The role of generalized trust in COVID-19 vaccine acceptance

PLOS ONE RESEARCH ARTICLE The role of generalized trust in COVID-19 vaccine acceptance Philipp Simon Eisnecker ID*☯, Martin Kroh☯, Simon Kühne ID☯ Faculty of Sociology, Bielefeld University, Bielefeld, North Rhine-Westphalia, Germany ☯ These authors contributed equally to this work. * a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Eisnecker PS, Kroh M, Kühne S (2022) The role of generalized trust in COVID-19 vaccine acceptance. PLoS ONE 17(12): e0278854. https:// doi.org/10.1371/journal.pone.0278854 Editor: Dragan Pamucar, University of Belgrade Faculty of Organisational Sciences: Univerzitet u Beogradu Fakultet organizacionih nauka, SERBIA Received: February 8, 2022 Accepted: November 25, 2022 Published: December 22, 2022 Copyright: © 2022 Eisnecker et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The authors cannot make the data used in this article (SOEP and SOEPCoV) directly available, as this is forbidden by SOEP data-protection regulations. This restriction is in place because SOEP data are personal data that are subject to special protections in Europe. However, interested parties can access the data by signing a data contribution contract with DIW Berlin, the data holders. This contract ensures that data are used for scientific or teaching purposes only and that data protection is respected. After the contract has been signed, data are available free of charge. All SOEP and SOEP-CoV data the authors Abstract Immunization by vaccination is one of the most important tools for fighting the COVID-19 pandemic. Yet in many countries, immunization campaigns have been hampered by vaccine hesitancy within the population. Building on the idea that vaccination decisions are embedded in the broader societal context, we study the role of generalized trust—the belief that most people can generally be trusted—in vaccine acceptance. Immunization campaigns face an inherent collective action problem: As all individuals benefit collectively from high immunization rates regardless of individual contribution, especially those with a low risk of severe COVID infection have an incentive to decide against the (perceived) costs and risks of vaccination. We argue that generalized trust may help to overcome this problem by encouraging the belief that cooperation for the common good is achievable and that those who cooperate are unlikely to be exploited by others. We further argue that the positive effect of generalized trust on vaccination decisions is weaker among individuals who are at higher risk of severe outcomes from the disease, as the collective action problem is less pronounced in this group. To test our predictions, we used data from the SOEP-CoV survey, which queried a representative probability sample of Germany’s population between January and February 2021 on topics connected to the pandemic. Using multiple logistic regression models, and in line with expectations, we found a positive and robust link between generalized trust and the willingness to accept vaccination as soon as offered. However, overall, our examination of heterogeneous effects does not unequivocally support the idea that the role of generalized trust varies according to individual COVID risk. Introduction As of January 2022, there were 319 million confirmed cases of coronavirus disease (COVID19) caused by the SARS-CoV-2 virus worldwide, including 5.5 million deaths [1]. The World Health Organization declared the COVID-19 outbreak to be a global pandemic in March 2020 [2]. Safe and effective vaccines are seen by many experts as a way out of the pandemic [3]. Beginning in December 2020, the EU Commission granted several vaccines conditional marketing authorization [4], and the US Food and Drug Administration authorized a number of PLOS ONE | https://doi.org/10.1371/journal.pone.0278854 December 22, 2022 1 / 17 PLOS ONE used for their analyses are accessible with SOEP data release v37, which is available for all users since April 2022. The application form can be downloaded under https://www.diw.de/documents/ dokumentenarchiv/17/diw_01.c.88926.de/soep_ application_contract.596893.pdf For data requests or questions regarding data access, please contact the SOEPhotline under +49 30 89789 – 292 or via email under . Funding: Martin Kroh received funding from the VolkswagenStiftung (https://www. volkswagenstiftung.de/en) for the project ‘Interpersonal Trust at Times of a Pandemic’ (Az. 98 980). Philipp Simon Eisnecker and Simon Kühne are members of the project. We also acknowledge support for the publication costs by the Open Access Publication Fund of Bielefeld University and the Deutsche Forschungsgemeinschaft (DFG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. The role of generalized trust in COVID-19 vaccine acceptance vaccines for emergency use [5]. At a time when many of the poorest countries still had virtually no access to vaccines [6], many wealthy countries launched mass vaccination campaigns but often encountered decreasing vaccination rates and high vaccine hesitancy in parts of their populations. As of January 2022, so roughly one year after vaccines became available at a large scale, only 72 percent of the population in Germany [7], 71 percent in Austria [8], 70 percent in the United Kingdom [9], and 63 percent in the United States [10] were fully vaccinated. The WHO highlighted vaccine hesitancy—the reluctance or refusal to vaccinate despite the availability of vaccines—as one of ten threats to global health [11] even before the current pandemic. Vaccine hesitancy is understood as existing along a spectrum between actively seeking and completely refusing vaccination [12]. The spectrum includes different groups. For example, some are willing to accept only certain vaccines, some choose to delay vaccination, and some get vaccinated but have second thoughts about it. Scholars from various disciplines including medicine (e.g., [13]), public health (e.g., [14]), psychology (e.g., [15]), and sociology (e.g., [16]) have provided valuable insights into a comprehensive understanding of the causes, dynamics, and consequences of vaccine hesitancy. Trust has been pointed out as central factor in vaccine decision-making [17]. The role of trust has been researched in relation to vaccines themselves, to the providers of vaccines, the policy makers involved in approving and recommending vaccines, and the media distributing information about vaccines [17, p. 1600]. However, social scientists have pointed out that vaccine hesitancy is embedded in specific historical, political, and socio (...truncated)