safety work on victims and services, 2) the lack of prioritisation of online child protection by technology companies during COVID-19 and 3) the complicity of the technology industry with the online sexploitation of children.

CONCLUSIONS

The analysis of the views of anti-exploitation professionals highlights the alignment between the economic interests of the technology sector and the sexual interests of online child abusers in the absence of government oversight. A framework of sexual politics highlights the gendered nature this alignment and emphasises the need for regulatory intervention, harm minimisation and the restructuring of the online environment and technology sector in the interests of child safety.

Trust in information sources as a moderator of the impact of COVID-19 anxiety and exposure to information on conspiracy thinking and misinformation beliefs: a multilevel study

This study investigates the intricate relationship between exposure to information sources, trust in these sources, conspiracy and misinformation beliefs, and COVID-19 anxiety among 509 Omani citizens aged 11 to 50, representing 11 governorates. Employing structural equation modeling, we not only examine these associations but also explore how trust and COVID-19 anxiety act as moderating variables in this context. Additionally, we delve into demographic factors such as age group, educational level, gender, and place of residence (governorate) to discern potential variations.Our findings reveal that trust in health experts is inversely related to belief in conspiracy theories, while trust in health experts negatively correlates with exposure to conspiracy and misinformation. Intriguingly, trust in health experts exhibits divergent effects across governorates: it diminishes conspiracy and misinformation beliefs in some regions but not in others. Exposure to personal contacts and digital media, on the other hand, is associated with heightened beliefs in misinformation and conspiracy theories, respectively, in select governorates. These distinctions may be attributed to proximity to Muscat, the capital city of Oman, where various media outlets and policy-making institutions are situated. Furthermore, lower educational attainment is linked to greater belief in conspiracy and misinformation. Females reported higher levels of conspiracy theory beliefs and COVID-19 anxiety while no significant differences were detected in misinformation beliefs.This study sheds light on the intricate dynamics of misinformation and conspiracy theories in the context of COVID-19 in Oman, highlighting the pivotal roles of trust and COVID-19 anxiety as moderating factors. These findings offer valuable insights into understanding and addressing the spread of misinformation and conspiracy theories during a public health crisis.

Sense of safety and opinions about COVID-19 vaccinations in Polish school teachers: the role of conspiracy theories belief and fear of COVID-19

The co-occurrence of COVID-19 conspiracy theories (CCT) and fear of the coronavirus (FCV) can be linked to how safe people feel and how much they endorse vaccinations. School teachers were one of the vaccination priority groups in Poland. We conducted three cross-sectional studies (N1 = 1006; N2 = 1689; N3 = 627) to find out the potential interaction effects of CCT belief and FCV in predicting sense of safety (SoS; Studies 1-3), opinions about vaccinations efficacy (Studies 2-3) and endorsement of vaccinations of children (Study 3) among school teachers. In all three studies, the belief in CCT was related to lower SoS only when FCV was low. For low CCT belief, although the belief in vaccination efficacy was higher than for CCT endorsers, it was unrelated to FCV. However, for high and average CCT belief, FCV was linked to belief in vaccination efficacy. FCV was positively related to acceptance of vaccinating children on all levels of CCT endorsement. The results are discussed in light of the available literature and their potential use in public health.

Do media objectivity and frequency of informing mediate the relationship between traditionalist social attitudes and COVID-19 conspiracy beliefs?

In this study, we hypothesized that traditionalist social attitudes (conservatism, religiousness, and authoritarianism) significantly predict COVID-19 conspiracy beliefs (Hiding Information and Harmless Virus), as well as conspiracy mentality in general. We also hypothesized that these relationships are mediated by the objectivity of the media through which individuals inform themselves, and the frequency with which people informed themselves about the pandemic. The sample consisted of 341 participants from Serbia (mean age 33.51 years), of which 40.5% were women. The results revealed that conservatism predicts both conspiracy belief sets and conspiracy mentality, authoritarianism only COVID-19 conspiracy beliefs, and religiousness only beliefs that the virus is harmless. Media objectivity does not mediate these relationships. The frequency of informing is a significant mediator only of the relationships between authoritarianism, and conspiracy beliefs and conspiracy mentality, indicating that the role of seeking information is in reducing the threat perceived by more authoritarian individuals. The study reveals that media objectivity might not play a role in reducing conspiracy beliefs. An explanation might be found in the importance of the perceived credibility of the media.

Belief in COVID-19 related conspiracy theories around the globe: A systematic review

Conspiracy theories have been widespread in public discourses about COVID-19. Belief in conspiracy theories has negative effects on COVID-19 protective and preventive behaviour. However, evidence on the prevalence of belief in COVID-19 conspiracy theories, remains fragmented. We conducted a systematic review on the adult general population prevalence of belief in different COVID-19 conspiracy theories at country and regional level around the globe. Searches were performed in PubMed, Scopus and Google Scholar databases (end of search: March 22, 2022). We followed guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified 1637 potentially relevant titles in our search and included 33 studies in our review, reflecting conspiracy theory endorsement between March 2020 and August 2021. We found high belief in COVID-19 conspiracy theories in most studies: 29 studies measured at least one conspiracy theory belief prevalence ≥20%. For several conspiracy theories, e.g. "Lab origin" or "Destabilization and power gain", prevalence was often between 20 and 50%. Our findings call for increased awareness about COVID-19 conspiracy theories and the need for tailored, context specific conspiracy theory preparedness, prevention and control. Development and integration of a public health oriented communication and infodemic management strategy, alongside the implementation of conspiracy theory endorsement risk assessments are essential for supporting public health policy in future health emergencies.

