Is It All a Conspiracy? Conspiracy Theories and People's Attitude to COVID-19 Vaccination

"People who believe in conspiracy theories may resist the authority of scientific or health experts who propose preventative measures and vaccination."

Research has shown that people's beliefs in conspiracy theories about infectious diseases negatively impact their vaccination behaviour. Conspiracy-belief-based vaccination hesitancy has become more rampant since the global outbreak of COVID-19. Even in China, considered to have a smoothly run vaccination programme, many people are still reluctant to be vaccinated against COVID-19, as evidenced by widespread social media posts expressing public concern about the vaccine.

This study seeks to explore questions including: Do different versions of conspiracy theories - particularly conspiracy theories about the origin of the epidemic (e.g., that SARS-CoV-2 leaked from a Wuhan, China, virology laboratory or that the virus was of foreign origin) and theories about vaccine conspiracies (e.g., that pharmaceutical companies covered up the danger of vaccines or that people are being deceived about the effectiveness of vaccines) - have the same effect on vaccination intentions? Can scientific literacy and vaccine knowledge shift people's intention for COVID-19 vaccination, offsetting the effects of various conspiracy theories?

The study was based on an anonymous, self-designed, structured nationwide online questionnaire survey, which was administered during April 2021 to 2,038 individuals, of which 1,890 (92.7%) had not received any COVID-19 vaccination before the survey. The data show that most of those surveyed generally had a positive attitude toward COVID-19 vaccination, with 74.8% of them believing to varying degrees they were likely to get vaccinated against COVID-19 that year. However, a significant proportion held a more conservative and hesitant attitude.

In the survey, 15 questions were designed to measure Chinese public awareness and recognition of conspiracy theories, of which six were related to the COVID-19 pandemic and the virus, five were related to vaccines, and four were related to other political topics/conspiracy theories. Hierarchical regression shows that only conspiracy theories related to vaccines had a significant impact, while belief in more general theories about COVID-19 did not significantly affect vaccination intentions.

Eleven survey questions were designed to measure the Chinese public's general scientific literacy, and six were designed to measure their vaccine knowledge. Hierarchical regression shows that the more knowledge the Chinese public has about COVID-19 vaccines, the greater their intention to receive the COVID-19 vaccine. But general science literacy is not significantly related to the Chinese public's intention to get the COVID-19 vaccine.

In short, this study found that people with lower beliefs in vaccine conspiracy theories and higher levels of vaccine literacy were more likely to receive the COVID-19 vaccine. The researchers stress that, when analysing the impacts of conspiracy beliefs on the public's intention to get vaccinated, it is necessary to consider specific contexts. For example, different temporal and sociocultural backgrounds may mediate the impact of conspiracy theory beliefs on the public's intentions regarding vaccination. For China, to enhance the public's intention to get vaccinated, it will be more effective to refute the rumours of vaccine conspiracy theories than COVID-19 and other conspiracy theories. However, this conclusion may not be applicable in other periods of pandemic and other sociocultural contexts.