Measuring trust in vaccination: A systematic review

Abstract

Vaccine acceptance depends on public trust and confidence in the safety and efficacy of vaccines and immunization, the health system, healthcare professionals and the wider vaccine research community. This systematic review analyses the current breadth and depth of vaccine research literature that explicitly refers to the concept of trust within their stated aims or research questions. After duplicates were removed, 19,643 articles were screened by title and abstract. Of these 2,779 were screened by full text, 35 of which were included in the final analysis. These studies examined a range of trust relationships as they pertain to vaccination, including trust in healthcare professionals, the health system, the government, and friends and family members. Three studies examined generalized trust. Findings indicated that trust is often referred to implicitly (19/35), rather than explicitly examined in the context of a formal definition or discussion of the existing literature on trust in a health context. Within the quantitative research analysed, trust was commonly measured with a single-item measure (9/25). Only two studies used validated multi-item measures of trust. Three studies examined changes in trust, either following an intervention or over the course of a pandemic. The findings of this review indicate a disconnect between the current vaccine hesitancy research and the wider health-related trust literature, a dearth in research on trust in low and middle-income settings, a need for studies on how trust levels change over time and investigations on how resilience to trust-eroding information can be built into a trustworthy health system.

Challenges facing vaccinators in the 21stcentury: results from a focus group qualitative study

“…Trust in vaccination is not always specifically evaluated. 20 The causes of reduced patient trust and the impact on HCPs have not, to our knowledge, been explored. The negative impact of rapidly changing and complex vaccination schedules on vaccinators has also perhaps been underestimated.…”

A systematic review of parental vaccine hesitancy and refusal in childhood vaccination

“…Further, many models fail to measure trust, yet trust in vaccination arises as a relevant phenomenon in both qualitative accounts of under-vaccination and the influence of vaccine safety scares (90). Trust is often "ill-defined and a loosely measured concept" (91). Recent work on the moral foundations of behaviour suggests that measuring constructs such as contamination and liberty are also relevant (92,93).…”

Vaccine hesitancy among parents in Kuala Lumpur: a single center study

“…The term 'trust' has an array of meanings in the medical literature. To put it simply in the context of vaccine and vaccination, it is about making a risk versus benefit decision when someone has incomplete or inadequate information 66 . A few studies have shown that VH is closely related to the idea of trust in health professionals and health providers, including the health system and health institutions 67,68 .…”

“…Benin et al 20 noticed that trust, or the lack of it, forms the basis for parents to either vaccinate or not vaccinate their children, while Larson et al have pointed out that trust placed in the healthcare system, in the healthcare workers, and also in the policy makers who decide on the vaccination programs, mediates the impact of these factors on vaccine hesitancy 17 . It is also interesting to note that the level of trust in the healthcare system is much lower among religious and ethnic minorities 66 . Perhaps this distrust could be traced back to way these minority groups were either neglected or discriminated against by the government that provides the healthcare system 66 .…”

“…It is also interesting to note that the level of trust in the healthcare system is much lower among religious and ethnic minorities 66 . Perhaps this distrust could be traced back to way these minority groups were either neglected or discriminated against by the government that provides the healthcare system 66 . This is a possible explanation to the finding by Azizi et al 54 that non-Muslims in Malaysia were more vaccine hesitant than Muslims, since they were in the minority of the population in this country and felt they were being discriminated against.…”