Is It All a Conspiracy? Conspiracy Theories and People's Attitude to COVID-19 Vaccination

Multilevel analysis of COVID-19 vaccination intention: the moderating role of economic and cultural country characteristics

BACKGROUND

Predictors of COVID-19 (coronavirus) vaccination have been extensively researched; however, the contextual factors contributing to understanding vaccination intention remain largely unexplored. The present study aimed to investigate the moderating role of economic development (Gross domestic product - GDP per capita), economic inequality (Gini index), the perceived corruption index and Hofstede's measurements of cultural values-index of individualism/collectivism and power distance index-in the relationship between determinants of satisfaction with the healthcare system, trust in political institutions, conspiracy beliefs and COVID-19 vaccination intention.

METHODS

A multilevel modelling approach was employed on a sample of approximately 51 000 individuals nested within 26 countries. Data were drawn from the European Social Survey Round 10. The model examined the effect of individual- and country-level predictors and their interaction on vaccination intention.

RESULTS

Satisfaction with the healthcare system had a stronger positive effect on intention to get vaccinated in countries with lower perceived corruption and more individualistic countries. Trust in political institutions had a stronger positive effect on vaccination intention in countries with higher economic development and lower perceived corruption, while a negative effect of conspiracy beliefs on vaccination intention was stronger in countries with lower economic development, higher perceived corruption and a more collectivistic cultural orientation.

CONCLUSION

Our findings highlight the importance of considering individual and contextual factors when addressing vaccination intention.

The Impact of COVID-Related Restrictions on the Mental Health of Students

The first stage of the COVID pandemic in spring and early summer of 2020 was shaped by restrictions due to the so-called flattening-the-curve approach. Students globally were impacted when public and private colleges and universities were forced to either shut down temporarily or transition to remote learning. Studies from around the world found increased levels of stress, anxiety, depression, and suicidal ideation. Female students often reported being more affected than male students. Suicide rates, however, did not increase. The second stage, starting in late summer 2020, saw the highest case numbers but also a slow and mostly partial return to normal life enabled by vaccination efforts and policy decisions. The mental health of students in most countries recovered well, even when they had to go through repeated or continued lockdowns or restrictions. Although it cannot be predicted what portion of students will be affected by mental health issues in ten or twenty years, it is certain that there will be long-term mental health consequences for many. It is also uncertain which approach, "living with COVID" or "zero COVID," will show less impact on the mental health of students' long term.

Similarities and differences with the 'general public': Chinese civil servants' attitude to genetically modified organisms and its influencing factors

This study examines Chinese civil servants' attitudes toward genetically modified organisms by reviewing a national survey of 3,018 Chinese civil servants. The findings show that Chinese civil servants hold a more positive attitude to GMOs than the wider Chinese "general public", with a similar level of genetic scientific literacy and belief in GMOs conspiracy theories and their influence mechanisms. While the Chinese civil servants' occupational literacy plays an important role in their GMOs attitude. This study provides a new mind-set for studying some specific groups' attitudes toward GMOs and related food policies.

Relationship Between Fear of COVID-19, Conspiracy Beliefs About Vaccines and Intention to Vaccinate Against COVID-19: A Cross-National Indirect Effect Model in 13 Latin American Countries

The present study explored the predictive capacity of fear of COVID-19 on the intention to be vaccinated against COVID-19 and the influence in this relationship of conspiracy beliefs as a possible mediating psychological variable, in 13 Latin American countries. A total of 5779 people recruited through non-probabilistic convenience sampling participated. To collect information, we used the Fear of COVID-19 Scale, Vaccine conspiracy beliefs Scale-COVID-19 and a single item of intention to vaccinate. A full a priori Structural Equation Model was used; whereas, cross-country invariance was performed from increasingly restricted structural models. The results indicated that, fear of COVID-19 positively predicts intention to vaccinate and the presence of conspiracy beliefs about COVID-19 vaccines. The latter negatively predicted intention to vaccinate against COVID-19. Besides, conspiracy beliefs about COVID-19 vaccines had an indirect effect on the relationship between fear of COVID-19 and intention to vaccinate against COVID-19 in the 13 countries assessed. Finally, the cross-national similarities of the mediational model among the 13 participating countries are strongly supported. The study is the first to test a cross-national mediational model across variables in a large number of Latin American countries. However, further studies with other countries in other regions of the world are needed.