Validating a German Version of the Conspiracy Mentality Scale (CMS)

Increased scientific interest in conspiracy beliefs raises the need for validated individual difference measures in the general tendency to believe in conspiracy theories, otherwise referred to as conspiracy mentality. In this article, we present a German language version of the Conspiracy Mentality Scale (CMS). A representative sample of German-speaking Swiss residents (N = 468) filled in the scale, along with measures of trust in several sources of information, need for social validation, compliance with Covid-19 preventive measures, perceived severity of the pandemic, loneliness, functional literacy and interpersonal conflict. Confirmatory factor analysis supported the two-dimensional structure of the original scale. Positive correlations between conspiracy theory ideation and trust in friends and the need for social validation on the one hand, and negative correlations with trust in scientific publications and scientific experts, perceived severity of the pandemic and functional literacy on the other hand supported construct validity. We conclude that our German language version of the scale is a valid measure of conspiracy theory ideation and skepticism.

Retrospective Analysis of the Psychological Predictors of Public Health Support in Bulgarians at the Beginning of the Coronavirus Pandemic

The earliest critical context of the pandemic, preceding the first real epidemiological wave of contagion in Bulgaria, was examined using a socio-affective perspective. A retrospective and agnostic analytical approach was adopted. Our goal was to identify traits and trends that explain public health support (PHS) of Bulgarians during the first two months of the declared state of emergency. We investigated a set of variables with a unified method within an international scientific network named the International Collaboration on Social & Moral Psychology of COVID-19 (ICSMP) in April and May 2020. A total of 733 Bulgarians participated in the study (67.3% females), with an average age of 31.8 years (SD = 11.66). Conspiracy Theories Beliefs were a significant predictor of lower PHS. Psychological Well-Being was significantly associated with Physical Contact and Anti-Corona Policy Support. Physical Contact was significantly predicted by fewer Conspiracy Theories Beliefs, higher Collective Narcissism, Open-mindedness, higher Trait Self-Control, Moral Identity, Risk Perception and Psychological Well-Being. Physical Hygiene compliance was predicted by fewer Conspiracy Theories Beliefs, Collective Narcissism, Morality-as-Cooperation, Moral Identity and Psychological Well-Being. The results revealed two polar trends of support and non-support of public health policies. The contribution of this study is in providing evidence for the affective polarization and phenomenology of (non)precarity during the outbreak of the pandemic.

The role of defense styles and psychopathological symptoms on adherence to conspiracy theories during the COVID-19 pandemic

Due to the unpredictability of the COVID-19 pandemic situation, individuals felt uncertain and insecure. As a consequence, conspiracy theories flourished and quickly spread. In the current study, we examine the relationship between general and COVID-19-related conspiracy theories, cognitive reflection, psychopathological symptoms, and defense styles in a sample of Italian adults. A total of 450 participants (50.2% male; mean age = 40.89 years, SD = 12.15) took part in an online survey. Two linear regression models on the general (explained variance 22.6%) and COVID-19-related (explained variance 33.0%) conspiracy theories have been tested. Among the predictive factors, older age, mania symptoms, and immature defenses facilitate adherence to conspiracy theories; on the opposite side, higher education, cognitive reflection, and mature defenses protected from adherence to conspiracy theories. The study provides some novel findings about factors that are significantly associated with general and COVID-19-related conspiracy theories, and highlights the pivotal role of individuals' psychological defenses in conspiracy theories.

Who falls for fake news? Psychological and clinical profiling evidence of fake news consumers

Awareness of the potential psychological significance of false news increased during the coronavirus pandemic, however, its impact on psychopathology and individual differences remains unclear. Acknowledging this, the authors investigated the psychological and psychopathological profiles that characterize fake news consumption. A total of 1452 volunteers from the general population with no previous psychiatric history participated. They responded to clinical psychopathology assessment tests. Respondents solved a fake news screening test, which allowed them to be allocated to a quasi-experimental condition: group 1 (non-fake news consumers) or group 2 (fake news consumers). Mean comparison, Bayesian inference, and multiple regression analyses were applied. Participants with a schizotypal, paranoid, and histrionic personality were ineffective at detecting fake news. They were also more vulnerable to suffer its negative effects. Specifically, they displayed higher levels of anxiety and committed more cognitive biases based on suggestibility and the Barnum Effect. No significant effects on psychotic symptomatology or affective mood states were observed. Corresponding to these outcomes, two clinical and therapeutic recommendations related to the reduction of the Barnum Effect and the reinterpretation of digital media sensationalism were made. The impact of fake news and possible ways of prevention are discussed.

