Information trust and COVID-19 vaccine hesitancy amongst middle-aged and older adults in Singapore: A latent class analysis Approach

Rationale: COVID-19 vaccine hesitancy presents significant challenges for public health. Objective: Vaccine hesitancy among middle-aged and older adults has been a significant barrier in Singapore's battle against COVID-19. We hypothesize that the trust middle-aged and older adults place in various sources of information influences vaccine hesitancy, and that distinct typologies of trust can be identified to better inform targeted health communication efforts. Method: Data from a nationally representative panel survey of Singaporeans aged 56-75 (N =6094) was utilized. Modules fielded in August and November 2020, and June 2021 were analyzed, assessing social networks, trust in sources of information, and vaccination status respectively. Predictors of vaccination status were first examined. Latent class analysis was then used to identify typologies of trust in various sources of information. Results: Trust in formal sources of information (e.g government sources) is found to predict vaccination status among respondents. Contrary to expectations, trust in social media and informal sources (family and friends), and perceived social support did not predict vaccination status. Latent class analysis identified 4 typologies of respondents based on their patterns of trust in these sources. Significantly, it is found that a portion of respondents with low trust in formal sources of information have high trust in informal sources. The four distinct typologies of trust in sources of information are also found to predict vaccination status. Conclusions: Because trust in formal sources of information influences vaccination status, authorities should build trust in such sources to encourage vaccination against COVID-19. However, health communication strategies with middle-aged and older adults who have low levels of trust in the formal sources may be more effective if authorities leveraged alternative channels such as informal sources, including the social networks of such individuals. Overall, the findings suggest the need for targeted communication strategies to encourage vaccination