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.

The association of conspiracy beliefs and the uptake of COVID-19 vaccination: a cross-sectional study

The COVID-19 pandemic revealed that health denialism might be an important determinant of adherence to preventive measures during epidemic challenges. Conspiracy beliefs seem to be one of the most visible manifestations of denialism in society. Despite intensive efforts to promote COVID-19 vaccinations, the number of citizens reluctant to get vaccinated was very large in many countries. The main aim of this study was the analysis of the association between the acceptance of the COVID-19 vaccination and conspiracy beliefs among adult Internet users in Poland. The analysis was based on data from a survey performed on a sample of 2008 respondents in October 2021. Uni- and multivariable logistic regression models were applied to evaluate the association between attitudes towards COVID-19 vaccination and generic conspiracist, vaccine-conspiracy, and COVID-19-related conspiracy beliefs. In the multivariable model, the effect of conspiracy beliefs was adjusted for the level of vaccine hesitancy, future anxiety, political sympathies, and socio-demographic variables. Univariate regression models showed that COVID-19 vaccination acceptance is significantly lower among respondents with higher levels of all three types of conspiracy beliefs. In the multivariable model, the effect of COVID-19-related and vaccine conspiracy beliefs, but not generic conspiracist beliefs, was maintained after adjusting for vaccine hesitancy. We conclude that conspiracy beliefs should be treated as a potential indicator of lower adherence to preventive measures during epidemic challenges. The respondents revealing a high level of conspirational thinking are a potential group for intensified actions which employ health educational and motivational interventions.

Nationalism, conspiracy theories and vaccine mandates: Exploring the statism determinants for attitudes to COVID-19 control in China

Introduction

China's loosening its COVID-19 controls highlighted its insufficiency in vaccination protection. Mandatory vaccination might be necessary if the gap cannot be filled over a short time. However, few studies have explored how Chinese people view the COVID-19 vaccine mandates, let alone placing such views in the country's highly politicized context.

Material and methods

The current study utilizes data from a national survey adopting quota sampling to analyze the Chinese public's medical and non-medical considerations when judging compulsory COVID-19 vaccination (n = 1,523). The survey was conducted between 1 and 8 April 2021. All adults aged 18 years and older were eligible to take part. The survey included sociodemographic details, perceived susceptibility to infection, perceived vaccine benefit, attitudes to vaccination policies, nationalism, beliefs in various conspiracy theories and science literacy. Multiple regression analyses were done to examine factors associated with the attitude to COVID-19 vaccine mandates.

Results

The study reveals that personal risk and benefit perceptions did not dominate the Chinese public's attitude toward vaccination mandates. Instead, nationalism was relatively strongly associated with their willingness to accept mandatory vaccination. Contrary to studies in the West, various conspiracy beliefs and conspiratorial thinking were robustly related to the support for mandatory vacciniation. Science literacy didn't link to the attitude to vaccination mandates. It only had a weak moderating effect on the influence of conspiratorial thinking on attitudes to the vaccination policies.

Conclusions

The results indicated that Chinese people's attitude to the COVID-19 vaccination policy is highly politicized and influenced by conspiracy theories. Given the potentially massive impacts of the COVID-19 infection, we need to educate the Chinese public with more medically valuable and relevant information to help them make sound decisions regarding vaccination. Meanwhile, we can adopt nationalistic tones to improve the persuasion effect, but misinformation during the process must be overcome.

COVID-19 vaccination hesitancy is not all a conspiracy theory: A qualitative study from Iran

BACKGROUND

The COVID-19 pandemic has burdened disastrous mortality and morbidity rates in society all over the world. While vaccination is one of the most effective immunization methods to control infectious diseases globally, some have avoided receiving the vaccine. We have aimed to investigate the reasons behind the hesitancy of vaccination among healthcare workers.

METHOD

We performed ten semi-structured interviews with volunteered healthcare workers of Rasoul Akram hospital. Then each interview was anonymized, and Braun and Clarke's thematic analysis method was used to analyze the interviews.