"They're trying to bribe you and taking away your freedoms": COVID-19 vaccine hesitancy in communities with traditionally low vaccination rates

Vaccination is an essential public health intervention to control the COVID-19 pandemic. A minority of Canadians, however, remain hesitant about COVID-19 vaccines, while others outright refuse them. We conducted focus groups to gauge perceptions and attitudes towards COVID-19 vaccines in people who live in a region with historically low rates of childhood vaccination. Participants discussed their perception of COVID-19 vaccines and their intention to get vaccinated, and the low rate of COVID-19 vaccine uptake in Manitoba's Southern Health Region compared to other regions in Canada. We identified three drivers of vaccine hesitancy: (1) risk perceptions about COVID-19 and the vaccines developed to protect against it, (2) religious and conservative views; and (3) distrust in government and science. Participant proposed recommendations for improving communication and uptake of the COVID-19 vaccines included: public health messages emphasising the benefits of vaccination; addressing the community's specific concerns and dispelling misinformation; highlighting vaccine safety; and emphasising vaccination as a desirable behaviour from a religious perspective. Understanding the specific anxieties elicited by COVID-19 vaccines in areas with low childhood immunization rates can inform risk communication strategies tailored to increase vaccination in these specific regions. This study adds important information on potential reasons for vaccine hesitancy in areas with historically low rates of childhood vaccination, and provides important lessons learned for future emergencies in terms of vaccine hesitancy drivers and effective risk communication to increase vaccine uptake.

Summarising data and factors associated with COVID-19 related conspiracy theories in the first year of the pandemic: a systematic review and narrative synthesis

Conspiracy theories can have particularly harmful effects by negatively shaping health-related behaviours. A significant number of COVID-19 specific conspiracy theories emerged in the immediate aftermath of the pandemic outbreak. The aim of this study was to systematically review the literature on conspiracy theories related to COVID-19 during the first year of the pandemic (2020), to identify their prevalence, their determinants and their public health consequences. A comprehensive literature search was carried out in PubMed and PsycINFO to detect all studies examining any conspiracy theory related to COVID-19 between January 1st 2020, and January 10th 2021. Forty-three studies were included with a total of 61,809 participants. Between 0.4 and 82.7% of participants agreed with at least one conspiracy belief. Certain sociodemographic factors (young age, female gender, being non-white, lower socioeconomic status), psychological aspects (pessimism, blaming others, anger) and other qualities (political conservatism, religiosity, mistrust in science and using social media as source of information) were associated with increased acceptance of conspiracy theories. Conspiracy beliefs led to harmful health-related behaviours and posed a serious public health threat. Large-scale collaborations between governments and healthcare organizations are needed to curb the spread of conspiracy theories and their adverse consequences.

False memory and COVID-19: How people fall for fake news about COVID-19 in digital contexts

People are often exposed to fake news. Such an exposure to misleading information might lead to false memory creation. We examined whether people can form false memories for COVID-19-related fake news. Furthermore, we investigated which individual factors might predict false memory formation for fake news. In two experiments, we provided participants with two pieces of COVID-19-related fake news along with a non-probative photograph. In Experiment 1, 41% (n = 66/161) of our sample reported at least one false memory for COVID-19-related fake news. In Experiment 2, even a higher percentage emerged (54.9%; n = 185/337). Moreover, in Experiment 2, participants with conspiracy beliefs were more likely to report false memories for fake news than those without such beliefs, irrespective of the conspiratorial nature of the materials. Finally, while well-being was found to be positively associated with both true and false memories (Experiment 1), only analytical thinking was negatively linked to the vulnerability to form false memories for COVID-19-related fake news (Experiment 2). Overall, our data demonstrated that false memories can occur following exposure to fake news about COVID-19, and that governmental and social media interventions are needed to increase individuals’ discriminability between true and false COVID-19-related news.

Théories du complot et COVID-19 : comment naissent les croyances complotistes ?

La pandémie COVID-19 causée par le nouveau coronavirus SARS-CoV-2 a provoqué une crise mondiale sans précédent, associée à une prolifération de théories du complot. La prévalence de ces croyances complotistes a participé à affaiblir la crédibilité des mesures gouvernementales de santé publique, limiter l'accès des citoyens aux sources d’information fiables, et perturber la réponse des systèmes de santé face à la crise sanitaire. Plusieurs hypothèses ont été proposées en psychologie et en sciences sociales pour comprendre la genèse de ces croyances dans des contextes épidémiques, associant l’implication conjointe de facteurs psychologiques (comme la volonté de préserver sa sécurité, de maintenir une image de soi positive, ou encore de renforcer son rôle social) et sociodémographiques (comme les caractéristiques générationnelles, socioculturelles et politiques des individus). Toutefois, les découvertes récentes en sciences cognitives à propos des mécanismes élémentaires de traitement de l'information offrent un nouvel éclairage sur la génération des croyances conspirationnistes à travers les époques et les cultures. Dans cet article, nous proposons une définition de la théorie du complot et une classification des croyances complotistes pendant la pandémie de COVID-19. Nous montrons comment les mécanismes de génération et de mise à jour des croyances permettent d'expliquer la genèse des théories du complot, et nous proposons plusieurs hypothèses étayées par les recherches contemporaines en sciences cognitives et en sciences sociales à propos des théories du complot.

