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Interpersonal Trust Matters: Factors Associated With COVID-19 Vaccine Hesitancy in South Korea

Dear Editor, Although there is a strong recommendation from the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) to get vaccinated,1,2 some people have shown vaccine hesitancy, which is defined as “unwillingness to receive vaccines when vaccination services are available and accessible.”3 Demographic characteristics, such as younger age and female gender,4,5 and low socioeconomic status4,5 were associated with COVID-19 vaccine hesitancy. These pioneering studies on COVID-19 vaccine hesitancy have focused on Western countries, and there have only been a few studies on vaccine hesitancy in the Korean context. Furthermore, although previous studies found social capital to have a positive impact on COVID19 testing6 and social distancing7 during the COVID-19 pandemic, to the best of my knowledge, none of them examined the impact of social capital on COVID-19 vaccine hesitancy. A web survey of 1000 Korean participants aged 18 years and older was conducted in October 2021. A logistic regression analysis was conducted, and the dependent variable was COVID-19 vaccine hesitancy, which had dichotomous values: (1) hesitant group with people who did not get any shot or have no plans for vaccination after the first shot and (2) nonhesitant group with people who either have a plan for the second shot after having taken the first shot or have taken both the shots. The main independent variable was social capital based on the three components: social participation, interpersonal trust, and neighborhood perception. Control variables included sociodemographic characteristics. The Institutional Review Board of Sungkyunkwan University, Seoul, Korea approved the study protocol (IRB# 2021-09-017). Approximately 8.1% of the participants reported COVID-19 vaccine hesitancy. Of the three social capital components, only interpersonal trust was related to hesitancy (Table 1). Participants with higher interpersonal trust were less likely to be hesitant to get vaccinated. Additionally, participants who were married, with kids, showed lower hesitancy and the politically conservative had higher hesitancy. With the previous studies finding a relationship between COVID-19 vaccine hesitancy and the trust in healthcare professionals8 and the government,9 this study also found higher levels of interpersonal trust, as one of the components of social capital, having a positive impact on reducing the tendency of COVID-19 vaccine hesitancy. However, other components of social capital, such as social participation and neighborhood perception, were not significantly related to vaccine hesitancy. Social participation and neighborhood perception had a narrower scope, as they were limited to an individual’s acquaintance, compared with interpersonal trust which had a wider scope, including strangers and foreigners. This finding implies that the component of social capital at a higher national level is highly important for COVID-19 vaccine hesitancy. The implication of this study is that, as interpersonal trust could decrease COVID-19 vaccine hesitancy, more efforts should be made to build trust with each other using traditional or social media campaigns in addition to the dissemination of vaccine information. As trust in institutions is significantly positively related to interpersonal trust,10 clear communication between the government and nations could be another way to decrease COVID-19 vaccine hesitancy. 1100805 APHXXX10.1177/10105395221100805Asia Pacific Journal of Public HealthJang letter2022