RESULTS

Our data analysis revealed thirty-eight different codes as reasons for vaccination hesitancy among our interviewees. All these thirty-eight codes were grouped into ten sub-themes, and these sub-themes were further grouped into our four main themes: 1. Fear of side effects, 2. Distrust, 3. Inefficiency, and 4. Non-necessity. Fear of side effects was the most frequent reason that interviewees mentioned. Also, Half of the interviewees mentioned distrust as a reason for COVID-19 vaccine hesitancy. At least once, all interviewees mentioned that they believed vaccination is inefficient. Some interviewees had beliefs and reasons that made them assume vaccination is simply not necessary.

CONCLUSION

Fear of side effects, distrust, inefficiency, and non-necessity were the reasons that our participants refused to get vaccinated. Fear of side effects and distrust were the most common reasons that led to non-vaccination.

Policy Endorsement and Booster Shot: Exploring Politicized Determinants for Acceptance of a Third Dose of COVID-19 Vaccine in China

China's recent termination of strict COVID-19 control necessitates taking a booster vaccine shot as a precaution against the pandemic as quickly as possible. A large body of research has examined people's attitudes toward and intentions for the booster shot. However, most studies failed to explore how China's sociopolitical context has shaped their attitude regarding the booster jab take-up. The current study utilizes data from a national survey adopting quota sampling to analyze the Chinese public's medical and non-medical considerations to determine their intention for the third dose of the COVID-19 vaccine. The study found that thanks to China's initial successful lockdown policies, personal risk and benefit perceptions did not dominate their views regarding booster vaccination. Instead, respondents' gender, nationalism, endorsement of the zero-COVID policy, self-efficacy regarding vaccination, and perceived infection severity were the major factors underlying their booster shot intention. The situation highlights how the politicized context of China's COVID-19 control has impacted people's plans to practice preventive behaviors. It is necessary to offset the negative consequences. One strategy is to educate the Chinese public with more medically relevant information to help them make rational choices regarding vaccination and other protective measures. On the other hand, such education can utilize this nationalistic mental status to enhance the persuasion effect.

Contemporary trends in psychological research on conspiracy beliefs. A systematic review

Background

The number of psychological studies on conspiracy beliefs has been systematically growing for about a dozen years, but in recent years, the trend has intensified. We provided a review covering the psychological literature on conspiracy beliefs from 2018 to 2021. Halfway through this period, the COVID-19 pandemic broke out, accompanied by an explosion of movements based on conspiracy theories, intensifying researchers' interest in this issue.

Methods

Adhering to PRISMA guidelines, the review systematically searched for relevant journal articles published between 2018 and 2021. A search was done on Scopus and Web of Science (only peer-reviewed journals). A study was included if it contained primary empirical data, if specific or general conspiracy belief(s) were measured and if its correlation with at least one other psychological variable was reported. All the studies were grouped for the descriptive analysis according to the methodology used, the participants' characteristics, the continent of origin, the sample size, and the conspiracy beliefs measurement tools. Due to substantial methodological heterogeneity of the studies, narrative synthesis was performed. The five researchers were assigned specific roles at each stage of the analysis to ensure the highest quality of the research.

Results

Following the proposed methodology, 308 full-text articles were assessed for eligibility and 274 articles (417 studies) meeting the inclusion criteria were identified and included in the review. Almost half of the studies (49.6%) were conducted in European countries. The vast majority of the studies (85.7%) were carried out on samples of adult respondents. The research presents antecedents as well as (potential) consequences of conspiracy beliefs. We grouped the antecedents of conspiracy beliefs into six categories: cognitive (e.g., thinking style) motivational (e.g., uncertainty avoidance), personality (e.g., collective narcissism), psychopathology (e.g., Dark Triad traits), political (e.g., ideological orientation), and sociocultural factors (e.g., collectivism).

Conclusion and limitations

The research presents evidence on the links between conspiracy beliefs and a range of attitudes and behaviors considered unfavorable from the point of view of individuals and of the society at large. It turned out that different constructs of conspiracy thinking interact with each other. The limitations of the study are discussed in the last part of the article.