Depression, reduced education, and bias perceptions as risk factors of beliefs in misinformation

The spread of misinformation and conspiracy theories related to COVID‐19 has represented one of the several undesirable effects of the current pandemic. In understanding why people can be more or less at risk to believe in misinformation, emotional distress and education could play a crucial role. The present study aims to analyze the relationship among depressive symptoms, education, and beliefs in misinformation about COVID-19 during the early phase of the pandemic. We do this through a cross-sectional study carried out on a random and representative sample of the Italian population that allows us to go and verify the co-evolution of many factors: i.e., beliefs in misinformation, symptoms of depression, perceptions about COVID-19, ways in which citizens got informed about the pandemic, and sociodemographic characteristics (e.g., age, gender, education). The results show that the relationship between depression and beliefs in misinformation exists and is more complex than hypothesized because it is mediated by individual perceptions. In particular, the most at-risk people to believe in misinformation show higher bias perceptions, higher depression, and lower education. Practical implications are discussed suggesting a supportive intervention at both individual and social levels.

Morality in the echo chamber: The relationship between belief in COVID-19 conspiracy theories and public health support and the mediating role of moral identity and morality-as-cooperation across 67 countries

Believing in conspiracy theories is a major problem, especially in the face of a pandemic, as these constitute a significant obstacle to public health policies, like the use of masks and vaccination. Indeed, during the COVID-19 pandemic, several ungrounded explanations regarding the origin of the virus or the effects of vaccinations have been rising, leading to vaccination hesitancy or refusal which poses as a threat to public health. Recent studies have shown that in the core of conspiracy theories lies a moral evaluation component; one that triggers a moral reasoning which reinforces the conspiracy itself. To gain a better understanding of how conspiracy beliefs about COVID-19 affect public health containment behaviors and policy support via morality-relevant variables, we analysed comprehensive data from the International Collaboration on the Social & Moral Psychology (ICSMP) of COVID-19, consisting of 49.965 participants across 67 countries. We particularly explored the mediating role of two levels of morality: individual and group-based morality. Results show that believing in conspiracy theories reduces adoption of containment health-related behaviors and policy support of public health measures, but moral identity and morality-as-cooperation significantly mediate this relationship. This means that beliefs in conspiracy theories do not simply constitute antecedents of cognitive biases or failures, nor maladaptive behaviors based on personality traits, but are morally infused and should be dealt as such. Based on our findings, we further discuss the psychological, moral, and political implications of endorsement of conspiracy theories in the era of the pandemic.

Deconstructing the Conspiratorial Mind: the Computational Logic Behind Conspiracy Theories

In the social sciences, research on conspiracy theories is accumulating fast. To contribute to this research, here I introduce a computational model about the psychological processes underlying support for conspiracy theories. The proposal is that endorsement of these theories depends on three factors: prior beliefs, novel evidence, and expected consequences. Thanks to the latter, a conspiracy hypothesis might be selected because it is the costliest to reject even if it is not the best supported by evidence and by prior beliefs (i.e., even if it is not the most accurate). In this way, the model implies a key role for motivated reasoning. By examining the social conditions that favour the success of conspiracy theories, the paper embeds the model, whose focus is primarily psychological, within the broader social context, and applies this analysis to probe the role of conspiracy theories within contemporary Western societies. Altogether, the paper argues that a computational outlook can contribute to elucidate the socio-psychological dynamics underlying the attractiveness of conspiracy theories.

Understanding the "Sometimes Masker": Political Orientation and Trust in the Media During the COVID-19 Pandemic

Objectives

The COVID-19 pandemic in the United States has brought to light the problematic way partisan politics interferes with public health prevention and control measures. This study aims to investigate how Americans responded to the novel coronavirus with respect to their sociopolitical identity and masking habits.

Study Design

This mixed-methods study incorporated three ethnographic projects and surveys together, from two rural areas (in Iowa and California) and one suburban community in California.

Methods

We interviewed 156 Americans about how masking habits related to six themes: participants’ perceived risk level, concern for themselves and others, support for President Trump, trust in scientific organizations, and confidence in major news outlets. We conducted content analysis of qualitative interviews and evaluated survey questions to understand how and why people masked or engaged in public health prevention practices.

Results

Greater perceived risk, concern for others, and trust in health and media institutions was correlated with increased masking, while support for Trump was predictive of anti-masking sentiments. Participants who diverged from these trends, specifically those who sometimes wore masks, but not always were called “sometimes maskers”. These sometimes maskers often identified as politically moderate and were more likely to mask due to concern for a vulnerable person or group in their lives.

Conclusions

Since one in three Americans are political moderates, understanding what promotes their adherence to public health guidelines is essential for policy makers interested in pandemic containment. Relatedly, the conservative tendency to distrust mainstream media is what separated those who reported sometimes masking from those who reported always masking.

