Trust in government, science, and vaccine confidence in Southeast Asia: A latent profile analysis

Global immunization efforts have saved millions of lives, with vaccines playing a crucial role in mitigating disease transmission. However, the COVID-19 pandemic highlighted both increased vaccine uptake and rising skepticism, fueled in part by misinformation on social media. This trend extends beyond COVID-19, contributing to overall vaccine hesitancy and a resurgence of vaccine-preventable diseases. Southeast Asia presents a diverse context for examining vaccine confidence, with varying political systems, economic development, and information ecosystems shaping public trust in science, authority, and vaccines. This study describes a cross-sectional survey across six Southeast Asian countries-Singapore, Malaysia, Indonesia, the Philippines, Thailand, and Vietnam-to explore trust dynamics and vaccine confidence using Latent Profile Analysis (LPA). We developed indices for trust in science, trust in government regarding COVID-19, and vaccine confidence to identify latent subgroups within the population. A total of 6611 respondents in six countries participated between April and June 2023. Our analysis identified three distinct trust profiles across countries, highlighting significant variations in vaccine confidence and trust in authority and science. The largest subgroup demonstrated high levels of trust and confidence across all three indicators, followed by profiles characterized by moderate and low levels of trust and confidence respectively. The three-profile solution was selected based on AIC, BIC, and entropy criteria. Trust in science was notably higher in Vietnam and Thailand compared to Singapore, while education and age emerged as significant predictors of vaccine confidence across countries. The study underscores the complexity of public trust and emphasizes the importance of considering multi-dimensional trust profiles when designing public health interventions to address vaccine hesitancy. These findings offer critical insights for policymakers aiming to strengthen vaccine confidence and improve health communication strategies in the region.