Barriers to COVID-19 vaccine acceptance to improve messages for vaccine uptake in indigenous populations in the central highlands of Guatemala: a participatory qualitative study

INTRODUCTION

As of July 2022, a little over one-third of Guatemalans were fully vaccinated. While COVID-19 vaccination rates are not officially reported nationally by racial/ethnic groups, non-governmental organisations and reporters have observed that COVID-19 vaccination rates are especially low among high-risk Indigenous populations. We conducted one of the first studies on COVID-19 vaccine acceptance in Indigenous populations in the Central Highlands of Guatemala, which aimed to better understand the barriers to COVID-19 vaccine uptake and how to improve vaccine promotional campaigns.

METHODS

In November 2021, we conducted eight focus group discussions (FGDs) with 42 Indigenous men and women and 16 in-depth interviews (IDIs) with community health workers, nurses and physicians in Chimaltenango and Sololá. Using a participatory design approach, our qualitative analysis used constant comparative methods to understand the inductive and deductive themes from the FGD and IDI transcripts.

RESULTS

We found three major overarching barriers to vaccination within the sampled population: (1) a lack of available easily understandable, linguistically appropriate and culturally sensitive COVID-19 vaccine information; (2) vaccine access and supply issues that prevented people from being vaccinated efficiently and quickly; and (3) widespread misinformation and disinformation that prey on people's fears of the unknown and mistrust of the medical establishment and government.

CONCLUSION

When developing COVID-19 vaccine messages, content should be culturally relevant, appropriate for low-literacy populations and in the languages that people prefer to speak. Promotional materials should be in multiple modalities (print, radio and social media) and also have specific Maya cultural references (dress, food and concepts of disease) to ensure messaging connects with intended targets. This study supports the need for more robust research into best practices for communicating about COVID-19 vaccines to marginalised communities globally and suggests that policy makers should invest in targeted local solutions to increase vaccine uptake.

Determinants of the Attitude to COVID-19 Vaccine in Lima-Peru: Path Analysis and Structural Regression

Introduction

Research on the effects of COVID-19 has shown that a favorable attitude toward the COVID-19 vaccine would help reduce the pandemic's sequelae and avoid lethal variants.

Objective

A theoretical model was tested through the strategy of path analysis and structural equation modeling, seeking to evaluate the direct effect of neuroticism and the indirect effects of risk-avoidance and rule-following behaviors, mediated by attitudes toward science.

Methods

A total of 459 adults, mostly women (61%), mean age 28.51 (SD = 10.36), living in Lima (Peru), participated. The scales of neuroticism, risk avoidance behavior (RAB), norm following (NF), attitudes toward science, and attitudes toward vaccination were administered.

Results

The path analysis explained 36% of the variance in vaccine attitude, whereas the latent structural regression model achieved a 54% explanation; according to this model attitude toward science (β=.70, p < .01) and neuroticism (β=-.16, p < .01) are significant predictors of vaccine attitude. Likewise, risk avoidance behavior and rule-following have indirect effects on attitudes toward vaccination.

Conclusion

Low neuroticism and a positive attitude toward the science that mediates the effects of RAB and NF directly condition the possibility of vaccination against COVID-19 in the adult population.

Public Opinion Manipulation on Social Media: Social Network Analysis of Twitter Bots during the COVID-19 Pandemic

Social media is not only an essential platform for the dissemination of public health-related information, but also an important channel for people to communicate during the COVID-19 pandemic. However, social bots can interfere with the social media topics that humans follow. We analyzed and visualized Twitter data during the prevalence of the Wuhan lab leak theory and discovered that 29% of the accounts participating in the discussion were social bots. We found evidence that social bots play an essential mediating role in communication networks. Although human accounts have a more direct influence on the information diffusion network, social bots have a more indirect influence. Unverified social bot accounts retweet more, and through multiple levels of diffusion, humans are vulnerable to messages manipulated by bots, driving the spread of unverified messages across social media. These findings show that limiting the use of social bots might be an effective method to minimize the spread of conspiracy theories and hate speech online.