Design and Cross-Cultural Invariance of the COVID-19 Vaccine Conspiracy Beliefs Scale (COVID-VCBS) in 13 Latin American Countries

Aims

Over the past 2 years, the vaccine conspiracy beliefs construct has been used in a number of different studies. These publications have assessed the determinants and outcomes of vaccine conspiracy beliefs using, in some cases, pooled data from different countries, and compared the results across these contexts. However, studies often do not consider measurement invariance as a necessary requirement for comparative analyses. Therefore, the aim of this study was to develop and evaluate the cross-cultural MI of the COVID-19 Vaccine Conspiracy Beliefs Scale (COVID-VCBS) in 12 Latin American countries.

Methods

Confirmatory factor analysis, item response theory analysis and alignment method were applied to test measurement invariance in a large number of groups.

Results

The COVID-VCBS showed robust psychometric properties and measurement invariance for both factor loadings and crosstabs. Also, a higher level of acceptance of conspiracy beliefs about vaccines is necessary to respond to higher response categories. Similarly, greater acceptance of conspiracy beliefs about COVID-19 vaccines was related to a lower intention to be vaccinated.

Conclusion

The results allow for improved understanding of conspiracy beliefs about COVID-19 vaccines in the countries assessed; furthermore, they provide researchers and practitioners with an invariant measure that they can use in cross-cultural studies in Latin America. However, further studies are needed to test invariance in other countries, with the goal of developing a truly international measure of conspiracy beliefs about COVID-19 vaccines.

"I Felt Completely Turned off by the Message": The Effects of Controlling Language, Fear, and Disgust Appeals on Responses to COVID-19 Vaccination Messages

Psychological reactance theory (PRT) posits that when individuals' perceived freedoms are threatened or restricted, they become aversively aroused and are motivated to reestablish those freedoms, leading to a state of psychological reactance. Applying PRT, this study examined the effects of controlling language, fear, and disgust appeals on responses to COVID-19 vaccination promotion messages. Participants were randomly assigned to one of eight conditions across controlling language (high/low), fear appeals (high/low), and disgust appeals (high/low), wherein they viewed two messages, with responses measured after each message. Results showed persuasion was diminished when the levels of any of these three variables were elevated, as in conditions of either high controlling language, high fear appeals, or high disgust appeals. Relative to low levels of these variables, high levels resulted in greater freedom threat perceptions, reactance, source derogation, and less positive attitudes toward the message. A 2-way interaction between fear and disgust appeals on source derogation and message attitudes in the low controlling language condition was significant-participants reported the least source derogation and most positive attitudes toward the message in response to the low controlling language, low fear, and low disgust appeals.

Suicidality Related to the COVID-19 Lockdown in Romania: Structural Equation Modeling

Background

Suicidality is a serious public health concern at a global scale. Suicide itself is considered to be preventable death; worldwide, suicide rates and their trends are under constant scrutiny. As part of the international COMET-G cross-sectional study, we conducted a national level investigation to examine the individual disturbances (such as anxiety, depression, or history of life-threatening attempts) and contextual factors (such as adherence to conspiracy theories or Internet use) associated with suicidality related to the COVID-19 lockdown in a lot of Romanian adults.

Participants and Methods

One thousand four hundred and forty-six adults responded to an anonymous on-line questionnaire, with mean age ± standard deviation of 47.03 ± 14.21 years (1,142 females, 292 males, 12 identified themselves as non-binary). Data were analyzed using descriptive statistics and structural equation modeling (SEM).

Results

Univariate analysis showed strong significant correlation between anxiety and depression scorings among the respondents (Spearman R = 0.776, p < 0.001). Both the suicidality scorings and the Internet use correlated fairly with anxiety and depression, with two-by-two Spearman coefficients between R = 0.334 and R = 0.370 (p < 0.001 for each). SEM analysis substantiated the emotional disturbances, previous life-threatening attempts, and younger age as significant predictors for suicidality. The patterns of reality reading (including religious inquiries, Internet use, and beliefs in conspiracy theories) did not reach the statistical significance as influential factors in the suicidality of these respondents. There was no covariance between the Internet use and belief in conspiracy theories.

Conclusion

The study confirmed the suicidality risk initially hypothesized as being associated with the history of life-threatening attempts, increased depression within the younger population, and higher anxiety during the first year of the COVID-19 pandemic and its related lockdown. National strategies for effective interventions at various levels of the healthcare system should be developed.

