Many existing studies and researches have shown the link between vaccine hesitancy and rurality. To test the validity of this assertion, this paper uses COVID-19 vaccine as a reference case and tries to understand vaccine hesitancy in urban communities through the conceptual lens of post-truth. The argument enunciated in the paper is based on data gathered through an online survey, conducted from May to October 2021. Thematically, this paper identified two themes: ‘mistrust’ and ‘misinformation’, revealing the coupling effect of the themes and the intersection of vaccine hesitancy and post-truth in two urban (Islamabad and Rawalpindi) communities of Pakistan. While the discussions were contextual, this paper epistemically shows that the reality of COVID-19 was blurred by misinformation which translated into cynicism, mistrust and hesitancy for COVID-19 vaccine and the outcome proved why health security must be taken seriously, especially in the post-truth era.