The relationship between fear of COVID-19 infection, fear of COVID-19 vaccination and Big Five personality traits: a mediation model

BACKGROUND

The primary objective of our correlational, cross-sectional study was to determine the relationship between fear of COVID-19 infection and fear of COVID-19 vaccination and the role of the Big Five personality traits in this relationship.

PARTICIPANTS AND PROCEDURE

The study sample consisted of 462 participants, including 286 women and 176 men, aged 18 to 75, recruited from the general population. The Big Five personality traits were diagnosed using the Polish version of the Ten-Item Personality Inventory. We used an 11-point numerical rating scale to measure the intensity of fear of COVID-19 infection as well as fear of COVID-19 vaccination.

RESULTS

The results indicate that fear of infection has a weak positive correlation with fear of vaccination. Both types of fear have a weak negative correlation with emotional stability and openness to experience. People diagnosed with COVID-19 have significantly higher levels of fear of vaccination and lower levels of emotional stability compared to those without a COVID-19 diagnosis. Fear of infection proves a good predictor of fear of vaccination and a likely mediator between emotional stability and fear of vaccination against COVID-19.

CONCLUSIONS

The results may increase our understanding of the role of personality traits, such as emotional stability, in the fear of infection and COVID-19 vaccination hesitancy.

Evaluation of Conspiracy Beliefs, Vaccine Hesitancy, and Willingness to Pay towards COVID-19 Vaccines in Six Countries from Asian and African Regions: A Large Multinational Analysis

Vaccination protects people from serious illness and associated complications. Conspiracy theories and misinformation on vaccines have been rampant during the COVID-19 pandemic and are considered significant drivers of vaccine hesitancy. Since vaccine hesitancy can undermine efforts to immunize the population against COVID-19 and interferes with the vaccination rate, this study aimed to ascertain the COVID-19-vaccine-related conspiracy beliefs, vaccine hesitancy, views regarding vaccine mandates, and willingness to pay for vaccines among the general population. A web-based, cross-sectional survey was conducted (April−August 2021) among the adult population in six countries (Pakistan, Saudi Arabia, India, Malaysia, Sudan, and Egypt). Participants were recruited using an exponential, non-discriminate snowball sampling method. A validated self-completed electronic questionnaire was used for the data collection. All the participants responded to questions on various domains of the study instrument, including conspiracy beliefs, vaccine hesitancy, and willingness to pay. The responses were scored according to predefined criteria and stratified into various groups. All data were entered and analyzed using SPSS version 22. A total of 2481 responses were included in the study (Pakistan 24.1%, Saudi Arabia 19.5%, India 11.6%, Malaysia 8.1%, Sudan 19.3%, and Egypt 17.3%). There was a preponderance of participants ≤40 years old (18−25 years: 55.8%, 26−40 years: 28.5%) and females (57.1%). The average score of the COVID-19 vaccine conspiracy belief scale (C19V-CBS) was 2.30 ± 2.12 (median 2; range 0−7). Our analysis showed that 30% of the respondents were found to achieve the ideal score of zero, indicating no conspiracy belief. The mean score of the COVID-19 vaccine hesitancy scale (C19V-HS) was 25.93 ± 8.11 (range: 10−50). The majority (45.7%) had C19V-HA scores of 21−30 and nearly 28% achieved a score greater than 30, indicating a higher degree of hesitancy. There was a significant positive correlation between conspiracy beliefs and vaccine hesitancy (Spearman’s rho = 0.547, p < 0.001). Half of the study population were against the vaccine mandate. Respondents in favor of governmental enforcement of COVID-19 vaccines had significantly (p < 0.001) lower scores on the C19V-CBS and C19V-HS scale. Nearly 52% reported that they would only take vaccine if it were free, and only 24% were willing to pay for COVID-19 vaccines. A high prevalence of conspiracy beliefs and vaccine hesitancy was observed in the targeted countries. Our findings highlight the dire need for aggressive measures to counter the conspiracy beliefs and factors underlying this vaccine hesitancy.