The Vaccination Concerns in COVID-19 Scale (VaCCS): Development and validation

Vaccines are highly effective in minimizing serious cases of COVID-19 and pivotal to managing the COVID-19 pandemic. Despite widespread availability, vaccination rates fall short of levels required to bring about widespread immunity, with low rates attributed to vaccine hesitancy. It is therefore important to identify the beliefs and concerns associated with vaccine intentions and uptake. The present study aimed to develop and validate, using the AMEE Guide, the Vaccination Concerns in COVID-19 Scale (VaCCS), a comprehensive measure of beliefs and concerns with respect to COVID-19 vaccines. In the scale development phase, samples of Australian (N = 53) and USA (N = 48) residents completed an initial open-response survey to elicit beliefs and concerns about COVID-19 vaccines. A concurrent rapid literature review was conducted to identify content from existing scales on vaccination beliefs. An initial pool of items was developed informed by the survey responses and rapid review. The readability and face validity of the item pool was assessed by behavioral science experts (N = 5) and non-experts (N = 10). In the scale validation phase, samples of Australian (N = 522) and USA (N = 499) residents completed scaled versions of the final item pool and measures of socio-political, health beliefs and outcomes, and trait measures. Exploratory factor analysis yielded a scale comprising 35 items with 8 subscales, and subsequent confirmatory factor analyses indicated acceptable fit of the scale structure with the data in each sample and factorial invariance across samples. Concurrent and predictive validity tests indicated a theoretically and conceptually predictable pattern of relations between the VaCCS subscales with the socio-political, health beliefs and outcomes, and trait measures, and key subscales predicted intentions to receive the COVID-19 vaccine. The VaCCS provides a novel measure to assess beliefs and concerns toward COVID-19 vaccination that researchers and practitioners can use in its entirety or select specific sub-scales to use according to their needs.

Public Policy Measures to Increase Anti-SARS-CoV-2 Vaccination Rate in Russia

The total vaccination rate remains relatively low in Russia as of March 2022 (around 55%, with around 20% in some regions). In the paper, we study the reasons for it. We communicate the results of our survey aimed at detecting reasons for the relatively low anti-SARS-CoV-2 vaccination rate in Russia (47.1% as of mid-January 2022) and suggest potential measures to increase the level of confidence in the Russian vaccination campaign. A total of 14,310 users exhibited interest to participate in the research (16.84% of the total number of invitations sent in the Russian social network VKontakte). After the sample set repair, only 5822 (40.68% of those who agreed to participate) responses were suitable for the research, and they composed the final set. The age range of the respondents was 16–51 years old (y.o.) with a mean of 29.1 ± 10.6 y.o. The proportion of the female gender in responses was 44.23%. A total of 2454 persons (42.15%) expressed their hesitant, cautious, or negative attitude towards vaccine uptake. Of the 2454 persons with cautious attitude towards vaccination, only 928 (37.82%) were concerned about the quality of the Russian vaccines. A total of 1323 individuals (53.91%) supported one or more conspiracy beliefs. A total of 5064 (86.98% of the whole set) showed cautious or negative attitude towards the planned introduction of a nationwide system of vaccination certification/verification based on QR codes. The main social factors that hinder the Russian vaccination campaign are: vexation over the lack of desire of officials to receive feedback from the general population regarding vaccination, wide support for conspiracy beliefs, and controversy over the QR code-based digital system. To elevate the vaccination rate in Russia, the following steps may be taken: social encouragement of those who support vaccination, increase in transparency of the vaccination campaign, acceptance of both digital and paper vaccination certificates, increase in participation of society in vaccination-related discussions, public disclosure of vaccine composition, and avoidance of excessive digitalization of data in the vaccination campaign.

Exploring the relationships of citizens' scientific interest and self-understanding to their learning enjoyment and self-efficacy in science

The aim of this study was to explore whether citizens' scientific interest and self-understanding relate to their learning enjoyment and self-efficacy in science. The sample participants consisted of 1,657 Taiwanese citizens ranging from 18 to 70 years of age. All participants were asked to complete the 2018 "Taiwan Citizens Science and Technology Literacy Survey" to assess their scientific interest, scientific self-understanding, science learning enjoyment, and scientific self-efficacy. Multiple regression models were used to analyze the data. The important findings included: (1) scientific interest was the most important predictor of science learning enjoyment, while scientific self-understanding was the most important predictor of scientific self-efficacy; and (2) the effects of scientific interest on self-understanding and the effect of science learning enjoyment on scientific self-efficacy each were significantly moderated by respondents' age, with stronger relationships observed in younger citizens than older citizens. This study provides insight into Taiwanese citizens' scientific learning enjoyment and self-efficacy and also informs potential governmental policies and/or societal practices that could be considered to promote scientific literacy.

Worry and behaviour at the start of the COVID-19 outbreak: Results from three UK surveys (the COVID-19 rapid survey of Adherence to Interventions and responses [CORSAIR] study)

We aimed to describe worry and uptake of behaviours that prevent the spread of infection (respiratory and hand hygiene, distancing) in the UK at the start of the COVID-19 outbreak (January and February 2020) and to investigate factors associated with worry and adopting protective behaviours. Three cross-sectional online surveys of UK adults (28 to 30 January, n = 2016; 3 to 6 February, n = 2002; 10 to 13 February 2020, n = 2006) were conducted. We used logistic regressions to investigate associations between outcome measures (worry, respiratory and hand hygiene behaviour, distancing behaviour) and explanatory variables. 19.8% of participants (95% CI 18.8% to 20.8%) were very or extremely worried about COVID-19. People from minoritized ethnic groups were particularly likely to feel worried. 39.9% of participants (95% CI 37.7% to 42.0%) had completed one or more hand or respiratory hygiene behaviour more than usual in the last seven days. Uptake was associated with greater worry, perceived effectiveness of individual behaviours, self-efficacy for engaging in them, and having heard more information about COVID-19. 13.7% (95% CI 12.2% to 15.2%) had reduced the number of people they had met. This was associated with greater worry, perceived effectiveness, and self-efficacy. At the start of novel infectious disease outbreaks, communications should emphasise perceived effectiveness of behaviours and the ease with which they can be carried out.

