Investigating the link between COVID-19 misinformation exposure and vaccine hesitancy through perceptions of efficacy and unsafety

Abstract

Background: Misinformation has played a significant role in shaping public attitudes toward COVID-19 vaccines, contributing to vaccine hesitancy. This study examines the relationship between misinformation exposure and vaccine hesitancy, focusing on the mediating roles of perceived vaccine safety and efficacy. Additionally, it explores how trust in misinformation influences these relationships. Methods: A cross-sectional survey was conducted between March and May 2021 across four university campuses in the southeastern United States (N = 819). Participants (Mean age = 20.55, SD = 2.85) were predominantly female (N = 525, 64.1%). Mediation and moderated mediation analyses were performed using Hayes’ PROCESS Model 4 and Model 8. Results: Findings revealed that greater exposure to vaccine misinformation was associated with higher vaccine hesitancy. This relationship was mediated by increased perceptions of vaccine unsafety and reduced beliefs in vaccine efficacy. Additionally, trust in misinformation strengthened the indirect effect through perceived vaccine unsafety, reinforcing hesitancy among individuals who found misinformation more credible. Conclusion: This study highlights the critical role of misinformation in shaping vaccine hesitancy. By identifying the psychological mechanisms underlying this relationship, these insights can inform strategies to counter misinformation, improve public trust in vaccines, and enhance health communication in future public health crises.