On the relationship between conspiracy theory beliefs, misinformation, and vaccine hesitancy

At the time of writing, nearly one hundred published studies demonstrate that beliefs in COVID-19 conspiracy theories and misinformation are negatively associated with COVID-19 preventive behaviors. These correlational findings are often interpreted as evidence that beliefs in conspiracy theories and misinformation are exogenous factors that shape human behavior, such as forgoing vaccination. This interpretation has motivated researchers to develop methods for "prebunking," "debunking," or otherwise limiting the spread of conspiracy theories and misinformation online. However, the robust literatures on conspiracy theory beliefs, health behaviors, and media effects lead us to question whether beliefs in conspiracy theories and misinformation should be treated as exogenous to vaccine hesitancy and refusal. Employing U.S. survey data (n = 2,065) from July 2021, we show that beliefs in COVID-19 conspiracy theories and misinformation are not only related to COVID-19 vaccine hesitancy and refusal, but also strongly associated with the same psychological, social, and political motivations theorized to drive COVID-19 vaccine hesitancy and refusal. These findings suggest that beliefs in conspiracy theories and misinformation might not always be an exogenous cause, but rather a manifestation of the same factors that lead to vaccine hesitancy and refusal. We conclude by encouraging researchers to carefully consider modeling choices and imploring practitioners to refocus on the worldviews, personality traits, and political orientations that underlie both health-related behaviors and beliefs in conspiracy theories and misinformation.

Strengthened belief in vaccine effectiveness predicted increased COVID-19 vaccination intention and behaviour: Results from a nationally representative longitudinal survey of U.S. adults from July 2020 to April/May 2021

Vaccine hesitancy remains a major barrier to ending the COVID-19 pandemic in the United States (U.S.) and an important target for communication interventions. Using longitudinal survey data, we examined whether baseline levels and changes in beliefs about the COVID-19 vaccines predicted change in vaccination intention/behaviour. Repeated measures were collected from a nationally representative sample of U.S. adults (n = 665) in July 2020 and April/June 2021. Linear regressions associated change in COVID-19 vaccination intention/behaviour with changes in beliefs about the COVID-19 vaccines' safety, effectiveness in protecting others from infection, and effectiveness in protecting oneself from infection. Changes in beliefs from T1 to T2 were significantly associated with change in vaccination outcomes for all belief types (safety B = 0.39, SE = 0.07; effectiveness for self B = 0.38, SE = 0.09; effectiveness for others B = 0.43, SE = 0.07). Cross-lagged models suggested a reciprocal causal relationship between pro-vaccine beliefs and vaccination intention/behaviour: Intention to get vaccinated at T1 predicted strengthened safety and effectiveness beliefs at T2. T1 effectiveness beliefs predicted T2 vaccination intention/behaviour, though T1 safety beliefs did not. Communication interventions highlighting the protective benefits of COVID-19 vaccines may be particularly successful in reducing vaccine hesitancy.

How does Information Exposure Affect Public Attitudes Toward GMO in China? The mediating and moderating roles of Conspiracy Belief and Knowledge

Background

In China, controversy about genetically modified organisms (GMO) is ongoing and some regard GMO as a “product of a conspiracy,” which affects people’s attitudes (PAs) toward GMO. Beliefs in conspiracy theories (BCT) are formed from the information that people are exposed to. Information exposure not only constructs a pseudo-environment for individuals to perceive the world, but also generates external stimuli for their mental states and attitudes. People’s objective knowledge and self-assessed knowledge play an important moderating role in this process.

Method

The study adopted the stimulus-organism-response (SOR) model, with conspiracy beliefs as mediating variables, to test the mechanism of the independent variable of information exposure on the dependent variable of PAs toward GMO. Objective knowledge and self-assessed knowledge were introduced as moderator variables to explore the different roles of knowledge. A survey of Chinese adults was conducted in February 2022, and partial least squares structural equation modeling (PLS-SEM) was employed to estimate the multi-construct relationships.

Results

Information exposure was significantly and directly connected with PAs toward GMO. BCT also played a significant mediating role. Unofficial information exposure reinforced beliefs in conspiracy theories. Stronger beliefs in conspiracy theories reduced people’s willingness to consume GMO foods and made them pessimistic about the development prospects of GMO foods. In contrast, exposure to official information weakened people’s beliefs in conspiracy theories and increased their willingness to consume GMO foods. In addition, the level of knowledge had a moderating role. Individual’s objective knowledge can effectively reduce the negative relationship of conspiracy beliefs on attitudes toward GMO development. Conversely, individual’s self-assessed knowledge can enhance the negative relationship of conspiracy beliefs on attitudes toward GMO development.