Vaccine Hesitancy in the Time of COVID-19: Attitudes and Intentions of Teens and Parents Regarding the COVID-19 Vaccine

To assess attitudes and intentions related to the COVID-19 vaccine during the pandemic, we surveyed adolescents aged 13–18 years and the parents of 13–18-year-olds using national research panels on three occasions or “waves”: before the COVID-19 vaccine was available, after it was available for adults, and after it was available for ages ≥12 years. Data on experiences with COVID-19, the importance of adolescent vaccines, and intentions regarding COVID-19 vaccination were analyzed across time points. We found that parental concerns about vaccine safety significantly increased from Wave 1 to 2. Social media had a negative influence on parents’ and adolescents’ opinions about vaccine safety. Demographic variables were associated with vaccination rates reported in Wave 3, consistent with known inequities related to vaccine access. Parents (70%) were supportive of concomitant COVID-19 vaccination with other adolescent vaccines for teens. It is important to address variables associated with vaccine hesitancy to increase COVID-19 vaccine coverage rates in the US.

Characterization of non-adopters of COVID-19 non-pharmaceutical interventions through a national cross-sectional survey to assess attitudes and behaviours

Adoption of non-pharmaceutical interventions (NPIs) remains critical to curtail the spread of COVID-19. Using self-reported adherence to NPIs in Canada, assessed through a national cross-sectional survey of 4498 respondents, we aimed to identify and characterize non-adopters of NPIs, evaluating their attitudes and behaviours to understand barriers and facilitators of adoption. A cluster analysis was used to group adopters separately from non-adopters of NPIs. Associations with sociodemographic factors, attitudes towards COVID-19 and the public health response were assessed using logistic regression models comparing non-adopters to adopters. Of the 4498 respondents, 994 (22%) were clustered as non-adopters. Sociodemographic factors significantly associated with the non-adoption cluster were: (1) being male, (2) age 18–34 years, (3) Albertans, (4) lower education level and (5) higher conservative political leaning. Participants who expressed low concern for COVID-19 and distrust towards several institutions had greater odds of being non-adopters. This information characterizes individuals at greatest odds for non-adoption of NPIs to inform targeted marketing interventions.

Does Seeing What Others Do Through Social Media Influence Vaccine Uptake and Help in the Herd Immunity Through Vaccination? A Cross-Sectional Analysis

Widespread acceptance of COVID-19 vaccination is the next major step in fighting the pandemic. However, significant variations are observed in the willingness to take the vaccination by citizens across different countries. Arguably, differences in vaccination intentions will be influenced by beliefs around vaccines to influence health. Often perceptions of what others are doing and the information available guide individuals' behaviors for vaccination. This is more so in the digital age with the influence of the internet and media. This study aims to determine the factors that impact willingness to vaccinate for COVID-19. We examined factors associated with acceptance of vaccine based on (1) constructs of the Health Belief Model (HBM), (2) sources of information, (3) social media usage, (4) knowledge of COVID-19 treatment, and (5) perception of government's efforts for mitigation. Randomly sampled online survey data was collected by a global firm between December 2020 and January 2021 from 372 citizens (with a response rate of 96.6%) from multiple regions, including North America, the Middle East, Europe, and Asia. Ordered probit regression suggests that the health belief model constructs hold. Perceived severity of COVID-19 (P < 0.001) and action cues of others taking the vaccine positively influences a subject's vaccine intent (P < 0.001), perceived benefits and perceived efficacy of the vaccine positively influences a subject's vaccine intent (P < 0.001). Perceived barriers negatively influence vaccine intent (P < 0.001). Interestingly as for media usage, mainstream media (e.g., TV, newspaper) (P = 0.006) and social media (P = 0.013) both negatively influence a subject's vaccine intent. Social media platforms that are more entertainment and social-based, such as Whatsapp, Instagram, and YouTube, have a negative and significant influence on vaccine intent (P = 0.061), compared to other more information-based social media platforms (e.g., Twitter, LinkedIn). Knowledge of COVID-19 treatment positively influences vaccine intent (P = 0.023). Lastly, governmental efforts' perceived reliability in mitigation strategy (P = 0.028) and response efforts (P = 0.004) negatively influence vaccine intent. The study highlights the "wait-and-see" action cue from others and leaders in the community. It also informs the importance of shaping media information for vaccination through informative media and social media outlets to counteract any misinformation.

COVID-19, conspiracies and manufactured consent

Questions about what comes next for the coronavirus disease 2019 pandemic have been posed by the editors to everyone except those who proliferate conspiracy theories. Conspiracy theories have consequences for public health. Making these dangers known can initiate discussions on public trust. The problem is that the pressing concerns of the pandemic have enabled manufactured consent to be a suspicious thing known of the propaganda model more than ever. Although such a model can be put into question, the public must also be able to practice empathy and true choice so that asking and responding to the questions at hand considers a responsibility to public health.

