Vaccine Hesitancy and the Concept of Trust: An Analysis Based on the Israeli COVID-19 Vaccination Campaign

Abstract

This paper examines the trust relations involved in Israel’s COVID-19 vaccination campaign, focusing on vaccine hesitancy and the concept of ‘trust’. The first section offers a conceptual analysis of ‘trust’. Instead of analyzing trust in the vaccination campaign as a whole, a few objects of trust are identified and examined. In section two, the Israeli vaccination campaign is presented, and the focus is placed on vaccine hesitancy. In section three, different trust relations are examined: public trust in the Israeli government and health institutions, interpersonal trust in healthcare professionals and experts, trust in the pharmaceutical companies that make the COVID-19 vaccine, the US FDA, and trust in the new vaccine and the new technology. Through this complexity of trust relations, I argue that it is impossible to completely separate the trust that the vaccine is safe and effective from social aspects of mistrust. Additionally, practices of silencing and censoring the concerns of vaccine hesitaters – both experts and among the public, are pointed out. I contend that these cases further minimize vaccine hesitaters' trust in vaccine-related entities. In contrast, in section four, I suggest the ‘trust-based approach’: since vaccine hesitancy is not solely the result of knowledge deficiency but also a lack of trust relations, any campaign that addresses vaccine hesitancy should also focus on trust. The advantages of this approach are spelled out. For governments, a discussion based on trust is, ultimately, the best democratic way to encourage hesitaters to take the plunge and get vaccinated.

The Association between Levels of Trust in the Healthcare System and Influenza Vaccine Hesitancy among College Students in Israel

“…In the context of vaccinations, decision-making is associated with trust in government and public health professionals [26]. In line with our findings, studies have reported a negative correlation between an individual's vaccine hesitancy and their trust in the healthcare system and healthcare workers [38][39][40]. Physicians' advocacy of vaccinations is recognized as one of the most influential factors affecting public attitudes toward vaccinations [20][21][22].…”

“…When delving into the association between trust and vaccine hesitancy, it is crucial to acknowledge the erosion of public trust in governments, healthcare systems, and experts on a global scale due to the influence of the COVID-19 pandemic [40]. The pandemic unleashed a flood of misinformation, famously termed an "Infodemic" [52], contributing to the rise in vaccine hesitancy.…”

“…The pandemic unleashed a flood of misinformation, famously termed an "Infodemic" [52], contributing to the rise in vaccine hesitancy. Freiman [40] advocates for mitigating vaccine concerns and fostering trust among the hesitant by actively engaging and imparting knowledge [53]. It is reasonable to anticipate that improving trust will streamline intricate decisions about vaccination [54].…”

Factors Influencing the Healthcare Workers’ Willingness to Receive the COVID-19 Booster Dose in Tuscany (Italy)

“…These efforts are vital to ensure the success of vaccination campaigns, leading to the attainment of herd immunity and the containment of infection spread within communities [ 11 ]. Vaccine hesitancy can arise from various reasons, encompassing apprehensions about vaccine safety and efficacy, distrust in healthcare systems or pharmaceutical entities, the propagation of misinformation, religious, or philosophical beliefs, and the fear of potential side effects [ 12 , 13 , 14 , 15 , 16 ]. Among certain employee cohorts, such as healthcare workers, vaccine hesitancy has garnered significant attention during the COVID-19 pandemic.…”