Conclusion

Based on psychological and cognitive dimensions, this study provides a new perspective on how information exposure and people’s attitudes toward GMO are related to each other and enriches the variable measurement dimension of knowledge. Simultaneously, it provides a localized explanation of the factors affecting people’s attitudes toward GMO in China, providing a new theoretical basis for the subsequent development strategy of GMO foods.

Acceptance, Hesitancy, and Refusal in Anti-COVID-19 Vaccination: A Cluster Analysis Aiming at the Typology behind These Three Concepts

This paper presents the findings of a study aiming at an innovative typology of attitudes towards COVID-19 vaccination. The proposed typology tries to go beyond the common sociological studies who divide the public into three categories: pro-vaxxers, anti-vaxxers, and hesitants. Our purpose is obtaining a more complex typology using cluster analysis. The article is based on a nation-wide survey conducted in Romania. The sample of the survey was statistically representative to the population of Romania and was composed of 1002 participants. A k-means algorithm for classifying cases was used to identify how the studied population structures itself when it comes to attitudes towards COVID-19 vaccination. We see hesitancy as an expression of concern or doubt about the value or safety of the vaccination, but also as fear or dis(trust) in the authorities, or as disinterest. We found out that the Romanian public falls into three categories regarding the attitude towards COVID-19 vaccination: the “non-fanatical” pro-vaxxers, the anti-vaxxers, and those without a clear opinion (uninterested and/or undecided). What we usually call “vaccine hesitancy” can be found, depending on motivation or type of hesitancy, in both of the last two clusters.

The Mediating Roles of Attitude Toward COVID-19 Vaccination, Trust in Science and Trust in Government in the Relationship Between Anti-vaccine Conspiracy Beliefs and Vaccination Intention

Since the outbreak of COVID-19, many conspiracy theories have spread widely, which has the potential to reduce adherence to recommended preventive measures. Specifically, anti-vaccine conspiracy beliefs can have a strong negative impact on COVID-19 vaccination attitude and intention. The present study aimed to clarify how such beliefs can reduce vaccination intention, exploring the possible mediating roles of attitude toward vaccination, trust in science, and trust in government, among a sample of 822 unvaccinated Italian adults (Women = 67.4%; M age = 38.1). Path analysis showed that anti-vaccine conspiracy beliefs influenced intention to get vaccinated both directly and indirectly through the mediating effects of attitude, trust in science, and trust in government. In particular, the simple mediating effect of attitude was the strongest one, followed by the serial mediating effect of trust in science and attitude itself. Findings provide insights into the design of interventions aimed at reducing misinformation and subsequent vaccine hesitancy.

Never Thought I was Going to be Placed in a Situation Like This: In the Shoes of the Doctor Responsible for Municipal Health, Back in My Country, Perú

The COVID-19 pandemic changed the way of living on the planet and, in my case, revealed the fragility of primary care services to respond to a health emergency that mainly affected older adults. Upon obtaining my medical degree, I felt guaranteed to have the skills to be a primary care physician; however, the coronavirus gave me "a reality bath with the aroma of impotence, bewilderment, and abandonment." Contradictory provisions and regulations, absence of a continuous policy, poor leadership, insufficient resources, and mismanagement by the Ministry of Health. Scandals of possible corruption and vices in the processes of research studies on vaccines. Anti-vaccine strategies, screening tests without evidence. The reference hospitals without oxygen, intensive care beds, and the outpatient consultations of specialist doctors closed. A community that is organized and wants to help but does not have a clear technical guide. These are some of the things I have had to deal with as head of a municipal health program. Meanwhile, I watched helplessly as members of my community continued to die and become disabled. Learning from mistakes and horrors is our duty. I narrate this experience to contribute to being prepared for the next time.