Are COVID-19 conspiracies a threat to public health? Psychological characteristics and health protective behaviours of believers

We tested the link between COVID‐19 conspiracy theories and health protective behaviours in three studies: one at the onset of the pandemic in the United Kingdom (UK), a second just before the first national lockdown, and a third during that lockdown (N = 302, 404 and 399). We focused on conspiracy theories that did not deny the existence of COVID‐19 and evaluated the extent to which they predicted a range of health protective behaviours, before and after controlling for psychological and sociodemographic characteristics associated with conspiracy theory belief. COVID‐19 conspiracy beliefs were positively correlated with beliefs in other unrelated conspiracies and a general conspiracy mind‐set, and negatively correlated with trust in government and a tendency towards analytical thinking (vs. intuitive thinking). Unexpectedly, COVID‐19 conspiracy believers adhered to basic health guidelines and advanced health protective measures as strictly as non‐believers. Conspiracy believers were, however, less willing to install the contact‐tracing app, get tested for and vaccinated against COVID‐19, and were more likely to share COVID‐19 misinformation—all of which might undermine public health initiatives. Study 3 showed conspiracy theory believers were less willing to undertake health protective behaviours that were outside of their personal control, perceiving these as having a negative balance of risks and benefits. We discuss models explaining conspiracy beliefs and health protective behaviours, and suggest practical recommendations for public health initiatives.

Attitudes, behaviours and barriers to public health measures for COVID-19: a survey to inform public health messaging

Background

Public support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health measures as well as barriers individuals face in following public health measures. We also sought to identify attitudes persons have regarding a COVID-19 vaccine and reasons why they may not accept a vaccine.

Methods

A cross-sectional online survey was conducted in August 2020, in Alberta, Canada in persons 18 years and older. This survey evaluated current behaviours, barriers and attitudes towards public health measures and a COVID-19 vaccine. Cluster analysis was used to identify key patterns that summarize data variations among observations.

Results

Of the 60 total respondents, the majority of persons were always or often physically distancing (73%), masking (65%) and staying home while sick (67%). Bars/pubs/lounges or nightclubs were visited rarely or never by 63% of respondents. Persons identified staying home while sick to provide the highest benefit (83%) in reducing spread of COVID-19. There were a large proportion of persons who had not downloaded or used a contact tracing/exposure notification app (77%) and who would not receive a COVID-19 vaccine when available (20%) or were unsure (12%). Reporting health authorities as most trusted sources of health information was associated with greater percentage of potential uptake of vaccine but not related to contact tracing app download and use. Individuals with lower concern of getting and spreading COVID-19 showed the least uptake of public health measures except for avoiding public places such as bars. Lower concern regarding COVID-19 was also associated with more negative responses to taking a potential COVID-19 vaccine.

Conclusion

These results suggest informational frames and themes focusing on individual risks, highlighting concern for COVID-19 and targeting improving trust for health authorities may be most effective in increasing public health measures. With the ultimate goal of preventing spread of COVID-19, understanding persons’ attitudes towards both public health measures and a COVID-19 vaccine remains critical to addressing barriers and implementing targeted interventions and messaging to improve uptake.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10790-0.

Low COVID-19 Vaccine Acceptance Is Correlated with Conspiracy Beliefs among University Students in Jordan

Vaccination to prevent coronavirus disease 2019 (COVID-19) emerged as a promising measure to overcome the negative consequences of the pandemic. Since university students could be considered a knowledgeable group, this study aimed to evaluate COVID-19 vaccine acceptance among this group in Jordan. Additionally, we aimed to examine the association between vaccine conspiracy beliefs and vaccine hesitancy. We used an online survey conducted in January 2021 with a chain-referral sampling approach. Conspiracy beliefs were evaluated using the validated Vaccine Conspiracy Belief Scale (VCBS), with higher scores implying embrace of conspiracies. A total of 1106 respondents completed the survey with female predominance (n = 802, 72.5%). The intention to get COVID-19 vaccines was low: 34.9% (yes) compared to 39.6% (no) and 25.5% (maybe). Higher rates of COVID-19 vaccine acceptance were seen among males (42.1%) and students at Health Schools (43.5%). A Low rate of influenza vaccine acceptance was seen as well (28.8%), in addition to 18.6% of respondents being anti-vaccination altogether. A significantly higher VCBS score was correlated with reluctance to get the vaccine (p < 0.001). Dependence on social media platforms was significantly associated with lower intention to get COVID-19 vaccines (19.8%) compared to dependence on medical doctors, scientists, and scientific journals (47.2%, p < 0.001). The results of this study showed the high prevalence of COVID-19 vaccine hesitancy and its association with conspiracy beliefs among university students in Jordan. The implementation of targeted actions to increase the awareness of such a group is highly recommended. This includes educational programs to dismantle vaccine conspiracy beliefs and awareness campaigns to build recognition of the safety and efficacy of COVID-19 vaccines.