Similar Attitudes, Different Strategies: A Limited Survey of the Discourse Strategies to Oppose Genetically Modified Organisms Conspiracy Theories by Chinese Scientist Communicators and Citizen Communicators on Zhihu

The development of the digital media environment has led to a diversification in the role of science communicators. Both scientists and non-scientist citizens can act as science communicators in relation to online discussion of genetically modified organisms (GMOs). Through a limited study, based on thematic and open coding of 60 answers provided by scientist science communicators and citizen science communicators on GMOs on Zhihu, the biggest Chinese knowledge sharing network, it has been found that "business conspiracy theories" about GMOs are the most mentioned and discussed theories, followed by the conspiracy theory of "GMOs as state control tool" on Zhihu. Both citizen science communicators and scientist science communicators are inclined to show oppositional attitudes to GMOs conspiracy theories on Zhihu, despite the differences in their scientific backgrounds; however, they use very different discourse strategies. Citizen science communicators tend to use "lay logic" with more rhetoric, while scientist science communicators tend to use direct scientific knowledge and logic with less rhetoric.

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.

What Is the Support for Conspiracy Beliefs About COVID-19 Vaccines in Latin America? A Prospective Exploratory Study in 13 Countries

Conspiracy theories about COVID-19 began to emerge immediately after the first news about the disease and threaten to prolong the negative impact of the COVID-19 pandemic by limiting people's willingness of receiving a life-saving vaccine. In this context, this study aimed to explore the variation of conspiracy beliefs regarding COVID-19 and the vaccine against it in 5779 people living in 13 Latin American countries (Argentina, Bolivia, Chile, Colombia, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, Uruguay and Venezuela) according to sociodemographic variables such as gender, age, educational level and source of information about COVID-19. The study was conducted during the COVID-19 pandemic between September 15 and October 25, 2021. The Spanish-language COVID-19 Vaccine Conspiracy Beliefs Scale (ECCV-COVID) and a sociodemographic survey were used. The results indicate that, in most countries, women, people with a lower educational level and those who receive information about the vaccine and COVID-19 from family/friends are more supportive of conspiracy ideas regarding the COVID-19 vaccine. In the case of age, the results vary by country. The analysis of the responses to each of the questions of the ECCV-COVID reveals that, in general, the countries evaluated are mostly in some degree of disagreement or indecision regarding conspiratorial beliefs about COVID-19 vaccines. The findings could help open further study which could support prevention and treatment efforts during the COVID-19 pandemic.

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.

Government Communication, Perceptions of COVID-19, and Vaccination Intention: A Multi-Group Comparison in China

Government communication has been playing an important role in mass vaccination to conduct the largest vaccination campaign of the world for COVID-19 and to counter vaccine hesitancy. This study employs the health belief model to examine the association between government communication and the COVID-19 vaccination intention. A survey of Chinese adults (N = 557) was conducted in March 2021, and partial least squares structural equation modeling was employed to estimate the multi-construct relationships. The findings indicate that government communication has both direct positive association with vaccination intention and indirect association with vaccination intention through the mediation of perceived severity, benefits, and barriers. Multi-group comparisons suggest that individuals from private sectors are more easily mobilized to receive COVID-19 vaccination by government communication than those from public sectors. Similarly, the correlation between government communication and the vaccination intention of individuals with a good health status was stronger than that of those with a poor health status. The theoretical and practical implications of these findings are further discussed.

Passport to a Mighty Nation: Exploring Sociocultural Foundation of Chinese Public's Attitude to COVID-19 Vaccine Certificates

Vaccination against COVID-19 is essential against the pandemic. There are broad discussions on adopting certificates for vaccination and the immunity obtained after infection. Based on a national sample of over 2000 participants administered in April 2021, the current study examines the Chinese public's attitudes to the so-called COVID-19 vaccination passport and factors contributing to their viewpoints. Generally, the Chinese people had favorable opinions on the passport. Among possible contributing factors, income, personal benefit perception, the subjective norm of COVID-19 vaccination, and nationalism were significantly associated with the public's positive attitude. At the same time, general vaccine knowledge and scientific literacy had an inconstant effect. Echoing recent studies, these findings reveal a collectivism-oriented attitude of the Chinese public towards the proposal to certify vaccination publicly. Theoretical and practical implications of the results were discussed.